Mayo Clinic

The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, across three major campuses: Rochester, Minnesota; Jacksonville, Florida; and Phoenix/Scottsdale, Arizona. The practice specializes in treating difficult cases through tertiary care and destination medicine. It is home to the top-15 ranked Mayo Clinic Alix School of Medicine in addition to many of the highest regarded residency education programs in the United States. It spends over $660 million a year on research and has more than 3,000 full-time research personnel.

William Worrall Mayo settled his family in Rochester in 1864 and opened a sole proprietorship medical practice that evolved under his sons, Will and Charlie Mayo, along with practice partners Stinchfield, Graham, Plummer, Millet, Judd, and Balfour, into Mayo Clinic. Today, in addition to the hospital at Rochester, Mayo Clinic has major campuses in Arizona and Florida. Most recently, in 2020, the Mayo Clinic bought a facility in central London, UK. The Mayo Clinic Health System also operates affiliated facilities throughout Minnesota, Wisconsin, and Iowa.

Mayo Clinic has ranked number one in the United States for seven consecutive years in '' U.S. News & World Report'' Best Hospitals Honor Roll, maintaining a position at or near the top for more than 35 years. It has been on the list of " 100 Best Companies to Work For" published by ''Fortune'' magazine for fourteen consecutive years, and has continued to achieve this ranking through 2017. Drawing in patients from around the globe, Mayo Clinic performs near the highest number of transplants in the country, including both solid organ and hematologic transplantation.

Corporate affairs

Mayo Clinic is a nonprofit hospital system with campuses in Rochester, Minnesota, Scottsdale and Phoenix, Arizona, and Jacksonville, Florida. Mayo Clinic employs 63,000 people, including more than 4,500 physicians and scientists and 58,400 administrative and allied health staff, as of 2018. Of those, approximately 34,000 are based in Rochester. In addition, Mayo Clinic partially owns and operates the Mayo Clinic Health System, which consists of more than 70 hospitals and clinics across Minnesota, Iowa, and Wisconsin. Mayo Clinic also operates the Mayo Clinic College of Medicine and Science, a nonprofit college dedicated to training medical and allied health professionals at Mayo Hospitals in Minnesota, Arizona, and Florida.

The clinic created an independent business subsidiary in London in partnership with Oxford University Clinic, a collaboration between the University of Oxford and Oxford University Hospitals NHS Foundation Trust to operate a clinic starting in 2019. The clinic, in the Harley Street Medical Area, will focus on preventative healthcare, with magnetic resonance imaging and CT scan technology and open in the summer of 2019.

Mayo Clinic is led by president and CEO Gianrico Farrugia, M.D. John H. Noseworthy, M.D. retired as president and CEO in December 2018; his predecessor, Denis A. Cortese, M.D. retired in November 2009. Samuel A. DiPiazza, Jr., retired CEO of PricewaterhouseCoopers, is chairman of Mayo Clinic's governing board of trustees.

Core operations

Clinical practice

In 2018, more than 1.2 million different patients from all 50 states and 138 countries were seen at Mayo Clinic facilities. Mayo Clinic offers highly specialized medical care, and a large portion of the patient population are referrals from smaller clinics and hospitals across the upper Midwest and the United States. Mayo Clinic physicians are paid a fixed salary, which is not linked to patient volume (relative value units) or income from fee-for-service payments. This practice is thought to decrease the monetary motivation to see patients in excessive numbers and increase the incentive to spend more time with individuals.

Research

Mayo Clinic researchers contribute to the understanding of disease processes, best clinical practices, and translation of findings from the laboratory to the clinical practice. As of 2018, research personnel included 254 full-time scientific faculty, 766 physicians actively involved in research, and 4,027 full-time research personnel. In 2018, there were 3,067 new human research studies approved by the institutional review board and 12,760 ongoing human research studies. These research initiatives led to 9,275 research publications and review articles in peer-reviewed journals. In recent years, 100% of Mayo Clinic's internal medicine residents across the three campuses have published research during their tenure.

Education

The Mayo Clinic College of Medicine and Science (MCCMS), established in 1915, offers educational programs embedded in Mayo Clinic's clinical practice and biomedical research activities. MCCMS consists of five accredited schools, including the M.D. degree-granting Mayo Clinic Alix School of Medicine as well as the master's and Ph.D. degree-granting Mayo Clinic Graduate School of Biomedical Sciences. The Mayo Clinic School of Health Sciences offers training for about 60 health sciences career fields. The Mayo Clinic School of Graduate Medical Education runs over 300 residences and fellowships in all medical and surgical specialties. The Mayo Clinic School of Continuous Professional Development delivers continuing education courses aimed at practicing medical professionals.

History

Early years

Mayo Clinic originated with the medical practice of William Worrall Mayo, M.D., (1819–1911). Born near Manchester, England, he was mentored by the eminent British scientist John Dalton and immigrated to the United States in 1846. He worked his way west, earning two medical degrees at a time when formal education for physicians was limited. Mayo settled in Indiana, and he married Louise Abigail Wright in 1851. They moved to Minnesota Territory in 1854, seeking a more healthful climate. The family relocated within Minnesota several times until Mayo's appointment as an examining surgeon for the Union Army military draft board during the American Civil War brought them to Rochester. On January 27, 1864, Mayo advertised in the ''Rochester City Post'' the opening of a private medical practice "over the Union Drug Store on Third Street" with "all calls answered by day or night".

Both of W. W. Mayo's sons, William James Mayo (1861–1939) and Charles Horace Mayo (1865–1939), who became known as Dr. Will and Dr. Charlie, grew up in Rochester and attended medical school. William graduated in 1883 and joined his father's practice, with Charles joining in 1888.
On August 21, 1883, a tornado struck Rochester, causing at least 37 deaths and over 200 injuries. One-third of the town was destroyed, but the Mayo family escaped serious harm. Relief efforts began immediately in a variety of makeshift facilities. Mayo was placed in charge of organizing medical care for the wounded survivors. Needing nurses, he reached out to Mother Alfred Moes, the founder of the Sisters of Saint Francis of Rochester, Minnesota (a teaching order).

After the crisis subsided, Mother Alfred approached W. W. Mayo with a proposal: The Sisters of St. Francis would raise the funds to build a hospital in Rochester if he and his sons would provide the medical and surgical care. The agreement was made over a handshake. On September 30, 1889, Saint Marys Hospital was opened by the Sisters with the three Mayo physicians on staff.

Group practice

The growing specialization of medicine and the expanding use of railroads, automobiles, and mass communications provided context for what Mayo Clinic calls its most significant and enduring contribution to the medical field: the content of integrated multispecialty practice.

Starting in the 1890s, the Mayo brothers welcomed other physicians to join them. W. W. Mayo's solo practice had evolved into a family practice with his sons' participation and now became a group practice with colleagues whose professional skills and ethos of teamwork complemented those of the Mayo brothers. Mayo Clinic's first partners were physicians Augustus W. Stinchfield, Christopher Graham, Melvin C. Millet, Henry Plummer, E. Star Judd, and Donald Balfour.

Preeminent among the early physicians who joined the practice was Henry Plummer, M.D. A specialist in thyroid disease, he made milestone contributions to the treatment of goiter. In terms of organizational development, he collaborated with the Mayo brothers in coordinating the introduction of specialties that expanded the scope of the Mayo practice beyond its origins in surgery. A polymath whose interests included architecture, engineering, and art, Plummer also created many of the systems and procedures that remain central to Mayo Clinic today, such as the integrated "dossier" medical record. In fact, Dr. Will said that hiring Plummer was the best day's work he ever did.

Growth and national expansion

By virtue of their surgical skills and efficient management, the Mayo brothers were financially successful and professionally prominent. They both served as president of the American Medical Association and achieved international recognition as surgeons. In 1919, the brothers and their wives donated the assets of the medical practice including land, buildings, and equipment, as well as the majority of their life savings, to transform the private partnership into a not-for-profit organization dedicated to an integrated mission of patient care, medical education, and medical research.

Following World War II, Mayo Clinic continued to expand in Rochester, Minnesota. The 1980s initiated transformative changes that set the course for the modern Mayo Clinic. An early adopter of the Internet, Mayo Clinic has been recognized for its online communications to patients, members of the public and medical professionals.

In 1986, Mayo Clinic formally united with Saint Marys Hospital and Rochester Methodist Hospital. That same year, Mayo Clinic expanded to Florida partly because of a donation of 400 acres of land in Jacksonville from the Davis family. This was followed by expansion to Scottsdale, Arizona, in 1987; the Phoenix, Arizona, campus opened in 1998. In 1992, Mayo Clinic Health System began as a network of community-based medical services in Minnesota, Iowa, and Wisconsin. In 2011, Mayo Clinic launched the Mayo Clinic Care Network, a collection of facilities with access to Mayo Clinic protocols and experts.

In November 2019, the Mayo Clinic, in a joint partnership with SEHA Abu Dhabi Health Services Co, invested $50 million into a 741-bed hospital in the United Arab Emirates for a 25% stake.

At the beginning of 2020 the Mayo Clinic opened a health clinic in central London, in partnership with Oxford University Clinic. It was officially named Mayo Clinic Healthcare. In July 2020 it was reported that the Mayo Clinic had bought Oxford University Clinic's share of the facility, to become the sole owner and its first overseas clinic operated as a Mayo Clinic entity.

Contributions to medicine and science

In the early 20th century, Henry Plummer developed Mayo Clinic's multi-specialty group practice model and an integrated medical record system. Plummer's system allowed physicians to better share patient information with one another. Prior to Plummer's system, physicians worked in solo practice and shared patient information when necessary either verbally or by letter. Plummer also helped design and fabricate building systems innovations, such as steam sterilization rooms, metal surgical tools and equipment, pneumatic tube system, and knee operated sinks. In 1905, Mayo Clinic advanced a technique of using frozen tissue during surgery to determine if a patient had cancer while the patient was still in the operating room. Mayo Clinic offered the first graduate medical education program in 1915 and the first nonprofit practice aligned with medical education and research. In the 1920s, Albert Compton Broders of the Mayo Clinic created the first index to grade tumors. Mayo Clinic opened the first hospital-based blood bank in Rochester in 1935. Early in Mayo Clinic's history, the hospital designed the one-legged mobile instrument stand known as the Mayo stand.

In the 1930s, Mayo Clinic associates Walter M. Boothby, Randolph Lovelace, and Arthur H. Bulbulian developed a high-altitude mask for oxygen therapy that became known as the BLB flight mask.

During World War II, the U.S. Army tasked Mayo Clinic with finding a solution for pilots who were dying after suffering blackouts. Mayo Clinic hired a team of physicians to research and define the specific physiologic effects causing blackout and unconsciousness during high G forces. Physiologists Earl H. Wood, Edward Baldes, Charles Code, and Edward H. Lambert developed the G-suit with air bladders that prevented blood from pooling in pilots' legs. The suit was worn by U.S. pilots toward the end of World War II.

Two Mayo Clinic physicians were among three people awarded the Nobel Prize in medicine in 1950 for the discovery of cortisone. Professor Edward C. Kendall, PhD, and Philip S. Hench of Mayo Clinic were jointly awarded the Nobel Prize in medicine alongside Tadeus Reichstein, a Swiss chemist who conducted independent research, for the discovery. They separated and identified compounds from the adrenal cortex that produced cortisone and hydrocortisone. Later in the decade, Mayo Clinic began using and refining the Gibbon heart–lung machine in cardiac surgery. It is now known as the Mayo–Gibbon heart–lung machine.

Mayo Clinic associates Edward Howard Lambert, Lealdes (Lee) McKendree Eaton, and Edward Douglas Rooke were the first physicians to substantially describe the clinic and electrophysiological findings of what is known as Lambert–Eaton myasthenic syndrome in 1956. In 1972, the clustering of LEMS with other autoimmune diseases led to the hypothesis that it was caused by autoimmunity.

In 1969, Mayo Clinic doctors performed the first Food and Drug Administration-approved hip replacement in the United States. In 1973, Mayo Clinic bought the first CT scanner