MAYO CLINIC SUMMARY

Take-Aways

 Mayo Clinic, a “medical group practice,” grew from the clinic that William Worrall Mayo
founded in Rochester, Minnesota.
 The practice took its current name in 1914 when Mayo’s sons, Drs. William J. and Charles H.
Mayo, were in charge.
 Its three areas of focus are patient care, research and “medical education.”
 Mayo Clinic’s core and primary value is “The needs of the patient come first.”
 To evaluate any service organization, consumers should note “functional, mechanical and
humanic” clues.
 Mayo is a “physician-led” organization that practices “team medicine.”
 “Destination medicine” is the condensed delivery of all clinical care in one place.
 Systems engineering is a critical component of developing patient-focused care.
 A “one-bucket philosophy of resource allocation” defines Mayo’s governance.
 Mayo thrives by executing its vision and fostering a corporate culture based on respect.

Summary

“The 100-Year Brand” of the Doctors Mayo

Mayo Clinic is the world’s first nonprofit “medical group practice”; it is also one of the largest. Patients
and their families hold it in high regard as a “medical mecca” where they can get clear, authoritative
answers few other health facilities can provide. More than 90% of its patients report that they speak
highly of Mayo, serving as the organization’s word-of-mouth marketers.

“Great service organizations focus on execution. They focus on delivering the performance that is
promised and expected.”
Dr. William Worrall Mayo opened his medical office in Rochester, Minnesota, in the late 1800s. His sons,
Dr. William J. (“Will”) Mayo and Dr. Charles H. Mayo, eventually joined the practice, carrying on their
father’s vision, values, and focus on infrastructure and corporate culture. By the 1880s, their practice
was already well known as a place where settlers new to the region could obtain medical care. By 1914,
when the practice took the name Mayo Clinic, its reputation for quality care had spread. Word of mouth
was so effective that Mayo didn’t rely on marketing staff until 1986. Mayo Clinic grew by absorbing
other hospitals in Rochester. In 1986, it added a campus in Jacksonville, Florida. In 1987, it opened its
Scottsdale, Arizona, campus. All three locations function as a single organization and share the same
priorities. Total individual patient registrations, already more than 15,000 in 1912, grew with Mayo
Clinic’s growth and expansion. By 2007, registrations at all three locations totaled 520,000; revenue that
year was $7.3 billion.

“A Three-Shield Organization”
With its reputation for quality medical care, Mayo Clinic identifies itself as a three-shield organization.
The shields represent the three vital areas the Mayo brothers chose as priorities: care of patients,
research and medical education. Research and education continue to complement the organization’s
primary focus on clinical medicine. It is home to a medical school – a rarity, since most medical schools
are university-based. Approximately 80% of Mayo physicians remain actively involved in research, with
some 7,000 ongoing projects.

Applicable Service Lessons

Your service organization shares many dynamics with Mayo Clinic, and these similarities are more
relevant than any differences. This makes Mayo’s examples highly transferable.

“The issue is not, ‘What is the best structure?’ but, rather, ‘What is the best structure to execute the
strategy’?”
Your service business and Mayo Clinic may have these elements in common:

 The main benefit of your service is intangible; the consumer spends money, but doesn’t gain a
physical, tangible asset.
 The service you perform demands skill and is labor-intensive. The individuals who perform your
service represent your company to your clients and customers.
 Customers must be present to receive your service, so you must synchronize and schedule
service delivery to meet their needs.
 Customers may need your service urgently.
 Demand varies, necessitating uneven distribution.
 Customers have varied preference and requirements, so your organization must be flexible in
providing services and in deploying resources.
 Different providers meet different customer needs, so coordinating various interdependent
elements is essential.

The Tradition Continues

Mayo Clinic builds on its tradition of excellence by combining engineering (identifying a problem and
using appropriate technology to remedy it) and artistry (making patients feel welcome, reassured and
optimistic). This creates an enduring, organizationwide service culture.

“Teamwork cannot be sustained without mutual respect, for teamwork depends on trust, listening,
inclusion, teammate contribution and fair treatment – the attributes of respect.”
Mayo merges this culture with its quality strategy, efficient management and thoughtful systems to
provide care. It built its reputation on the excellence of its clinical tests and analysis, its organizational
efficiency and its top services delivered with an emphasis on patients’ needs.

“Three Big Ideas”

Mayo Clinic grew, and continues to grow, based on three big ideas:

1. Put patient interests first.

2. Group your talent to create a “union of forces.”

3. Provide medical care with “time-condensed efficiency.”

“Any company that seeks long-term value from its employees must consider not only what each
employee is at the time of hire but also what that employee can become.”
This mission-driven approach distinguishes Mayo Clinic. It attracts quality staff members, and hires
people for their values and talent. It typically retains employees over the long term. Mayo’s culture of
collaboration helps staff members develop knowledge and skills.

“The Needs of the Patient Come First”

Mayo formally defines prioritizing patients’ needs as the primary value driving its operations and
success. Mayo’s community of stakeholders – physicians, health care professionals, board members,
administrators, social workers and staff members – draws on its “patient-first” mind-set for motivation.
This core value drives scheduling, architecture, employee empowerment, and more. The ways Mayo
implements it evolve in big and small steps to fit patients’ needs.

“When one understands how to be a Mayo Clinic employee, the value has been internalized – the
employee knows it. It is transmitted culturally, not didactically.”
Mayo’s patient-first approach means that any staff member has the authority to consult with someone
higher up the ladder to address a patient’s needs, and is expected to do so. It means that Mayo staffers
volunteer extra “discretionary effort” to make patients feel comfortable. This has included taking care of
a patient’s dog and holding a wedding so a terminally ill parent could see a child get married. It means
that surgeons respect and consult one another, regardless of rank or seniority. When new clinics join the
Mayo Health System, they adopt these core values.

A Union of Forces
As a physician-led organization, Mayo Clinic puts together expert teams to care for patients. Its doctors
support this second primary concept, “team medicine,” by practicing “collaboration, cooperation, and
coordination.” The resources of the full company support each patient’s needs.

“The basic philosophy, spirit, and drive of an organization have far more to do with its relative
achievement than do technological or economical resources, organization structure, innovation, and
timing.” (Thomas Watson, Jr., former CEO of IBM)
A patient receives a treatment plan, typically coordinated by his or her first Mayo physician. That doctor
consults with the patient’s hometown primary-care doctor and with other Mayo staff members,
including the patient’s surgeons, nurses, dietitians, physical rehab specialists, social workers, and so on.
A respectful work environment supports teamwork. Mayo’s management expects employees to ask for
assistance when they need it. The company honors everyone’s work, from housekeeping staff to
physicians.

“The more consequential, complex, variable, and personal the service, the more customers need brand
reassurance.”
Mayo Clinic’s structure enhances the functionality of its team-based approach. Staff members earn
salaries. Unlike the remuneration policies at some other health care facilities, physicians don’t receive
incentive-based payments. They have no financial reasons to keep a patient within their ambit, and they
often refer patients to colleagues who are more suited to their needs.

“One Bucket”
Mayo defines its governance as being based on a “one-bucket philosophy of resource allocation.” This
centralized structure allows it to fund projects according to how well they serve patients or the
organization’s research initiatives.
“The belief that Mayo can give you a definitive answer is a very prominent facet of its image.” (Social
Research, an independent consumer research firm)
Today, with 2,500 physicians on staff across three locations, a doctor still leads the organization and
MDs hold all top management roles. Mayo’s practicing physicians have a peer relationship with those
who run the institution. Physician leaders rotate in and out of executive roles, and often continue to
practice medicine so they can maintain their connections with their colleagues and patients. Newly hired
administrative leaders must adapt to the strengths and styles of their physician peers.

“Practicing Destination Medicine”

Mayo uses the name destination medicine to describe its third big idea, the “efficiently condensed”
delivery of clinical care. It provides patients – who come from every US state and nearly 150 countries –
with an integrated approach to comprehensive treatments, addressing individuals’ medical needs within
a rapidly accelerated, efficient schedule. It’s like a department store where you can shop for everything
in one stop.

“Kindness coupled with competence can go a long way.”

This strategy eliminates the lag times found in some other medical models. In many places, a patient
with multiple issues may see a physician, then wait to see another doctor in a separate practice who
may not have access to the results of previous tests. Patients often must schedule multiple follow-ups,
and use time away from work and family to travel for care. At Mayo Clinic a patient can complete a
sequence of exams and visits within a thoughtfully scheduled week that might take weeks or months in
other medical systems – reducing stress, travel-time and cost.

“Branding plays a special role in service organizations because strong brands increase customers’ trust
of intangible performances.”
In 1907, Dr. Henry Plummer institutionalized a new, integrated system of records at Mayo, replacing a
fragmented scheme in which each physician kept his own ledgers. By 1914, Mayo adopted a mechanical
system designed to move even a patient’s physical record to his or her next exam location before the
patient arrived.

“All technology should solve real problems in the context of an organization’s core values and strategy.”
Mayo migrated to electronic records in the 1990s. It improved how it schedules appointments by
establishing a centralized appointment desk (CAD). By 2005, Mayo integrated the CAD process with a
computing system based on an algorithm that draws on rules for approximately 8,000 types of
appointments to identify the best sequence of appointments for the condition of each particular
patient. This efficient scheduling of services is one manifestation of Mayo’s integration of engineering
and artistry. Smart scheduling is a crucial part of meeting patients’ needs.

“The best physicians and health care providers are part engineers and part artists.” (Mayo Clinic
president and CEO Dr. Denis Cortese)
Mayo’s “systems and procedures” team of 50 analysts and industrial engineers recognizes the cascading
effects of business decisions. Members of this team optimize efficiency, forecast prospective traffic, and
balance capacity and demand. Patients benefit from seamless service delivery, and Mayo benefits from
optimizing the productivity of its labs, doctors and service areas.
“Orchestrate the Clues of Quality”
Think of your consumers as detectives who perceive and sense three kinds of clues about their service
experiences. “Functional clues” relate to technical qualities of services, such as how well they work and
how reliable they are. “Mechanic clues” evolve from their senses – how something smells or sounds,
how clean the facilities and equipment are, and what messages your personnel’s actions communicate.
Your employees provide “humanic clues” through their appearance, behavior, voices, enthusiasm,
conversation and body language. Mayo heeds how these clues work together to contribute to patient
experiences of their brand.

Making Excellence Your Path

Consistent execution of its vision allows Mayo Clinic to thrive – and can help your service organization
thrive, too. Lessons from Mayo and its “culture of respect” include:

1. “Excellence is a journey” – Internally motivated staff members deliver quality care. They’ve
made Mayo “the strongest health care brand” in America.

2. “Align structure with the brand” – Patients find the quality they expect from Mayo Clinic behind
every door in every facility. To ensure this consistency, Mayo refines its structure to meet its
strategy and aligns its management and service delivery.

3. “Challenge the performers to improve the performance” – At Mayo, doctors, nurses,

therapists, computer programmers, technicians, systems engineers and other employees work
together to achieve high standards.