Mayo (10): a reputation established over one hundred years

The previous posts in this series on the Mayo Clinic have shown the extent to which the culture of this venerable institution successfully resolved the conflict between tradition and progress. For a hundred years, the Mayo Clinic has withstood the changes in American health policies, fluctuations in the stock market, changes in modern medicine and surgical procedures, competition from other establishments of similar size and changes in the mentality and expectations of patients and their families. To say “withstood” is inaccurate, even unfair. The Mayo Clinic has matured while adapting to all these changes. The two Mayo brothers and their father set up a group practice with 12 well-known surgeons at the beginning of the twentieth century: not having their own premises, they used the neighbouring hospital run by the Sisters of Saint Francis of Rochester (Saint Mary’s Hospital, which has only been an integral part of the Mayo Clinic since 1986). Now, there are 42,000 employees, with more than 2,500 physicians of all branches. The managers have extended the scope of the institution, even branching out as the Mayo Clinic now runs two other campuses (one in Florida which opened in 1986 and one in Arizona which opened in 1987), both on the same principles and with a single governance. The Board has always monitored the “Mayo Clinic” brand name, taking action, for example, against an establishment that called itself the “Mayo Clinic of the North” in Canada, and has refused to degrade the Mayo Clinic name by associating it with cosmetics (including those discovered by dermatologists working at the Clinic).

The brand was extended along the following four lines:

1. The geographical expansion from Rochester (Minnesota) to Florida and Arizona

2. The creation of the regional and international service (profit making), the Mayo Medical Laboratories

3. Publications in the health field aimed at the general public, such as the Mayo Clinic Family Health Book (available from Amazon), 3rd edition, 1 million copies sold, 1,448 pages and the websites MayoClinic.com (health information for consumers) and MayoClinic.org (clinical services, appointments, etc)

4. The development of a local network of small hospitals and practices approved by the Mayo Health System.

The implementation of this strategy was both bold and prudent.

It was a bold move to set up two new centres starting from scratch, in particular to have a presence in the sunbelt, the south of the United States with a large community of affluent retired people, it was a bold move to bring together local general practitioners in geographical areas where the Mayo Clinic is established to assure the future, in particular with respect to health care reform, and it was a bold move to feel that there will be a major change in access to care in the future with many patients using Internet to find out further information and the need to be present in these rapidly changing sectors while maintaining the institution’s ethical values.

Prudence can be seen in the slow, gradual growth, the measured expansion into new areas, without relaxing the cardinal principles that govern the century old name: putting the best interests of the patients first, involving all those within the institution and providing an efficient medical service of excellence, at the risk of not taking up opportunities, sometimes even those that could have been highly profitable. Even now, 93% of patients recommend the clinic when they return home. Even now, Mayo Clinic relies almost entirely on word of mouth to attract its clientele. It is not the clinic’s marketing department that has created the Mayo Clinic brand, it was created by the physicians, the managers and all the personnel who, over the years, provided a personalised, high quality service to all the patients who became and have remained loyal customers.
You can find a comprehensive critical overview by Daniel Désir (medical department of the Belgian Erasmus Training Hospital) in the quarterly review hospitals.be (article free on line, in French).

This post is the last in the series that started on 4 January 2010, the day of the start of the third intake of 159 directors of hospitals, health and welfare establishments and care establishments who will be taking courses lasting 27, 24 and 12 months respectively at the EHESP to whom I should like to extend my very best wishes for every success in the New Year!