Mayo Clinic Model of Care Guide — page 1

Mayo Clinic Model of Care

Introduction

ayo Clinic will provide the best care to every patient

every day through integrated clinical practice,

education and research.

The Mayo Clinic Boards of Governors and the Clinical

Practice Committees are committed to preserving the highest

standards of clinical practice as established by the rich

heritage of the Mayo brothers. These attributes, as defined

in the following pages, are the Mayo Clinic Model of Care.

Mayo Clinic Model of Care

The Mayo Clinic Model of Care is defined by high quality,

compassionate medical care delivered in a multispecialty,

integrated academic institution. The primary focus, meeting

the needs of the patient, is accomplished by embracing the

following core elements (attributes) as the practice continues

to evolve.

Patient Care

•

Collegial, cooperative, staff teamwork with true

multi-specialty integration

•

An unhurried examination with time to listen to the

patient

•

Physicians taking personal responsibility for directing

patient care over time in a partnership with the local

physician

•

Highest quality patient care provided with compassion

and trust

•

Respect for the patient, family and the patient’s local

physician

•

Comprehensive evaluation with timely, efficient

assessment and treatment

•

Availability of the most advanced, innovative diagnostic

and therapeutic technology and techniques

Environment

•

Highest quality staff mentored in the culture of Mayo

and valued for their contributions

•

Valued professional allied-health staff with a strong

work ethic, special expertise and devotion to Mayo

•

A scholarly environment of research and education

•

Physician leadership

•

Integrated medical record with common support

services for all outpatients and inpatients

•

Professional compensation that allows a focus on

quality, not quantity

•

Unique professional dress, decorum and facilities

Mayo Clinic Model of Care Guide — page 5

or more than 135 years, our patients have told us that

the care they receive at Mayo Clinic is special. In

1998, national focus groups determined that people see

Mayo Clinic as the gold standard in healthcare. Studies in

that same year showed that one in every five Americans

would prefer to come to Mayo Clinic for highly specialized

healthcare and that more than 84 percent of people across

the country recognize our name.

These studies confirmed what we have always known —

patients view Mayo Clinic as unique.

Throughout its history, Mayo Clinic has embraced change,

new ideas and new ways of working, whenever and

wherever necessary, to provide the highest quality care

possible. Today, changes in society and the marketplace

are forcing dramatic changes in healthcare. As Mayo Clinic

responds to the changing healthcare environment, we

remain committed to the preservation of our unique model

of care. That commitment requires an understanding of the

specific attributes that make up our model of care.

This booklet will remind you of the attributes that define

the Mayo Clinic Model of Care and help you understand the

Mayo Clinic environment.

Mayo Clinic Model of Care Guide — page 6

What is the Mayo Clinic Model of Care?

he Mayo Clinic Model of Care (

MCMC

) is a prescription

for providing patient care in concert with our mission

— Mayo Clinic will provide the best care to every patient

every day through integrated clinical practice, education and

research.

It is the set of objectives that addresses our core principle for

practice — Practice medicine as an integrated team of

compassionate, multi-disciplinary physicians, scientists and

allied-health professionals who are focused on the needs of

patients from our communities, regions, the nation and the

world.

Mayo Clinic Model of Care Guide — page 7

“Today the only thing that is

permanent is change.”

Charles H. Mayo, MD, 1930

Why is it Important?

he Mayo Clinic name is so widely recognized that it

may be the only true national brand name in American

medicine. Rather than the result of a carefully crafted

advertising campaign, our reputation has been built by

word-of-mouth on more than a century of quality patient

care. It is the quality of care that Mayo Clinic patients

appreciate and that makes us stand out from the many

healthcare centers that also provide excellent care. The

Mayo Clinic Model of Care describes what we must do to

continue providing our unique and valued patient care.

It is our rich heritage that provides the foundation for

today’s MCMC. Recognizing that our practice will change,

the Mayo Clinic Boards of Governors and the Clinical

Practice Committees are committed to preserving the

highest standards of clinical practice when considering

practice and policy changes. To that end, we have sought

broad input from our staff and patients and examined our

history in order to identify those qualities that cause patients

to travel across the country and around the world to seek

healthcare at Mayo Clinic. The result of these efforts is a

list of attributes that, taken as a whole, define Mayo Clinic

patient care and the Mayo Clinic environment — the two

components of the Mayo Clinic Model of Care.

Mayo Clinic Model of Care Guide — page 8

“Group medicine is not a financial arrangement

except for minor details, but a scientific

cooperation for the welfare of the sick.“

William J. Mayo, M.D.

o preserve our reputation for providing quality patient

care in today’s changing healthcare environment, it is

important that Mayo Clinic staff recognize the aspects of our

patient care that sets us apart. The following description

contains historical vignettes, comments and quotes that

describe the MCMC.

Collegial, cooperative, staff teamwork with true

multispecialty integration

Dr. William Worrall Mayo’s precept: “No one is big enough

to be independent of others,“made a huge impression on

his sons. As their surgical expertise developed and their

fame spread, Drs. Will and Charlie began inviting more

and more partners to provide services to complement their

own surgical practice. Together with Dr. Henry Plummer,

they developed one of the worlds’ first private integrated

group practice of medicine. The teamwork approach

generated continuous staff interactions through which Mayo

physicians taught each other and developed a continuing

interest in each other’s professional growth.

Our founders’ belief that the combined wisdom of one’s

peers is greater than any individual has even more relevance

in today’s highly specialized environment. We provide

teams of integrated Mayo Clinic specialists who cooperate

within an environment of mutual respect to provide both

outpatients and inpatients with quality services. At each

of our three Mayo Clinic sites, we also collaborate among

our three sites to see the input of experts in a special

specialty. Our integrated services give patients the option

of comprehensive diagnosis and treatment of virtually any

medical problem.

Defining Mayo Clinic patient care

Mayo Clinic Model of Care Guide — page 9

“Sometimes I wonder whether today we take sufficient care to make a thorough physical

examination before our patient starts off on the round of the laboratories...“

William J. Mayo, M.D.

An unhurried examination with time to listen to the patient

At Mayo Clinic, we treat a whole person rather than an

isolated disease entity. We recognize the additional time it

takes to listen to patients and assess their needs in order to

make sure that everything possible is done to provide quality

care for our patients.

Physicians taking personal responsibility for directing

patient care over time in a partnership with the local

physician

As the levels of medical specialization increased, Drs. Will

and Charlie raised concerns about the individual needs of the

patient being neglected. To prevent that from happening, they

assigned each patient a personal physician to be responsible

for his or her care and to coordinate access to other healthcare

services at the clinic.

The continuity of care and patient loyalty that this system

fosters, justifies the continuation of this approach today.

Whenever possible, patients returning to Mayo Clinic are

scheduled to see the same physician who took care of them

during the first episode of care. Even specialists function in that

role, directing the patient to other specialists and discussing

care with the patient when all evaluations are complete. We

know that patients feel safe and cared for when they have their

own doctor to contact for complex medical needs.

Mayo Clinic physicians also recognize the importance of

including the patient’s local physician in the direction of

their care, and they accept responsibility for communicating

with them.

“…the highly scientific development of this mechanistic age had led perhaps to some

loss in appreciation of the individuality of the patient and to trusting largely to the

laboratories and outside agencies which tended to make the patient not the hub of

the wheel, but a spoke.“

William J. Mayo, M.D.

Mayo Clinic Model of Care Guide — page 10

“We have never been allowed

to lose sight of the fact that

the main purpose to be served

by the Clinic is the care

of the sick.“

William J. Mayo, M.D.

Highest quality patient care provided with

compassion and trust

Patients report that the most significant difference between

Mayo Clinic and other healthcare centers is that at Mayo Clinic

everyone cares about them. Our patients recognize Mayo

Clinic as a place of trust where they are treated with dignity

and compassion.

And Mayo Clinic’s concern for the patient extends to the

community. By supporting community services, Mayo Clinic

works to improve the communities in which we live.

Respect for the patient, family and the

patient’s local physician

At Mayo Clinic, we understand that many patients want to

play an active role in their diagnosis and treatment, and we

offer them the opportunity to be involved. We recognize that

patients, their families and their local physicians want prompt

access, timely evaluations and health and disease education.

We allow extra time to provide our patients a detailed

explanation of their medical evaluation.

Mayo Clinic Model of Care Guide — page 11

Comprehensive evaluation with timely, efficient

assessment and treatment

One of Mayo Clinic’s strengths is our simultaneous, efficient

evaluation process. Although some patients needs require

that we address a single subspecialty problem rather

than have every medical problem addressed, we have the

capability of bringing together a team of physicians and

allied health staff to address different problems in the same

patient during the same encounter. This capability, together

with our highly efficient laboratory and radiology services

gives us the unique ability to complete an episode of care in

a short period of time. In many cases, we can offer complex

evaluation and testing followed by next-day surgery — a

capability that is appreciated by patients who travel long

distances to seek healthcare at Mayo Clinic.

Availability of the most advanced, innovative diagnostic

and therapeutic technology and techniques

The Mayo brothers traveled frequently throughout the world

to bring the latest medical advances to Mayo. That tradition

continues today as our consultants travel throughout the

world to teach and to learn. Our commitment to research

and education keeps us aware of the most recent medical

developments and allows us to offer them to our patients

in a timely manner. As a result, our translational research

activity is among the largest in the world.

Mayo Clinic Model of Care Guide — page 12

Defining the “the spirit of the Clinic”

r. William J. Mayo felt that “the spirit of the clinic”

was what separated it from others. The following

attributes characterize Mayo Clinic as an environment of

compassion, cooperation, commitment, integrity, wisdom

and professionalism.

Highest quality staff mentored in the culture of Mayo and

valued for their contributions

Our medical school and graduate schools are highly

competitive and serve as the training ground for many of

our consulting staff who come from all areas of the world.

Mayo Clinic can attract the best by training the best. All

candidates for a staff position are required to serve an

evaluation period of several years before being considered

for promotion. The large volume of patients with both

rare and common diseases, as well as common diseases

with unusual variations, continually improves Mayo Clinic

physicians’ diagnostic and treatment skills.

Mayo Clinic Model of Care Guide — page 13

“The spirit of the Clinic, into which is incorporated the desire to aid those who

are suffering, the desire to advance in medical education by research, by diligent

observation, and by the application of knowledge gained from others and, most

of all, the desire to pass on to others the scientific candle this spirit has lighted.“

William J. Mayo, M.D.

Mayo’s team-oriented culture combines the desire to aid

those who are suffering with the desire to advance patient

care through observation, research and education. With the

best interest of the patient as the primary consideration, the

opinion of every member of the patient’s team is discussed

in an atmosphere of collegiality and respect.

Mayo Clinic Model of Care Guide — page 14

Valued professional allied-health staff with a strong work

ethic, special expertise and devotion to Mayo

Mayo Clinic’s founders urged a division of labor that

improved both the quality and efficiency of medical practice

and nurtured a caring attitude towards its employees.

Our employees are our most valuable asset. The Mayo

School of Health Related Sciences ensures a constant source

of highly trained allied health professionals. In addition,

allied health staff are recruited from our local communities

and around the world. These caring and self-motivated

individuals of diverse backgrounds contribute to the special

“spirit of the clinic” through their compassion, strong

work ethic and sincere dedication to our patients. They

have repaid our genuine concern for them with strong

institutional loyalty and contribute in very important ways

to both the medical care and the service that sets us apart.

The Mayo Clinic logo of three interlocking shields

symbolizes Mayo’s commitment to excellence and

interdependence in the three areas of Research,

Education and Clinical Practice.

Mayo Clinic Model of Care Guide — page 15

A scholarly environment of research and education

In 1915, the Mayo Graduate School of Medicine was

established — the first program in the world to train medical

specialists. In 1919, the Mayo brothers founded Mayo

Properties Association (today known as Mayo Foundation).

Since then, all Mayo Clinic physicians receive a salary and

any profits from the proceeds of the practice are used to

further education, research and patient care.

Today, we continue to provide quality patient care by

striving for excellence in research and education as well as in

our clinical practice. The three missions are represented in

the Mayo Clinic logo by three shields which are interlocked

to symbolize their interdependence. We strive to integrate

our practice in a way that facilitates collaboration between

clinicians, investigators and educators. Much of our

architecture is specifically designed to promote integration

and is further advanced by consultant physicians who have

commitments to more than one mission.

Our commitment to education is substantiated by our five

excellent and highly competitive education programs: Mayo

Medical School, Mayo Graduate School of Medicine, Mayo

Graduate School, Mayo School of Health-Related Sciences

and Mayo School of Continuing Medical Education. The

commitment to research is visible in recent organizational

restructuring, expanded research facilities, strengthened

bonds between basic scientists and clinical investigators

as well as several initiatives to enhance research efforts in

specific areas.

“It is a great thing to make scientific discoveries of rare value, but it is

even greater to be willing to share these discoveries to encourage other

workers in the same field of scientific research.“

William J. Mayo, M.D.

Mayo Clinic Model of Care Guide — page 16

“Commercialism in medicine never leads to true satisfaction, and to

maintain our self-respect is more precious than gold.“

William J. Mayo, M.D.

Professional compensation that allows a focus on quality,

not quantity

All Mayo Clinic physicians receive a fixed salary. Their

income is not related to the number of physical examinations,

surgeries or laboratory tests performed. Being free of

financial incentives allows Mayo Clinic physicians to spend

the time they deem needed to provide quality patient care.

We are a not-for-profit, charitable public trust. As such, our

patients never have to question if a test is being ordered with

anything other than their best interest in mind.

Physician leadership

Mayo Clinic is a private group practice governed by

physician-led committees. While most other healthcare

centers turn the management of their practices over to

professional administrators, we stand by the philosophy that

physician leadership keeps us grounded in the reason we

are here — to provide the best care to every patient every

day. Mayo Clinic physicians undertake rotating committee

assignments where they partner with administrators to

develop strategies and resolve problems because it is they

who understand the practice best.

The strengths of this physician-administrator partnership

have served Mayo Clinic well for the past century. Physician

Leadership ensures the preservation of our unique culture.

Mayo Clinic Model of Care Guide — page 17

Integrated medical record with common support services

for all outpatients and inpatients

In 1907, Dr. Henry Plummer introduced the dossier concept

of medical records, wherein all data, both inpatient and

outpatient, about a specific patient are contained in a single

file linked to a unique Mayo Clinic identification number

and stored in a central repository. In 1910, he devised a

diagnostic index to allow evaluation of clinical data for

research. In 1975, Mayo introduced an efficient and flexible

on-line computerized system that tracks patient charts by

computerized bar codes.

Our ability to retain an up-to-date, integrated medical

record on every Mayo Clinic patient, coordinated with

laboratory, pathology and radiology services, remains one

of our hallmarks. Our system is designed to bring patient,

physician, laboratory tests, radiology reports and the

patient’s medical record into one room at the same time.

Without this service, we would not be able to offer multiple

timely evaluations or next-day surgery.

Mayo Clinic Model of Care Guide — page 18

Unique professional dress, decorum and facilities

Dr. William Mayo defined standards of conduct for the staff

that are still maintained today. The wearing of business

attire is recognized by our patients as a unique dress code

that projects an aura of expertise and respect for the patient

accompanied by warmth and friendliness.

Dr. Henry Plummer, the architect of many early Mayo

innovations, thought of buildings as tools to help physicians

provide efficient patient care. He believed in the importance

of using good materials to build well-designed, well-

constructed facilities that were planned for easy maintenance

and kept spotlessly clean. Mayo Clinic’s modern buildings

are designed to provide a friendly and warm environment

in which to continue Dr. Plummer’s concepts. They are

built with the intention of advancing the integrated model of

medicine to the next level of excellence.

Mayo Clinic Model of Care Guide — page 19

Conclusion

Mayo is committed to preserving and enhancing the core

elements of its Model of Care in concert with our mission —

Mayo Clinic will provide the best care to every patient every

day through integrated clinical practice, education and

research. The dedicated staff and resources that support the

Mayo Clinic Model of Care will preserve our unique and

valued patient care.

Mayo Clinic Model of Care Guide — page 20

Mission

Mayo will provide the best care to every patient every day

through integrated clinical practice, education and research.

Primary Value

The needs of the patient come first.

Core Principles

Practice

Practice medicine as an integrated team of compassionate,

multi-disciplinary physicians, scientists and allied-health

professionals who are focused on the needs of patients from

our communities, regions, the nation and the world.

Education

Educate physicians, scientists and allied-health professionals

and be a dependable source of health information for our

patients and the public.

Research

Conduct basic and clinical research programs to improve

patient care and to benefit society.

Mutual respect

Treat everyone in our diverse community with respect and

dignity.

Commitment to quality

Continuously improve all processes that support patient

care, education and research.

Work atmosphere

Foster teamwork, personal responsibility, integrity,

innovation, trust and communication within the context

of a physician-led institution.

Mayo Foundation

Mayo Clinic Model of Care Guide — page 21

Societal commitment

Benefit humanity through patient care, education and

research. Support the communities in which we live and

work. Serve appropriately patients in difficult financial

circumstances.

Finances

Allocate resources within the context of a system rather than

its individual entities. Operate in a manner intended not to

create wealth but to provide a financial return sufficient for

present and future needs.

Mayo Clinic Model of Care Guide — page 22

Mayo Clinic Model of Care Guide — page 23

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Mayo Clinic Model of Care Guide

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