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Medical system in the US---Mayo clinic. Zhi Hua Ran Department of gastroenterology Ren Ji Hospital. History of Mayo clinic. Mayo Clinic evolved gradually from the frontier practice of Dr. William W. Mayo and his two sons--- Dr. William J. Mayo and Charles H. Mayo. Dr. Mayo and his two sons .

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medical system in the us mayo clinic

Medical system in the US---Mayo clinic

Zhi Hua Ran

Department of gastroenterology

Ren Ji Hospital

history of mayo clinic

History of Mayo clinic

Mayo Clinic evolved gradually from the frontier practice of Dr. William W. Mayo and his two sons--- Dr. William J. Mayo and Charles H. Mayo.

dr mayo and his two sons

Dr. Mayo and his two sons

Dr. Charles H. Mayo

Dr. William J. Mayo

Dr. William W. Mayo

history key dates

History --- Key Dates

Dr. William W. Mayo emigrated from England to the US in 1846

Became a doctor in 1863

Appointed as a Civil War examining surgeon for the Union enrollment board, first Minnesota district

Moved to Rochester in 1864

history key dates5

History --- Key Dates

His two sons began their medical training early, first by observing, and later by assisting their father on patient visit and with autopsies

"We came along in medicine like farm boys do on a farm" --- Dr. William J. Mayo

dr william j mayo

Dr. William J. Mayo

The elder brother, graduated from University of Michigan Medical School in 1883

dr charles h mayo

Dr. Charles H. Mayo

The younger brother, graduated from Chicago Medical College of Northwest University in 1888

history key dates8

History--- Key Dates

1864 --- Dr. William Worrall Mayo moves to Rochester

1883 and 1888 --- Dr. Mayo’s two sons, William and Charles, join him in practice after they had finished medical school

1883 --- A tornado strikes Rochester. Mother Alfred Moes, founder of the Sister of St. Francis, proposes to build and staff a hospital if Dr. W.W.Mayo and sons will provide medical care.

1889 --- Saint Marys Hospital opens with 27 beds

1892 --- First partner added to Mayo family practice. More physicians are involved to join, thus beginning the concept of medical teamwork.

history key dates9

History--- Key Dates

1905 --- Dr. Louis Wilson develops a rapid way to diagnose surgical specimens (quick-frozen tissue section stained with methylene blue), which allows Mayo surgeons to explore, diagnose, and repair all in one operation

1907 --- Patient registration number “1” given out. 5000 patients register at “Mayo clinic”, as it has come to known

1914 --- Mayo isolates throxin, the principle active component of the thyroid gland. This is only second time that a pure hormone has been isolated

1915 --- Organization of the world’s first formal graduate training program for physicians, the Mayo School of Graduate Medical Education

1919 --- The Mayo turn over the assets of the Mayo clinic to the nonprofit Mayo Properties Association, the forerunner of Mayo Foundation

history key dates10

History--- Key Dates

1920 --- Mayo develops a system for grading cancer numerically, which is adopted worldwide and still used today

1925 --- Dr. William H. Goeckerman reports on the use of tar and ultraviolet light to successfully treat psoriasis. This is a therapeutic breakthrough that remains a highly effective treatment for psoriasis

1926 --- Mayo Clinic Proceedings begins publication

1930s --- Mayo scientists pioneer methods for measuring motility of the esophagus and adapt them for clinical testing now used worldwide

1934 --- Edward C. Kendall, Ph.D, isolates cortisone, a hormone from the suprarenal cortex that will later be used to treat rhematoid arthritis with dramatic results

history key dates11

History--- Key Dates

1938 --- Dr. Frederick Moersch first reports median thenar neuritis (carpal tunnel syndrome)

1939 --- William and Charles Mayo die within a few months of each other

1944 --- First therapeutic application of streptomycin to treat tuberculosis.

1947 --- Discovery of Factor VII, a blood-clotting component

1950 --- Drs. Edward C. Kendall and Philip S. Hench are awarded the Nobel Prize for isolation and first clinical use of cortisone

First human diagnostic cardic catherization

1955 --- Mayo is among the first to perform successful open heart surgery to repair congenital heart abnormalities after refining the Gibbon heart-lung bypass machine

history key dates12

History--- Key Dates

1965 --- Computer monitoring of patients introduced in Cardiac Care Unit at Saint Marys Hospital

1966 --- Dr. Leonard Kurland introduces the Rochester Epidemiology Project, a medical records- linkage system that has made Olmsted County one of few places in the world where the occurrence and natural history of disease can be accurately described. The project has generate more than 1,000 publication on long-term incidence, prevalence, and mortality rates for many diseases

1969 --- First FDA approved total hip replacement in the US

1972 --- Mayo Medical School opens

1973 --- Mayo introduces the first CT scanner in North American

history key dates13

History--- Key Dates

1976 --- The North Central Cancer Treatment Group is created

1980 --- Mayo researchers are among the first to propose intensive insulin therapy to reduce the complication of diabetes

1986 --- Mayo Clinic Rochester, Saint Marys Hospital, and Rochester Methodist Hospital integrate

1986 --- Mayo expands outside Minnesota for the first time with the opening of Mayo clinic in Jacksonville, Fla

1987 --- Mayo Clinic opens in Scottsdale, Ariz. And St. Luke’s hospital, Jacksonville, Fla

Mayo Clinic Rochester goes smoke-free, of the first medical centers in the country to do so

1990 --- Mayo researchers help identify the source of illness affecting people taking health supplement L-tryptophan

history key dates14

History--- Key Dates

1992 --- Mayo begins to form a regional network of clinics and hospital

1994 --- Mayo study finds no link between breast implants and connective tissue disease

1995 --- Mayo opens it web site

1996 --- Mayo Eugenio Litta Children’s hospital opens, part of Saint Marys Hospital in Rochester

1998 --- Mayo Clinic Hospital opens in Phoenix, Ariz.

2000 --- Mayo Clinic Transplant Center opens in Rochester providing a single setting where patient receive all of their transplant service – from evaluation to follow-up

the beginning of group practice

The Beginning of Group Practice

Pressed by the demands of their busy surgical practice and the exploding growth of medical knowledge, the Mayo brothers invited others to joint their practice:

Augustus Stinchfield (1892)

Christopher Graham (1895)

Melvin Millet (1898)

Henry Plummer (1901)

added diagnostic skill

Louis Wilson (1905)

developed the lab

Maud Mellish (1907)

developed editorial services

Harry J. Harwick (1908,local banker)

improved business procedures

the beginning of group practice16

The Beginning of Group Practice

The group was the beginning of a new way to practice medicine

‘It has become necessary to develop medicine as a cooperative science; the clinician, the specialist, and the laboratory workers uniting for the good of the patient’

‘Individualism in medicine can no longer exist’

group practice

Group Practice

‘No one is big enough to be independent of others’

--- A quote by Dr. William W.Mayo

the beginning of group practice18

The Beginning of Group Practice

Group practice was also a natural expression of the Mayo brothers' personalities.

As Harry Harwick, who worked alongside them for 31 years, wrote: "The first and perhaps greatest lesson I learned from the Mayos was that of teamwork. For 'my brother and I' was no mere convenient term of reference, but rather the expression of a basic, indivisible philosophy of life."

architect of the mayo practice

Architect of the Mayo Practice

Dr. William Mayo claimed that the best day’s work he ever did for the clinic was the day he hired Henry Plummer

dr henry plummer

Dr. Henry Plummer

  • He introduced the dossier medical records system that facilitated sharing of information
  • All of a patient’s data, from both clinic visits and hospital stays, was entered into a single file, which traveled with the patient and was stored in a central repository
  • Divided a diagnostic index to facilitate access to these records for research
first building for an integrated medical practice 1914

First building for an integrated medical practice---1914

Registered patients:

30,000

On the site Harold W. Siebens building

growth of specialtes

Growth of Specialtes

  • Orthopedics in 1912
  • Neurology in 1912
  • Thoracic surgery in 1915
  • Dermatology in 1916
  • Pediatrics in 1917
  • Neurologic surgery/proctology in 1919
integrating research and education with practice

Integrating research and education with practice

  • The Mayo school of Graduate Medical Education opened in 1915 with an endowment from the Mayo brothers
  • Their program became one of the first in the world to train medical specialists
a gift to the people

A gift to the people

The Mayo brothers contributed the bulk of their life saving to a private, non-for-profit, charitable organization----Mayo foundation in 1919

a gift to the people26

A gift to the people

“We want the money to go back to the people, from whom it came, and we think we can best give it back to them through medical education”

Said Dr. William J. Mayo

a gift to the people27

A gift to the people

  • From this point on the Mayos, their partners and all future Mayo Clinic physicians would receive a salary and would not profit personally from the proceeds of the practice
  • All proceeds beyond operating expenses were contributed to education, research and patients care
  • They established a board of governors and a committee system to provide effective oversight of many aspects of Mayo life, thereby reinforcing the cooperative spirit of the founders
the present

The present

  • More than six million people have been treated at Mayo Clinic since its frontier founding
  • It encompasses three clinics and four hospitals in three states, employing more than 40,000 physicians, scientists, nurses and allied health workers
  • Through growth and change, Mayo Clinic remains committed to its guiding principle
  • “The best interest of the patient is the only interest to be considered”
location of mayo clinic

Location of Mayo Clinic

  • Rochester, Minnesota
  • Jacksonville, Florida
  • Scottsdale, Arizona
rochester minnesota

Rochester, Minnesota

  • 1500 doctors and scientists
  • Mayo Clinic
  • Saint Marys Hospital
  • Rochester Methodist Hospital
rochester minnesota31

Rochester, Minnesota

Gonda building

rochester minnesota32

Rochester, Minnesota

Gonda building

rochester minnesota33

Rochester, Minnesota

Gonda building

rochester minnesota34

Rochester, Minnesota

Rochester Methodist Hospital

rochester minnesota35

Rochester, Minnesota

Plummer building

slide36

Siebens-Plummer

Plummer building

Kahler Hotel

rochester methodist hospital

Rochester Methodist Hospital

  • Licensed beds available 794
  • Admissions 18,412
  • Average length of stay (days) 4.5
  • Operating rooms 41
  • Surgical cases 18,159
rochester minnesota38

Rochester, Minnesota

Saint Marys Hospital

saint marys hospital

Saint Marys Hospital

  • Licensed beds available 1,157
  • Admissions 42,328
  • Average length of stay (days) 5.6
  • Operating rooms 58
  • Surgical cases 29,849
rochester minnesota 2004 statistics

Rochester, Minnesota --- 2004 Statistics

  • Mayo Clinic
  • Unique patients 321,900
  • Outpatients visits 1.42 million
  • Personnel
  • Staff physicians and scientists 1,509
  • Residents
  • Fellows 1,414
  • Temporary professionals
  • Allied health staff (clinic and hospital) 21,077
  • Total Staff24,000
rochester minnesota 2004 statistics41

Rochester, Minnesota --- 2004 Statistics

  • 80% of the patients --- outpatients
  • 20% --- hospitalized
  • 80% of Mayo Clinic patients: from Minnesota, Iowa,
  • Wisconsin
a typical day at mayo clinic

A typical day at Mayo Clinic

New (outpatients) arriving 266

Admissions to the hospital 238

Surgical procedures 204

Lab tests 33,653

Radiology procedures 4,064

CT scans 563

Chest X-rays 726

MRIs 219

Electrocardiograms 670

Units of blood and blood components used 326

2004 Statistics

medical research

Medical Research

Biomedical research at Mayo Clinic includes strong programs in basic and clinic research

Most Mayo medical staff participate in some research activity

Research Funding Sources (in millions)

Mayo funds $121

Extramural funds $251

National Institutes of Health

Other federal sources

Commercial sources

Total $372

medical education

Medical Education

  • Mayo School of Graduate Medical Education
  • trained >17,000 alumni since 1915
  • Clinical residents and fellows 1,390
  • Mayo Graduate School
  • has granted 459 graduate degrees in seven specialties
  • since 1917
  • Predoctoral students 150
  • Mayo Medical School
  • has trained and graduated >1,000 students since 1972
jacksonville florida

Jacksonville, Florida

Mayo Clinic

St. Luke’s Hospital

jacksonville florida46

Jacksonville, Florida

  • 325 doctors and scientists
  • 253 Residents, fellows and temporary professionals
  • Opened in 1986
  • Delivering health care services in >50 medical / surgical
  • specialties
  • cancer treatment
  • organ transplantation
  • heart surgery
  • neurosciences
  • >91,000 patients were diagnosed/treated in 2004
  • >13,000 patients underwent surgery
scottsdale arizona

Scottsdale, Arizona

Mayo Clinic Arizona

Mayo Clinic Hospital

arizona

Arizona

  • Opened in 1987
  • Services in > 65 specialty and surgical disciplines, including programs in cancer treatment and organ transplantation.
  • Mayo Clinic is a premier academic medical center in the Southwest.
  • Staff physicians/scientists 344
  • Residents, fellows and temporary professions 101
  • Served >100,000 patients
system in mayo clinic

System in Mayo Clinic

  • Clinic Bulletin
  • Weekly announced; From Monday to Saturday
  • As early as at 7 AM; Noon time (12:30~1:30); 6 PM
  • Medical grand rounds (every Wednesday)
  • H. Lee --- New Technologies in criminal investigation
  • GI grand rounds (every Thursday)
system in mayo clinic50

System in Mayo Clinic

  • Well-organized and advanced system
  • shuttle bus --- every 5 min
  • page --- telephone everywhere
  • Computer connected --- included all patients’ information
  • Humanity
system in mayo clinic51

System in Mayo Clinic

  • Residency 3 y
  • Resident in chief: the forth year
  • General Internal Medicine 2 mo (outside Rochester)
  • Community Internal Medicine 2 mo (Rochester)
  • Urgent Care 1 mo (outpatient w/o appointment)
  • Primary Care Clinic 1 mo (outpatient w/ appointment)
  • Pulmonary 1 mo (inpatient)
  • Oncology 1 mo (inpatient)
  • Cardiology 2 mo (inpatient)
  • MICU 1 mo
resident training

Resident training

  • Morbidity & Mortality (every Monday noon time)
  • Journal club
  • Friday 7:30~8:30
  • Morning report (teaching): 8:00 -8:30
  • 8:30 ~ 11:30: work round
  • Lectures: ground rounds
  • morbidity and mortality
gi fellow training

GI fellow training

  • Pick mentor
  • 1st year
  • Weekly core lectures
  • Journal club
  • Statistics
  • Endoscopy
  • 2rd year: research
  • 3rd: clinic practice
questions about mayo clinic

Questions about Mayo Clinic

  • Why do patients come to Mayo?
  • Help with the diagnosis and treatment of a difficult medical problem --- the main reason
  • Because of its expertise, reputation for thoroughness and its team practice, which lets people get all the opinions, tests and treatments they need in one place, in a coordinated way
questions about mayo clinic55

Questions about Mayo Clinic

  • How much time will a medical evaluation require?
  • six working days
  • Does Mayo specialize in certain areas?
  • Mayo specialized in virtually everything
  • Mayo’s strength is its comprehensiveness, its ability to
  • provide “one-stop shopping” for the diagnosis and treatment
  • of virtually any medical problem
  • >100 medical/surgical specialties
questions about mayo clinic56

Questions about Mayo Clinic

  • Do the Mayo still own Mayo Clinic?
  • Mayo foundation was established in 1919.
  • All Mayo staff members are paid a salary and there is no profit-sharing
  • Are there any Mayos still working at Mayo Clinic?
  • The last family member on the medical staff was Charles W. Mayo (son of Dr. Charles H. Mayo), who retired in 1963.
  • Robert Walters, a great-grandson of Dr. William J. Mayo is an administrator at Mayo Clinic Jacksonville.
best hospital 2005

Best Hospital 2005

#1: Johns Hopkins Hospital, Baltimore

32 points in 16 specialties

#2: Mayo Clinic, Rochester, Minn.

28 points in 14 specialties

#3: Massachusetts General Hospital, Boston

24 points in 13 specialties

#4: Cleveland Clinic

23 points in 12 specialties

#5: UCLA Medical Center, Los Angeles

22 points in 14 specialties

best hospital 2005 mayo clinic

Best Hospital 2005---Mayo Clinic

#1 Digestive disorders U.S. News Score: 100

Reputation: 65.6%

#1 Hormonal disorders U.S. News Score: 100

Reputation: 67.2%

#1 Neurology and neurosurgery U.S. News Score: 100

Reputation: 52.5%

#1 Orthopedics U.S. News Score: 100

Reputation: 58.2%

#2: 4 specialties; #3: 2 specialties