Dr. Kent Seltman

PhD, served as director of marketing at Mayo Clinic from 1992 to 2006

Leonard Berry

Professor of Marketing, Mayo School of Business at the University of Texas

Cherish your brand story

About 140 years ago, the first private hospital opened in the small rural town of Rochester, Minnesota, which in the early 1900s became known as the Mayo Clinic. The most amazing thing is not that this clinic still exists, but that it has become one of the most influential and expensive brands in the world in the service sector. And the fact that this brand has been successfully supported, protected and developed throughout its long history deserves admiration.

The number of people who travel to and from Mayo Clinic every week is comparable to the population of a small town. The working day starts at five in the morning, and during the day, 42,000 employees, students and volunteers work within the walls of three campuses located in Minnesota, Arizona and Florida. Surgical patients begin to arrive at 5:30, and an average of 300 operations are performed here per day. The flow of patients picks up at 6:45 a.m. when labs open and blood tests are done. By noon, more than 13,500 patients, most often accompanied by relatives, are receiving medical care. In total, 65,000 people participate in the dramatic struggle for human life every day - medical and service personnel, students, patients and their relatives.

The Mayo brothers gained international recognition during their lifetime and made the clinic that now bears their name famous, largely due to their scientific contribution to medicine and innovations used in surgery. Their work had a serious impact on theoretical and practical medicine for seven decades, until 1939, when their lives were cut short.

In 1961, the independent consumer research firm Social Research described the image Mayo Clinic has on first-time patients. Among the dominant statements were the following: "This is where you should go if you are seriously ill" and "The court of last resort is the supreme court of medical decisions."

Put the needs of the patient first

The principles that sustain the brand today were defined by founders William and Charles Mayo in the first two decades of their careers. “The interests of the patient are the most important, they are the only ones worth considering, and in order for the patient to benefit from the latest knowledge, efforts must be combined. We must develop medicine as a science of interaction."

CEOs in other industries may argue that a corporate consensus based on the humane principle of "Patient First" is more inherent in health care than in other industries dominated by commercial gain and fierce competition. However, focusing on the needs of the patient is far from always observed in healthcare - it is something more complex than handing out charity soup.

Although there is no special course that teaches patient orientation, this is constantly talked about by the leaders of the clinic and various programs support it. For example, the main principle is highlighted in the induction training programs that new hires go through. Robert E. Brigham, general administrator of the Jacksonville campus, reports, "Newcomers hear about this in their first five minutes of being in the clinic, because it is with the main principle that I begin the first orientation session." In Rochester, this class shows the educational film Mayo's Legacy.

Hire team workers

“Teamwork is a must,” reads the headline of an article about Mayo Clinic in Fast Company magazine. And it is true. Many excellent clinicians do not meet Mayo's requirements, particularly those who prefer to work independently, crave fame, or want to make as much money as possible.

The clinic is persistently looking for team players. It recruits them and then keeps them collaborating with significant investments in communications technology and medical equipment. Collaboration is also stimulated by the principle of remuneration: an employee's salary does not depend on the number of patients he examined or treated. Clinic doctors have no financial reason why they would want to keep the patient and not send him for treatment to a colleague who is better able to meet the needs of the patient. The same applies to the time spent consulting colleagues.

Most specialties in the service sector involve the employee's actions at his own discretion. These actions are limited, on the one hand, by the maximum energy that a person can apply to provide a service, and on the other hand, by the minimum effort required to avoid punishment (this may be a reprimand, a reduction in salary, or even dismissal). And the employee voluntarily chooses whether to put maximum or minimum energy into his work. Truly successful service organizations receive more voluntary returns from their employees than any other. And this extra effort ensures their superiority.

Make an accurate schedule

Every business day, Mayo Clinic patients are given schedules for thousands of different appointments, including laboratory tests, clinical procedures, and consultations with physicians. Their distribution bears little resemblance to filling seats in a theater or an airplane. Many appointments must follow a strict sequence, others must be made at intervals of several hours, and still others must be preceded by special procedures. Scheduling appointments isn't romantic, but it's perhaps the most fundamental function, since it starts the delivery of healthcare services.

The Process Streamlining Department and its systems engineers have been researching for decades to balance clinic capacity, especially with mainstream traffic needs, so that patients can experience responsive service. Before the advent of computers, most of the work was related to statistical calculations. Thus, industrial engineers have come up with coefficients that, before the start of each procedure, show the expected need for a chest x-ray, blood tests, orthopedic or urological consultations, etc. who will come to the clinic in the direction of their attending physicians.

As you use the model, you can make more accurate predictions, which provides a double benefit. First, patients spend less time waiting for an appointment. Secondly, the productivity of doctors, laboratories and treatment rooms increases, which is beneficial for the clinic. Such an analysis is typical for various industries, but is not typical for healthcare.

Make subordinates partners

John Hurrell explains why Mayo Clinic's overall management structure is so effective: “Physicians are just as interested as administrators in the institution's financial well-being. Administrators, no less than doctors, strive to ensure that the clinic provides quality medical services.” All this is so simple and obvious that one might think that this is how the health care system should work. But such unity is not observed in all cases. Competing groups of doctors in a private hospital sometimes engage in violent combat with each other. Doctors set up their own specialized clinics or medical services to make more money, not to help public health.

Most leadership decisions at Mayo Clinic are group based, not individual. The CEO acts as a speaker presenting the idea to the board of governors. A similar presentation is taking place at the campus, department, and branch level. A leader rarely, if ever, makes a public statement without first gaining support from peers. Without the intellectual and emotional involvement of physicians and other staff who come into contact with patients, truly humane medical care would not be possible. Similar involvement of employees providing services to consumers is relevant for other service organizations. Well-established communication is at the heart of the decision-making process and reaching prior consensus. After the meeting of the committee, its participants (10–20 people) return to their workplaces and tell their colleagues about the decision made, preventing the spread of anxiety and misunderstanding throughout the organization. Consensus helps create an environment conducive to purposeful work. Trust in management means that employees are not worried about keeping their positions; there is no place for autocracy, arbitrariness and political intrigues.

Look for talented professionals who share similar principles

Proper recruitment seems like a no-brainer when Dr. George Bartley, CEO of the Jacksonville campus, begins to explain what the ideal employee should be: “We need to find people whose intrinsic values ​​are aligned with our core principle of putting the patient first.” The fact is that Mayo Clinic is known for its principles in the medical community, so professionals who put the interests of the patient first understand that they meet the requirements of the organization, and often seek to get a job here themselves. “The professional environment in Rochester is conducive to the career development of nursing staff, and word of this has spread throughout the country. So we have a steady flow of nurses who want to work here,” says Teresa Elwood, registered nurse, coordinator for filling vacancies in nursing positions.

Rest assured that working at Mayo Clinic is not easy. Some doctors and scientists are dissatisfied with the fact that only 18 days a year are allowed for business trips, which are used to visit professional societies and present scientific works. Some well-known professionals outside the clinic, who are invited to lecture at universities or speak at scientific conferences, believe that this activity is more likely to strengthen Mayo's reputation than simply attending meetings of professional societies. Others are unhappy with the rules that restrict the placement of information on business cards. Someone does not like the style of dress adopted in the clinic. “You have to understand the organization and its rules. If you succeed, then you will stay here. But if you can't, you'll have to leave, says Dr. Maury Hertz. - And you must be the same as your colleagues - men and women, doctors and workers of other specialties. Authoritarian personalities, unrestrained and rude people will not be able to stay here.”

Make the intangible tangible

Typically, consumers buy a service without being able to “touch” it. The silent role of external signs is to create a first impression. Often, consumers evaluate external features a little earlier than functional and interactive ones. With little knowledge of the service, people, such as visitors looking for a restaurant or hotel, often make their choice based on the appearance of the facilities. And if functional features help to assure consumers of the performer's competence during and after the provision of a service, then external features help to do this at the very beginning of the service, that is, at the time of purchase.

Health care services are inseparable from the premises in which they are provided, and there are many ways to help patients and their loved ones find peace of mind, peace of mind and instill confidence in the successful outcome of their treatment.

While functional features are usually very important in meeting the expectations of consumers of all types of services (since functionality is related to the satisfaction of basic needs), interactive features are usually especially important in order to exceed the expectations of consumers of labor-intensive, communication-intensive types of services ( since the attitude towards people plays a major role here, and a very caring attitude can be a pleasant surprise). To exceed consumer expectations, you need to pleasantly surprise them when they interact with the service provider.

Mayo Clinic also creates interactive quality cues by regulating staff dress code. Doctors never appear in front of patients in special clothes. They always wear a business suit, unless they are in the operating room.

When expanding, do not forget about the core values ​​of the brand

The personal principles of the contractor directly affect the quality and value of the services he provides. When the clinic expanded its brand to open campuses in Florida and Arizona, it deployed talented and experienced staff to virtually every department, mostly in leadership roles and leading by example newcomers to learn the corporate culture and patient care practices.

In 1983, Mayo Clinic embarked on three aggressive initiatives for the first time in its history: it decided to expand geographically, develop Mayo Medical Laboratories (MLM), and publish to consumers
health care information. In the context of the century-old history of the organization, these actions look like an exception to the rule. Of much greater importance are promotions aimed at protecting the brand. Mayo Clinic remains cautious, believing that quality is more important than growth. The Mayo Clinic plays quite decisively on defense and quite cautiously on offense.

Invest in tomorrow

The Innovation Center grew out of the SPDS (Watch, Plan, Act, Improve, Communicate) project in the Department of Internal Medicine under the direction of Dr. La Russo and Barbara Spurrier, then Chief Administrator of the Department. The aim of the SPDS project was to redefine the methods of individual patient care. A significant workspace was set aside for this, including examination rooms and other rooms on the Rochester campus, converted into a medical services laboratory. The laboratory had movable walls that could be moved to evaluate the functionality of the space. When the treatment prototype was created,
it was studied in real time with the participation of outpatients and attending physicians. More than 25 treatments have been researched under the SPDS project.

Let employees realize themselves

The Career and Leadership Development Program is an example of an investment that supports leadership development and staff personal development.

The entrepreneurial spirit of Mayo Clinic does not dominate its mission. Striving to be financially responsible is not the same as saving on resources. Mayo Clinic staff are provided with the necessary conditions: they are provided with equipment and time so that they can conscientiously do their job. Laurie Plate's confession (“Here I was able to become the nurse I always wanted to be”) reflects the attitude of Mayo Clinic employees to their duties. They have all the necessary resources to achieve excellent results.

Long time no see, friends. I'll start with a short introduction, if you don't mind, my hands itched to write a fresh article and there are a lot of ideas, but there was sorely lacking time and finally it appeared.

In our country, medicine is treated as something due and free, it is not considered a service, it is considered rather a duty. And there is some truth in this. But there is another approach. Today I want to talk about a clinic that has turned the medical services provided within its walls into a brand, guided by very bright and correct principles, while looking at its work as one of the types of services. Whether this is good or bad is not for us to judge. We will just see what it has become and what it has led to. Here is the world-famous Mayo Brothers Clinic.

History of the clinic

Mayo Clinic is a non-profit organization (an organization that does not have profit as its main goal and does not distribute profits among participants), one of the largest private medical and research centers in the world.

Dr. William Worrall Mayo (1819-1911) was posted to Rochester in 1863, where he practiced medicine. The population of Rochester was then 5,000 people. William Worrall traveled a lot to the largest US clinics, where he “absorbed” not only surgical techniques, but also paid attention to the organization of the structure of institutions, adopting the most effective models. After a quarter of a century of medical practice, donations from the convent of St. Francis, grateful to him and his sons for their help in eliminating the consequences of a devastating hurricane, he opened a clinic in 1889 - one of the first private clinics in the world (!!!).

From 1911 to 1939, the clinic was headed by his two sons - William James and Charles Horace. Guided by high moral values, the brothers manage to create an effective corporate culture and the investment infrastructure that supports it. At that time, the clinic was already a major center, and rumors about it went far beyond the state of Minnesota.

The marketing department appears in 1986. Up until 1992 the marketing department consisted of one person! The main bet was made on word of mouth, because even Dr. William Mayo said:

“If you do something better than your neighbors, then the path to your house will not overgrow, even if you live in the forest.”

The clinic exists to this day. It currently has 3 campuses located in Minnesota, Arizona and Florida. The clinic employs 42 thousand people. The number of patients per year reaches the population of a small town. The hospital, along with clinical activities, is actively involved in the educational and scientific fields. The clinic's revenue for 2012 exceeded $8.8 billion; about $500 million is allocated for scientific research. According to Forbes, the annual revenue of the clinic in 2013 amounted to $3.74 billion.

So, what is the secret of the Mayo Brothers Clinic?

Principle of operation

The Mayo Center is not just the name of a clinic, it is a brand in the world of medicine, both clinical and scientific. A brand that, like all brands, has a clear development strategy. This development is based on 3 fundamental principles.

1. The needs of the patient come first

In this clinic, this is the first principle of work, from which everything else follows. And it's not just words. The heads of all participants in the process are saturated with this principle: from the nurse to the doctor and, what is very important, the clinic administrators. Everyone moves in unison — to make the patient's stay as comfortable as possible when contacting a hospital or an outpatient clinic.

Nurses should be sympathetic to the process. Doctors, not only should they be involved in the latest trends in their industry, are constantly improving their level of specialists, undergoing trainings, including in the field of communication with patients. Research is being conducted on the topic: what color of the uniform has a better effect on the recovery of the patient; the noise level in the premises is measured and everything possible is done to reduce it as much as possible; the territory of the hospital is ennobled in order to ensure a pleasant pastime for patients and for meetings with relatives visiting patients; the clinic constantly arranges musical concerts for patients. In general, everything is done so that the patient is distracted from his illness and feels the support of a team of professionals.

As for medical services, everything is aimed at the efficiency and consistency of their implementation. The appointment with the doctor lasts about an hour, so that the patient can ask all the questions that interest him regarding his condition and the method of treatment. If you came to the appointment and you need an MRI, then you will have it on the same day, and with the result of the MRI, you will be recorded for a second consultation as soon as possible, possibly right on the same day. If surgery is required, then it will be done immediately after the necessary additional examination. The administration understands that most of the patients come from other cities and do not have time to “build up”. This principle is applied in the treatment of all patients of this clinic.

2. Teamwork

The work of the clinic is arranged in such a way that the scope of functional duties is defined for each group. At the same time, departments actively interact with each other. Consultation of a specialist of a different profile will be received in a matter of minutes, if the situation so requires. The council will be assembled within 30 minutes, and at the same time, doctors do not need the presence of clinic administrators at the council. It is the policy of the medical facility that the involvement of allied professionals is encouraged, as the hospital adheres to the principle of holistic medicine, which will be discussed below. All this provides a quick solution to many controversial issues and prompt correction of therapy.

3. Holistic medicine

A very important principle, which embodies the fact that a doctor must treat a person with all his concomitant diseases. I very often heard at the institute “You should not treat the disease, but the person”, which meant: I should look at the accompanying diseases and treat them too. In practice, following this principle, I have not seen anywhere. At the Mayo Clinic, this principle has been elevated to a cult.

It would seem that I did not name anything unusual, all the principles are clear, and it seems to everyone that every doctor and every clinic should follow them, but alas. And here the point is sometimes even in the maniacal suggestion of these principles to their employees. There are also a number of organizational features in the work of the clinic. We will talk about these features further.

Liaison doctor-administrator

Doctors in the clinic have complete freedom in terms of clinical approaches. Physicians are grouped into departments, which are led by heads. Heads are replaceable and are selected from the doctors of the department. An administrator (a person with a specialized education) is assigned to such a head, helping him solve bureaucratic, analytical and economic problems. As a result, we have a department that is profitable and has fewer problems with emerging issues in which the doctor may not be competent due to the specifics of medical education.

Recruitment

In the clinic, when hiring a candidate, up to 8 people are interviewed, and this can happen in 2 stages. During the interview, attention will be directed not only to the level of knowledge and experience of the applicant, but also to how he can work in a team. The clinic employs not star doctors, but entire constellations. And of course, the clinic cannot afford to underestimate the level of employees. The institution devotes a huge share of the budget to the continuous improvement of doctors, administrators and nurses.

Well, the most important part is the creation of quality features. After all, the patient, turning to the clinic, has experience in receiving medical services and compares exactly the signs of quality when choosing a place where he will be provided with a service. In the clinic, three groups of signs are distinguished.

• Functional features - the technical quality of services, namely, how the main service is provided - treatment. Quality should be in everything: what preparations will be used, what endoprosthesis is installed during the operation, and on what machine the MRI is performed.
• External signs - the atmosphere created in the clinic: the cleanliness of the floors, the color of the rooms, repairs, decorations, the facade of the building and the territory. Agree that you pay your attention to this when you go to the hospital for a consultation.
• Interactive - the behavior and appearance of the attendants: the manner of behaving and speaking, the manner of dressing, and so on.

The clinic pays attention to this and tries to exceed the expectations of patients.

Conclusion

I am amazed at the attention to detail that Mayo Clinic leaders have, the vision and understanding of the need to invest in the process of improving the staff.

At the dawn of this clinic, the Mayo brothers already boasted a serious income, but independently limited themselves to wages, and the remaining money was used to improve the level of certain services.

Such a wonderful blade with its management and approach to management appeared in 1889. Its position is only getting stronger, despite the incredible competition in the United States, proving to us the viability of the system they have chosen. But the main secret is a sincere desire to help people, do exactly what you love and know that your work will be appreciated.

Leonard Berry, Kent Seltman

Mayo Clinic Management Practice. Lessons from the world's best service organization

© Edition in Russian. Mann, Ivanov and Ferber LLC, Eksmo Publishing House LLC, 2013

© Translation into Russian, design. LLC "Mann, Ivanov and Ferber", 2013

All rights reserved. No part of the electronic version of this book may be reproduced in any form or by any means, including posting on the Internet and corporate networks, for private and public use, without the written permission of the copyright owner.

Legal support for the publishing house is provided by Vegas Lex law firm.

© Electronic version of the book prepared by Litres (www.litres.ru)

This book is well complemented by:

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Michael George

Clients for life

Carl Sewell

Five vices of a team

Patrick Lencioni

War for talent

Ed Michaels, Helen Handfield-Jones and Beth Axelrod

Foreword by the publication partner

The right book...

The uniqueness of this book lies in the fact that it tells in a very simple language about the cornerstone principles of building a client-oriented organization, in which the service and attitude towards its clients (in this case, patients of a network of clinics) is set to the highest level. The authors constantly use living and concrete examples, using cases from the daily practice of the clinic staff, to show how one of the most important principles of the clinic is actually implemented - “the needs of the patient come first”.

A century of experience at the legendary Mayo Clinic shows that listening is one of the most important conditions in building the “right” business, what success can be achieved if the desire to “make the world a better place” is at the forefront. Even more amazing is that people were able to create a whole culture from this, which has been living for a century and is resistant to social changes. And all the more I want the book to find its reader in Russia and similar clinics to appear in our country.

Medlinesoft team

In order to conduct meaningful research and then write this book, we had to play the roles of both students and teachers. Before we became teachers, we had to learn for ourselves about an outstanding health care organization, and now we can tell you what lessons it taught us. It was an exciting and exciting journey.

We started our project convinced that we understand the Mayo Clinic and know what makes it great. We really knew a lot. However, now, when we write words of gratitude to the people who helped us, we understand how much we managed to learn. Writing a good book requires careful research and analysis. It is indeed an effective way of learning. We carefully studied the material, trying to see what we had not paid attention to before, in order to discover new patterns and relationships. But it is one thing to think about ideas and quite another to turn them into words: this activity requires a clearer and deeper understanding. When your words have a long life on the printed page, you want them to reflect the real state of things.

We tried to find words that would describe the Mayo Clinic as accurately as possible, convey the story of the services provided as honestly as possible and talk about the lessons she teaches. We are grateful to the many people who helped us on this exciting journey; his final destination was the completion of the manuscript. We were inspired to write this book by Carlton Ryder, who had a distinguished career at Mayo and retired in 2007. He was the first chief administrator of the new clinic campus opened in Jacksonville.

The history of Mayo Clinic has been written extensively, but there have not yet been books about its culture of service, strategy, management, and a systematic approach to organizing work. Ryder was convinced that such a publication would be useful not only to "outside" readers representing various corporations, commercial and non-profit organizations, as well as managers working in healthcare, but also to "internal" readers, that is, those who are directly related to the clinic Mayo. Thousands of new employees join the staff of this organization every year, and our book about the unique features of Mayo Clinic can be useful for them. Through the history of the clinic's services, this paper can help many patients (more than half a million visit the clinic a year) understand why interacting with this organization makes such a positive impression on them.

Mayo Clinic is the world's largest association of multidisciplinary community clinics and research institutes and laboratories located in three states - Minnesota, Arizona and Florida. Mayo is a one-stop shop for state-of-the-art medical care. The clinic is accredited by JCI as the most competent institution in all traditional areas of medicine and interdisciplinary medical specializations of the XXI century.

Mayo employs more than 3,300 physicians and 46,000 specialized staff. Every year, more than 500,000 patients receive treatment at Mayo at the level of the world's best standards, using innovative high technologies and new concepts of personalized medicine.

The largest medical center in the world is the Mayo complex in Minnesota - Saint Marys Hospital and Rochester Methodist Hospital, which serve more than 350 thousand patients a year inpatients and 1.5 million outpatients. Within just one working day, 205 surgeries, 41,000 laboratory tests, 700 X-ray, 3,800 radiological and 250 MRI examinations, 650 CT scans, 200 transfusions of blood components, 5,800 consultations are performed.

Mayo Clinic is a major research center. In Arizona, the Mayo system includes the largest complex of research institutes - Samuel C. Johnson Medical Research Buildings and Mayo Clinic Collaborative Research Building. It develops and implements research programs in the field of molecular genetics and biology, in many other relevant areas of biomedicine in close cooperation with clinicians. On the basis of Mayo Clinics, clinical trials of the latest drugs are conducted, and the latest developments in the field of pharmacology are available to patients.

The Mayo Clinic in Florida is a multi-specialty hospital complex specializing in 43 medical, predominantly surgical specialties ranging from ophthalmology to orthopedics. Major achievements are noted in oncology, neurology and neurosurgery, transplantation of organs and cells. In Mayo Clinic Hospital's 22 operating theaters, all types of surgical interventions are performed - from minimally invasive manipulations to the most complex operations involving several surgeons of various specializations and the use of robotic systems, the use of MRI scanning during surgery. The Department of Transplantation performs the largest number of liver transplants in the United States, transplants of the kidneys, heart, lungs, pancreas, and bone marrow are put on stream. The stroke treatment program in the specialized center is carried out by a multifunctional team, which includes intensive care physicians, neurosurgeons, neurologists, radiologists, nurses, psychologists, and social workers.

Mayo Clinics is an excellent training base for many medical colleges and universities to specialize in doctors and nurses.

Mayo does a great job of educating both the population of the United States and the whole world, widely informing the users of its site about its own achievements in practical medicine and scientific work. Such work is an important part of preventive medicine and early diagnosis of diseases.

Mayo patients in the United States and many other countries can be sure that they are receiving the best medical care in the world.