Noseworthy: 'It's been a good run'

As the curtains come down on his 28-year career with Mayo Clinic, Dr. John Noseworthy has a final message to deliver: Despite uncertainty in the external world, Mayo Clinic remains as strong as ever.

Noseworthy, 67, is retiring from Mayo at the end of the year following a distinguished career that began in neurology and concluded with a decade-long stint as president and CEO of the 63,000-employee system.

“It’s been a good run,” Noseworthy said this week during an interview with local media from inside the Plummer Building library.

Noseworthy said he is unsure what the future might hold. For now, he plans to stay in Rochester and perhaps take up the piano. In the event he does come out of retirement — which he is not ruling out — it won’t be to continue his practice, an option for retiring CEOs of Mayo. Instead, he would be looking for an environment where he could “bring the voice of the patient and the voice of the medical profession” to advance healthcare.

During the course of Noseworthy’s tenure, Mayo was forced to confront some of the most complex problems in American healthcare as political turbulence and advances in technology swept through the industry.

There was the implementation of the Affordable Care Act, and the backlash that followed it. There were breakthroughs in medical research and debates on the ethics of them. And there were issues, like the role of money in medicine, that continued to challenge Mayo’s commitment to the patient.

Still, through the disruptions, Noseworthy said the organization became more resilient — without ever straying from its founding values.

Mayo continued to invest heavily in its three campuses, including making a $3.5 billion pledge toward Rochester as part of the Destination Medical Center project. The Clinic also leveraged new partnerships to expand its global footprint, increased its annual revenues ($7.9 billion in 2010 to $12 billion in 2017) and maintained a ranking as the top hospital in the U.S.

Speaking to reporters, Noseworthy credited the success to the staff and culture at Mayo. Following the advice of his predecessor, Dr. Denis Cortese, Noseworthy said he made it a point to stay close to the people of Mayo so he could better understand issues from their perspective.

“You know the proverb, ‘you want to go fast, go alone. If you want to go far, go with others.’ That plays out every single day at the Mayo Clinic,” said Noseworthy. “And patients notice it, usually within a few minutes of coming here... that there’s something different about this place.”

Replacing Noseworthy will be Dr. Gianrico Farrugia, a longtime Mayo physician who had been heading up the Clinic’s Florida campus.

Because of Farrugia’s experience, which includes 26 years in Rochester, Noseworthy said he expects a seamless and smooth transition of power. He described Farrugia as a “futuristic thinker” who understands Mayo well.

“My advice to him would be: listen well, listen often,” said Noseworthy. “Understand the community, understand the people of Mayo, and help convey the next step of where we’re going.”

Below are a few more excerpts from this week’s exit interview.

On making healthcare a priority

Even as he reflected on the organization’s achievements over the past 10 years, Noseworthy acknowledged Mayo Clinic’s limitations in addressing some of the deficiencies in America’s healthcare system.

“There is a lot Mayo Clinic can do,” he said, “but society basically has to make a decision — does America want to have an affordable, accessible, sustainable, high-quality healthcare system? That’s a national decision.”

To achieve a better system, Noseworthy said the voices of the patients and providers will need to be brought into the discussion more. He added that creating a better model will also require other sectors — insurance, transportation, education — working together with government.

“At the moment, [healthcare] has not been the top priority of the United States. It just hasn’t,” Noseworthy said, lamenting about the state of politics. “We’re locked into these two-year election cycles where ‘we’re going to do this’ or ‘we’re going to do that’ and back and forth. And it’s a very narrow look of the whole spectrum of health and healthcare. I think when the country decides that it’s a priority of its citizens, Mayo Clinic will continue to do what it’s always done — and that’s provide our best advice.”

On the Austin/Albert Lea merger

No other decision made during Noseworthy’s tenure was met with as much backlash as the one to consolidate Mayo services in Austin and Albert Lea.

“We hadn’t engaged the community adequately,” Noseworthy said this week. “That was bad on us. It was our mistake.”

Noseworthy said Mayo was having trouble for years finding the high-quality workforce needed to sustain both locations. Fearful the workforce shortage could be affecting the quality of care, Mayo commissioned an 18-month study analyzing every aspect of the operations.

The study, according to Noseworthy, concluded that Mayo could not sustain all services in both hospitals and that consolidation was necessary to ensure higher quality care and better outcomes.

Nobody lost their job in the transition — but the move rattled rural areas where Mayo has a presence and put the Clinic on the defense.

Noseworthy admitted this week that the situation could have been handled better, but added that it would have been worse had they not acted.

“We did not handle that well,” said Noseworthy. “I take full accountability for that. But it was the right answer.”

On continuing to innovate

Heading into the second decade of the 21st century, Noseworthy realized Mayo had a problem: too many good ideas were leaving the organization.

Despite the entrepreneurial legacy of its founders, Mayo had been hesitant to allow its physicians and researchers to start spin-off businesses of their own.

“We were falling behind, I felt, in our entrepreneurship efforts,” said Noseworthy, adding that “our policies and our environment were not fostering entrepreneurial activity.”

In 2011, Noseworthy made the decision to begin loosening restrictions on entrepreneurial activity — opening the door for employees to launch startups. The move has resulted in the emergence of a number of new promising biotechnology companies in Rochester.

“I think we’ve navigated that very well,” Noseworthy said regarding the need to balance entrepreneurship with the values that have guided Mayo for more than a century. “We’ve realized that entrepreneurship is where we came from and entrepreneurship is part of where we’re going.”

On his legacy

This fall, filmmaker Ken Burns released his long-anticipated documentary highlighting the history and culture of Mayo Clinic.

Burns routinely offered praised for the Rochester-based medical practice. But when asked about Mayo’s role in current events, Burns said the verdict is still out. His job as a historian, he said, was to reflect on the past.

So, we asked Noseworthy what a future historian might say about the Mayo Clinic of the 21st century. He told us: “I’m hopeful that they will say, in spite of the Great Recession, all the tumultuous changes, social medias, social unrest, two different administrations in Washington, all that stuff, that Mayo was a steady ship that navigated itself well and became stronger and advanced its mission.”

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Cover photo: Dr. Noseworthy at his retirement reception / Mayo Clinic