Archive for Saturday, February 23, 2013

Simons’ Saturday Column: Clinic’s high standards provide example for others

February 23, 2013


“We can no longer take for granted that what makes Mayo so special will continue,” said Dr. Michael Brennan, director of Mayo Clinic’s program in professionalism and ethics. He is a consultant in the division of endocrinology, diabetes, metabolism and nutrition at Mayo Clinic in Rochester, Minn., and a professor of medicine.

“Rather,” he adds, “we must take deliberate, meaningful steps to make sure the values of professionalism are internalized by all who work here.”

Think how great it would be if this were the prevailing philosophy or motto of most private businesses, even our government.

The Mayo Clinic program in professionalism and ethics is far more than a nice-sounding slogan. Those at the Mayo Clinic work to advance professionalism through employee training and orientation, scholarly activity and national and international conferences. This model of professionalism is tied to the clinic’s operating plan, which seeks to create a health care workforce of the future and sustains Mayo’s values. This philosophy and model are made quite clear to every member of the Mayo operation. The level of how well this belief is practiced can be used in annual staff and employee performance reviews and staff credentialing, recertification and medical licensure.

Brennan notes, “Documentation of competence in professionalism is now a requirement for credentialing, accreditation and recertification.”

He adds, interest in professionalism has increased among other professional organizations, regulatory bodies and medical educators.

There are 12 elements in the patient-centered Mayo plan.

  1. Engender trust and confidence by considering our patients foremost as people — people with illnesses; care about the person while caring for their illness.

  2. Partner with our patients, respect their values, acknowledge their autonomy, protect their safety and preserve their confidentiality.

  3. Provide care that is supported, to the extent possible by valid and reliable evidence, while taking into account individual personal needs and preferences.

  4. Be collegial and supportive of colleagues, master teamwork skills and acknowledge the contributions of all.

  5. Celebrate diversity and promote a respectful and trusting environment that is conducive to speaking up and listening.

  6. Promote affordability of care through prudent use of resources.

  7. Develop and practice superior communication skills.

  8. Be disciplined in completing tasks and responsibilities and serve as a positive role model and mentor.

  9. Continually improve skills, pursue scholarship, seek and generate new knowledge and share it generously.

  10. Be accountable and hold others accountable.

  11. Attend to personal physical, emotional and spiritual well-being and strive to achieve a healthy balance.

  12. Discourage cynicism, reject arrogance, engage actively in the life of Mayo Clinic, live its culture and values and preserve its facilities and healing environment.

These are the Mayo elements of professionalism. Why couldn’t they be applied to most any business or professional organization? Or used by an individual to guide how he or she conducts activities and relationships with other individuals. Instead of patients, think about customers or your neighbor.

Kansas University Hospital has become one of the nation’s foremost and highest-ranked university-related teaching hospitals, and one reason is that taking care of the patient, making sure the patient comes first, is the driving philosophy and practice at the Kansas City, Kan., hospital. Fifteen or 16 years ago, the hospital was in bad shape. There were three options: close the hospital, sell the hospital, or make it work. Hospital officials chose the latter, and, through the visionary and tough leadership of Irene Cumming and now Bob Page and the buy-in by all doctors and staff members, the hospital transformed itself from a poor, struggling and financially stressed facility to Kansas City’s best hospital and one of the nation’s elite teaching and research hospitals.

Those at KU Hospital share many of Mayo’s elements of professionalism.

In addition to being guided by the “12 elements,” Mayo also places great emphasis on improving the communication skills of those at the clinic. A communications program is offered to all new Mayo doctors. Physicians practice communicating with patients in simulation scenarios that include listening without interrupting, delivering bad news, describing procedures and operations, obtaining informed consent, providing patient education and responding to a range of emotions.

Dr. Amy Connors a consultant in the department of radiology in the division of breast imaging and intervention, says, “Giving patients the best possible experience and the highest quality of care includes communicating directly, honestly and compassionately. This has a huge impact on our relationships with them and on their outcomes. You can be the best doctor in the world, but if you can’t communicate effectively, you’re not going to be very effective at helping our patients. They need great communication in addition to great care.”

Again, why not apply this same thinking to other businesses or in an individual’s life?

The Mayo Clinic is recognized as offering the “gold standard” of health care. However, Mayo is not alone. There are large clinics such as the Scripps Clinic and the Cleveland Clinic and other fine hospitals that offer excellent health care.

This writer is not suggesting the Mayo, Scripps or Cleveland clinics’ plans or the KU Hospital plan should be THE blueprint for all health care facilities or businesses or governments but rather that the ideas, goals and a commitment to professionalism and ethics by any and all would be good for this country.

The idea of “anything goes,” where poor manners are tolerated and carelessness is accepted, where those in government or private business are allowed to lie or deliberately mislead, where communication skills are deteriorating and millions of Americans rely on government assistance and where being “average” rather than “excellent” is the common yardstick all suggest a society that needs a loud wake-up call.

The Mayo plan and commitment to professionalism and ethics may be looked upon by many as too demanding or not applicable or appropriate to their particular business or occupation, but why not set some challenging standards rather than coasting, doing just what comes easy?

Isn’t it important for this country to have a plan or goal of professionalism and ethics to help insure the nation creates a populace and workforce of the future that sustains the values that have made this country great?

Perhaps it is understandable and makes sense that a place like Mayo, Scripps, Cleveland Clinic or KU Hospital, which are recognized as the best, emphasize professionalism and ethics in one manner or another. Good health care is pretty damned important — often the difference between life and death. Those recognized as delivering the best in health care can’t tolerate average, mediocre or sloppy care.

Can this country afford, or long sustain, a society that accommodates or makes excuses for being average or careless and lowering its standards of personal performance and behavior and find a way to rationalize or minimize the importance of ethics?


appleaday 5 years, 2 months ago

All it takes is millions of dollars from both private and government funds:

Financial Information (in millions) Total revenue, gains and other support $8,476 Income from current activities $610 Total assets $10,129 Contributions from benefactors $318 Education and Research funding sources
Government, foundations and industry $418 Mayo Clinic funds and benefactor gifts $421 Mayo Clinic Facts

Download 2011 Mayo Clinic Facts & Hightlights (PDF)

Carol Bowen 5 years, 2 months ago

And? Do you take exception with their example?

appleaday 5 years, 2 months ago

Absolutely not. I was just pointing out that excellence isn't free or cheap. I work in health care and have nothing but respect for the work done by the Mayo Clinic.

Carol Bowen 5 years, 2 months ago

Oh, I see. Then I take back my comment. Sorry.

appleaday 5 years, 2 months ago

I agree with your later comment below.

Armstrong 5 years, 2 months ago

Hmmm, high standards and expectations - who knew ?

yourworstnightmare 5 years, 2 months ago

I agree with Mr. Simons. Let's start with the Kansas legislature.

Carol Bowen 5 years, 2 months ago

The Mayo Clinic is a non profit organization. It started with principles and no money. It is still non profit and provides cutting edge research to its patients and the general public. The doctors are on salary rather then charging for each visit. (fee for service). These clinics are the model for the Affordable Care Act.

Carol Bowen 5 years, 2 months ago

Billybob. Your comment was inappropriate and irrelevant. Stay on topic. Skip the personal insults.

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