Cleveland Clinic CEO Dr Delos Cosgrove talks with Brunswick’s Anita Scott about better healthcare through teamwork
Before his appointment as president and CEO of the Cleveland Clinic in 2004, Dr Delos “Toby” Cosgrove performed 22,000 surgeries as a heart specialist at the nonprofit medical practice.
Two years into his tenure as CEO, Dr Cosgrove oversaw a move that seemingly lacked the delicate touch one expects from a world-renowned heart surgeon: in Dr Cosgrove’s words, Cleveland Clinic “got rid of all its employees.”
Instead, everyone working at the world’s second-largest private medical practice became a “caregiver.” Mandatory training sessions and discussions accompanied the name change, which cost an estimated 20-plus million dollars to implement. More than a decade later, the organization has an annual operating budget of $8 billion and 52,000 caregivers worldwide – and still boasts zero employees.
The rationale behind the move? One, it helped unify the organization’s team of workers across the world. And two, changing how employees thought of themselves helped change the quality of care they provided. “Everybody here is, in one way or another, directly and indirectly involved in taking care of patients,” Cosgrove told Brunswick in a recent interview. “And it’s important that everybody feels they’re involved.”
Data suggests the initiative worked on both counts. In 2008, Cleveland Clinic’s patient satisfaction scores, measured by the US government, were in the 32nd percentile. In 2016, it scored in the 79th percentile.
And its caregivers are engaged. While employee surveys are often ignored in other companies, Cleveland Clinic’s 2017 survey had an 85 percent participation rate. A clearer demonstration of team members’ interest and investment in the company: Cleveland Clinic’s turnover rate in Ohio – including retirements, deaths, and departures – is only 5.5 percent. The average turnover among hospitals according to PwC’s latest report, was 17 percent.
If its approach to engaging employees is distinctive, so too is its structure. Cleveland Clinic is a group practice. Its 3,600 group members elect leaders and participate in decision making.
Another uncommon practice: Cleveland Clinic’s doctors are salaried, receiving no bonuses or financial incentives. This means physicians don’t make money by ordering tests or performing operations. All doctors sign one-year contracts and receive annual performance reviews – standard in the business world, but not among Cleveland Clinic’s peers.
The Cleveland Clinic’s three-part mission of clinical care, research, and education is “a bit like a tricycle,” says Dr Cosgrove. “The big wheel is clinical care – that’s the name of our organization; it’s what’s on the door. Our education and research support and strengthen the clinical practice.” Though they play supporting roles,
the group’s education and research practices are significant: among other initiatives, they provide the only tuition-free medical school in the US and have allocated roughly $250 million toward medical research.
Dr Cosgrove has announced he will step down from the CEO role at the end of 2017, but will stay on in an advisory capacity to help the incoming CEO. In our discussion, he told Brunswick how Cleveland Clinic’s model is evolving through technology and teamwork to match the ever-more complicated demands of healthcare.