Summary Notes (PDF) - AAMC

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Delos M. Cosgrove, M.D., Chief Executive Officer, Cleveland Clinic Health System
About Cleveland Clinic:
Tripartite nonprofit group practice, physician lead, salaried, annual review take seriously that go to the board of governors, salary adjusted based on
contribution to organization. Made it patient care centric.
How they are organized is to be patient centric first and not function as a guild –moved from departments to institutes that focus on patient problem or disease.
Started with Neurology, Psychology, Neurosurgery. The change created so much anxiety they decided to do it all at once rather than dragging it out and it was
very successful. No one has talked about going back.
Example of hiring mistake was when they hired a Nobel laureate who left after six weeks because he wasn’t hired for leadership skills.
RRC had trouble understanding what was happening – now all accredited
New model Improved collaboration – fostered innovation – (innovation takes place at the boarders of disciplines)
Recruiting and retaining good chairs/leaders requires recruiting for those skills. It is about leadership not just the CV
Skills to lead include – empathy, street credibility, communication.
Organization has adopted a team mindset – everyone is called CAREGIVER which had huge impact on how people perform their roles as well as interact.
Discussion:
Was it difficult to get transition? Not difficult
How do cross subsidies work in this model? All centralized then goes out (always had this)
Cost? Turnover? Physical arrangement? Moved the deck chairs, at the time just started a new building project moved Heart and Vascular first. Backfilled after
that. Lost almost nobody, no cost impact.
How do you do evaluations? Evaluations are done by institute leaders then sent to board of governors
How do you open up when looking for a leader – how do you identify traits you are looking for? Standard process – biggest failures have been personality not
competence
1 year contract with faculty – no tenure, Salary done based on contribution to clinic – The do not give academic appointments (Lerner fills that role)
Regular communication with all staff important with meetings, TV recording, electronic
Fact that group practice and docs lead is secret sauce – don’t have pockets of money it is all one to help make common decision
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