Mayo Magazine

A Conversation with Denis A. Cortese, M.D.,
President and Chief Executive Officer, Mayo Clinic

A native of Philadelphia, Denis Cortese (whose first name, reflecting his French heritage, is pronounced "Denny") earned the B.A. degree at Franklin & Marshall College in Lancaster, Pa. He received the M.D. degree from Temple University in Philadelphia and trained in the fields of internal medicine and thoracic (chest) diseases at Mayo Clinic.

Dr. Cortese is a respected researcher and professor of medicine, whose students twice named him Teacher of the Year. He is active with many national and international organizations and scholarly publications related to his specialty interests. His numerous professional honors include election to the Royal College of Physicians, London, and the Institute of Medicine in the United States.

Dr. Cortese also has a distinguished career in medical administration. For more than 20 years, he has served on principal boards and committees of Mayo Clinic Rochester; from 1999 to 2002, he was chair of the Board of Governors, Mayo Clinic Jacksonville. Dr. Cortese became president and chief executive officer of Mayo Clinic in 2003.

You often describe Mayo Clinic as a learning organization. What does that phrase mean?
It explains who we are, what we do and where we're going. With a learning organization, you have professionals who've mastered a body of knowledge. They're applying it in their daily work, they're generating new information and they're passing on what they know to others. Learning organizations develop in many fields of endeavor — business and industry, academia and, in our case, health care.

How does Mayo fit that definition?
We have all the components of a learning organization in place. These components are the foundation of our culture. Not only do we practice state-of-the-art medical care, we're also focused on continuously advancing that standard.

We advance medicine through research — making discoveries and translating them into better ways of caring for patients. We advance medicine through education — communicating with the medical profession, our patients and the public. For example, we're adding Mayo's voice to the debate on health care reform through our new Health Policy Center.

We also tap other disciplines to advance medicine. Systems engineering helps us work more effectively. We streamline our processes, resulting in improvements such as more efficient coordination of a patient's test results. Another discipline is information management. By processing vast amounts of data, we can pinpoint the early symptoms of a disease or adverse reactions to a medication.

Still, I know we can do better. When I hear about Mayo Clinic colleagues finding ways to improve aspects of our work, I always ask if we're passing on that knowledge. Are we reaching our potential as a learning organization? We need to keep pushing ourselves, looking for a better way.

What's your vision for Mayo Clinic?
I believe this is a pivotal time in health care, and Mayo Clinic has a moral imperative to provide leadership.

The genomics revolution is transforming medicine by revealing the fundamental processes of human life. In my view, Mayo is ideally positioned to apply those discoveries to an area that's always been our main focus — the care of patients. We will be the world leader in applying the newest genomic information to the prediction, prevention, more precise diagnosis and tailored treatment of diseases for individual patients.

No other medical center connects the laboratory with patient care as effectively as Mayo Clinic. Take one example: pharmacogenomics. This field involves determining how an individual's genetic differences affect his or her response to drug treatment. It's a way for doctors to know ahead of time if the medication they are considering will help, harm or have no effect on a patient. Mayo Clinic is leading the way in this field.

This kind of innovation — focused on the patient — is what we're all about, and it sets Mayo Clinic apart from other medical centers. It's an incredibly exciting time. We have the potential to accomplish more in the next decade than we did in the past century.

How is Mayo's research transforming patient care?
Think about conditions like cancer, heart disease and neurological disorders. They're some of the leading causes of death and disability in our nation. Research is opening the era of individualized or personalized medicine, increasing our ability to determine who has a higher risk for these and other conditions.

We know that effective treatment doesn't mean 'one size fits all.' In the future, we'll be able to customize your treatment plan and intervene at the earliest stages, even at the point of prevention. This will have a huge impact on quality of life for patients and cost savings for society.

Mayo can deliver those results across a wide spectrum of conditions. To take one example, Mayo has the nation's first multisite comprehensive cancer center. It includes each of our campuses — Rochester, Minn., Jacksonville, Fla., and Scottsdale and Phoenix, Arizona. The center is involved with a broad spectrum of research — including basic science in the laboratory, clinical trials for patients who want to try new treatments and studies of risk factors and treatment methods in large population groups. The synergy of this research — all under the umbrella of Mayo Clinic Cancer Center — has a transformative impact on the care that patients receive.

You mentioned Mayo's three campuses. Please explain the concept of 'one Mayo Clinic.'
Each Mayo campus has its own unique strengths — but what's more important is how they work together. The goal is that wherever you go at Mayo, you'll have a seamless experience of quality care.

Transplantation is another example of integration among our three campuses. Mayo has one of the nation's largest transplant programs, with some of the highest survival rates. Whether it's Mayo Clinic Cancer Center, the transplantation program or our initiatives in Alzheimer's disease and other conditions, the key is teamwork. Our specialists unite their skills, always pushing the frontier of knowledge and always focused on what's best for the patient.

We've discussed patient care and research, two of the three shields in the Mayo Clinic logo. What about the other part of Mayo's mission, education?
It's obvious that no one can master all the knowledge in a given specialty field. And with today's complex technology, we know it's important to understand techniques and procedures before working directly with patients.

We've developed two initiatives — the Education Technology Center (ETC) and the Multidisciplinary Simulation Center — to meet those needs and define the future of medical education.

What is the Education Technology Center?
The ETC is a computer-based system — a comprehensive, interactive repository of medical data. This virtual center collects and organizes state-of-the-art information, providing what your doctor needs, when he or she needs it — whether it's in the classroom, the office or your hospital room.

Using this system, physicians and other professionals can dig deeply into a topic, asking questions about a symptom or procedure. The system offers tests and scenarios to enhance each user's understanding of the topic. The ETC helps your doctor customize the treatment you receive.

And the Simulation Center?
It opened last year in the Stabile Building in Rochester, with computer and video connections throughout Mayo Clinic.

The center takes a revolutionary approach to hands-on learning. It's a high-tech environment that imitates actual patient-care episodes. The center has life-size mannequins that 'respond' as a human would to procedures and medications.

Students and seasoned professionals alike — from a wide range of specialty fields — go there to master specific skills before applying them to patients.

The center teaches techniques, but equally important are the lessons in teamwork and communication. Participants in the center learn to work with colleagues to meet the patient's needs.

Both of these new initiatives are off to a great start. With the dedication of our staff and the support of our benefactors, they'll continue to grow.

How does philanthropy support Mayo's mission?
Philanthropy has always been part of Mayo Clinic, but today it's more important than ever. To fund new buildings and technology, we depend on private support. Initiatives like the ETC and Simulation Center are possible because of generous gifts.

In terms of research, our scientists compete successfully for grants from the National Institutes of Health and other organizations — but these grants rarely cover translational research. Philanthropy bridges that gap. We recently established a Discovery and Innovation Fund as a catalyst for benefactors who want to help us speed the translation of discoveries into better ways of fighting disease.

Why is the Mayo Clinic endowment so important?
It funds our future. When you give to the endowment, the principal of your gift remains in perpetuity. Every year, a portion of the interest income supports the priorities that you and Mayo identify.

One of my goals is to increase the endowment. We took the unprecedented step of creating the Endowment Matching Gift Program for Mayo's highest priorities. Mayo is matching — dollar for dollar — the annual income from benefactor-designated endowed funds. This program represents a partnership with our benefactors and patients in the best sense of that term.

You're the CEO of Mayo Clinic, but you describe yourself first and foremost as a physician. What have you learned from your patients?
Many things, but the most important is trust.

When I was practicing in Jacksonville, I treated a patient with Wegener's granulomatosis, a disease characterized by inflammation of the blood vessels, which damages vital organs. My patient was a 38-year-old man, married, with two young children. We tried all the treatments to no avail, and he was on a ventilator. When his family made the agonizing decision to turn off the ventilator, I was out of town. They decided to wait until I got back.

This was an incredibly humbling but inspiring experience for me. It made me more determined than ever to fight the diseases that our patients face, and it reminded me again that our patients hold us in great trust.

The heart of Mayo Clinic is that we're here for our patients. Everything we've been talking about comes down to making sure we have the time, the knowledge and the tools to do our best for every patient, every day. There's nothing more important than that.