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Obama Touts Mayo Model For Health Care Reform

Mon, 08/03/2009 - 7:49am
by Jeff Hansel

ROCHESTER, Minn. (AP) — President Barack Obama seems to talk more about Mayo Clinic lately than the medical center itself does.

Obama points to Mayo as one of the lowest-cost, highest-quality health systems in the country, one he'd like health reformers to emulate.

Statistics back that up. Mayo's hospitals in Rochester, combined, were recently named the second-best hospital in the United States by US News & World Report. And the Dartmouth Atlas confirms that Mayo uses fewer resources and spends less per capita than its peers "while simultaneously receiving high marks on established quality measures."

A 2006 Dartmouth report says it cost Medicare patients at Saint Marys Hospital $34,372 during the final two years of life, whereas it cost their counterparts at Cedars-Sinai Medical Center in Los Angeles more than double — $71,637.

A peek behind the statistics gives an idea of how Mayo does this.

Pueblo, Colo. resident Jacob Chi, an internationally recognized orchestra conductor, and his wife, researcher Lin Chang, sought a surgeon most skilled at the heart surgery Chi needed. They ended up at Mayo's Saint Marys Hospital in Rochester. Chi is director and conductor of the Pueblo Symphony Orchestra.

His wife drew comparisons between his work and the work of Mayo cardiovascular surgeon Dr. Thor Sundt, along with Sundt's medical team.

"Dr. Sundt has his own orchestra that he's conducting," Chang said. Each person in the operating room has specific duties, she said.

For example, when her husband was taken to the OR, there was a specific person whose job it was to guide her to the waiting area.

"Everybody together — the ICU nurses, everybody — they're very professional," she said. Chi said he's fortunate to have insurance that covered his July heart repair.

"I think I did receive the best service in the world. It's beyond my imagination," he said.

Whether the Mayo model can be applied "to every corner of the world," he said, "I don't know."

Mayo Health Policy Center officials have argued that a team approach to medical care saves money because professionals from various specialties all consult with the patient at the same time, saving delays and allowing a reasoned, team decision that's ultimately best for the patient.

When he conducts an orchestra, Chi said, he performs work similar to surgery, so he understands why Mayo's team approach has been cited as a way to save costs.

"There's no mistakes allowed," he said. "It's something that we shared; no mistakes allowed."

Sundt grew up in Rochester, but trained at Johns Hopkins and worked elsewhere before returning to practice at Mayo.

There are cultural differences at Mayo that he appreciates.

"I feel perfectly comfortable here saying that somebody should not have surgery," he said, whereas doctors elsewhere might feel pressure to perform it.

Sundt also recognizes that Mayo has a community history that might be hard to replicate elsewhere. Everyone in town from bus drivers to hotel clerks and restaurant servers feed into the care patients receive here, he said.

The fact that Mayo physicians are paid a set salary, regardless of how many surgeries or tests they perform, encourages higher quality care at lower cost, Sundt said.

At Mayo, "my job is to take the best care of the patients, it's not to worry about how much I get paid," he said. That makes it easier to make decisions based on what's best for the patient.

"If you do the right thing, in the end it should all work out," Sundt said. "I have a sense of this being an 'organized' organization," Chang said. "There's efficiency there."

Once her husband's surgery was done, there was someone who was "right there at the door" to get her. "It just gives you a sense of order," she said.

 

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