Health care leaders must recognize that change comes quickly, says the CEO of Mayo Clinic, and from places they might not expect: technology, data, and consumerism.
He also stresses the need to chip away at administrative and clerical burdens so that staff can focus on the tasks they truly enjoy.
NEJM Group
Gianrico Farrugia, MD and Thomas H. Lee, MD, MSc
July 9, 2020
Thomas H. Lee, MD, MSc, interviews Gianrico Farrugia, MD, President and CEO of Mayo Clinic.
Summary
In a discussion with NEJM Catalyst, Gianrico Farrugia, MD, President and CEO of Mayo Clinic, describes a strategy focused on the need to
- cure (the traditional core mission),
- connect (to develop tools to simplify care and eliminate fragmentation),
- and transform (to use a digital data platform that can deliver knowledge and insights globally).
He cautions that change comes quickly now and from places we might not have imagined: technology, data, and consumerism.
He also stresses the need to chip away at administrative and clerical burdens so that staff can focus on the tasks they truly enjoy.
Tom Lee: This is Tom Lee, Editor-in-Chief for NEJM Catalyst, talking with Gianrico Farrugia, who is the CEO and President of Mayo Clinic and the overall system.
He is leading a new strategy that has three major components — cure, connect, and transform within — which are going to be of interest to everyone in health care.
But before we get to that, our listeners [might] like to hear a bit about the Gianrico Farrugia story. If you don’t mind, take a couple of minutes to tell us where you’re from, and how did you make your way to Mayo?
Gianrico Farrugia: Thanks for having me. I’m not quite sure that listeners are going to have that same enthusiasm you have for my story, so I’ll make it short.
I was born and raised in Malta. My father was a physician. He was highly motivated to make Malta a better place, and of course he had a big impact on my decision going into medicine, and we have other physicians in our family, including my brother.
During medical school, I met a physician; he’d just come back from a fellowship at Mayo Clinic. He was excited about his experience. He subsequently joined the Mayo Clinic staff, and we kept in touch.
He arranged for me to interview for residency, and I was lucky enough to be accepted.
I left Malta in 1988 and I’ve been now with Mayo Clinic for 31 years. Five years ago, I went to lead Mayo Clinic in Florida and have been in my current role for about a year [and a half].
Tom Lee: You are a gastroenterologist and still running a research program, I understand?
Gianrico Farrugia: That’s correct. I have an NIH-funded lab [translational laboratory focusing on the enteric neurosciences], and up to now, we’d been able to keep things going by having a lot of help from a lot of people being with me for many years. I still enjoy keeping up to date with what’s going on in gastroenterology.
Tom Lee: Some of your colleagues have told me that you are an interesting combination of being both an outside and an insider, that even though you’ve been at Mayo for more than 3 decades, you are being seen as a change agent.
Gianrico Farrugia: I wonder who you spoke to, but I’ll leave that alone.
Let me start off by saying I have an unwavering commitment to Mayo Clinic and its values.
Its salary philosophy, the committee-driven decision process, the obsession with the needs of the patient coming first are, to me, inviolate.
We have a legacy of servant leadership, and it’s something I truly believe you need if you’re going to be a successful leader at Mayo.
We have a legacy of servant leadership, and it’s something I truly believe you need if you’re going to be a successful leader at Mayo.
But I also believe that if you’re going to be a leader, you need to be a change agent.
Reacting to change is not going to get us to success.
Change is not linear. It doesn’t work like that anymore.
It certainly doesn’t work in health care.
A servant leader is still a leader, and therefore you cannot abdicate on your responsibility to lead. So, you have to be a change agent.
A servant leader is still a leader, and therefore you cannot abdicate on your responsibility to lead. So, you have to be a change agent.
You have to learn how to anticipate change, and that’s different from the past, where perhaps health care leaders were able to better understand where things were going to go and then adapt to them.
Now change comes quickly, as you very well know. It comes from places we wouldn’t have imagined: technology, data, consumerism.
I truly believe leaders cannot just respond to what’s happening. They have to anticipate where things are, where things are going, and then they have to chart a course for their organization to get them there.
Leaders cannot just respond to what’s happening.
They have to anticipate where things are, where things are going, and then they have to chart a course for their organization to get them there.
Of course, gut-checking everything with their organization’s value.
For me, being a change agent is somebody who can be the best form of a servant leader.
For me, being a change agent is somebody who can be the best form of a servant leader.
You’re a servant leader, but at the same time, you can take measured risk, which is very different from being risky, taking risky behavior.
The last point I’d make here is that if you’re going to effect change, you need to be authentic; you need to be transparent about it.
When you think about a better way, you better have the data and the information to back it up, and then, as I said, be willing to assume some risk.
I very much believe that with the right structure, with the right people, with the right space, with the right technology, we truly can get to new or better cures.
But in order to cure, we also need to connect, and we need to transform.
I very much believe that with the right structure, with the right people, with the right space, with the right technology, we truly can get to new or better cures.
But in order to cure, we also need to connect, and we need to transform.
Tom Lee: Let’s talk about where you’re trying to lead Mayo [with] the three major elements of cure, connect, and transform within.
I know that you have specificity for what those three things mean. What do you hope will be different in the decade ahead because of the work you’re launching now in those three areas?
Gianrico Farrugia: What’s critical is that we describe Mayo Clinic’s strategy as a strategy that leads us to 2030 and beyond, and it’s bold forward.
It’s a plan to be a bold leader as an organization in creating the future of health care, transforming health care from within rather than waiting for others to transform it for us.
We truly believe health care needs to be transformed, and we believe that we in health care are the ones that have to lead. We have this strategy.
It’s a strategy that can be best described by those three words you mentioned: cure, connect, and transform.
Cure is all about our traditional core of Mayo Clinic,
… the mission of providing team-based medical expertise for patients with complex or serious conditions, provided to people who are either local or are willing to travel to come for their cures.
I very much believe that with the right structure, with the right people, with the right space, with the right technology, we truly can get to new or better cures.
But in order to cure, we also need to connect, and we need to transform.
That second word, connect, is about dealing with health care’s complexity, its fragmentation, its inaccessibility.
This is the time. We have the right digital technology to innovate, to simplify health care for patients. This is where we will develop those physical and virtual tools so we can connect with patients when and wherever they need it and in ways that they’re so accustomed to in other spheres of their life but not in health care.
The last one is transform, and that’s about building Mayo Clinic as a platform, moving all of Mayo’s data onto a platform so we can extract new knowledge from it.
That will mean that we now can deliver digital knowledge and insights globally.
We can provide world-class health care globally while at the same time informing our own practice.
We’re moving forward in three main areas:
- home hospital,
- clinical data analytics, and
- advanced digital diagnostics.
The platform will help us
- connect with patients more effectively,
- deliver care when our patients need it, and
- do it in a way that still provides that unparalleled experience with the highest quality and
- always with that human touch that health care so much continues to need.
Simplification is necessary if you’re going to transform health care from within.
Our staff — we, you, me — got into health care because we wanted to help people, and having a joyful, resilient, flexible, diverse workforce will be imperative to our success.
Tom Lee: I’ve heard also that as you do this work, you’re giving great emphasis to simplification for patients and for providers.
That sounds good because we all know that health care has become unbearably complex. What does it mean to do this work? How do you go about it? Is there an example you can give of either the problem or an early success story?
Gianrico Farrugia: Let me start with saying why. Why am I so passionate about this?
Simplification is necessary if you’re going to transform health care from within.
Our staff — we, you, me — got into health care because we wanted to help people, and having a joyful, resilient, flexible, diverse workforce will be imperative to our success.
The future calls for staff who are innovative, who are empowered, who are adaptable to the changes we all know are coming.
We as leaders now have a responsibility to empower and energize our teams to create solutions for our patients and even for each other.
And our staff cannot do it, nobody can do it if you’re bogged down in all sorts of administrative work.
We started off and were direct about saying we need to streamline how many committees are needed to get to a yes, that we will place more trust in you as our employees.
We will reduce little things; we took away pretty much all travel documentation, placing our trust in our employees and chipping away at all the administrative burdens so that we can focus on the tasks they truly enjoy.
What we’ve done is we’ve asked every one of our employees to help other employees and all our patients find joy in the Mayo experience, because if they do so, we know they will, in turn, experience joy themselves.
And I’m a human-focused person, but I very much know that technology will play an even bigger part.
I see AI [artificial intelligence] as further reducing clerical burden so that our staff can tackle complex, interesting, and innovative projects.
It’s better for them, it’s better for us, and it’s certainly better for our patients.
Tom Lee: This is interesting work. We’re all rooting for your success, and I hope that that will create pressure on other organizations to figure out how to build trust, as well.
Gianrico Farrugia: Thank you. I look forward to that continuing discussion.
About the authors
Gianrico Farrugia, MD
President and Chief Executive Officer, Mayo Clinic
Thomas H. Lee, MD, MSc
Editor-in-Chief, NEJM Catalyst Innovations in Care Delivery; Co-Chair, NEJM Catalyst Editorial Board; Chief Medical Officer, Press Ganey Associates, Inc.; Member, Editorial Board, New England Journal of Medicine
Originally published at https://catalyst.nejm.org on July 9, 2020.
TAGS: Servant Leadership; Health and Tech Strategy; Leaders; Smart Health, Vision of The Future of Health Care in 2030, Servant Leader, Change Management,
