I would not be the person I am today without what my patients have given me since I started this journey called medicine. From the very first patient I saw as a medical student to the ones I treat today, they teach me, inspire me, and challenge me to think differently and to care more. They have taught me the gift of empathy, and it is an honor to have been a part of their lives in such a personal way. The same is true for the incredible people, my caregiver colleagues across healthcare, who share the profound responsibility of delivering care for people.
I would not be successful personally or professionally without the support and encouragement of my wife and best friend, Amy. She was at my side when this patient-centered epiphany occurred, and has supported me during my journey at Cleveland Clinic. Writing a book like this requires the sacrifice of nights and weekends; they were her sacrifices as well.
My father’s name was Carmen, and I owe who I am to my family: my mother, Shirley, and my siblings, Sue and Tom.
Toby Cosgrove, CEO and president, and Joe Hahn, chief of staff of Cleveland Clinic, have given me this awesome opportunity to help shape an organization and start a movement. Toby’s vision to drive the patient experience was a disruptive innovation in healthcare at a time when no one else was talking about it. Together, Toby and Joe have taken the Clinic to heights many thought not possible. They have never wavered in their support, and there is nothing I will ever be able to do to thank them.
Kelly Hancock, our executive chief nursing officer, has been my friend, confidant, and an early and critical ally in all our efforts to improve the patient experience at Cleveland Clinic. Our success belongs as much to her as it does to me. We would not have achieved what we have without her passion, support, determination, and keen instincts. She is an incredibly gifted leader highly respected not only in our organization, but in healthcare across the United States.
Feza Remzi is my clinical mentor, my friend, and the department chair of colorectal surgery. My first rotation during my fellowship was with him. He taught me the value of a personal connection with patients and is a role model for compassion and humanism. He got me back on track after my father died, and he was the first to enchant me with what Cleveland Clinic is about. I am at Cleveland Clinic because of him, and I will be forever in his debt.
Brian Bolwell, chair of Cleveland Clinic Taussig Cancer Institute, is likely more responsible than anyone else for my holding the position of chief experience officer, encouraging me to persevere during the search process. He is a remarkable leader from whom I learned never to fear speaking up for what’s right, especially when it concerns the patient.
Ananth Raman has been my mentor, friend, and, more important, patient experience soul mate from the beginning. He has tutored me in the nuances of execution and continually challenges me to think differently regarding opportunities we face so we may find success in what we do. He has been a constant and consistent navigational beacon in this journey.
David Longworth began his career at Cleveland Clinic and, after 10 years at the Clinic, joined a Boston health system. He returned to Cleveland Clinic 10 years later as chair of medicine. He is my barometer of the “before and after” comparison, constantly reassuring me that where we stand today is better than where we stood yesterday. David has a great mind and has been my muse for many ideas about the patient experience.
Adrienne Boissy has been by my side on this journey from day one. She is passionate, committed, and driven to provide what is needed and right for patients. Her incredible work has enhanced our physician culture and likely will effect meaningful change in the practice of medicine worldwide.
Cindy Hundorfean, our chief administrative officer, is responsible for leading the clinical enterprise. This is the engine of Cleveland Clinic, and there are few people whom I have ever met who can boil down such an enormous operation into something manageable. Cindy has been an important mentor from the beginning. If I owe Brian Bolwell the credit for keeping me in the race for the job, I owe Cindy credit for keeping me in the job. She has been an important source of encouragement, guidance, and support throughout this journey.
Linda McHugh, executive administrator to the CEO and Board of Governors, has been at Cleveland Clinic her entire career, most of it at Toby Cosgrove’s side. She knows the organization’s history well and has lived through and assisted in leading our tremendous growth and success, including helping to propel the heart institute to the number one position in the world. Through my years as chief experience officer, she has been a guide, mentor, and friend. I am indebted to her for reading the entire manuscript and providing her historical, candid, and objective advice.
Beth Mooney, chairman and CEO of KeyCorp, is a member of Cleveland Clinic’s Board of Directors and chairman of its Safety, Quality, and Patient Experience Committee. She is an incredible leader who rose to the top in part by differentiating on the customer experience. She taught me how to think and act like a professional and, from the very beginning, guided me in framing our capability, enhancing it for short-term success, and innovating to drive long-term differentiation. I am indebted to her for her critical review of the manuscript and for writing the wonderful Foreword to this book.
We developed our international patient experience footprint with Bill Peacock, Jim Benedict, Rob Stall, and the late Bill Ruschhaupt, MD, from operations. They taught me volumes about international healthcare and challenged us to think out of the box to meet the needs of other cultures.
Marc Harrison and I both started in the Clinic’s C-suite at about the same time; he with much more healthcare leadership experience than I. He is a smart and gifted leader who personally knows the other side of healthcare better than most. He was a beacon in the early fog and has taught me the importance of skepticism, healthy debate, accountability, and integrity.
Tom Graham serves as our chair of innovations. He has a brilliant mind that brings unmatched business acumen to the world of medicine, and he and his team have taught us how to take our success and push it into the market.
I find it a little amusing to tell people “I have an editor.” Casey Ebro from McGraw-Hill has shepherded this work from the beginning. Her incredible mind and engaging and inquiring personality match no one I have met. She has made me smarter and this book better.
Writing was never my strength in school, and there was always something attractive to me about the unintelligibility of a doctor’s handwriting. Beth Brumbaugh shaped my words and made this book readable. I am indebted to her for taking this work and making it concise for all to understand. She is extremely talented, and from her, I have become better as well.
A colleague of mine often remarks that leaders are not successful without a great team of people to support them, and my work in the patient experience is no exception. I have been successful because the people around me are gifted and exponentially smarter than I: Jennifer Fragapane, Carmen Kestranek, Stacie Pallotta, Mary Linda Rivera, Tom Vernon, and Donna Zabell.
We become better leaders through a variety of methods, but the best way is to acquire the skills and attributes of those around us whom we respect and admire. I am honored and fortunate to work with some of the brightest and most talented leaders in healthcare, including my colleagues on the Clinic’s executive team, our medical and nursing leadership, and our administrative leaders across the organization. From you, I have learned much, and together we have created success.
There are many people who have worked very hard to transform this organization around the patient and create a world-class patient experience; I cannot possibly list and thank everyone individually. But this book is about you, and the tremendous achievement we have accomplished is your achievement—thank you!
Finally, Toby often talks about the incredible platform that is Cleveland Clinic—meaning that bright, innovative people working in this incredible organization create synergies that allow success beyond what any one person can bring on his or her own. Toby is right! Anyone who believes that what happens here is the result of one person is mistaken. The Clinic provides a unique, innovative platform to drive collective success; it is an intangible that is hard to describe, but one that produces results that are real!