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"Do you teach empathy at Cleveland Clinic?"


These words would forever change our organization. It was 2006 and our CEO, Dr. Toby Cosgrove, had been invited to speak at Harvard Business School. As he finished his comments, a young student named Kara Medoff Barnett raised her hand. She spoke of her father, a physician, who needed a mitral valve surgery and how their family decided where to have his heart surgery done. They were familiar with the excellent cardiac outcomes we had, yet ultimately they decided against Cleveland Clinic for his care "because we heard you had no empathy."

Reflecting on this experience, Cosgrove was "floored."1 Ten days later, he was in Saudi Arabia attending the dedication of an International Medical City. As he listened to the president of the hospital speak about the type of care they were hoping to provide, he looked over at the king and saw that he was crying. As he looked out into the audience, he realized they were crying, too. In that moment, he recognized, "We are really missing something. We need to treat the soul and spirit of the patient, not just the body."

Patients First

One of the most important changes was Cosgrove's conception of Patients First as Cleveland Clinic's motto. Patients First became the True North of the organization. What this meant on the ground level was that any strategic decisions or initiatives that the organization put forward had to involve improving the care and experience of our patients at their core. Although there was marketing associated with the Patients First model and many caregivers were skeptical, repeated messaging reinforced that we all exist for the care of the patient. When there was pushback about the motto, it was usually in the form of "patients first and caregivers last." That was a noteworthy reflection of our culture at the time. As an organization, we know that both patients and caregivers are important and have intrinsic value. If Patients First was really going to permeate our culture, we would need to be intentional about building programs that had perceived value to the caregivers we wanted to reach. Thinking about how we could evolve programs that not only enhanced the patient experience, but also the experience of our caregivers remains a critical, foundational approach.

Many changes occurred during these years that helped to evolve our culture toward a more patient-centered environment. Cosgrove wanted to align care physically around the patient. He wanted to streamline service lines so that cardiothoracic surgeons worked alongside cardiologists and radiologists to deliver exceptional cardiac care, to break down the silos of a traditional academic structure, and to create teams of diverse individuals and professionals all working toward Patients First. Although there was initial concern about what that would feel like or look like, he was ...

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