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Researching and writing this book thrust us into the roles of both student and teacher. Before we could teach, we first had to learn. We now have studied a remarkably successful service organization and, in this book, teach its lessons. We have had an enlightening and rewarding journey.

We began this project believing that we already understood Mayo Clinic and what makes it tick. And we did know many things. However, as we write these words to thank those who have helped us, it is clear to us how much more we learned. The disciplined exploration and personal reflection required to write a good book is a wonderful way to learn. The process forces you to dig deep, to see what you haven’t seen before, to consider new patterns and connections. It is one thing to have ideas that resonate in your mind; transforming those ideas into words on a printed page forces clearer, deeper thinking. When your words are going to be on a printed page for a long time, you want to get them right.

We have done our best to get the words right in portraying the real Mayo Clinic, in accurately telling its service story, and in teaching its lessons. We are grateful to many people who have helped us on our journey to a completed manuscript. Carleton Rider, who retired at the end of 2007 from Mayo Clinic following a distinguished administrative leadership career that included being the first chief administrative officer of Mayo Clinic Jacksonville, encouraged us to write this book. Although historical accounts of Mayo Clinic have been published in book form, no book has ever been published on Mayo Clinic’s service culture, strategy, management, and systems. Rider felt that such a book could make a genuine contribution, not only to external audiences of corporate, not-for-profit, and healthcare organization managers but also to the internal audience of Mayo Clinic itself. With thousands of new staff members joining Mayo Clinic each year, such a book could be useful in capturing and reinforcing the uniqueness of Mayo Clinic. And in telling the service story of Mayo Clinic, this book could also help many patients, who number over 500,000 each year, understand the background of their excellent patient experiences.

Carleton Rider was one of seven individuals whom we asked to carefully read and critique a draft of our manuscript. Mayo Clinic’s complexity, stemming from its age, size, governance structure, and type and breadth of services, among other factors, increases the opportunity for inadvertent errors as well as misinterpretation of historical events. Thus we recruited a group of prepublication reviewers with broad and diverse Mayo Clinic experience to help us tell the story as accurately and completely as possible. The review process proved invaluable, and we wish to thank the other members of the review team in addition to Carleton Rider: John La Forgia, Dr. Robert Waller, Dr. Michael O’Sullivan, Robert Smoldt, Matthew Dacy, and Dr. James Donnelly, Jr.

John La Forgia, chair of the division of public affairs at Mayo Clinic, not only offered excellent insights on our manuscript but also championed this project and secured the internal support for the independence that this study required.

Dr. Waller retired as Mayo Clinic’s CEO in 1999. A Clinic physician for 30 years, he played key leadership roles in Mayo’s geographic expansion. Dr. Waller was always available to us and always gracious when we called with “just a few more questions.”

Dr. O’Sullivan started as a resident in pathology at Mayo Clinic in 1964, joined the clinical pathology staff in 1969, and retired as CEO of Mayo Clinic Scottsdale in 2002. Dr. O’Sullivan had an amazing career at Mayo, providing leadership during the early years for some of the Clinic’s most successful ventures.

Robert Smoldt retired from Mayo Clinic in 2008 following a nearly 36-year career in administrative and management positions, including chief administrative officer. Smoldt knows the inner workings of the Clinic’s management systems. He was our go-to person for a wide range of issues requiring clarification or amplification. Smoldt has devoted considerable thought to improving healthcare public policy and has much insight to offer in any discussion of the future of healthcare.

Matthew Dacy is director of Mayo Clinic Heritage Hall in the department of development. A skilled writer and editor, Dacy also is an astute student of Mayo Clinic’s history. We benefited greatly from his detailed, constructive suggestions.

Dr. James Donnelly, Jr., who recently retired as the Thomas C. Simons professor of business at the Gatton College of Business and Economics, University of Kentucky, was our seventh external reviewer. We reached out to him not only because of his background as a prolific book author but also because of his experiences as a Mayo Clinic patient. Professor Donnelly’s careful reading of the manuscript through the lens of both patient and author was extremely helpful.

This book was written with the blessing and cooperation—but not under the control—of Mayo Clinic. We thank Mayo Clinic’s leaders, all of whom supported this project and participated in one or more candid, in-depth interviews. We are grateful not only for their time and insights but also for the trust they extended to us. Among the Clinic leaders who helped us are: Dr. Denis Cortese, Dr. George Bartley, Dr. Victor Trastek, Dr. Glenn Forbes, Dr. Hugh Smith, Shirley Weis, Doreen Frusti, Craig Smoldt, Dr. Dawn Milliner, Dr. Stephen Swenson, James G. Anderson, Robert Brigham, and Jeffrey Korsmo.

In Chapter 1, we describe how we conducted the research that underlies this book in two distinct phases. Both phases involved personal interviews with numerous current and former Mayo Clinic staff members. We thank each of our interviewees, a number of whom readers meet in the pages that follow. We also thank the many employees across the three Mayo campuses for their efforts in locating the specific details and data our book required as well as those who facilitated our work in countless ways: Nicole Babcock, Adam Brase, Virginia Bruce, Dorothy Burch, Amy Davis, Lindsay Dingle, Jean Engler, Susan Fargo-Prosser, Daniel Goldman, James Houck, Patrick McCarty, Heidi Miller, Jim Nassens, Robert Nellis, Donly Okrzynski, Marie Perhay, Gail Prechel, Clifford Romme, Ann Schauer, Alan Schilmoeller, Kimberley Schmidt, Tripp Welch, Laurie Wilshusen, and Renee Zeimer.

We also thank Glenda Bessler and Shirley Deffenbaugh, longtime members of Leonard Berry’s “book team.” Glenda Bessler has served as Berry’s splendid administrative assistant for more than 20 years and always embraces a new book project with good cheer even though it means considerably more work for an already hard-working professional. This book is the sixth one Glenda has helped bring to fruition. Shirley Deffenbaugh, who lives in Seattle, is a gifted copy editor who absolutely will not tolerate needlessly long sentences. This is the fourth book on which Shirley has provided assistance.

We appreciate the opportunity to work with McGraw-Hill and our editor, Mary Glenn, and her associates. Mayo Clinic is a global brand and so is McGraw-Hill. We thought it made sense to bring these two brands together to see if we could create some magic with this book.

Kent Seltman thanks his wife, Kristine, and daughters, Lee and Ann, for loving affection and support even as his passion for this book delayed production in his family-focused furniture shop. Happily, the family members all know firsthand that good comes from hard work on big projects—Kristine as a creative and committed mother, Lee as a civil rights attorney in the U.S. Department of Justice, and Ann as a colon and rectal surgeon whose 30th and final year of education was completed at Mayo Clinic. He also thanks Lee who critiqued the manuscript on behalf of general readers who have not been to business school or who do not work in healthcare. He also wishes to acknowledge Dr. Patricia Simmons, Franklin Iossi, and Robert Smoldt who explained the Mayo culture as it existed early in his career and guided and mentored him in “the Mayo Way.”

Leonard Berry thanks his wife, Nancy, and sons, Matthew and Jonathan, for their love and for their pride in this book’s publication. He, in turn, feels great pride in their pursuits, Nancy as an active community leader and member of several local and regional boards of directors, including the College Station Medical Center; Matthew as head of fantasy sports for the ESPN network where he is known as “the talented Mr. Roto;” and Jonathan as a creator of new television shows and other entertainment services. Leonard Berry also thanks Dr. Donald Berwick and Maureen Bisognano, the leaders of the Institute of Healthcare Improvement (IHI), for their passion and commitment to improving healthcare safety, effectiveness, and efficiency. Their work and the jewel of an organization they head are an inspiration.

To the people of Mayo Clinic, we did our best to tell your story accurately, interestingly, and usefully. To our readers, thank you. We believe you will receive a good return on your investment.

Leonard L. Berry
College Station, Texas

Kent D. Seltman
Rochester, Minnesota

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