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HEALTH CARE HALL OF FAME 2016

Dr. Henry Plummer

Top left: President Franklin D. Roosevelt is flanked by Dr. Charles Mayo, left, and Dr. William Mayo. Standing are prominent Mayo physicians Louis Wilson, left, Donald Balfour, Plummer and Edward Starr Judd. Bottom left: The Plummer Building.

Road to the Mayo Clinic: Plummer's novel ideas transformed healthcare
Dr. Henry Plummer died nearly 80 years ago, but the physician who was influential at the Mayo Clinic almost since its founding left a legacy that continues to influence the institution to this day.

Hired at age 27 by the Mayo brothers in 1901, Plummer implemented innovative systems, processes and structures throughout his 35-year career at Mayo.
His contributions to the beginnings of the clinic were so influential, Dr. William Mayo is famously known for saying the decision to hire Plummer was his “best day's work.” For his many achievements, Plummer was chosen for induction into the Health Care Hall of Fame.

Plummer, a graduate of Northwestern University, transformed patient care with his innovative ideas. Arguably his most significant contribution was his invention of the dossier medical record.

The record system, created with his assistant, Mabel Root, consolidated a patient's medical information into one chart by assigning each Mayo patient a number. The chart was used by all Mayo physicians the patient would see, and it was organized for easy accessibility.
Dr. Steve Peters, vice medical information officer at Mayo, said Plummer's invention is an early example of streamlining care with the patient in mind. Before Plummer's medical-record system, physicians kept their own ledgers or index cards on patients. If staff members needed access to patients' records, they had to find the physician who treated them, slowing the care process.

In recognition of Plummer's lasting impact, Mayo's recent initiative to consolidate all health records into one electronic system has been dubbed the Plummer Project. Mayo began replacing its three disparate electronic health-record systems in January 2015. It plans to begin rolling it out in early 2017, with completion expected by fall 2018.

Plummer “was sort of the father of early patient-centered medical recordkeeping,” said Peters, co-director of the project. “That's why we call it the Plummer Project. We're going from a unified record on paper and now converging to a single integrated (electronic) system.”

CAREER HIGHLIGHTS

1901: Joins the fledgling Mayo Clinic medical practice in Minnesota
1907: Begins implementation of a centralized patient-record system, replacing an outdated and inefficient ledger system
1910: Plummer, working closely with the Mayo brothers, devises an organizational structure known as the integrated multispecialty group practice
1912: Helps lead design of first Mayo building created using patient-centered architectural features
1917-18: Chairman of the local Red Cross Association during World War I
1919: Charter member of the Central Interurban Clinic Club 1928: Helped lead the design of what would later be called the Plummer Building, employing many patient-centric features
1933: President of the American Association for the Study of Goiter

Plummer's innovative mind can also be seen in the architecture of the Plummer Building, which is still in use today on Mayo's campus in Rochester, Minn. The building, which Plummer helped design, was meticulously envisioned with the patient in mind. It included an underground walkway that connected to other campus buildings and a pneumatic tube system to transport patient records quickly.

The building was unique when it opened in 1928 because of its expansive size and layout, said Dr. W. Bruce Fye, professor of history of medicine at Mayo. William Mayo was initially hesitant to build such a vast structure, but with trust in Plummer's vision, he approved the construction.

Mayo not only recognized and trusted his physicians' ideas, but “also knew how to delegate effectively and efficiently,” said Dr. Peter Kernahan, a professor in the history of medicine at the University of Minnesota.

Mayo's ability to delegate would inspire him to task Plummer with developing an integrated, multispecialty group practice. Plummer would design a system in which physicians with different subspecialties were grouped together to care for one patient. This practice has since become common practice at hospitals and clinics, and it's arguably Mayo Clinic's most significant contribution to healthcare.
Not only did Mayo encourage Plummer's pursuit of innovation, but also his interest in the thyroid gland, which he began to study intently when he was 16 years old.

Throughout his career at Mayo, Plummer specialized in thyroid disease and contributed greatly to early knowledge, diagnosis and management of the illness, said Dr. John Morris, a Mayo endocrinologist who focuses on the thyroid gland.

Plummer discovered hypothyroidism, which is the second most common cause of thyroid disease. The condition is commonly referred to as Plummer's disease in the physician's honor. He also discovered that using iodine drops before surgery on Graves' disease patients significantly reduced mortality. The method is still used today.

It's a testament to his abilities as a diagnostician that Plummer recognized he suffered a fatal blood clot on Dec. 31, 1936. He returned home to spend the final hours of his life with his family. He was 62.
Two years after his death, William Mayo said of Plummer's work on the thyroid, “Developing many new things along many diverse lines, always he came back to his fundamental work on the thyroid gland, in which he was no less than a genius.”

Plummer was often characterized as a genius by the Mayo brothers and his colleagues for his groundbreaking ideas, but also because of his peculiar, distracted behavior, Fye said.

Dr. William Braasch, a Mayo Clinic colleague, wrote of Plummer in his book, Early Days in the Mayo Clinic, “He had a complex personality. The casual observer would gain the impression that he was an eccentric, absent-minded person. However, his apparent diffidence was usually explained by complete absorption in solving some problem of the moment, so that when spoken to he often made no reply.”

Fye said that although such eccentric qualities are not usually appealing for a physician, his innovative mind likely made up for his flaws. “If you're trying to build a practice, that wouldn't be the kind of person you'd hire,” he said. “But clearly, his other attributes sort of trumped whatever shortcomings there were.”
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