Making best use of the assets of the Cleveland Clinic after a period of explosive growth will be the a challenge facing thoracic surgeon Delos "Toby" Cosgrove, M.D., as he prepares to take the helm as chairman of board of governors and chief executive officer of the organization.
Cosgrove is only the fifth CEO named to the clinic since its founding in 1921, but the healthcare organization that existed then, and what the Cleveland Clinic has become today, are two different creatures.
"We've grown from one hospital to 12 in 15 years, and from $750 million in revenues to $3.6 billion in 15 years," Cosgrove said in a telephone interview Friday. "We have grown across multiple fields. We've got some integration problems to deal with," he said, but in terms of finance, the organization is in great shape.
"With healthcare, and any industry, the biggest challenge is attracting and keeping the best people," Cosgrove said.
In that area, the structure of the Cleveland Clinic, where the physicians are employed by the same entity that owns the hospital, is "a huge advantage," he said. Physicians are salaried, and their pay is adjusted following annual reviews.
"It allows us to align incentives," Cosgrove said. "We don't have doctors going in one direction and hospitals going in another. It's a great place."
Cleveland itself, home to new landmarks like Jacobs Field and the Rock and Roll Hall of Fame, has put a lot of time and civic pride between its bright image today and its notoriety as the gritty industrial center whose main stream, the pollution-choked Cuyahoga River, caught fire in the 1950s and '60s.
But Cleveland is still in the Midwest, on Lake Erie. And that's OK, Cosgrove said: It acts like a recruitment filter.
"One of our biggest challenges is Cleveland, and one of our biggest advantages is Cleveland," he said. "We're about full-time concentration on our medicine. If you want the place to spend time at the beach, this isn't your place."
Cosgrove has been head of the clinic's department of thoracic surgery since 1989. He began his career at Cleveland in 1975 after serving as chief resident in cardiac surgery at Boston Children's Hospital.
After graduating in 1966 from the University of Virginia School of Medicine in Charlottesville, Cosgrove served a surgical internship and residency at Strong Memorial Hospital, Rochester, N.Y., from 1966-1968, then served in the U.S. Air Force from 1968-1970, first as chief of USAF Casualty Staging Flight at Da Nang, Republic of Viet Nam, then at Hamilton Air Force Base in California. He was awarded the Bronze Star and the Republic of Vietnam Commendation Medal.
Cosgrove completed further clinical training at Massachusetts General Hospital, Boston, and Brook General Hospital, London.
Persistence, Cosgrove says, is the cardinal leadership attribute he'll bring to the job.
"Most projects that are worth doing take a lot of effort," he said. It takes persistence, he said, "to drive them across the finish line."
Cosgrove, whose appointment was announced June 2, will replace CEO Floyd "Fred" Loop, M.D., starting Oct. 1. Loop led the Cleveland Clinic for 14 years.