After frequently accompanying their father on professional visits and attending medical school themselves, the brothers returned to Rochester, Minn., to practice. They joined their father, first in private practice and then in helping to open St. Marys Hospital in 1889, inspired in part by a disastrous tornado.
Their surgical section of the hospital became known as the Mayo Clinic in 1903 and spun out as a full-service medical center in 1915. That same year, they created the Mayo Foundation for Medical Education and Research affiliated with the University of Minnesota to which the brothers donated a significant chunk of their considerable personal fortune.
The philosophy of putting patients first had heft partly because of the system of paying physicians a salary, says W. Bruce Fye, a cardiologist at Mayo and a medical historian. You didnt have divided loyalties, he says. There was no competition between doctors to take care of patients.
The teamwork among doctors helped the notion of group practice to take root, Fye says, as the Mayos added to their own surgical expertise with other specialties. The Mayo brothers are responsible for that concept, he says. Theres no question in my mind that the group practice model is that absolute ideal way to practice medicine. But it cant be replicated in most places.
Schwenk describes how doctors of different specialties are able to reach one another by phone on a moments notice for consultations. This person has a strange murmur. I dont know what test (to order) because Im not a cardiologist, she lists as an example. Our financial and administrative structures as such that those walls are very porous, so we can make an effective decision.
When you change how people are paid, you change incentives, Walters says. Mayos incentive has always been, Dont worry about the number, or what generates revenue. You do what needs to be done. If someone needs something, pick up the phone and talk. Those are some of the cultural things in place.
The Carillon Clinic in Roanoke, Va., has looked to the Mayo brothers and the clinics legacy as it has been trying to move toward such a system for the past three years, says Edward Murphy, president and chief executive officer.
Doctors are good at focusing on the patient in front of you, moment to moment, but were not as good as we could be at handoffs, and the collective management of patients with chronic diseases with a bunch of different doctors with a bunch of different specialties, Murphy says. The approach is meant to be much more of a team approach than an individual approach, which I think is better for patients.
At a rural hospital without a medical school affiliation, the Mayos had the opportunity to become surgical experts. They werent teaching anyone to do it, and they had no competition, Fye says. They did high volumes. The incredibly low mortality rates attracted attention from around the country.
Over time, the Mayos did begin a fellowship program that helped lead to the current structure of post-graduate, formal specialty training, Fye says. There were no residency programs when they started the fellowships. I cant tell you we were the only one, but I know we were very early educators, Schwenk says.
There were other contributions to the field: An early hire, Henry Plummer, a physician, developed a system that set a new standard for medical records storage and retrieval, while an intricate conveyer system carried those records from floor to floor. Case studies the brothers wrote proved invaluable to their contemporaries.
On a personal level, Charles and William Mayo are remembered as inseparable yet distinct. A DVD called My Brother and I, produced by the clinic and narrated by radio host Garrison Keillor, recalls that they lived next door, but their wives put the kibosh on building a connecting passageway between their homesso they constructed a window-to-window speaking tube.
Walters remembers hearing about the brothers spirit of togetherness, captured in their frequently used phrase, my brother and I, from his grandmother, William Mayos daughter Phoebe, and his grandfather Walt, a staff surgeon at Mayo throughout his career. Everything Ive read in the various biographies or histories of Will and Charlie seemed to be validated by my grandmother, he says.