Cleveland Clinic CEO Toby Cosgrove to step down

Dr. Toby Cosgrove, the longtime CEO of the Cleveland Clinic, announced on Monday he will be stepping down by the end of this year.

A succession process for his replacement has now begun and Cosgrove will stay on at the clinic in an advisory role, according to a news release. The clinic also said his successor will be a practicing physician, keeping up with the system's long history as a physician-led institution.

"It is an honor and a privilege to be a part of an extraordinary and forward-thinking organization that puts patients at the center of everything we do," Cosgrove said in statement.

During his nearly 13 years at the helm, Cosgrove led the prestigious institution through widespread expansion. But his tenure has also been marred with controversy, especially recently due to his ties with the Trump administration.

Under his leadership, revenue at the clinic grew from $3.7 billion in 2004 to $8.5 billion in 2016. He oversaw growth by establishing multiple new locations nationwide and internationally, including setting up services in Canada and Abu Dhabi.

The number of physician-scientists nearly doubled under his leadership from 1,800 to 3,400. And total visits to the clinic increased from 2.8 million to 7.1 million.

Cosgrove recently received some backlash because of his ties to the Trump administration. He was among prospective cabinet picks who met with President-elect Donald Trump in December about leading the Veterans Affairs Department. Although Cosgrove ultimately declined the role, he remains a Trump adviser as a member of the strategic and policy forum.

That wasn't the first time Cosgrove has been considered to lead the VA. The Obama administration reportedly looked at Cosgrove but he eventually took himself out of the running. He was also a member of the Veterans Administration Commission on Care in 2015.

The Cleveland Clinic faced controversy again in February when it refused to cancel a fundraiser at Trump's resort in Florida. After Trump signed an executive order that banned one of its doctors from re-entering the U.S., hundreds of medical students and doctors signed a letter asking the clinic to cancel the fundraiser. The CMS has also threatened on several occasions to remove Medicare payments after inspections showed the system failed to investigate patient safety concerns.

Despite those recent controversies, Cosgrove is well-regarded for his leadership approaches. He emphasized the importance of a patient-centered approach to care delivery, coining the phrase "patient first" at the clinic.

Cosgrove hired the system's first chief patient experience officer to focus on the physical and emotional aspects of patient care. The clinic also began offering same-day doctor's appointments last year to improve access to services.

In his book​ The Cleveland Clinic Way, Cosgrove advocated for more collaborative approaches to treatment, innovation through the use of big data and more personalized care.

Cosgrove has publicly spoken about the opioid epidemic, skyrocketing drug prices, the high cost of healthcare services and the Affordable Care Act.

Cosgrove has spent more than 40 years at the clinic. He joined the system in 1975 as a cardiac surgeon and was named chairman of the thoracic and cardiovascular surgery department in 1989.

A veteran, Cosgrove was awarded a Bronze Star for his service as the U.S. Air Force's chief of casualty staging flights during the Vietnam War.

Cosgrove has been named to Modern Healthcare's annual list of the 100 Most Influential People in Healthcare 10 times.