Noseworthy in 2010

Dr. John Noseworthy shows Health and Human Services Secretary Kathleen Sebelius around the Gonda Building on June 3, 2010, several months after Noseworthy became president and CEO of Mayo Clinic. Less than three years later, in January 2013, Noseworthy announced the Destination Medical Center initiative. DMC was approved by the Legislature and signed by Gov. Mark Dayton five years ago in May.

Later this year, when Dr. John Noseworthy packs his boxes and doctor’s bag and moves out of the Mayo Clinic CEO suite, we can assess his legacy after nine years.

He has several months to go, so we’ll save the post-mortems for later. A lot can happen in eight months. But here’s a preview of what those stories will say.

They’ll say Noseworthy was one of the most consequential Mayo leaders since Dr. Will and Dr. Charlie. He didn’t invent Destination Medical Center, but he’s the one who made it happen. Yes, the Mayo Board of Governors presumably made final calls, but Noseworthy is the one who will get the praise or blame, however it turns out.

He’s already getting it, and we’re only five years in.

As the Post Bulletin has reported over the years, DMC was kicked around as a concept well before Noseworthy hung up his diplomas and awards in the CEO office in November 2009. There was talk about Rochester as a “destination medical community” — all lowercase — a few years before legislation was dreamed up, and when the city asked voters to approve the $139.5 million local option sales tax extension in 2012, it included $20 million for DMC, even though promoters couldn’t really say what it was for.

It was Noseworthy who was at the podium in the governor’s office on Jan. 30, 2013, as he and Gov. Mark Dayton, joined by just about every local elected official who could squeeze into the Governor’s Reception Room, announced this thing called Destination Medical Center.

Noseworthy has been the person most associated with DMC, even more than Dayton or his lieutenant governor/chief of staff/all-around handywoman Tina Smith, who was the first chair of the DMC Corp. board and since has gone on to become a U.S. senator.

Before DMC, it was a good bet that just about no one outside of Rochester could have told you the name of the reigning Mayo Clinic CEO. Sorry, Dr. Denis Cortese, but when you were the top dog at Mayo, no one in Eveleth or Fergus Falls knew your name. Same for you, Dr. Hugh Smith. Even in Rochester, it’s hard to recall who the CEO was 20 years ago. (Hint: It wasn’t Sister Generose.)

Target of political attacks

Noseworthy almost certainly didn’t wish for the intense personal attention that DMC has brought him. I’m guessing he assumed the attention to Mayo as the prime mover of DMC would diminish as the initiative gained momentum, with the spotlight shifting to the DMCC, the EDA, Lisa Clarke and others.

I’m also guessing he and other Mayo leaders didn’t expect the kind of political whacks the clinic has taken. Since DMC is a creature of the state, Mayo is exposed to the kind of criticism that few other institutions in Minnesota get, not even the for-profit Minnesota Vikings, who benefited immensely from the public contribution to the $1.1 billion U.S. Bank Stadium.

Mayo isn’t directly benefiting from DMC — no taxpayer money goes to the clinic — and it’ll be years before Mayo patients and city residents get to enjoy the hypothetical “people mover,” the “winter garden” and all the other amenities that DMC promises.

DMC has taken Mayo Clinic into a politically charged world and it’ll be there for decades to come as the taxpayer dollars are doled out. Historically, the clinic has tried to stay out of politics, leaving few fingerprints on issues and eschewing attention for its charitable work.

Those days are gone. The fierce reaction to its plan to end inpatient hospital care in Albert Lea is a prime example, but not the only one. The Save Our Hospital group in Albert Lea has boasted that they’ve given Mayo its biggest PR black eye ever, and elected leaders, especially DFLers, have been eager to pile on. Even Dayton, the godfather of DMC, has whacked Mayo over the Albert Lea issue.

As Mayo is learning, if you’re going to play in the public arena, initiate what’s called the largest economic development program in Minnesota history and leverage hundreds of millions of dollars in public money, you’ll take the grief that goes with it.

And Noseworthy has taken more than his share of lumps. His poorly chosen words about Medicaid and Medicare reimbursement a few years ago were magnified because of his larger public profile. He’s been the target of some intensely harsh and personal attacks regarding DMC.

A few other things happened

By the end of this year, presumably he’ll get the recognition he deserves for his work on DMC and for the rest of what happened at Mayo during his tenure. A few other things happened, though they didn’t get big headlines.

During his tenure, the clinic increased the number of patients treated from 1 million in 2010 to more than 1.3 million in 2016. Annual revenues grew from $7.9 billion in 2010 to $12 billion in 2017. The total number of employees grew from 51,000 to 63,000, about 24 percent.

During his time in charge, Mayo restructured to function as a single operating company, rather than a holding company with units in Minnesota, Florida and Arizona, which dramatically changed how Mayo works. The Mayo Clinic Care Network was launched, as was the vast and costly Epic electronic records project. Mayo Clinic Square opened in downtown Minneapolis.

The clinic navigated a little thing called the Affordable Care Act, and now the piecemeal dismantling of the ACA, and has kept an even keel.

And most important, Mayo Clinic remains at or near the top of just about any credible ranking for the quality of its care. There would be no Destination Medical Center if Mayo wasn’t already a global medical destination.

To some degree, it’s a measure of how successful the clinic has been over the years that these numbers are unremarkable. If Mayo were to have a crummy financial year, it would make news. When it grows dynamically, as it has for years, nobody pays attention — or in fact, it’s cited as another reason why Noseworthy is a Scrooge and betraying Mayo’s heritage by moving hospital beds from Albert Lea to Austin.

A full assessment of Noseworthy’s record will come only after DMC hits the 15- or 20-year mark. Will the DMC-inspired private development ever measure up to predictions? Will the reconstruction of downtown be a good thing for people who live here, or will it be just a flashy place for visitors that locals can’t afford or won’t use?

Will the city’s historic character be wiped out? Will transit improvements ever happen? Will blue-collar workers be able to afford to live here? Check back in 2030 and we may have some answers.

For now, what’s clear is that Mayo Clinic has set in motion an era of profound change for Rochester, and it’s Noseworthy who threw the switch.

Jay Furst is the Post Bulletin’s executive editor.

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