Outgoing leader reflects on Mayo Clinic, DMC and Rochester

Jeff Bolton announced this week that he plans to retire this fall from his role as Mayo Clinic's chief administrative officer. It's a title he has held since in 2013. Bolton joined Mayo Clinic in 2002, originally as the chief financial officer.

He chatted with the Post Bulletin about his experiences with Mayo Clinic and Rochester in the past 19 years, as well as looking to the future.

How would you compare the Mayo Clinic of 2002 when you arrived to the Mayo Clinic of 2021?

That is an interesting question, really. ... I would probably start with what is the same about Mayo Clinic between 2002 and 2021.

And I would say that this focus on our primary value of the needs of the patient coming first. It was something that I picked up on in my interviews when I was interviewing for the CFO job.

And it's as true today as it ever has been, as are the Mayo and Franciscan values, the rich ties ... our 73,000 staff live and breathe every day. Another thing, you know, that is really incredible, is this kind of relentless focus on finding medical solutions for patients with serious and/or complex medical conditions. You know, those are things that remain as strong today … even stronger than when I started in 2002.

What’s different?

Obviously, we're a lot bigger. As an organization, we've grown considerably. You know, when I first started, there was focus on how technology would enable physicians and scientists to improve care for patients. We're focused on aggregating data. Over this 19-year period, there has been just a tremendous growth in ... the positive impact that technology can have on health care delivery.

Some of our strategies related to digital health platform strategies are coming to fruition, and much of that is based on ... the stewardship of Mayo data that dated back well before 2002. It is a major thrust that, obviously, over the years, has attracted patients from countries across the globe.

And now, in 2021, we've got a significant presence in Abu Dhabi and a growing presence in London. And ... I think our international extension of Mayo capabilities internationally will continue to grow over the course of time.

Anything else?

If I could add one other thing ... that is when I came to Mayo, I think there were like 15 different operating entities. You had Rochester, Arizona, Florida ... I think there were 12 regions and health systems. Mayo moved from that holding company, business model to one that's a single operating organization ... one Mayo Clinic. That diffusion of best practices — whether it's practice research, education, or administrative services — happens much more fluidly today than it did back in 2002.

How do you answer local people who think of Mayo Clinic primarily as a Rochester and Midwest thing, who question Mayo Clinic growing internationally in Abu Dhabi and London?

I think that that growth maintains our relevance internationally. I'm assuming most of the people in Rochester recognize that international patient flow generates significant revenue and income for Mayo Clinic, relative to the size of the patient population.

And what we're seeing is many nations are moving away from sending patients to Europe or the United States for their care, and trying to create care centers in their country.

So Abu Dhabi, in particular, was an effort to ensure that we would set up a presence in Abu Dhabi, with earned income, that would allow us to reinvest in our practice here and abroad.

But it also kept us in a strong position in terms of being able to continue to attract patients with serious and/or complex medical conditions that can't be treated in that country. ... We wanted to be the preferred provider for patients traveling to Rochester, Arizona and Florida.

Mayo Clinic has long used a fairly unique leadership approach that partners physicians, like Dr. Farrugia, with an administrator, like yourself, to lead the organization. After having worked elsewhere, what are your thoughts on how that works for Mayo Clinic?

I think it's a model that really sets us apart. I can say working with Dr. John Noseworthy before ... and working with Dr. Gianrico Farrugia, that you have two lenses that you view opportunities and challenges through. The partnership for me, as an administrator, allows me to look through the lens of a world-renowned scientist's position and see patients through that lens and to understand what's required ... the types of investments we need for our staff and ... equipment and facilities. And, presumably, the lens that I provide is one that allows us to operate in a model that is sustainable for the long term ... so there's a good business model that allows us to continue to thrive in fulfilling our mission as an organization.

You shifted from being chief financial officer to being chief administrative officer. Those are pretty significantly different jobs. Can you talk about that?

They are different roles, different responsibilities. But, they both are a part of the team approach to leadership at Mayo Clinic. There's the physician, administrative dyad, but there's also a team, as you look at challenges and opportunities... So as a CFO, I had insights into opportunities and challenges within the practice, within research, within education, within business extensions. So while I was not a practice administrator or a research administrator, I was very actively involved in realizing opportunities in those areas, and also the challenges. And likewise, if you think about 2008, through the financial crisis nationally ... it wasn’t the CFO that solved the issues, it was really the team looking at how we work together to address those concerns. It's been a great experience working across those disciplines. And I've learned a lot as a result of it.

You mentioned 2008. Talk to me about that and how Mayo was able to come out of 2008 as well as it did. Was there some foresight in 2007?

I would say there was (preparation for the financial crash) in 2007, and even as early as 2006 ... What we were focused on was the value of health care delivery. And ... quality, safety, experience over costs, so cost was the denominator. There was a significant effort underway to improve the value that we provided. So we were already looking at ways to reduce costs, reduce waste in the organization, so that we could provide a higher level of value. That positioned us very well to weather the 2008-2009 recession.

You serve on the Destination Medical Center Economic Development Agency board. Any thoughts on how DMC has progressed to this point, and where it might be going in the future?

I'm really proud of the Economic Development Agency for DMC and the DMC board. They've done a phenomenal job, I believe, working collaboratively with the city, with the county, Mayo Clinic, RAEDI, and other organizations. If you look back over the past five years, significant progress has been made in terms of strengthening the downtown. Also the private investment that has come in is right on plan.

Mayo just announced a $200 million investment for the expansion of the proton beam center, so Mayo is investing significantly in Rochester. Look at One Discovery Square, which is fully leased up, and the momentum of leasing Two Discovery Square. And the developer is looking at Three Discovery Square ...

To diversify the economy supporting Rochester was a critical objective that I had. I feel that an economy that's based on one organization is always vulnerable. I see great progress in companies wanting to be close to Mayo Clinic, wanting to be close to other businesses in the community, to develop new IP and commercialize. I think it's been very successful ... It's a very exciting time for Rochester.

Any final thoughts?

I would just say it's been an honor and tremendous privilege to serve Mayo, both as a CFO and as chief administrative officer, and to work closely with local businesses, the city and county.

I am very bullish on Mayo Clinic, and I'm very bullish on Rochester, as a destination.. I'll be watching from the sidelines as both Mayo Clinic and Rochester continue to prosper.