Checkup

Vital Signs

It's About Time

Dr. George Bartley

Dear Readers:

Finally, we have begun construction on Mayo Clinic Hospital on the San Pablo Road campus in Jacksonville. (See "Mayo Clinic Hospital: Out come the hard hats.") Nearly four years after the project's inception, all of the necessary legal hurdles to build the facility have been cleared. It's about time. But, unfortunately, it has also been about money.

Some states, including Florida, require health-care organizations to obtain a "Certificate of Need" (CON) if they wish to open a hospital. The stated purposes of this requirement are to maintain the quality of care and to control costs. It is assumed that quality will decline if medical teams have insufficient volume to keep their skills honed, particularly with complex procedures such as open-heart surgery or organ transplantation. Such a scenario could occur if there are too many hospitals competing for a finite number of patients, diluting everyone's experience. Additionally, some studies show that overall health-care costs escalate in proportion to the number of providers — and particularly the number of specialists — in a given area. So, it usually doesn't make much sense either in terms of quality or cost to have a hospital on every corner.

Regrettably, the Certificate of Need process frequently is used by existing hospitals to protect their "market share" by blocking or delaying competition, rather than to promote quality. When Mayo Clinic applied for its CON in the fall of 2001, the state of Florida gave its approval in short order. Legal appeals from a for-profit health-care institution have delayed our hospital project since that time, and lots of attorneys' fees have been diverted from our mission, which is "to heal the sick and advance the science." Meanwhile, the population of Jacksonville has continued its robust growth, challenging the city's health-care facilities to keep up. Our current hospital, St. Luke's, frequently is full, with patients waiting in the Emergency Department for a bed to open before they can be admitted. If anyone benefits from the current situation, it is not those who are infirm and in need.

Fortunately, this story does have some favorable elements, both regarding time and money. The delay has afforded the opportunity for more detailed facilities planning, and we're optimistic that Mayo Clinic Hospital will be second-to-none when it opens in early 2008. We've also had more time to work through the complex arrangements of selling and transferring St. Luke's Hospital to its purchaser, St. Vincent's Medical Center of the Ascension Health system. St. Luke's is an excellent facility that will continue to help meet Jacksonville's growing health-care needs.

From a financial perspective, there is much for which we are thankful. Mayo Clinic Hospital's original philanthropic goal was $70 million, and so far more than $72 million has been raised. This includes more than $1.5 million from the Mayo Clinic Jacksonville medical and administrative staff, who have been inspired by the generosity of our many grateful patients.

Thank you for your support and your patience during the past many months. We look forward to serving you on an integrated campus rather than having our hospital more than 10 miles from our main clinic offices. It's about time to make great progress toward that goal.

Sincerely,

George B. Bartley, M.D.
Chair, Board of Governors
Mayo Clinic Jacksonville