10 Things to Know About Cleveland Clinic CEO Dr. Toby Cosgrove

Ten years ago, Delos "Toby" Cosgrove, MD, was named president and CEO of Cleveland Clinic. He was 63.

"At an age where many people are considering retirement, I was handed a whole new career," Dr. Cosgrove wrote on his LinkedIn influencer page, which in itself is a testament to his powerful presence in the healthcare industry.

A physician, businessman and leader, here are 10 things to know about Dr. Cosgrove, one of healthcare's most successful leaders.

1. Dr. Cosgrove has worked with Cleveland Clinic for 39 years. After joining the Cleveland Clinic in 1975 as a cardiac surgeon, Dr. Cosgrove was named chairman of the department of thoracic and cardiovascular surgery in 1989. Dr. Cosgrove also was a surgeon in the U.S. Air Force, serving as chief of U.S. Air Force Casualty Staging flight in Da Nang, Republic of Vietnam. He received his undergraduate degree in history from Williams College in Williamstown, Mass., and received completed his medical degree at the University of Virginia School of Medicine in Charlottesville. He completed his clinical training at Massachusetts General Hospital in Boston, Boston Children's Hospital and Brook General Hospital in London, England. Dr. Cosgrove retired from surgery in 2006.

2. Dr. Cosgrove is an innovator, helping develop the health system's venture capitalist company. Before being appointed president and CEO of Cleveland Clinic, Dr. Cosgrove helped set up Cleveland Clinic Innovations, the technology transfer and commercialization arm of the health system, which has enabled nearly 60 spinoff companies to develop and sell new medical technology. Even as a cardiac surgeon, Dr. Cosgrove was pushing the boundaries of medical innovation. He performed the first minimally invasive mitral valve surgery over a worldwide video network in 1996, a practice that is widely used today. Dr. Cosgrove also holds 30 patents for medical and clinical products used in surgical environments, including the Cosgrove Mitral Valve Retractor, the Stentless Aortic Valve and the Low Velocity Aortic Cannula.

3. His foray into venture capitalism served as a stepping stone to his position as president and CEO. "Cardiac surgery is an athletic event," Dr. Cosgrove said during a C-SPAN interview with David Lamb. "I had seen a lot of surgeons come to the end of their careers and not stop when their athletic abilities deteriorate. I wanted to stop before that happened."

Dr. Cosgrove said he considered several opportunities, one of them being Cleveland Clinic Innovations, because he wasn't ready to "hang up my spikes completely" but still was figuring out what to do. His predecessor, Floyd Loop, MD, announced his retirement, and Dr. Cosgrove was asked to consider the position.

4. As CEO, Dr. Cosgrove oversees a $6.5 billion healthcare system spanning states and continents. The Cleveland Clinic includes a main campus, 75 outpatient locations in northern Ohio, 16 full-service Family Health Centers, Cleveland Clinic Florida in Weston and West Palm Beach, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada in Toronto and Cleveland Clinic Abu Dhabi, which is currently under construction. The $6.5 billion system Dr. Cosgrove oversees has steadily increased revenue since he first became CEO. In 2004, the operating revenue was approximately $3.5 billion. Additionally, the system's FY 2013 total profit of $900 million is a 46.7 percent increase from 2012.

5. Heavily published in journals, Dr. Cosgrove also recently published a book outlining Cleveland Clinic's formula for success. Dr. Cosgrove has published nearly 450 journal articles, and in December 2013, he published "The Cleveland Clinic Way," a 200-page book discussing trends for healthcare's future and how Cleveland Clinic continues to be such a prominent leader in healthcare business, strategy and care quality.

6. Dr. Cosgrove pitched, and oversaw the building of, the first-of-its-kind Global Center for Health Innovation. The Global Center for Health Innovation is a hospital supply showroom, of sorts, attached to the Cleveland Convention Center. The Center features four themed floors displaying "the future of health and healthcare," such as research, product development, branding and sales and service results. There are single-vendor showrooms that display and demonstrate technology-based products and multi-vendor areas that offer technology, "views of the future" and educational spaces. Based off Chicago's Merchandise Mart, the Global Center for Health Innovation was designed as a comprehensive offering of future medical and surgical innovations transforming the face of healthcare. He pitched his idea of this medical mart when he first interviewed for the CEO position, according to a Forbes report.

7. Transparency is critical to patient care quality, Dr. Cosgrove believes. Dr. Cosgrove sees transparency around clinical quality as one of the hospital's obligations to its community. "This is not an easy process," he said at the Becker's Hospital Review 5th Annual Meeting in Chicago. "We've invested heavily in this. It causes us to keep data, look at data, and causes us to do it better."

Dr. Cosgrove developed Cleveland Clinic's Outcomes Book concept, a publicly available set of reports on individual service lines detailing clinical performance measures of the health system, according to a Forbes report. He began measuring and sharing surgical outcomes as chair of heart surgery to hold staff accountable and carried that practice to his executive level position.

8. Dr. Cosgrove said Cleveland Clinic's employee reductions weren't entirely due to the healthcare reform; rather, it was a response to business pressures. In fall 2013, Cleveland Clinic was tasked with cutting $330 million from its budget. After cutting non-personnel costs, the health system cut several hundred open positions and offered early retirement packages to approximately 3,000 workers, 700 of whom accepted. Many attributed the cuts to healthcare reform, including hospital spokesperson Eileen Shields, who said, "To prepare for healthcare reform, Cleveland Clinic is transforming the way care is delivered to patients," in a Reuters report.

However, Dr. Cosgrove said the cuts aren't wholly related to the healthcare law, according to a CNBC report. "It is related to pressures from business, pressures from all the way around to reduce the cost of health care. So we are looking at this as a change in the entire ecosystem of the healthcare industry," he told CNBC.

9. Under Dr. Cosgrove's leadership, Cleveland Clinic became the first tuition-free medical center in the country. In 2008, Cleveland Clinic Lerner College of Medicine — a partnership between Cleveland Clinic and Case Western Reserve University in Cleveland — became the first virtually tuition-free medical school in the country. Every student receives a full scholarship covering tuition and fees, as well as a stipend to cover the fifth year when students typically are conducting research. "This is our investment and our intellectual capital for the future," Dr. Cosgrove said in his keynote speech at the Becker's Hospital Review 5th annual meeting.

Cleveland Clinic is supporting the full-tuition scholarships through endowments and hospital operations and hopes to eventually fund the scholarships entirely through endowment income. The goal of the full scholarship program is to encourage students to enter any field of medicine as opposed to high-paying specialties with the burden of student loans weighing in the backs of their minds, according to a report by The Plain Dealer.

"[CCLCM] had a unique curriculum designed to train medical doctors who were also able to do high quality research. But after several years of operation, we realized that it wouldn't be enough. Clinical research is not one of the higher-paying career paths. Why simply graduate our students into the same debt dilemma as those faced by all other young doctors?" Dr. Cosgrove has written.

10. For Dr. Cosgrove, the patients always come first, which is the basis of Cleveland Clinic's same-day appointment promise. Patient-centered care is at the heart of Cleveland Clinic and its mission and values, which is why anybody calling the health system is offered the opportunity to see a physician the very same day. Dr. Cosgrove made clear his commitment to patient-centered care his first day as CEO when he distributed nearly 40,000 buttons simply stating "Patients first." This commitment was also the inspiration for a Cleveland Clinic-produced video emphasizing the human element of patient care.

"People come to us at the most vulnerable times of their lives," Dr. Cosgrove has written. "They look to us for compassion. They trust us with their most precious assets — their health and the health of their parents, spouses and children. How could we ever be less than empathetic to anyone who comes through our doors?"

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