Baylor University Medical Center Proceedings April 2014, Volume 27, Number 2 | Page 99

Compensation of the physician staff focuses on quality, not
quantity. All physicians at Mayo Clinic are salaried. Their salary
range is approximately at the 70th percentile of market level
with no productivity bonuses. It is the Mayo Clinic perspective
that patients are not served well if physicians compete with each
other. The highly productive work of the staff is maintained
through careful staff selection for special expertise, proven excellence in patient care, and a strong work ethic. There are no
employment contracts or tenured periods for physicians. The
environment also promotes staff loyalty and stability, with low
attrition. In recent years, only 2.4% of physicians and 4% of
nurses left the institution after appointment to the staff.
And cost must be appropriate. Dr. Will described the neverending number of patients who would seek out care at the
Mayo Clinic if the clinic provided the best possible diagnostic
and treatment outcomes at low cost, a concept now recognized
as the value equation in health care. Mayo Clinic has taken a
strong stance nationally that medical reimbursement should
pay for value, not volume. Assessing and improving value is
taken seriously and is defined by outcomes, quality, safety, and
service divided by cost. Data from the Dartmouth Atlas of Health
Care looking at total cost for patients in the last 2 years of life
found that costs at Mayo Clinic were far less than at other
major medical centers for similar patients. Factors contributing
to these findings may include salaried physicians, efficiency of
testing and procedures, ready access to a team of physicians, fast
diagnoses, short hospitalizations and episodes of care, and fewer
evaluations, tests, and consultations. Physicians at Mayo Clinic
typically do not know the insurance status of their patients.
Behind the practice structure at the clinic is a highly involved
logistics system aimed at improving quali G