Delos “Toby” Cosgrove
president and CEO, The Cleveland Clinic
You need a map to track Dr. Toby Cosgrove’s influence. And not just a zoomed-in Google view of the Cleveland Clinic’s ever-growing, ever-transforming campus.
No, you’ll need to include Washington, D.C., where Cosgrove has traveled four times this year to press senators and presidential aides on including cost-saving innovations in health care reform.
Hospitals nationwide noticed when President Obama visited the Clinic in July, touting it as a model of efficiency. Cosgrove’s influence also stretches to the Middle East, where the Clinic manages a hospital in Abu Dhabi and plans to open another in 2012.
Cosgrove wields more power in more spheres of influence than anyone in Northeast Ohio. He’s the president and CEO of Cleveland’s largest employer, overseeing 40,000 workers and a $5 billion health care system — and he’s also a civic leader, innovator, entrepreneur, public-health crusader and inventor.
On his first day as CEO in 2004, Cosgrove passed out buttons that read “Patients First.” He was determined to lose the Clinic’s reputation as a technically brilliant hospital with a mediocre bedside manner.
“He has personalized the Cleveland Clinic,” says Sam Miller, Forest City co-chairman and Clinic board member. “Used to be, when people spoke about the Cleveland Clinic, it was like a factory. ... That’s over with.”
Cosgrove pushed to improve all of the Clinic’s interactions with patients, from appointments to check-ins to treatment. He even, at one point, named a chief empathy officer (a job now handled by an Office of Patient Experience).
“It’s very important to realize absolutely every individual is a caregiver in one way or another,” Cosgrove says.
He’s even improving a legendarily unpleasant aspect of hospital stays. “Ever had a hospital gown on?” he asks. “And you walk around with your backside hanging out? They’re humiliating, dehumanizing. We wanted something that brought a little more dignity to the patient.”
So Cosgrove approached renowned fashion designer Diane von Furstenberg at a CEO conference in Idaho and convinced her to create a better gown. After many experiments and redesigns, the new-age gowns, which resemble von Furstenberg’s famed wrap-around dresses, will debut at the Clinic this year.
When Cosgrove became CEO, he had to learn on the job. “I didn’t have an MBA. I went home every night and hit the books.” He spent a year and a half reading and talking to medical management experts. “It was kind of like an internship all over again.”
One key insight came from Harvard Business School professor Michael Porter: “Not all hospitals are going to be all things to all people,” Cosgrove says. “You needed to collect patients in areas of excellence.”
The Clinic stopped delivering babies on the main campus, leaving that to its community hospitals, while heart surgeries moved from the satellites to downtown. That saves money, but the quality of care goes up too, Cosgrove says, because doctors get better with more practice in their specialties.
Cosgrove has made the position of Clinic CEO into a sort of surgeon general for Northeast Ohio: He’s our top doctor, speaking for the medical profession, sounding alarms for the public.
He banned smoking on the Clinic campus, offered free smoking cessation programs to all employees, then stopped hiring smokers. He lobbied hard for Ohio’s 2006 ban on public smoking and sponsored a quit-cigarettes program for all of Cuyahoga County in 2007.
In four years, the incidence of smoking in Cuyahoga County dropped from 28 percent to 18 percent. (It’s a flat 20 percent nationwide.) “We might have saved more lives with the program than I did in a career in cardiac surgery,” he says.
Now he’s leading the Clinic in a similar campaign against obesity.
Cosgrove also wants to improve Northeast Ohio’s economic health. He proposed the Medical Mart project in 2005 and recruited Chicago developer MMPI to build it. Cosgrove, who got the idea from a Saudi sheik who wanted to build a med mart in Dubai, says he pushed for it after years of thinking about how to develop Northeast Ohio’s economy around medicine.
That’s why the Clinic is partnering in an incubator for startups, the Global Cardiovascular Innovation Center, under construction on Cedar Road. Before he was CEO, Cosgrove helped set up the Clinic’s technology transfer office; it’s since spun off about 33 companies.
An innovative heart surgeon, Cosgrove holds the most patents of anyone in the Clinic’s employ, and the tech transfer office has licensed some of his inventions: surgical instruments, heart valves and computerized drug delivery systems.
“We think that we are now in the age not of manufacturing, but of using intellectual capital,” says Cosgrove. “It’s a whole revolution in the economy.”
Proof of that spreads across Cleveland’s landscape: The Clinic continues to attract construction cranes even as downtown Cleveland seems locked in stasis. That’s why Cosgrove’s message — and his clout — resonate louder in Greater Cleveland every year.