January - March 2013 Edition: Naples Health

The network in action On the same day as the network asso- ciation between Mayo and NCH was announced, NCH psychiatrist Damian McGovern, M.D., was puzzling over the case of a patient who was exhibiting an unusual combination of psychiatric and neurologic symptoms. “We were wondering if the psychiat- ric symptoms were due to a particular psychiatric diagnosis or if we were dealing with two separate diseases at the same time,” Dr. McGovern says. “As we started to do an exploration of the underlying source, we discovered a fam- ily history. Similar symptoms had been exhibited by the patient’s parent.” A team consisting of an internal medi- cal specialist, a neuropsychologist, a neurologist and Dr. McGovern con- ducted a series of tests and concluded they were dealing with a rare form of hereditary mental illness. As part of his psychiatric residency at Mayo Clinic in Rochester, Dr. McGovern did a rotation at Mayo Jacksonville, under Dr. Neil Graf-Radford. “I spent an entire month under his supervision,” Dr. McGovern says. “I spent some time in a neuropsychology department where we did tests for spe- cific neuropsychiatric subcategories that are hereditary. This is where Mayo Clinic becomes invaluable. The people who are doing it every day are able to diagnose and offer suggestions for the next step.” “All of this came together on the day we became part of the Mayo network,”

The Mayo model And just how did Mayo become the go-to institution for cutting-edge medical expertise? The answer to that question lies in Mayo’s history. In 1863, Dr. W.W. Mayo arrived in Roch- ester as part of his appointment as an examining surgeon for the military dur- ing the Civil War. He found he liked the town and stayed on after the war ended, opening a private practice. In 1883, his older son, William J., completed medi- cal school and joined him. Younger son Charles followed suit in 1888. Within a few years the Drs. Mayo had convinced other physicians to join them in an integrated group practice, which allowed them to offer comprehensive care to patients. Before long physicians from around the world were coming to the “Mayos’ clinic” to observe and to learn from its cutting-edge procedures and protocols. Such a cooperative approach was unusual at the time, but Dr. William J. Mayo explained its necessity and advan- tage in a commencement address he gave at Rush Medical College in 1910: “The best interest of the patient is the only interest to be considered, and in order that the sick may have the benefit of advancing knowledge, union of forces is necessary. It has become necessary to develop medicine as a cooperative science.” That primary focus on the patient led to the Mayo Clinic we know today,

he continues. “I knew this was one of the more interesting cases we’d seen all year and one that goes beyond the scope of what a community hospital can do. I called down to administration and said, ‘What do I need to do to make (an eConsult) happen?’” Such eConsults allow local physicians to contact Mayo experts to ask for advice and assistance on specific cases. Allen Weiss, M.D., President and CEO of NCH Healthcare System, notes that the initial plan had been to phase in the use of eConsults, starting with cardiac and pulmonary critical care. “We didn’t want to expand so fast that the program didn’t work well,” Dr. Weiss explains. “So we decided to start with things we do well already. This first eConsult just popped up, and there was such a need. We asked ourselves, ‘What would Mayo do?’ You can’t put a patient who is already confused on a plane to Jacksonville.” And so Dr. McGovern was given the go-ahead for the consult. He contacted Mayo on a Friday to find out what was needed from NCH’s end. On Monday morning, he received all the information he needed to employ the system. He filed the information and within 48 hours received a full evaluation from Mayo Clinic experts. The Mayo physicians reassured the NCH team that they were taking the best approach and recommended additional testing. The consultation will continue as those results are received.

How a patient got a boost on almost the first day after NCH became a Mayo Clinic Care Network member. Photograph by Alex Stafford Mayo Bonus The

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JANUARY-MARCH 2013 | Naples Health

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