History of Cleveland Clinic

Cleveland Clinic's original building, built in 1921

Cleveland Clinic was established in 1921 as a hospital in Cleveland, Ohio.

Early beginnings

Origins

George Washington Crile, MD, one of the four founders

Cleveland Clinic grew out of the surgical practice of Frank J. Weed, MD, at 16 Church Street on the near west side of Cleveland.^[1] Weed died in 1891.^[2] The practice was purchased by his two assistants, Frank E. Bunts, MD, and George Washington Crile, MD. In 1892, they brought Crile’s cousin, William E. Lower, MD, into the practice.^[3] In 1897, they moved their practice to the Osborn Building on Prospect Avenue in downtown Cleveland.^[1][4] Crile, Lower and Bunts all became professors at Cleveland medical schools, and each would be elected president of the Academy of Medicine.^[5]

Crile organized the American military hospital in Paris in 1915, and later led the United States Army Base Hospital No. 4, in Rouen, France. It was the first contingent of the United States Army to see active duty in Europe during the First World War.^[6][7] Bunts and Lower also served in the Rouen hospital. Lower later wrote of his admiration for the "teamwork and efficient organization" of military medicine.^[8] In his autobiography, Crile reports that while in France, the three doctors discussed starting a new medical center in Cleveland upon their return.^[7][9]

First years of operation

A four-story outpatient building was constructed on the purchased land. Cleveland Clinic was dedicated at a private ceremony on February 26, 1921.^[10] William Benson Mayo, MD, of the Mayo Clinic, delivered the main address.^[9][11] On February 28, 1921, Cleveland Clinic opened its doors to the public and registered 42 patients.^[5] In April 1921, Cleveland Clinic had 60 employees, including 14 physicians, four nurses, a telephone operator, six cleaners, 22 clerical workers, an art department, and an unknown number of laboratory technicians. In 1922, the founders purchased four private homes nearby for hospitalization, radiation treatment, and administration.^[12] A fifth house was acquired as a residence for patients with diabetes receiving insulin treatments.^[12][13] To meet rising patient volume, a 184-bed hospital was built in 1924, located at East 90th Street and Carnegie Avenue.^[14] A power plant, laundry, and ice plant were also built.^[12][15] A research laboratory was constructed in 1928.^[12][16]

Disaster and recovery

On May 15, 1929, nitrocellulose x-ray films stored in the basement of the outpatient building ignited.^[17][18][19] An explosion sent a cloud of toxic oxides of nitrogen and carbon though the building. One hundred and twenty-three people lost their lives, including founder Phillips. A dozen investigating agencies were not able to determine a single cause for the Cleveland Clinic fire of 1929.^[18] Cleveland Clinic’s own inquiry narrowed the possible causes down to three: spontaneous combustion caused by heat; a discarded cigarette or match; contact with an extension cord light hung over a stack of films.^[18]

Philanthropist Samuel Mather formed a committee of 36 community leaders to help Cleveland Clinic reestablish itself in temporary quarters across the street.^[18][20][21] Patient care services resumed five days later.^[20] The 1921 building was completely renovated, and a new three story clinic building, with a new main entrance, was added in 1931.^[18] All debts were repaid by 1941.^[22]

Growth of specialization

Leadership

Cine-coronary angiography was developed at Cleveland Clinic by F. Mason Sones, MD, in the late 1950s.^[23]

Crile and Lower relinquished their administrative duties in 1941.^[15] In 1942 Cleveland Clinic’s Naval Reserve Unit, which included George Crile, Jr., MD, son of one of the founders, established a mobile hospital in New Zealand to treat wounded from the Guadalcanal Campaign.^[24]

In 1954 Cleveland Clinic formally adopted governance by a physician-led Board of Governors. The nine physician governors are elected by the physician staff. They work with the CEO and lay administrators to formulate and carry out policy, overseen by a board of directors and board of trustees^[22][25] This is a list of the chairman of the Board of Governors, and their terms of office:

• Fay Lefevre, MD, 1954–1968
• Carle E. Wasmuth, MD, 1968–1973
• William S. Kiser, MD, 1973–1989
• Floyd D. Loop, MD, 1989–2004
• Delos M. Cosgrove, MD, 2004–present.^[15][26]

Organization

Until 2007 Cleveland Clinic's largest organizational unit was the division: division > department > section. There was a Division of Medicine, Division of Surgery, Division of Anesthesiology, etc.^[27] Within each division were departments (Department of Infectious Disease, Department of Cell Biology, etc.).^[27] Within each department were sections, (Section of Headache and Facial Pain, Section of Metastatic Disease, etc.). Divisions and departments were led by chairs, and section were led by heads.^[27] In 2007, Cleveland Clinic reorganized patient care services around disease and organ-system-based institutes.^[27][28][29]

Growing facilities

Cleveland Clinic Taussig Cancer Institute

Cleveland Clinic built new operating rooms in the early 1970s to accommodate the growth of cardiac surgery.^[15] The Martha Holding Jennings Education Building opened in 1964, with an auditorium named for Bunts. A new hospital building (currently home to Cleveland Clinic Children’s) was opened in 1966, and a new research building went up in 1974 (demolished in 2007).^[15] A pathology and laboratory medicine building was constructed on Carnegie Avenue in 1980.^[27] Kiser led the development of a strategic plan to accommodate growing patient volumes in the late 1970s. This resulted in a group of buildings known as the Century Project. Completed in 1985, the Century Project including a 14-story outpatient building (now known as the Crile Building), designed by architect Cesar Pelli, .^[30]

Becoming a system

Patient drop-off roundabout and fountain at Cleveland Clinic's main entrance

Loop was appointed chairman of the Board of Governors in 1989. In the late 1990s, Cleveland Clinic merged with nine regional hospitals: Marymount Hospital, Lakewood Hospital, Fairview Hospital, Lutheran Hospital, South Pointe Hospital, Euclid Hospital, Health Hill Hospital, and Ashtabula County Medical Center (an affiliate hospital). (Medina Hospital joined the system in 2009; Akron General Hospital became an affiliate in 2015.) ^{[31][32][33][34]}

For access from local communities, Cleveland Clinic began building what are now 18 Family Health and Service Centers across the region. These facilities offer primary care, specialty services and outpatient surgery.^[25][35]

Other Cleveland Clinic programs and facilities dating from 1998 to 2004 include the Sherwin Research Building, Children’s Hospital, Cleveland Clinic Innovations,^[36] the Surgery Center, Neurological Imaging Center, Cleveland Clinic Sports Health, Intercontinental Hotel and Bank of America Conference Center. During this period also, Cleveland Clinic invested in electronic medical records system that now links all its sites.^[37][38] Cleveland Clinic Florida (begun in Ft.Lauderdale in 1988) opened a medical campus in Weston, Florida, with a hospital, outpatient clinic and 24-hour emergency room.^[25][39]

Loop launched a capital campaign in 1997 with a $16 million lead gift from the Norma and Al Lerner and family.^[40] This campaign raised $191 million to build the Lerner Research Institute, Cole Eye Institute, and Taussig Cancer Center.^[25] Another gift from the Lerner family enabled the launch of the Cleveland Clinic Lerner College of Medicine of the Case Western Reserve University (CWRU) School of Medicine in 2004.^[41] A $44 million Center for Genomics Research^[42] was completed in 2004, along with a new parking garage across the street from the 1921 building.^[14][43] In 2001 Loop announced plans for a new home for heart and vascular services. The campaign to finance the project continued after his retirement in 2004.^[25]

References