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@sueinmn

Thanks, Colleen, for inviting me into this discussion, even though I haven't been a Mayo patient.
@mpflood7 - How wise to research this issue ahead of your visit!

I can share my story of care in the large multi-specialty practice I have been with for 45 years now in the Twin Cities, and contrast it with the care provided through an independent ortho practice I also use. Over that time I have dealt with many health issues.

Here is how the group practice collaborates - I have a primary physician, chosen after several earlier docs "moved on" to other practices. She readily acknowledges when a health concern is beyond her expertise and refers me to a specialist. Based on our working relationship, and her knowledge, she "matches" me with the specialist best suited to my problem and whose expertise and approach she respects. At times she has cautioned me that I need to travel across town to get better care as the local specialist is not the best one for me. It is important to me that she continues to study (she was recently certified in Gerontology - nice since I'm now older) because it tells me she is keeping up on the latest in medicine.

The specialists collaborate with my primary, and at times with additional specialists to plan and manage my care. When hospitalized, other than surgeons, the docs may not be in the hospital, and my care is overseen by a hospitalist who is part of the clinic team. He consults as often as necessary with my clinical care team as well as docs in the hospital.

Recently, I have been treated by my primary, pulmonologist, infectious disease doc, pain management doc, bone specialist, opthalmologist and a specially trained physical therapist, all of whom communicate to manage my care. Several of them have also called me personally to respond to questions sent by other team members or through the patient portal.

This same group managed my Mom's very complex medical issues, all the way through compassionate end-of-life care, and communicated with my sister and me through the entire process. My daughter was the case manager in the assisted living facility where Mom lived, and said her clinic was one of few that always responded timely to her when she left messages, and never required multiple calls to get a reply.

In sharp contrast, my ortho docs, whom I have chosen individually for their specialties in specific surgeries, are in a well-respected but not collaborative practice. When I had severe medical issues after hip surgery, the surgeon never responded to repeated pages and calls, and finally the hospitalist from my clinic stepped in and brought in appropriate specialists. When I asked the surgeon why, he said he knew they would "take care of it" - needless to say I never saw him again & filed a complaint. When my hand surgeon left the practice and I asked for referral to another, who would do a very specific procedure, all I got was a list of their hand surgeons. I had to call my hand therapist for a recommendation to the best person.

I hope this (long) description of how multi-specialty integrated care can work helps you in your decision making. If I did not have this practice to rely on, I would be a Mayo patient, and in fact at one point in my lung illness, the docs were considering referring me there.

I wish you good luck as you seek help - dealing with complex medical issues can be daunting. The added pressure of having only a single opportunity to choose a hospital makes it even more difficult. Mayo is truly a place for the best of care - when my daughter was a paramedic, she often met planes in Minneapolis and transported patients from all over the world to Rochester.
Sue

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Replies to "Thanks, Colleen, for inviting me into this discussion, even though I haven't been a Mayo patient...."

Thank you. Very informative. I am particularly interested in both the collaborative and the comparative aspects which you addressed. A theme well-underscored in your comment re: collaborative is the quality communication. And learning about the process regarding the integrated versus specialty comparison is also helpful.

In so far as systemic disorders, it puzzles me that the trend (in both training and practice) seems to be toward greater specialization when no individual organ can be viewed in isolation from its role in the functioning of the overall body. My father specialized in cardiopulmonary but always had a stack of internal medicine journals to read every Sunday (day off) - and stay abreast of holistic medical developments. This allowed him to be both a generalist and a specialist, which is what am told is needed in my case.

Do you (or anyone) know whether the Mayo approach emphasizes the idea of a generalist/specialist in their doctors?

Thank you for sharing. It appears that you have a great medical team, which I am searching for.