assisting in the elucidation of the problem at hand, and each dependent
upon the other for support.”^16
Henry Plummer continued to innovate, serving as the chief
diagnostician and “systematizer” for decades. He and his colleagues
invented the unified medical record, the hospital chart that is so common
to us today. Prior to this ingenious idea, patients’ information was
handwritten in a daily log, making it impossible to retrieve patient
information and track outcomes. Now, each patient was identified by a
Mayo patient number, a numeral that stays with them for life—proudly, I
have one—and an individual paper chart was created exclusively for that
patient. Each subsequent hospitalization was recorded in that patient’s
chart, allowing for greatly enhanced continuity of care.
Plummer also played key roles in the construction of world-class
medical buildings in Rochester, performed groundbreaking research, and
served as one of the best diagnosticians in the world. His career spanned
the decades of vastly improved medical technology, and his early adoption
of X-rays and the EKG machine helped propel the Mayo Clinic to the
vanguard of medical practice.
Both Mayo brothers died in 1939, by which time the Mayo Clinic had
become the preeminent medical destination in the world. US presidents,
CEOs, dignitaries, the wealthy and the destitute, and surgeons themselves
had flocked to Rochester. It had become the world’s oldest and largest
multispecialty group practice, helping shape the very nature of
specialization itself. Historian Rosemary Stevens states that
“specialization is the fundamental theme for the organization of medicine
in the 20th century.”^17 By the end of World War I, most doctors were
specialists, there was an outgrowth of technological expansion, the
introduction of residency training, and there were improvements in the
structure of medical schools following the Flexner Report.
The fact that the Mayo brothers had not completed surgical residencies,
and yet helped transform the practice of surgery, the organization of
hospitals, and the education of doctors—is amazing, to say nothing of the
notion that it was worth traveling to tiny Rochester, Minnesota, to receive
expert care.
The Mayo brothers, William Halsted in Baltimore, and the surgeons in
London, Berlin, and Vienna were radically changing surgery at the turn of
the 20th century. As generalists embraced specialization, additional years