May 1959: Understanding Where Patients Come from
Facts and figures don’t usually make very sparkling stories. Yet registration at Mayo Clinic—the numbers of people who come here for medical care—is the best single indicator of demand for Mayo services. In May 1959, a quiet, young man named K. J. Ladner, Section of Administration, presented years of studies on the who, when, and why of Mayo patients.
Registration in 1913 was more than 24,000, a fantastic total for the period. This skyrocketed to 78,000-plus by 1929. The Big Depression dropped it to around 50,000. With better times, a generally steady annual increase continued until about 1950.
Registration topped 150,000 for the first time in 1956. It was up again in 1957. In 1958, it was just a few hundred under 160,000. Since 1907 more than 2,200,000 different men, women, and children have come to Mayo, from once to many times.
Where did they come from? Ladner prepared graphs “plotting” the number of patients registered at Mayo by year from 1946 to 1958. He also prepared “curves” to show the geographic origin of patients in four categories. These categories were "Rochester;" "Minnesota excluding Rochester;" "within 500 miles of Rochester, excluding Minnesota and Rochester"; and "beyond 500 miles of Rochester." Changes in registration patterns for the 4 geographic areas over those 12 years showed the following:
- The biggest increase, both in number and in percentage of the total, was from the growing Rochester community—from 21,000 in 1946 to 39,500 in 1958.
- The next biggest increase on both points was from Minnesota excluding Rochester—from 22,100 in 1946 to 32,300 in 1958.
- Next came the “within 500 miles of Rochester, excluding Minnesota” category. While this was up in numbers (54,400 to 61,900), it was down a small fraction in percentage of total registration.
- The number of patients from more than 500 miles of Rochester in 1958 was an impressive 25,400. But the 1946 figure had been 35,700. That is, both in numbers and percentage of total registration this group showed the most marked decline.
These findings suggested that Mayo Clinic’s practice, while still including thousands of patients from great distances, was becoming more regional and less national and international.
One factor was the growth of major medical centers in other parts of the country. Another factor might have been a continuing revolution in transportation. While trains, airplanes, and buses were vastly important, a majority of patients were coming to Mayo by car. It was thought back then, that as highways of the area and region improved, the number of patients who come to Mayo for examination and still be able to sleep in their own beds each night will increase. In 1959, the “come to Mayo, sleep at home” group was limited to a 40–50 mile radius of Rochester.
If the trends suggested in Ladner’s charts continue, another point becomes increasingly plain. No single patient should ever be thought of as being more—or less—important than any other patient, whatever the home address.