Bring the World’s Best Hospitals to Virginia

Mayo Clinic — why not aim for the best?

by James C. Sherlock

Virginia does not host a single one of the world’s best hospitals.[1] But America does. Mayo Clinic and Cleveland Clinic have been ranked at the top of such ratings for as long as I can remember. Neither of them are here in the Commonwealth, I believe Virginia could change that.

Mayo Clinic is top-ranked for quality more often than any other health care organization.It has medical centers in Rochester, Minn., Jacksonville, Fla., and Phoenix, Ariz. In addition, Mayo Clinic partially owns and operates the Mayo Clinic Health System in Minnesota, Iowa, and Wisconsin.

Cleveland Clinic has countless facilities all over Ohio and locations in Abu Dhabi, United Arab Emirates, London, in Charleston WV, Toronto,  Las Vegas and Elko, NV and dozens of locations in Florida.

With the exception of Cleveland Clinic’s Charleston, W.Va., outpost on the periphery of its Ohio core, neither system has a mid-Atlantic presence.

The business case for attracting Mayo Clinic and Cleveland Clinic to locate here must include:

  • freedom to create a regional system by a combination of acquisitions and construction;
  • state and local government support;
  • regional airports, interstate highways, lodging and other attractions to support destination medicine; and
  • freedom to develop a regional campus of the Mayo Clinic College of Medicine and Science or the Cleveland Clinic Lerner College of Medicine or both.

Most of what they need exists in Virginia  Freedom does not. Without permanent exemption from Certificate of Public Need, the conversation will never begin.

Those systems attract medical professionals from all over America. They will serve to alleviate Virginia’s shortages of doctors and nurses with the draw of world-class excellence, medical schools and Continuous Nursing Education (CNE) opportunities.

I recommend two locations in Virginia that should prove perfect for them.

South Hampton Roads. The first is South Hampton Roads and its 1.3 million people. Virginia Beach is already a major regional tourist destination and the largest city in the state.

Chesapeake can offer a major hospital that has struggled economically for a long time. Norfolk and Portsmouth host Bon Secours hospitals that have not made money for years. They are under constant economic pressure from regionally dominant Sentara and Sentara’s Optima Health HMO and health insurer. Good luck to Sentara in trying to pressure Mayo Clinic.

The Chesapeake Regional Medical Center is an outlier here. It is not a part of a larger system. The Board of the Chesapeake Hospital Authority is appointed by the city council. The board already has legal authority to sell the hospital. Bon Secours would, I believe, readily sell DePaul (Norfolk) and Maryview (Portsmouth) or form a joint venture with the new system. This would not present antitrust issues because Sentara would still be larger.

Norfolk/Virginia Beach International Airport serves the entire mid-Atlantic. I-64 is being widened all the way to I-95 and a third tube is being built for the Hampton Roads Bridge Tunnel.

Prince William County. The other potential location is Prince William County. It is growing fast. It is already seeking to attract a medical school. It is served by Dulles and two very busy general aviation airports.

Prince William is served by Sentara Northern Virginia Medical Center in Woodbridge and Novant Health UVA Health System Medical Centers in Manassas and Haymarket. While the new system will want to build its own central campus and medical school, it also will be open to joint ventures with existing hospitals. Again no antitrust issues.

Leadership Required. Each location is attractive. Each healthcare system would raise the quality of medical care in Virginia. Each would help alleviate Virginia’s physician and nursing shortages. Each would prove a major economic boon.

With the COPN exemption in place, it is not unreasonable to think that Virginia could attract both Mayo Clinic and Cleveland Clinic. God knows we need the help. We will never know unless we try.

What say you, Governor? General Assembly members? Chambers of Commerce? Local elected officials?

James C. Sherlock, a Virginia Beach resident, is a retired Navy Captain and a certified enterprise architect. As a private citizen, he has researched and written about the business of healthcare in Virginia. 


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11 responses to “Bring the World’s Best Hospitals to Virginia”

  1. Peter Galuszka Avatar
    Peter Galuszka

    Bill goodwin, a richmond investor, tried several years ago to build a children’s hospital in the city. He met great opposition from VCU and it never happened

    1. Not just any old children’s hospital, but a world-class research children’s hospital. He pledged something like $300 million (maybe it was $500 million) to the initiative. VCU wanted to build a children’s hospital, too, but it could have re-directed its resources to other initiatives…. or, god forbid, charging its patients less.

  2. Rowinguy Avatar

    Maybe a reason (if not the reason) neither Cleveland Clinic nor Mayo has a mid-Atlantic presence is a little place in Baltimore…..

    1. Dick Hall-Sizemore Avatar
      Dick Hall-Sizemore

      There is also a little hospital in Durham, N.C., that is ranked fairly highly.

  3. Rowinguy Avatar

    World class children’s hospitals also exist in D.C. and Philadelphia, as well.

  4. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    Would COPN be a factor in whether Mayo or Cleveland could purchase the Chesapeake hospital and then merge with the two Bon Secours facilities as you suggest? That would not be an expansion of facilities, just a change in ownership, as Sentara has done, so it does not seem that the acquiring hospital would have to go through the COPN process.

    1. sherlockj Avatar

      COPN would be a factor because either Mayo or Cleveland Clinic would not find any campus it acquires meets its full requirements. They would want major expansions of existing facilities and new facilities, including medical schools.

  5. djrippert Avatar

    Isn’t the general strategy of Mayo and Cleveland Clinic to expand in retirement areas? Mayo has “major campuses” in Rochester, MN (where it was started) and Scottsdale, AZ, Phoenix, AZ and Jacksonville, FL. Cleveland Clinic has an operation in Weston, FL which is a planned community in the Miami suburbs.

    I can see why Virginia would want Cleveland Clinic and Mayo but would they see the value in coming to Virginia?

  6. sherlockj Avatar

    Hampton Roads has 1.7 million residents including 215,000 persons 62 and over. It is a major tourist destination that easily will support destination medical treatment from all over Virginia and surrounding states. (Most military retirees like me use public hospitals and primary care, not military hospitals. Retirees must have low incomes to use the VA Hospital in Hampton.)
    Prince William County is growing very fast and provides direct access to the massive Washington metro area population. It already is seeking to upgrade its medical infrastructure, including seeking a medical school.

  7. Peter Galuszka Avatar
    Peter Galuszka

    This is a story I did on the Children’s Hospital proposal four years ago in Style Weekly. It may illustrates the impediments to new hospitals.

  8. sherlockj Avatar

    That is a great article, Peter. Thank you. Congratulations for getting it published. The opposition to clarity in naming names about such selfishness is fierce. In the background of that piece is the fact that under our COPN process, VCU, Bon Secours and HCA would all have had to agree to bring new hospital ownership to Richmond. As you intimated in the article, the chance of that was zero from the beginning, no matter what they said in public.

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