Cleveland Clinic: Born from World War One

Four surgeons came home from the Western Front with a conviction that American medicine was doing it wrong. George Crile, Frank Bunts, William Lower, and John Phillips had served together in the Lakeside Unit, the Cleveland medical team attached to the Allied forces in France. What they experienced in the military hospitals was a kind of medical practice they had not encountered at home: specialists working together, sharing patients, sharing expertise, coordinating as a team rather than competing as individual practitioners.

Private medicine in the United States in the early twentieth century was organized around the individual physician. A doctor built his own practice, guarded his own patients, and operated largely alone. The four men who had worked in the military hospitals found this arrangement, by comparison, wasteful and inferior to what coordinated specialization could produce.

On February fifth, nineteen twenty-one, they incorporated the Cleveland Clinic, which opened at the corner of Euclid Avenue and East Ninety-Third Street. The model was explicit: they would function as a group practice. No individual ownership of patients. Specialists would consult freely across disciplines. The institution would own the practice, not the physicians. They took salaries rather than fees.

The model was radical for its time and resisted by most of the established medical profession, which viewed group practice as a kind of socialism. The Cleveland Clinic was sued, criticized, and ignored by mainstream medicine for years.

It survived. By the middle of the twentieth century, the group-practice model it had pioneered was becoming standard in American medicine. The clinic itself grew into one of the largest medical centers in the world. The four men who came home from France with a better idea built something that outlasted everything around it.