Ohio History Journal

THE ORIGIN OF THE CLEVELAND CLINIC

by HOWARD DITTRICK, M.D.

Editorial Director, the Cleveland Clinic, Cleveland

 

At the request of Dr. Jonathan Forman I have prepared an

historical resume of the origin of the Cleveland Clinic, beginning

with the time when the founders began to work together pro-

fessionally and ending with the opening of the institution which

they created. Much will be said about a figure that drew the

first founders together, and after that events will center about

the activities of the four founders. The methods devised to care

for a complex casualty and general surgical practice, experience

in military medicine in three wars, a persistent urge to carry out

experimental research in the biophysical realm of medicine, and

above all the satisfaction attained in the teamwork which they

developed, all these factors contributed to the establishment of an

institution where patients with more or less obscure problems of

disease could obtain consultation promptly, efficiently, and con-

veniently. Although it does not come within the scope of this

paper, the fact that this institution started from scratch and

now has a plant valued at about five million dollars, and the addi-

tional fact that it serves over 1,000 patients daily would seem to

prove that the founders' vision was justified.

About the turn of the last century there was considerable

discussion over a new system of caring for patients which was

called group practice.  Private practitioners did not regard it

favorably. They considered a combination into clinics as unfair

competitive practice.  Little was said of any advantages that

might accrue to patients from such an arrangement. In earlier

organizations of this type, development occurred through a

nucleus of a few men who were associated together and who,

because of their outstanding success, attracted practice from a

considerable distance. These men decided to expand and invited

other specialists to join the organization. In clinics formed later

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332 OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

a few persons decided to form a partnership and at the beginning

picked out a number of specialists to man the organization. With

the demonstration of immediate success in these early groups the

innovation encountered considerable resistance from private

practitioners; but patients appreciated increased use of consulta-

tions and laboratory procedures and accepted group practice. Over

400 clinics in the United States today testify to that acceptance.

Looming large in the background of the Cleveland under-

taking is the forceful figure of Dr. Frank J. Weed (1846-91),

dean of the medical department of the University of Wooster

(1884-91). Trained under Dr. Gustav C. E. Weber (1828-1912),

the able, autocratic professor of surgery at the Wooster school,

Dr. Weed was himself an excellent surgeon and had a large and

exacting practice.

Cheery, even boisterous, he instilled hope and happiness into

the hearts of his patients. At times he could be autocratic. On

one occasion when the professor of physiology at the University

of Wooster had reported unsatisfactory grades of every member

of the graduating class, Dr. Weed informed him that anyone who

could not make his teaching sufficiently effective to pass at least

one man must be a damned poor teacher, and Dr. Weed gave

every member of the class a passing grade. Young men were

attracted to him and no work was too hard, no hours too long,

nor no duty too disagreeable ever to disturb their loyalty. If it

met with his approbation, that was sufficient reward. Good horses

and smart buggies were his pride. A horse was always instantly

available, a sufficient number being on hand so that fresh ones

were never lacking.

One reason for Dr. Weed's success was his uncanny ability

in diagnosis and in prognosis; this in spite of the lack of laboratory

aids that are so readily available today. The office was at 16

Church Street, not far from the western end of the Superior

Street viaduct. Through diagnostic ability, surgical training as

student and assistant to Dr. Weber, and prestige from teaching,

Dr. Weed built up a large practice.

Under Dr. Weed's inspiration his assistants developed a

system of teamwork that played an important part in this story.

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CLEVELAND CLINIC                   333

 

This can best be told by repeating information from those assist-

ants of Dr. Weed who carried on this tradition and associated

themselves together for the rest of their lives.

The first of these assistants was Dr. Frank E. Bunts (1861-

1928), born in Youngstown, Ohio. After the death of his father

in 1874 he attended high school for one year. Because of financial

considerations he went to live with his grandmother on a large

farm in Girard, Ohio. During the next three years he worked

on the farm and continued in high school. Then in 1877 he

obtained the first appointment to the United States Naval Acad-

emy from Garfield's district in Warren, Ohio. After graduation

there in 1881 he spent two years at sea, cruising from Panama

to Japan. Not being impressed with the opportunities for pro-

motion in the navy at that particular time, he turned to medicine

and matriculated in the medical department of Western Reserve

University. To supply funds for his medical course he taught in

a district school, earning $100 for three months' work. Grad-

uating in 1886 he obtained an internship at Charity Hospital.

This appointment afforded him an opportunity for training under

Dr. Gustav C. E. Weber. It was here also that Dr. Bunts gained

the attention of Dr. Weed and received an offer to work with

him in 1887 after the hospital service was completed. This was a

stroke of good fortune, for the only alternative opportunity had

been to enter practice with an old friend in Ellsworth, Ohio.

Not long after Dr. Bunts entered Dr. Weed's office a va-

cancy occurred for which Dr. Bunts was asked to find a suitable

man. Dr. Bunts has remarked that by this method of selection

Dr. Weed "could fire him if he didn't work out all right." This

subterfuge was never employed, for Dr. Bunts selected Dr. George

W. Crile, an intern at University Hospital, a small hospital on

Huntington Street near the Wooster school. Dr. Crile was the

other assistant to Dr. Weed who became such an important factor

in the clinic story.

Dr. Crile (1864-1943) was born in Chili, Ohio (postoffice,

Pearl). While working on the farm he attended school inter-

mittently until he qualified as a teacher. With money earned

from teaching he financed a college course at Ohio Northern Uni-

versity, graduating in 1885. His desire had been to become a

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CLEVELAND CLINIC                   335

 

naval surgeon, but he was prevented from taking the examination

by the onset of an attack of typhoid fever. However, he matricu-

lated in the medical department of the University of Wooster in

Cleveland and was granted the M.D. degree in 1887. Dr. Bunts

was teaching minor surgery in the Wooster school at that time.

With the arrival of Dr. Crile in Dr. Weed's office another

pre-clinic phase of this story began. Office stationery of that

time indicated a form of partnership as "Drs. Weed, Bunts, and

Crile," with the added information, "Office open at all hours."

The location on Church Street was convenient to both East Side

and West Side patients, as well as to the important industrial

area in the Flats along the Cuyahoga River. Accident surgery

from nearby plants accounted for a large part of the emergency

calls coming into the office around the clock. To care for this

type of practice it was necessary to develop a smoothly working

organization with doctors available at all times. Whenever a

serious railroad accident was reported a crew made up of a sur-

geon, assistants, and a nurse was mobilized, trains were sometimes

held for the surgical crew, and often the relief arrived before

the ambulance.

When there was added to Dr. Weed's large practice an in-

creased clientele attracted by Dr. Bunts and Dr. Crile, larger

quarters became necessary. A large house with a commodious

barn at 380 Pearl Street was taken over, and the office was moved

there in 1889. This was a particularly desirable move for Dr.

Crile, for here he was able to carry on the experimental work on

animals which became so much a part and parcel of his scientific

development.

Barely had the group become accustomed to the new sur-

roundings when Dr. Weed was stricken during an epidemic of

influenza and died of pneumonia in 1891. His death at the age of

45 is not astonishing. Dr. Crile in his reminiscences given to

friends in 1941 described Dr. Weed as weighing about 240

pounds. After an early swim Dr. Weed would go to the Weddell

House to enjoy a breakfast of steak and onions. He was always

too busy to take a vacation or to devote any time to social activ-

ities. Dr. Crile was wise not to be influenced in this regard by

his chief.

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336 OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

The unexpected calamity of Dr. Weed's early death left the

two younger men in a tight spot. Inasmuch as Dr. Weed owned

all the office equipment, there was nothing left for them to work

with except a stethoscope. Furthermore, other physicians were

aware of the patent advantages to be derived from acquiring the

office where so many firms were accustomed to send their casualty

work, and were making overtures to take it over. Dr. Bunts and

Dr. Crile spent the night long trying to figure out their next

move. By morning a course had been decided upon; they decided

to purchase the assets by negotiating personal loans and to remain

in the same location.

Parenthetically I may add that this principle of taking action

only when every member of the group was in agreement was

followed in all subsequent undertakings.    I have learned also

that, although Dr. Crile was temperamentally much more force-

ful in his actions, the principle still held: no action without full

agreement.

The following excerpt from the bill of sale was executed by

the administrator and has been carefully preserved at the

Cleveland Clinic:

BILL OF SALE

From Estate of Dr. Frank J. Weed

to

Dr. Frank E. Bunts and Dr. George W. Crile

 

Small brown mare (Brown Jug and Roseline) ................... $125.00

Small sorrel horse      (Duke)  ....................................                                     100.00

Bay  horse  (Roy)      ..............................................                                       75.00

Top buggy ........................................                                                              50.00

Top buggy ........................................                                                              50.00

Top buggy (very old) .......................................                                              10.00

Open buggy ........................................                                                            20.00

2 Cutters--one very old .......................................                                           20.00

4 Sets single harness ........................................                                               20.00

Lap   robes  .....................................................                                               15.00

Miscellaneous articles in barn ..................................                                       3.00

Shed, old  stoves, battery, etc.  ..................................                                     50.00

* * * * * * *

Articles on stand .............................................                                               20.00

Milliamperes  ...................................................                                                                                                     10.00

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CLEVELAND CLINIC                                         337

 

Contents of Case (silk, bandages and dressings) ................                                15.00

Contents of desk--hand mirror, 6 sprinklers, medicine case........                      8.00

Medicine  on  desk     ..............................................                                         25.00

3  McCune              chisels                                                                                       ..............................................  3.75

4 Small chisels .............................................                                                     2.00

14 Pair scissors ................................................                                                2.50

3 Large pairs shears ..........................................                                                1.50

2  Forceps               .......................................                                                   2.50

2  Pairs    retractors  .............................................                                           2.00

3 Nasal saws ........................................                                                             1.50

2  Intestinal  clasps  ........................................                                                  1.00

1 Chain saw ........................................                                                             2.00

2 Hayes saws ........................................                                                            1.50

1  Small  met.  saw  ..............................................                                            .50

2 Needles ....................................................                                                     1.00

4 Wire twisters ..........................................                                                       1.00

6 Sponge holders ..............................................                                                1.50

1 Clamp .........................................................                                                  2.00

4  Nasal    Ec.   ...................................................                                              2.00

2  Service stilators     ..............................................                                         5.00

3  Bullet   forceps    ...............................................                                           2.00

2  Large   retractors                                                                                          ........................................               2.00

4 Small nasal dilators ..........................................                                             1.25

1 Throat forceps      ..............................................                                         1.50

1  Head    reflector  ...............................................                                           2.50

4 Self retaining female catheters ................................                                      1.75

2 Tools .......................................................                                                     .50

5  Bone  elevators  ...............................................                                            2.00

5 Bone forceps .................................................                                               6.00

1  Chain   saw   guide                                                                                         ............................................. .75

1 Bone    drill with three  tips  ..................................... .75

1 Hamilton bone drill with four tips ............................                                     3.00

1 Emergency bag No. 2 ........................................                                           5.00

1 Emergency bag No. 3 ........................................                                            11.00

1 Box--3 knives and 3 pairs scissors ............................                                    1.50

1 Stomach pump in box ........................................                                           6.00

1 Stone   set  in      case                                                                                    ..........................................             8.00

1  Horse   shoe        turnica..........................................                                     1.00

1 Cloven clutch ................................................                                               4.00

1 Small aspirating set ..........................................                                             2.00

1 Kelley pad ..........................................               .75

1 Syringe ..........................................                                                               .50

1 Microscope ........................................                                                           40.00

2  Syringes  ........................................                                                              1.50

 

Total  .............................................  $1,778.10

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338  OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

In consideration of seventeen hundred and seventy eight 10/100 dollars

I have this day sold to Drs. F. E. Bunts and G. W. Crile all the goods,

chattels, instruments and other articles contained in brick house and barn in

rear at No. 380 Pearl St. as per inventory marked Exhibit A attached to

bill of sale.

C. H. Weed

Administrator of Frank J. Weed

In looking over the accompanying list, I feel sure nothing

was missed. Furthermore, having in mind numerous attempts

of doctors' widows to salvage something from their husband's

effects, I seem to read between the lines that the administrator

had remembered that other physicians were eager to purchase

the equipment and move in.

Shortly after Dr. Weed's death when it was necessary to

watch joint funds closely, Dr. Crile was unexpectedly paid 35

dollars for care of a fracture. That evening, feeling a need for

relaxation, he  attended  a  summer   opera  performance   at

Haltnorth's Gardens. Unfortunately his pocket was picked.

That was indeed a tragedy, for that money was to have been

used to pay rent and might have cost the office location; but the

unexpected payment of outstanding fees came to their rescue,

and before long financial worries became less bothersome.

In 1893 the third member of the "triple alliance," Dr.

William E. Lower, a cousin of Dr. Crile, was added to the

group. Born in Canton in 1867, Dr. Lower had looked after

himself from an early age; this he did by working on the

farm  or by teaching.  When he had accumulated enough to

study medicine he came to Cleveland and entered the medical

department of the University of Wooster. After graduation in

1891 he served as house physician at the City Hospital and at

University Hospital, and when his term was finished he located

at Conneaut, Ohio. He was associated there with an older

physician, Dr. Ward, but he was easily persuaded to join forces

with Dr. Bunts and Dr. Crile.

The office was a busy place in those days, and casualty work

poured in. In a stable back of the office the horses, like those

in a fire hall, were ready to go at a minute's notice. Several

students lived there, eager to pay 50 dollars a year for the experi-

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CLEVELAND CLINIC                    339

 

ence and to do certain chores for room rent. Every week there

were operations in neighboring towns; usually enough cases were

accumulated so that the day could be devoted to it. Once or

twice a week, for example, there were operations in the White

Hospital at Ravenna, and another day would be spent at

Conneaut or some other town. In addition to the office team

the visiting physician acted as anesthetist, or, when necessary,

the surgeon induced anesthesia and the visiting doctor carried on.

On one occasion when a lamp was necessary, Dr. Bunts

asked for someone to hold it. A fragile little woman was willing,

but a big burly man, who said he was a butcher and could stand

anything, was given the assignment. Upon delivery of the

intestine and appendix the wavering lights and shadows por-

tended a coming faint. The slender little woman made a capable

substitute.

Frequently calls came from less desirable parts of the West

Side, such as the Triangle or Whisky Island. However, even

the McCart Street gang seemed to respect the physician and his

mission, and, apart from losing a buggy whip, a horse blanket,

or carriage robe, no harm came to the doctors.

A word might be said of the financial arrangement made

between Dr. Crile and Dr. Bunts. All private work belonged

solely to the one interested, but any income derived from emer-

gency work, no matter how disproportionate was the care in-

volved, was shared equally. No books were kept, and whenever

a check for emergency work came to either, he made out a check

for half of it and laid it on the desk of the other, an evidence of

confidence which endured throughout the entire association of

these two men. This method was continued after Dr. Lower

joined the group, the division then being made three ways.

Dr. Bunts had his own method of classifying patients from

the different railroads.

In the early days nearly every injured man, especially perhaps on the

Erie, was given whisky before we saw him. Our visits had to be made at any

hour, day or night to the place of injury, for it was almost impossible

to get the victim to enter the hospital before being seen by the surgeon.

We had the employees of the three roads classified about as follows. The

Erie man drank the most, the Big Four [men] were the most exacting and

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340 OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

refractory, while the Nickel Plate employees were the best of all and a

delight to care for. That was in the early days, but stricter rules as to

their personal habits before being employed brought all to a splendid

standard before we gave up the roads.

Then, too, it must be remembered that these men were working

with the hand coupler and hand brake, and when they went out

on a run they never knew when it would be their turn to come

back with crushed hands, feet, or legs.

A typical example of Dr. Crile's resourcefulness in handling

organization problems was seen at a time when there was trouble

brewing with some of these men on the Erie. Dr. Crile attended

a ball and by his graciousness to the employees established friendly

relations between them and the road.

As an index of the amount of casualty surgery that was

handled, Dr. Bunts has jotted down from memory the list of com-

panies served: Erie, Nickel Plate, and Big Four railroads, Globe

Iron Works, Globe Ship Building Company, Cleveland Ship Build-

ing Company, Erie Iron Ore Docks, Walker Manufacturing Com-

pany, Hill Clutch Works, Theodore Kundtz Cabinet Works,

Cleveland Hardware Company, and Forest City Forge and Iron

Company.

Looking back to those early days we note that Dr. Crile

showed many tendencies which continued throughout his life. In

1889 he took a postgraduate course in histology at New York and

upon his return to Cleveland was given a teaching position in this

subject at the University of Wooster. Here from 1891 to 1893

he was professor of physiology and histology. Thus early in his

career he manifested an interest in scientific investigation. Dr.

Crile's appreciation and knowledge of the basic sciences stirred

up a continuous stream of speculations and theories which held

many of us spellbound. Now and then I note in current journals

such as Science discussions of problems which he projected many

years ago.

Increased demands of practice had now outgrown the build-

ing on Pearl Street, and an even more central location was decided

upon. A proposal by an insurance company to establish branch

offices in areas with many industrial plants was rejected. Instead,

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CLEVELAND CLINIC                   341

 

in 1897, space was leased in the new Osborn Building at the corner

of Huron Road and Prospect Street. About a year later another

forward step was taken when the three surgeons gave up indus-

trial surgery. They continued for a time the policy of operating

in small towns, but gradually they were able to attract most of

this surgery to Cleveland hospitals.

This fact required increased facilities in these local hospitals.

The expansion was accompanied by increased teaching appoint-

ments. During this time Dr. Bunts had become professor of

surgery and clinical surgery at Western Reserve University (1894-

1928) and visiting surgeon and chief of staff at Charity Hospital

(1913-28). Dr. Crile was professor of principles of surgery and

applied anatomy at the University of Wooster (1898-1900) and

clinical professor of surgery (1900-I910), but was operating at

several hospitals before he was appointed professor of surgery at

Western Reserve University and visiting surgeon to Lakeside Hos-

pital (1910-24). Dr. Lower held teaching positions in surgery

and urology in the medical departments of the University of

Wooster, Ohio Wesleyan University, and Western Reserve Uni-

versity. Dr. Lower was attending surgeon at Lutheran Hospital

(1896-1938), associate surgeon at Lakeside Hospital (1910-31),

and director of surgery at Mt. Sinai Hospital (1916-24).

These surgeons were ambitious and progressive and made

frequent visits to medical centers in this country and abroad. Dr.

Bunts in 1888 pursued surgical studies in Berlin, Dresden, Paris,

and London, and in 1896 again studied in Germany. On this sec-

ond occasion he sent home first-hand information about the dis-

covery of the X-ray which was published in the Cleveland Medical

Gazette. Shortly after Dr. Lower joined the group Dr. Crile

went to Europe, and among other experiences he carried on re-

search work with Sir Victor Horsley, eminent English brain sur-

geon. This experience fixed Dr. Crile's interest still more firmly

on research problems in surgery. Dr. Lower studied in Berlin,

Vienna, London, and Paris, where he devoted himself chiefly to

urology, and upon his return to Cleveland added genitourinary

surgery as a specialty to his general surgical work. These were

merely the earlier trips abroad. They were many times repeated.

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342 OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

Dr. Crile relates that on one occasion Dr. A. J. Ochsner ad-

vised him to visit Dr. Will Mayo in Rochester, Minnesota, to see

him operate. Dr. Crile followed up this suggestion, and Dr. Mayo

and he became great friends. It requires little imagination to

determine the influence of that visit upon Dr. Crile and his asso-

ciates.

One of the strongest forces to affect the future practice of

this group was their frequent periods of military service. Dr.

Bunts in his early years with the navy doubtless absorbed methods

of attacking problems through group action. Subsequent service

during the Spanish-American War as major and surgeon of the

First Ohio Volunteer Cavalry emphasized the importance of or-

ganization methods. He continued military activity as captain of

Troop A, First Ohio Cavalry (1899-1902).

Dr. Crile, as already mentioned, barely missed service in the

navy because of an attack of typhoid fever. He was surgeon of

the Gatling Gun Battery in 1898 and volunteered for service in

the Spanish-American War. He was commissioned major and

surgeon on the staff of General Garretson and went to Puerto Rico.

Dr. Lower had remained in charge of operations at home, and

upon the return of Dr. Bunts and Dr. Crile he offered his services

in putting down the Boxer Rebellion. Upon his arrival in China

he was chagrined to find that all was quiet, but was elated to re-

ceive orders to proceed to the Philippines where the Insurrection

was in progress.

When World War I broke out it is not surprising to find

these three warriors in the thick of it. Dr. Crile, who by this

time was professor of surgery in Western Reserve University and

visiting surgeon to Lakeside Hospital, organized for overseas serv-

ice the Lakeside Unit, known officially as Base Hospital No. 4,

A.E.F. Dr. Crile was professional director of the unit and was

subsequently advanced to senior consultant in surgical research,

A.E.F. (1918-19). He was successively lieutenant colonel (1918),

colonel (1918), and brigadier general (1921).  Dr. Bunts was

major and chief of surgical service, Base Hospital, Camp Travis,

Texas (1917-18), and in August 1918 was given command of the

Lakeside Unit at Rouen, France (1918-19), where he was pro-

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CLEVELAND CLINIC                   343

 

moted to lieutenant colonel. Dr. Lower in the meantime served

as assistant surgical director of this unit in 1917 and commanding

officer in 1917-18, and was given the rank of lieutenant colonel

in 1918.

Having held so many important posts in military service,

these three men, always accustomed to teamwork, became more

and more impressed with group methods as exemplified in the

army. A large number of departments under various heads func-

tioned as a single unit.

They had surely been successful in civilian life, having been

elected to various presidencies in the national surgical societies

and the Ohio State Medical Association; and each in turn had

been elected president of the Cleveland Academy of Medicine.

Their many hospital appointments have already been enumerated.

It seemed reasonable to expect that with this recognition their

practices would continue to expand. How, then, should future

expansion be planned? Although hospital facilities were adequate

in 1918, they would shortly be very inadequate. This problem

was the subject of many discussions in Rouen, and shortly after

hostilities ended it was brought up for serious study at home.

Urgency in this matter was particularly important to Dr.

Crile. A regulation had been adopted by the trustees of Western

Reserve University that terminated the appointment of the pro-

fessor of surgery at age 60. At the time of Dr. Crile's return

from France his service had but six years to run. These three

men had always worked together as a group. Group practice had

been demonstrated to be effective in their many military services.

Furthermore the Mayos had proved that a private group clinic

could be a success. This they decided to establish.

But the principals were all surgeons. How far should they

expand to take in other specialties? The first resolve was to in-

crease the number of founders to four by adding a capable in-

ternist to head up a department of medicine. And now comes the

story of this fourth founder of the clinic, Dr. John Phillips (1879-

1929).

Dr. Phillips was born on a farm near Welland, Ontario, in

1879. I first met him as a student qualifying for a teacher's certifi-

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344 OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

cate. He was a quiet, studious, serious-minded youth with a keen

sense of humor. After teaching for three years in a district

school, he attended the University of Toronto Faculty of Medicine.

He was awarded the silver medal when he won his M.B. degree

in 1903. Following graduation he applied for an interneship in

gynecology at Lakeside Hospital in Cleveland. In the meantime

I learned that an unexpected vacancy had occurred on the house

staff of the medical service of the same hospital. I wired Dr.

Phillips to come at once for an interview. Dr. E. F. Cushing

decided he was a promising youth and gave him the appointment.

He completed the interneship and residency and entered practice

as an associate in Dr. Cushing's office. By continued study, close

application to work, and attention to the little things in therapy

which contributed to the patient's comfort, he built up an exten-

sive private and consulting practice and was much respected for

his teaching ability. During World War I Dr. Phillips served as

captain in the Medical Corps of the United States Army.

This was the man to whom the three surgeons turned to head

up the medical department of the group. Four boys who had

worked on farms, who had taught school to earn a medical educa-

tion, who were familiar with the group methods used in military

medicine, and who had been accustomed to teamwork in practice,

these four men now decided to pool their energies and resources

in the establishment of a new method of practice.

Group practice at that time was by no means popular with

private physicians. 'It was looked upon in somewhat the same

light as the small businessman of the day looked upon trusts.

There was real concern lest with the large resources available

there would be unfair competition with Cleveland physicians. In

this connection it is of interest to note that since the institution

opened, never had the census of greater Cleveland patients ex-

ceeded one-third of the total admissions. Furthermore there has

been an endeavor on the part of the staff to maintain the work

of the clinic on a high level with the hope of retaining the con-

fidence of both patients and referring physicians. The election

of Dr. Phillips as president of the Cleveland Academy of Medicine

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345

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346  OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

in 1922, one year after the clinic was opened, would seem to me

to be significant in this connection.

Other physicians were added to the staff: Drs. Thomas E.

Jones, Oliver P. Kimball, Bernard H. Nichols, Thomas P.

Shupe, Harry G. Sloan, John Tucker, and Justin M. Waugh.

The enlarged staff enabled the clinic to set up six clinical

departments on opening day: clinical laboratories, medicine, oto-

laryngology, roentgenology, surgery, and urology.

This, however, is getting somewhat ahead of the story.

When the decision was made to found such an organization,

many problems arose regarding location, construction, and per-

sonnel. In an interview with Dr. Lower, I was told that expan-

sion was considered imperative. Facilities in the Osborn Build-

ing were outgrown, and provision for automobile parking space

had to be planned for the future. By moving farther east the

institution would be more readily reached from the highways

coming from the east and south. Evidently influenced by events

in Rochester, Minnesota, Dr. Lower said they were all convinced

that group practice would prove to be a more efficient method of

medical practice. Furthermore facilities were increasing in small

towns and local surgeons were being developed to care for the

routine surgery in rural areas. The amount of specialized sur-

gery referred to the group in Cleveland was constantly increasing.

There were many nonmedical arrangements that had to be

made: options on proposed sites, details regarding liabilities,

taxation, and organization, all of which required the training,

experience, and ability of a legal expert. For this task a man

was selected who, fortunately for the organization, was closely

identified with it later, namely, Edward C. Daoust. He was a

son-in-law of Dr. Bunts and a partner in one of the large Cleveland

law firms. Mr. Daoust stated:

I remember well one Sunday during the fall of 1919 when I was asked

to meet with Dr. Frank E. Bunts, Dr. George Crile, and Dr. William E.

Lower at their offices in the Osborn Building for a preliminary discussion

of rather nebulous plans to form an institution which would combine in

one organization the services of the internist, the surgeon, and the specialist;

which would seek to perfect the application of existing knowledge, to find

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CLEVELAND CLINIC                         347

 

new knowledge through animal research, and to offer advanced training to

young medical graduates.

Mr. Daoust was given the task of watching over all the busi-

ness angles of the organization and the setting up of the charter.

The location at East 93rd Street and Euclid Avenue was

selected because it was available and in the general area desired.

In October 1919, the founders formed themselves into the Asso-

ciation Building Company for purposes of financing, erecting,

and equipping the new building. It was further agreed among

the founders that not less than one-fourth of the income from

the new   venture should be devoted to research and to giving

free care to indigent patients.

In 1925 the Association Building Company turned the

building over to the Cleveland Clinic Foundation and passed out

of existence. A charter written by Mr. Daoust had been granted

by the State of Ohio to the Cleveland Clinic Foundation as a

corporation not for profit, which reads as follows:

 

CHARTER

THESE ARTICLES OF INCORPORATION OF THE CLEVE-

LAND CLINIC FOUNDATION

WITNESS That we, the undersigned, all of whom are citizens of the

State of Ohio, desiring to form a corporation not for profit under the

general corporation laws of said State, do hereby certify:

FIRST: The name of said corporation shall be THE CLEVELAND

CLINIC FOUNDATION.

SECOND: Said corporation and its principal office shall be located at

Cleveland, Cuyahoga County, Ohio, and its principal business there trans-

acted.

THIRD: The purpose for which said corporation is formed is to own

and conduct hospitals for sick and disabled persons; and in connection

therewith, owning, maintaining, developing and conducting institutions,

dispensaries, laboratories, buildings and equipment for medical, surgical, and

hygienic care and treatment of sick and disabled persons, engaging in making

scientific diagnoses and clinical studies in, carrying on scientific research

in, and conducting public lectures on, the sciences and subjects of medicine,

surgery, hygiene, anatomy and kindred sciences and subjects, accepting,

receiving and acquiring funds, stocks, securities, and property by donations,

bequests, devises or otherwise and holding, investing, conveying, exchang-

ing, selling, transferring, leasing, mortgaging, pledging and disposing of,

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348 OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

any and all funds, stocks, securities and property so received and acquired,

charging, and receiving compensation for services, care, treatment and

accommodations for the purpose of maintaining said hospitals not for

profit, and the doing of all acts, exercising all powers and assuming all

obligations necessary or incident thereto.

IN WITNESS WHEREOF, we have hereunto set our hands this 5th

day of February, 1921.

Frank E. Bunts

George W. Crile

William E. Lower

John Phillips

Edward C. Daoust.

The signers of the articles of incorporation were named

life members and trustees to administer the affairs of the founda-

tion. On February 26, 1921, the Cleveland Clinic was formally

opened with felicitations coming from far and wide. The guest

speaker was Dr. Will Mayo. The institution was dedicated by

the founders to three purposes: (1) better care of the sick;

(2) investigation of their problems; and (3) further education

of those who serve.

Thus ends the genesis of the Cleveland Clinic. As Dr.

Bunts commented upon another occasion, thus was completed an

organization "which has continued ever since. Many new and

esteemed connections have been made since then, but perhaps

it is that intangible something that comes from mutual hopes and

fears, struggles, disappointments and successes that has made

that tie a little closer, a little more cherished. We have gone

through so much together."

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