Forget sports. Ohio’s best rivalry is Cleveland Clinic-University Hospitals

A while ago I received an email attachment to a children’s birthday party. Another parent, a Cleveland Clinic doctor, couldn’t open the attachment. I made some adjustments to the file and sent it to her.

“How did you do that?” the doctor asked.

“I took it to University Hospitals,” I chided.

The Cleveland Clinic doc didn’t miss a beat. She replied: “So the dates and times are wrong?”

If you just yelled “Woahhhh!” or let out a snort, then you get it. If you rolled your eyes and wondered “Big deal,” then you’re still stuck in that time when sports rivalries were the biggest grudge matches around.

In an era of big healthcare, and when economic development is now a bar-stool discussion, hospital rivalries like Cleveland Clinic-University Hospitals are the hottest local feuds going. They have everything sports rivalries do — from a storied history to snippy jokes — but with the added bonus of the fate of local economies hanging in the balance.

Anyone in Cleveland with a vested interest in the healthcare industry is acutely aware of the rivalry. Though few probably realize it’s as old as Cleveland Clinic itself. University Hospitals took the first shot when it joined other hospitals in the 1940s in deriding the newly launched Cleveland Clinic as a purely clinical and nonacademic institution.

Then there was the time in the 1980s when then-Blue Cross & Blue Shield of Ohio stated Cleveland Clinic should run Rainbow Babies and Children’s Hospital because they would do it better than UH, according to the book, “Specialty Care in the Era of Managed Care: Cleveland Clinic versus University Hospitals of Cleveland“. Next came the hospital version of the 10-year war: a series of healthcare acquisitions started by the two giants in the mid-1990s that culminated in Cleveland Clinic winning (by one board vote) permission to take over Meridia Health System.

Talking about the rivalry today is akin to mentioning religion or politics at the dinner table. Spokeswomen for both health systems declined to discuss the rivalry for this article. And every so often someone from one hospital or another will tell me that they regularly have dinner and drinks with their peers from the other side — like how we all know a Cleveland Browns fan whose spouse cheers for the Pittsburgh Steelers.

But Cleveland Clinic and University Hospitals are still competitive, and it gets increasingly personal. A sore spot for University Hospitals: Cleveland Clinic, along with other Ohio health systems, contested UH’s attempts to get a Medicare exemption for its new cancer hospital that would bring the health system millions of dollars.

Plus, while Cleveland Clinic’s Children’s Hospital gets increasing plaudits from the likes of U.S. News & World Report, many at UH sneer at the idea that a Clinic “Children’s Hospital” even exists.

“It’s a floor,” several UH loyalists have told me emphatically, often tossing an alliterative expletive in for good measure.

Cities like Cleveland benefit from rivalries like this. Healthcare here is an embarrassment of riches. Amazing cancer, cardiology, kidney, wellness and other types of care — coupled with groundbreaking research — thanks in large part to two organizations that have never completely liked each other.

But there are also downsides. For one, the stakes are higher than your average sports rivalry. The worst thing that happens after a Browns-Steelers game are a handful of minor assault charges. With healthcare rivalry, economies and businesses are at stake.

That buying spree in the 1990s helped contribute to the closure of some of the city’s most treasured independent Catholic and Jewish hospitals. And it will take a generation for many folks in this town to get over that.

Also, most Cleveland-area healthcare companies — from medical device businesses to various service industries — have what’s called a “Clinic-UH strategy:” the diplomatic dance to determine how best to engage with both hospitals while not angering either for doing so. Many often simply commit to picking a side and accept they won’t be working with the other in any serious way. And that is a shame.

Dr. John Kastor, the author of “Specialty Care in the Era of Managed Care,” told me that such tenacity was an exception to the rule in healthcare. But I think you’ll see more white-hot healthcare rivalries across the country as major health systems gobble small hospitals and physician practices, or reach out across state and national borders to compete for patients and grants.

As I’ve traveled more to Minnesota, North Carolina and beyond, I’ve gotten a taste of this. Duke Medicine and UNC Health Care could someday be the No. 2 rivalry behind their mens’ basketball teams.

Plus, the rivalries between national systems will only grow. University Hospitals may be Cleveland Clinic’s local rival, but Mayo Clinic and Cleveland Clinic are just as often bumping up against one another and vying for clout and patients.

Now if there was only a way to sell tickets to watch.