The history of a hospital is written primarily by the actions of its doctors. From day one in 1921, Cleveland Clinic has always been about the doctors.
The elite health system has spent the last year celebrating its 90th birthday, making this an ideal time for a look back. Below is my list of the greatest 50 physicians who helped write Cleveland Clinic’s history. The list is replete with cardiologists — the Clinic’s signature specialty. But it also includes physicians who are revolutionizing healthcare technology today, who identified carpal tunnel syndrome, or have leveraged their research to create companies that will heal hundreds of thousands for decades.
Fifteen of the 50 are currently working at Cleveland Clinic.
Ranking the greatest doctors over 90 years is like comparing NFL quarterbacks. Who was better: Peyton Manning or Johnny Unitas? How can one physician from the 1920s compare to another in today’s era of healthcare reform and big health systems?
My criteria for the top 50: Physicians who made amazing contributions to medicine and to Cleveland Clinic, and whose names are forever tied to the health system.
Did I leave anyone out? Did I rank someone in the 40s who should have been in the top 10? What’s your list look like? Let me know in the comments or tweet us at @medcitynews.
(If you liked this story read my Twin Cities colleague, Arundhati Parmar’s, list of the greatest 50 Mayo Clinic doctors)
1. F. Mason Sones
The father of coronary angiography, Sones is credited with one of the most important discoveries in the history of cardiology — and it happened by accident. When Sones, who joined the Clinic in the 1950s, was performing a catheterization procedure on a patient, he noticed that the catheter had accidentally entered the patient’s right coronary artery and released some contrast dye. He expected the patient’s heart to begin to beat irregularly. When it didn’t, he knew he’d discovered a way to form a road map of the heart for medicine and surgery.
Injecting dye into the coronary arteries allowed the arteries to show up on X-rays and gave cardiologists the opportunity to identify obstructions in blood circulation. Sones’ innovation made possible, for the first time, accurate diagnosis of coronary disease and set the stage for the modern era of cardiology and cardiac surgery.
Sones was known as a stern taskmaster who wouldn’t hesitate to publicly criticize surgeons or nearly anyone else he encountered. Some nurses were said to hide in the bathroom when he appeared on their floor. He would frequently smoke cigarettes during procedures in the catheterization lab, using a sterile forceps to hold a lit cigarette that he’d lay on the edge of the instrument table.
2. Rene Favaloro
The Argentinian Favaloro is best known as the pioneer of coronary bypass surgery. The procedure is used to restore blood flow to the heart muscle by diverting the flow of blood around a section of a blocked artery in the heart by using a healthy blood vessel taken from elsewhere in a patient’s body. Favaloro performed the first coronary bypass at Cleveland Clinic in 1967, focusing the attention of the cardiology world on the hospital and significantly raising the organization’s profile.
Favaloro left the Clinic to return to Argentina in 1972, reportedly turning down a $2 million salary. He founded his own medical and research foundation in Buenos Aires in 1975 with the goal of improving cardiology in Argentina.
Despite being recognized as one of the true pioneers of his profession and having performed life-saving operations on thousands of patients, Favaloro’s own life ended in tragedy. He shot himself through the heart in 2000, with his suicide note revealing that he was frustrated by corruption in Argentina’s medical system.
3. Caldwell Esselstyn
Esselstyn is the greatest living physician associated with Cleveland Clinic because he has developed and promoted an approach that heals without the heavy medical intervention hospitals like Cleveland Clinic are known for. In an era of skyrocketing healthcare costs and runaway obesity, Esselstyn’s approach around an austere “heart-attack proof” diet could, decades from now, be considered one of the most important innovations of this era. And it is a supremely benevolent act, since his “Esselstyn Diet” has little revenue for hospitals and prevents reimbursable cardiac medical treatments.
Esselstyn, a surgeon and former Olympic gold medalist rower, claims you can prevent and reverse heart disease by eating a strict vegetarian diet with no meat, poultry, fish, dairy products or oils. “What really keeps me on fire about this is we have an epidemic of disease in this country that doesn’t need to exist,” Esselstyn told The Plain Dealer in 2008. “It’s so ridiculously simplistic to turn around this epidemic, it’s scary.”
His controversial stance has recently received more attention, thanks to lavish praise in the documentary “Forks Over Knives.”
4. George Crile
The most prominent of Cleveland Clinic’s four founding physicians. If alive today, he’d likely have a reality show or sitcom modeled after him. He would bring a phonograph into the operating room. In 1929, a fire tore through Cleveland Clinic that was so awful it nearly toppled the entire hospital system. Crile was in surgery at the time. He finished his surgery as the blaze burned, strode out of the building and led the rescue effort. He later rushed with his other founders to try and save, in vain, fellow Clinic founder John Phillips.
Crile is credited with driving the Clinic’s early success after co-founding the institution in 1921 and pushing a new, collaborative approach to medicine. He was a founding member of the American College of Surgeons, and took a lifelong interest in the treatment of surgical shock, which led him to perform the world’s first human-to-human blood transfusion. He’s also credited with improving anesthesia and streamlining the surgical removal of diseased thyroid glands.
Even near the end of Crile’s life, when he was going blind from glaucoma, he continued to operate on patients, feeling his way through procedures by touch.
5. Eric Topol
Cleveland Clinic owes much of its constant No. 1 ranking in heart care to Topol. His reputation during the 14 years he led the Clinic’s cardiology department, was built partly on his criticism of drug safety, particularly concerning the Merck painkiller Vioxx. He was among the first doctors to raise questions about the cardiovascular side effects of drugs in the so-called cox-2 class of painkillers. Topol’s biography credits him with pioneering the development of many medications that are routinely used in medical practice including t-PA, Plavix, Angiomax and ReoPro.
Topol’s exit from the Clinic happened in 2006, but it was paved by the 2004 decision to anoint Dr. Toby Cosgrove as the Clinic’s new CEO. Long regarded as rivals, Topol and Cosgrove clashed over financial arrangements between industry, each other and other Clinic doctors. Once Cosgrove got the nod in 2004, Topol’s fate with the Clinic was probably sealed.
Topol reinvented himself and further enhanced his global reputation since departing the Clinic. He now touts some of the most cutting-edge digital health initiatives in the country. “Instead of doctor-knows-best and this paternalistic type of thing — that is on the way out,” Topol said recently. “Doctors have to acknowledge that.”
6. Irvine Page
A pioneering researcher, Page helped shape the modern understanding and treatment of high blood pressure and heart attacks in the 1940s and ’50s. Page’s research helped unravel the complex nature of hypertension and to supplant the widely held concept that high blood pressure could be traced to a single causative agent.
Aside from his hypertension research, Page may be best known for discovering serotonin, a neurotransmitter that is involved in sleep, depression, memory and other neurological processes. He directed research at the Clinic for 21 years. Before Page, most doctors didn’t even believe high blood pressure was important, and many even thought that lowering high blood pressure could create harm by reducing a patient’s blood flow.
7. Steven Nissen
Unlike most physicians near the top of this list, Nissen isn’t best known for his medical innovations (though he has garnered plenty of renown for his work in the development of intravascular ultrasound). Instead, he fulfills the modern physician’s role of public patient advocate. He’s led the Clinic’s department of cardiology since 2006 and is best known as an outspoken critic of Big Pharma, having taken on drugs like Avandia and Vioxx. In 2007, he was named by Time Magazine as one of the 100 most influential people in the world.
Nissen has also been a target of criticism by other doctors, who charge that his public pronouncements have scared and harmed patients. Nissen seems to fancy himself a bit of an iconoclast and truth-to-power speaker, and traces his public activism and watchdog-like status back to his college days in the 1960s when he was a “political leader” and editor of the daily newspaper at the University of Michigan.
8. Bernadine Healy
Healy was the first woman to lead the National Institutes of Health. But before that, she led research at the Clinic in the mid-’80s. At the Clinic, she led nine departments and helped them more than double in size. Healy later led the American Red Cross.
Healy’s brash style and willingness to publicly challenge critics earned her lots of admirers but also her share of detractors. “She does not back down,” said former Cleveland Clinic CEO Floyd Loop, who was Healy’s husband. “She’s a fighter. I don’t have any problem with her, but I could be in the minority.”
Healy died earlier this year of brain cancer.
Cosgrove has already ascended to one of Cleveland Clinic’s greatest physicians, even with an incomplete legacy. An amazing innovator, Cosgrove’s true contribution to Cleveland Clinic will be based largely on his legacy as CEO.
Cosgrove has become the public face of today’s Cleveland Clinic and is recognized as among the nation’s leading physician executives. He’s not shy about voicing his opinions, speaking out against key provisions of federal health reform and criticizing an American culture that he believes goes too easy on obese people. His tenure has seen the Clinic’s national reputation ascend to new heights, as the health system was held up as a model of high-quality, low-cost care by President Obama.
The low point of Cosgrove’s time at the Clinic likely stemmed from a 2005 controversy about conflicts of interest between Cosgrove, the Clinic and AtriCure, a medical device company founded in part on Cosgrove’s innovations. (Although the public spat with Topol was no walk in the park, either.)
Cosgrove began establishing himself in 1970s as an innovative cardiologist at the Clinic. He’s viewed as a pioneer in the field of minimally invasive mitral valve repair surgery. Cosgrove has filed 30 patents medical and clinical products used in surgery, more than any other Clinic employee.
10. Willem Kolff
Kolff is a luminary in the history of the medical device industry, and is lauded as the father of the artificial organ. A Dutchman who died two years ago, Kolff is especially renowned as the inventor of the artificial kidney. At the Clinic in 1950s, Kolff led a project that was the first to implant a total artificial heart in an animal. He’s also credited with having developed the first artificial ear and eye, and inspired the first artificial heart, the Jarvik-7.
Kolff cobbled together his original dialysis machine in wartime Holland using an enamel tub, a wooden drum, metal, cellophane sausage casings and an electric motor. “His search for machines to treat disease encompassed the solidly successful and the quirkily quixotic,” the Washington Post said.
11. Donald Effler: Effler was a pioneer of open-heart cardiac surgery in the 1950s and ’60s. The procedure is also known as “stopped-heart surgery” because it requires stopping the heart temporarily while relying on a heart-lung machine to oxygenate and pump blood to the rest of the body. In 1968, he was the senior surgeon on one of the first heart transplant operations in the United States.
12. Rupert Turnbull Jr.: A noted colorectal surgeon, Turnbull was viewed as a top authority on ulcerative colitis. He joined the Clinic in the 1940s and was later recognized as the father of enterostomal therapy, the care of patients with stomas such as colostomies.
13. Harriet Dustan: Dustan joined the Clinic in the late 1940s and became a major figure in the field of hypertension research. She was among the first to suggest that reducing dietary sodium could lower hypertension and cardiac risks. She was the second woman to lead the American Heart Association.
14. Andrea Natale: The Italian Natale was a pioneer in catheter ablation for the treatment of atrial fibrillation, the most common type of heart arrhythmia. His career with the Clinic ended under a dark cloud in 2007, however, as the hospital apparently pushed him out over concerns about his performing medical procedures outside of Ohio without the Clinic’s permission. He’s since joined fellow Clinic castoff Topol at Scripps.
15. James Hewlett: Hewlett led the Clinic’s department of hematology in the 1970s. He pioneered exchange transfusion for a blood disorder called thrombocytopenic purpura, a condition that had previously almost always been fatal.
16. Andrew Novick: The former chair of the Clinic’s Urological and Kidney Institute, Novick was viewed as an innovator in the field of kidney transplant surgery. He’s credited with pioneering a technique of using ice baths to spare kidney function, and a nephron-sparing surgery that is credited with giving many patients longer lives. He died in 2008 at the age of 60.
17. Ralph Straffon: A urologist who enjoyed a 12-year stint as chief of staff, Straffon‘s career with the Clinic spanned four decades. He led a team that performed one of the first successful cadaver kidney transplants in 1963.
18. Victor Fazio: Fazio became chairman of the Clinic’s Digestive Disease Institute in 2008 after 33 years as head of the Department of Colorectal Surgery. An innovator in colorectal surgery, Fazio pioneered numerous surgical techniques in the field.
19. F. Merlin Bumpus: A colleague of Irvine Page, Bumpus joined the Clinic in 1949 and became a leading hypertension researcher. The two scientists led a team that in 1957 synthesized angiotensin, a substance in the blood that causes vessels to constrict and blood pressure to rise.
20. Michael Modic: A neuroradiologist, Modic currently is chair of the Clinic’s Neurological Institute. Modic is a noted spine researcher and is the namesake for “Modic changes,” observations associated with MRIs of degenerative spinal discs.
21. Floyd Loop: A cardiac surgeon, Loop was the Clinic’s CEO for about 15 years, with his tenure ending in 2004. In the 1970s, he identified the mammary artery as the preferred conduit for bypass surgery, still the standard of care today.
22. George Phalen: Phalen was an orthopedic hand surgeon. In the 1940s and ’50s, he identified carpal tunnel syndrome and helped create its diagnostic test.
23. Maria Siemionow: A native of Poland, Siemionow is currently the Clinic’s director of plastic surgery research. She achieved a measure of fame in 2008, when she lead a team that performed the world’s first near-total face transplant. “The wonder of discovery can occur in medical research, tedious as that research might seem when it involves staring through a microscope at tissue from a rat scrotum,” she wrote in her autobiography. Words to live by for anyone who’s ever stared at a rat scrotum.
24. Jay Yadav: Yadav is a noted interventional cardiologist and entrepreneur, often cited for his innovations around carotid stenting. His tenure at the Clinic came to an ugly end (are you sensing a theme in recent years with prominent Clinic cardiologists?) in 2006 over allegations of conflicts of interest related to the commercialization of his innovations. But Yadav had the last laugh, as the Clinic was forced to admit in a 2010 legal settlement that he did, in fact, provide the hospital with the proper disclosures around his commercialization activities. This year, he was named one of Ernst & Young’s entrepreneurs of the year.
25. Russell Haden: Haden took on a leadership position shortly after the greatest tragedy in the Clinic’s history: a disastrous fire and explosion of X-ray film that created toxic fumes and killed 123 people in 1929. After the tragedy, he replaced founder John Phillips as the leader of the Clinic’s medical department. Haden was a renowned researcher in his specialty, diseases of the blood, and became one of the best-known hematologists in the country.
26. Gene Barnett: Barnett joined the Clinic in 1987 and is currently director of its Brain Tumor and Neuro-Oncology Center. He’s a leader in the field of computer-assisted surgery and holds several patents related to technology in neurosurgery. Barnett helped develop the “sonic wand,” a brain-imaging technology that allows surgeons to locate tumors with high accuracy.
27. William Sheldon. Sheldon was the Clinic’s first chair of cardiology in 1975. He’s hailed for practicing some of the most advanced cardiac catheterization techniques of his time.
28. William Kiser: Kiser joined the Clinic in 1964 to help establish a groundbreaking cadaver kidney transplant program. He’s credited with an ambitious construction program that greatly expanded the hospital’s main campus. He led one of the first hospital expansions financed by bonds.
29. Joseph Hahn: Hahn is currently the Clinic’s chief of staff and joined the hospital in 1976. He’s a neurosurgeon who helped develop a brain-mapping technique that uses implantable electrodes to locate the site of seizures in epilepsy patients.
30. Marshall Strome: Strome was previously chairman of the Clinic’s Head and Neck Institute. In 1998, he performed the world’s first total human laryngeal transplant.
31. Charis Eng: Eng is currently chair and founding director of the Clinic’s Genomic Medicine Institute. Her research connected a second gene with Cowden syndrome — a genetic condition that affects about one in 200,000 people — opening the door for even more people to be definitively diagnosed with the disease.
32. George “Barney” Crile Jr.: Known as “Barney” to distinguish himself from his illustrious father, Crile Jr. was associated with the Clinic for about 50 years, retiring as head of the department of general surgery in 1968. Crile Jr. generated controversy with his campaign against radical mastectomy — removal of the entire breast and of surrounding lymph nodes and major chest muscle — which was routinely performed on breast cancer patients for a century. Crile Jr. advocated instead for the simpler and safer lumpectomy.
33. Roy Greenberg: Greenberg is a vascular surgeon who joined the Clinic in 1999. He specializes in stent grafting for aortic disease. Among his innovations is a branched endovascular stent graft specifically designed for the aortic arch.
34. Emmanuel Bravo: A renowned hypertension researcher, Bravo joined the Clinic in 1970. Among his specialties is pheochromocytoma, a rare, usually noncancerous tumor that develops in the core of an adrenal gland.
35. Eric Klein: Klein is chair of the Clinic’s Urological and Kidney Institute. He’s a leader in the biology and management of prostate cancer. His clinical interest is the study of urologic cancers, including those of the prostate, bladder, testis and kidney.
36. Irving Franco: Franco is an interventional cardiologist who’s still with the Clinic, having joined the institution in 1971. He trained under the legendary Sones and subsequently trained two generations of the Clinic’s cardiologists himself.
38. William Lower: Another of the founders, Lower was a urology specialist. For a time, he served as president of the American Urological Association.
39. John Phillips: Often referred to as the Clinic’s fourth founder, Phillips was one of the 123 people killed in the 1929 X-ray films fire. The tragedy has been credited with leading to new quality and safety standards for healthcare.
40. Fay LeFevre: In 1955, LeFevre was appointed chairman of the Cleveland Clinic Board of Governors upon the board’s founding. LeFevre’s appointment was significant because it reaffirmed the Clinic’s principle of physician leadership.
41. R.J.F. Renshaw: Renshaw was an early member of the Clinic’s gastroenterology department in the 1930s. He helped lay the groundwork for the emerging field of endoscopy.
42. Michael Roizen: The Clinic’s first-ever chief wellness officer, Roizen has shown an uncanny ability to translate wellness advice into cash. Perhaps more significantly, Roizen has also drawn praise for helping implement a wellness program for Clinic employees that’s improved workers’ health while helping control the Clinic’s costs.
43. Pat Whitlow: Whitlow is director of interventional cardiology in the Clinic’s department of cardiovascular medicine and has held the position since 1991. His specialties include cardiac catheterization, vascular and coronary angiography, coronary and peripheral vascular stenting, and aortic valve replacement.
44. John Eversman: An endocrinologist, Eversman is known more for his business contributions to the Clinic than any medical breakthroughs. He became the Clinic’s first-ever chief operating officer in the early 1980s and was the first member of the Clinic’s staff to be sent to complete an executive MBA program.
45. Hilel Lewis: Lewis was recruited by Loop to the Clinic in the mid-’90s to establish its Eye Institute. At $2.6 million, Lewis was the Clinic’s highest-paid employee in 2008, the same year he left the hospital. He’s now with Columbia University Medical Center.
46. Marc Penn: A cardiologist with strong experience in regenerative medicine, Penn is part of a new breed of aggressive physician-entrepreneurs to come out of the Clinic in the last decade or so. His research has led to the founding of promising startups Juventas Therapeutics, SironRx Therapeutics and Cleveland HeartLab, and he’s led clinical trials by stem cell developer Athersys. Earlier this year, Penn left the Clinic for Akron’s Summa Health System.
47. Martin Harris: Harris joined the Clinic in the late ’90s as its first-ever chief information officer. Harris has guided the Clinic into the world of electronic health records and helped the health system gain recognition as a national leader in the field of health information technology.
48. Carl Wasmuth Jr: Wasmuth chaired the Clinic’s department of anesthesiology before in 1969 becoming the second chairman of its Board of Governors. Wasmuth’s board chairmanship ushered in the Clinic’s modern era, as he was the first genuine physician-manager that the hospital had ever had.
49. A. Carlton Ernstene: Ernstene joined the Clinic as head of the Department of Cardiorespiratory Disease in 1932. He later was chair of the Division of Medicine, adding seven new departments during his tenure.
50. E. Perry McCullagh: The first chair of the Clinic’s Department of Endocrinology, McCullagh specialized in diabetes research. His belief in rigid control of blood glucose levels for diabetics was ahead of its time in the medical profession.