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On August 21, 1883, a tornado destroys parts of the town of Rochester, Minnesota. The physician William Worrall Mayo and several colleagues set up an emergency hospital in a dance hall. Franciscan sisters led by Mother Alfred Moes take on the nursing. That evening, people who normally go their separate ways work side by side. What grows out of it is an institution that shows the Team Principle of Position at work: everyone has a position where they contribute most – the team wins when everyone is in theirs.
Doctors and Sisters
Situation
William Worrall Mayo, born on May 31, 1819, near Manchester, had set up practice as a physician in Rochester in January 1864. After the tornado, Mother Alfred proposes a hospital. Saint Mary’s Hospital opens on September 30, 1889, with 27 beds. The sisters run the hospital; the doctors treat the patients. This partnership runs for decades without a written contract.
Connection to the team principle
It all starts with a clear division of positions. The order can do what the doctors cannot, and vice versa. Neither side tries to do the other’s work as well. That no paperwork was needed for decades shows how unambiguous the positions were.
Too Much Knowledge for One Mind
Situation
Mayo’s son William J. Mayo joins the practice in 1883, and his brother, Charles H. Mayo, follows in 1888. From the 1890s onward, the brothers take on more physicians as partners, among them Augustus Stinchfield, Christopher Graham and Henry Plummer. Around 1905, Saint Mary’s performs more operations than any other hospital in America. In 1910 William J. Mayo lays out the rationale for the model in a speech. In essence, he says that medical knowledge has grown too vast for any one individual, so efforts must be pooled.
Connection to the team principle
As sought-after surgeons, the brothers could have done everything themselves. They drew the opposite conclusion. When no one can master everything anymore, each doctor takes the position of their specialty, and the patient is treated by the team working together. The principle applies precisely where tasks differ. The more specialized the work, the more it matters who stands where.
One Record for Everyone
Situation
Henry Plummer, who joined in 1901, designs the unified patient record: one number and one file per patient, accessible to every physician involved. Conveyor belts and pneumatic tubes carry the files through the building. In 1914 the clinic moves into the first building constructed specifically for a multispecialty group practice – with consulting rooms, laboratories and teaching under one roof.
Connection to the team principle
Positions alone are not enough. They have to be connected. Plummer’s position was not that of the celebrated surgeon. He built the system that held the other positions together. If everyone on your team does good work and things still get lost, what’s usually missing is not another expert but the shared record.
Bigger Than the Founders
Situation
In 1919 the brothers transfer the practice’s assets, buildings and future earnings to a nonprofit foundation. Both brothers die in 1939. The clinic carries on. In the 1950s, nurses and surgeons there jointly develop an early intensive care unit with central monitoring. In 2022 the Mayo Clinic employs about 76,000 people, including more than 7,300 physicians, and treats over 1.3 million patients.
Connection to the team principle
A structure built on positions carries further than one built on individuals. The brothers designed their own position so that someone else could take it over. And the intensive care unit shows that new positions often emerge where two professions look at a problem together.
Key takeaways
Key Lessons
- Ask yourself honestly where the knowledge in your field has grown too large for one mind. That is where you need positions instead of all-rounders.
- Divide work according to what each person does best – across professional groups, too.
- Create a “shared record”: one place where everyone sees the same, up-to-date picture.
- Value the connectors. Whoever builds the system holds one of the most important positions.
- Shape your own position so that it outlasts you.
Summary
An emergency hospital in a dance hall became a clinic with tens of thousands of employees. The path led through clearly assigned positions: sisters and doctors, specialists side by side, plus a record, a building and a foundation that tied them together. The Mayo brothers did not try to master everything themselves. They made sure that everyone worked in their own position and that the patient benefited from the whole.