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    #FlashbackFriday 1959: The who, whence, when and why of patients

a 1953 photo of the patient registration desk in the Plummer Building

This article first appeared May 2, 1959, in the publication Mayovox.

Facts and figures don’t usually make very sparkling stories, and Clinic registration is essentially a matter of facts and figures. And yet registration — the numbers of people who come here for medical care — is the best single indicator of demand for Mayo Clinic services. As such, it is a matter of importance to us all. So ...

Registration is followed with particular care by the Section of Administration, one of whose jobs is to provide the Board of Governors with information needed in forming basic Clinic policy. And probably the top hand in Administration on registration trends is a quiet young man named K. J. Ladner.

For several years now, Karl Ladner has carried out studies on the who, whence, when and why of patients. Here — against a background of data familiar to most of us already — are some of his findings.

Registration in 1913 was more than 24,000, a fantastic total for the period. This skyrocketed to 78,000-plus by 1929. The Big Depression dropped it to around 50,000. With better times a generally steady annual increase continued until about 1950.

Registration topped 150,000 for the first time in 1956. It was up again in 1957. Last year it was just a few hundred under 160,000. Since 1907 more than 2,200,000 different men, women and children have come to the Clinic, from once to many times. Even in an era of tremendous totals, these are big numbers.

Where did they come from? We know that there have been patients here from just about everywhere in the world. But where did most of them come from, both in actual numbers and in percentage of total registration? Here is where Karl Ladner’s charts and graphs come in.

He prepared graphs “plotting” the number of patients registered at the Clinic by year from 1946 to 1958. He also prepared “curves” to show the geographic origin of patients in four categories. These categories were Rochester; Minnesota excluding Rochester; within 500 miles of Rochester excluding Minnesota and Rochester; beyond 500 miles of Rochester. Changes in registration patterns for the four geographic areas over the past 12 years showed the following:

  • The biggest increase, both in number and in percentage of the total, was from our own growing Rochester community — from 21,000 in 1946 to 39,500 last year.
  • The next biggest increase on both points was from Minnesota excluding Rochester — from 22,100 in 1946 to 32,300 last year.
  • Next came the “within 500 miles of Rochester excluding Minnesota” category. While this was up in numbers (54,400 to 61,900), it was down a small fraction in percentage of total registration.
  • The number of patients from more than 500 miles of Rochester in 1958 was an impressive 25,400. But the 1946 figure had been 35,700. That is, both in numbers and percentage of total registration this group showed the most marked decline.

What does this all mean?

Well, for one thing it suggests that Mayo Clinic’s practice, while still including thousands of patients from great distances, is becoming more regional and less national and international. Said the other way around, it indicates that percentage of registration totals becomes greater and greater with nearness to Rochester.

The “Why” of this shades off into educated guessing. One factor surely would be the growth of major medical centers in other parts of the country. Another factor might be a continuing revolution in transportation. While trains, airplanes and buses are vastly important to us, it is still true that a majority of patients come here by car. It may be, then, that as highways of the area and region improve, the number of patients who will come to the Clinic for examination and yet sleep in their own beds each night will increase.

Today this “come to Clinic, sleep at home” group is probably limited to a 40-50 mile radius of Rochester. Before too long, improved highways could expand this to 100 miles or more.

If the trends suggested in Ladner’s charts continue, another point becomes increasingly plain.

No single patient should ever be thought of as being more — or less — important than any other patient, whatever the home address.

But as a group, local, state and regional patients are of increasing significance to the Mayo Clinic.