'A Way Forward'

Cleveland Clinic CEO and President Tom Mihaljevic, MD, spoke with Cleveland Clinic Magazine about how the pandemic is reshaping healthcare, underscoring racial disparities and bringing out the best in caregivers.

Dr. Mihaljevic showed his support at the April send-off for Cleveland Clinic nurses who answered the call to help at Henry Ford Health System in Detroit. | Photo: Stephen Travarca

What are the keys to living with COVID-19?

There are ways to live with it by adhering to simple principles that we’ve instituted here at Cleveland Clinic: appropriate hand hygiene, cough etiquette, wearing a mask in public, social distancing, avoiding public gatherings and not coming to work if you have symptoms — cough or fever. These are especially important measures for individuals at higher risk due to age or comorbidities.

The good news is that there is a way to live safely and productively with this pandemic. We can create environments in which people can interact, without fear, and environments that are conducive to sustaining economic activity, which ultimately supports the entire society.

So there is a way forward, and I’m optimistic. We’ll coexist with this disease until we find a cure.

 

You’ve been in close contact with many government officials, from governors to the president of the United States. What guidance has Cleveland Clinic provided during the crisis?

Cleveland Clinic has been involved with government efforts, at the state level as well as at the federal level, from the very beginning of the pandemic.

In Ohio, we’ve partnered with Governor Mike DeWine’s office. We’ve provided guidance in crafting many healthcare policies for everything from coordinated testing to resource sharing to surge planning. We’ve also partnered with Florida Governor Ron DeSantis through our Cleveland Clinic Florida team. And those efforts aren’t over — we continue to be in touch daily with government officials.

At the federal level, we’ve had several impactful interactions. Probably the best example is telemedicine, the new way to deliver care that has been embraced during the pandemic. We asked the federal government to lift state-specific restrictions for telemedicine platforms — and they did. Now our caregivers in Ohio and Florida and Nevada can reach patients across the country, without needing to have a license in every state where patients reside. Lifting those restrictions with the help of the federal government has allowed us to extend our reach and care for more patients in need.

There are many silver linings. This country always finds a way to come out of every crisis stronger and smarter.

Tom Mihaljevic, MD | Cleveland Clinic CEO and President

What good things do you see coming out of the pandemic that will reshape healthcare?

There are many silver linings. This country always finds a way to come out of every crisis stronger and smarter.

When this is over, digital technology in healthcare is going to become more prevalent. Healthcare will be more integrated. And there’s going to be a substantially greater allocation of research dollars, because the understanding of the importance of research is now more firmly established.

In essence, I believe that all of the aspects of healthcare that we were seeking to improve for years will now improve in much more accelerated ways, just because of the needs uncovered during this pandemic.

 

The pandemic also has laid bare health disparities, with Black Americans dying of COVID-19 at three times the rate of white Americans. Simultaneously, the nation is in the midst of a historic moment of reckoning with racism. What can Cleveland Clinic do to create lasting change?

As surely as COVID-19 is a public health crisis, racism is a public health crisis.

At Cleveland Clinic, inclusion is one of our core values. We’re working to end disparities, which are the result of deeply rooted structural racism, that have been magnified during this pandemic.

Cleveland Clinic is promoting change by joining community working groups and by giving voice to our caregivers through a new series of forums. We’re taking action in pursuit of equality and justice for our patients, caregivers and communities.

 

How will the COVID-19 pandemic evolve as we go from summer to fall to winter?

I don’t believe that the pandemic is going to disappear anytime soon. There is no biological reason for that to happen. We don’t yet have a vaccine, and even when we do, it’s unlikely that one vaccine will work for every individual.

In the fall, the flu season will begin. I believe that we’re going to have an accentuated number of patients being hospitalized for other respiratory diseases that will be coming on top of the pandemic, such as flu. Fortunately, measures that have been effective for combating COVID-19 should be equally effective when it comes to combating the flu.

Dr. Mihaljevic standing at a presidential podium talking.

During an April visit to the White House by top hospital leaders, Dr. Mihaljevic discussed Cleveland Clinic’s COVID-19 response. | Photo: Associated Press

How have Cleveland Clinic’s hospital operations adjusted to the new normal?

We’re seeing a significant increase in the number of patients who are seeking non-COVID-19 care. Those numbers continue to rise. So reactivation of our services after states lifted restrictions has been successful.

Our patients are adapting to the new reality, just like our caregivers are. And I’m hopeful that we’ll be able to convince all of those who need care to come to the hospital for the care they need. Our hospitals are safe and ready to serve.

 

Cleveland Clinic also is helping other businesses reopen. What can you tell us about those efforts?

The broader business community recognizes the need to have a safe environment for workers, and they’ve reached out to us for guidance. We’ve advised hundreds of businesses, from restaurants to airlines to hotels, as well as manufacturers. We’re also aiding school districts and faith-based organizations. This work is only beginning. It’s an opportunity to meet a great need.

 

Cleveland Clinic’s response to COVID-19 has generated an incredible outpouring of support in all shapes and sizes, from moral support to financial support to in-kind support. What difference does this generosity make at a time like this?

It makes an enormous difference. This support allows us to care for our patients, to care for our caregivers and to conduct vitally important research. It also creates a strong feeling of being one family, with a shared interest to address the health of the community as a whole. It means a lot to us, and we’re very appreciative. Nothing we do would be possible without these contributions.

 

A crisis can bring clarity. Is there anything that you understand more clearly today than you did before the pandemic?

What has become very clear is that Cleveland Clinic is a special organization.

Our caregivers are our heroes. They’re engaged. They’re compassionate. And they’re doing exceptional work throughout this pandemic. We’ve been in a fortunate position as one of the better-prepared organizations in healthcare, and therefore our caregivers have had opportunities to extend a helping hand for patients in need in New York City, Detroit, London and Abu Dhabi.

I’ve never been more proud of the work that we do. This crisis, if anything, has reinforced my belief that we have a special mission, and that we’re part of an extraordinary organization not only with a wonderful heritage, but with a very bright future.