When people gained a renewed interest in diagnostic testing during the pandemic, Dr. Bill Morice became a great resource to the public. Dr. Morice, president and CEO of Mayo Clinic Laboratories, became a regular guest on sports talk radio as his expertise on COVID and testing reached a widespread audience. Dr. Morice now lends his knowledge to the Medical Alley community as this week's guest on the Medical Alley Podcast. He shares more about the work Mayo Clinic Labs does with diagnostic testing, talks about how his radio fame came about, and much more.
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Frank Jaskulke01:21
Good morning, good evening, good afternoon to everyone out there in Medical Alley. Thank you for joining us on another episode of the Medical Alley Podcast. We have one that I am personally very excited about, which should be an interesting interview and one that might be someone you're familiar with already. I'm joined today by Dr. Bill Morice, who's the President and CEO of Mayo Clinic Laboratories, an organization that I have been a client of multiple times, and I always appreciate the work that you guys do. Dr. Morice, I really appreciate you being on today. Something I've always wondered about, just a really simple thing. You guys have a very big laboratory setup. Do you know how many samples come in to Mayo Clinic Labs every day?
Dr. Bill Morice02:07
So it's important to remember, Mayo Clinic Labs is what allows us to take the testing that we do for our patients on our campus, predominantly in Rochester, and make them available for people that never visited our campuses. So especially here, and that's it's a significant number. It's about 30 to 40,000 specimens every day that come predominantly into the Rochester facility. There's a little bit that happens in Florida as well. But into Rochester, 30-40,000 specimens a day, so up to you know, maybe up to even a million tests in a month.
Frank Jaskulke02:40
It's like a metropolitan area coming in every month.
Dr. Bill Morice02:43
Yeah. It's hard to believe. I mean, it's something, it's very Minnesotan. You wouldn't really think of that happening here in Rochester. But it does.
Frank Jaskulke02:52
Of course. We'll back up for a second. And can you tell our listeners, for those who aren't familiar with you or your work, would you just give us a quick introduction of who you are?
Dr. Bill Morice03:04
Sure. So I'm Dr. Bill Morice. I guess you said that already. So I am both an MD and physician as well as a PhD. I came to Mayo Clinic in 1987 to do that training, to come here for medical school and graduate school. And I've been here ever since. And so I did clinical medicine, and then I did laboratory medicine training. My subspecialty hematopathology, meaning the diagnosis of disorders of blood and lymphomas and blood cancers, things like that. But for the last eight plus years, I have had the privilege of being the chair of the Department of Laboratory Medicine, pathology, as well as the president of Mayo Clinic Laboratories. And as you mentioned, I will be transitioning. At Mayo Clinic we have rotating leadership. So at eight years, leaders rotate, but I will be rotating into another leadership position that is to be the President and CEO of Mayo Clinic Laboratories and Mayo Collaborative Services, which is the parent company of which Mayo Clinic Labs is part of.
Frank Jaskulke03:59
Oh, fascinating. I did not know that about — I knew the rotations, but I didn't know that sort of timeline for it. That's quite interesting in its own right. Maybe for those who aren't as familiar with Mayo Clinic Laboratories, can you give an intro of that organization as well of like the the comprehensiveness of what you're up to?
Dr. Bill Morice04:18
Sure. So you know, one of the things that's when you think about first of all, laboratory medicine and pathology department, it is a department that every other department and healthcare system, in this case Mayo Clinic, will use, right? Because everyone that comes into the doctor needs understand needs a diagnosis or need to test to have or how they're responding to treatment. So because of that, and then you think about what Mayo Clinic is and Mayo Clinic isn't a cancer center or pediatric hospital. We're basically an answer shop for everybody with medical issues, right? And so we have in our department the most expansive test menu in the country, probably, maybe one of them in the world. We do over 3,000 unique different tests in our department. And so it's it's quite remarkable. Anything from testing of newborns for inborn errors of metabolism or inborn errors in a newborn to very advanced esoteric cancer testing, to neurologic testing through all sorts of testing, right? So that's what our department is. And then, actually one of my predecessors also a hematopathologist said, well, we should really think about how we make this specialized testing available to patients that never would come to Mayo Clinic, right? Because oftentimes, those tests are needed by doctors. And they don't have, you know, they don't work at Mayo Clinic. So they don't have a department like ours across the street. And so that was Dr. Michael Sullivan, who really started in the region to say, you know, we should — he would literally drive to other hospitals in our region and say, here are the tests that we perform. We know you do many of the same tests. And we really believe it's important that you continue to do those tests for your patients. But on the — just like Mayo Clinic, we're here when someone has a complex condition that they can come to a place like Mayo and get, you know, a group of experts around them. The lab, Mayo Clinic Labs, same thing. You can do most of your testing, we want to help you understand how to do that for your patients. But when you really have something seriously complex, we want to be able to have you send that to us. That's in essence, that is what is at the core of Mayo Clinic Laboratories. So what Mayo Clinic Laboratories is, then, are all the pre and post analytical functions that, you know, there's it's not so simple as just taking a blood specimen and sticking it in the mail. You know, it's a patient, it's part of a patient. So we need all of the systems that allow us to know what that doctor is thinking, verify that the specimen gets here in a condition that it can be tested, do the testing, get the testing back out to the patient, and to the provider as quickly as possible. That's all what Mayo Clinic Laboratories does. And from those really humble beginnings 50 years ago, it's now grown to, you know, the scale we talked about. We have actually over 4000 hospitals that we work with in the US and activities in over 60 countries. So it's actually a global business now. But with that same business model of really doing for for healthcare systems, and for patients, that type of testing, which they need from Mayo Clinic.
Frank Jaskulke07:14
I mean, knowing that especially knowing, like Dr. Sullivan started driving out to the different hospitals to build those relationships to bring that capability. It makes me think that's such a Mayo Clinic thing, that is such a Minnesota healthcare thing to go, we have this capability that could benefit patients elsewhere. Let's go out and make sure they have access to it. I have to imagine that as we came into the pandemic, I think about March of 2020, that capability really came to the fore and not just the capability to do that much testing, but to do the specialized testing, the complex testing, and probably then also things that might be new or novel and not as well understood yet. As we went into the pandemic, which seems forever ago and yesterday at the same time, how did the work of Mayo Clinic Laboratories evolve and change and respond to what was happening all around you in Rochester and around the world?
Dr. Bill Morice08:15
Yeah, well, first of all, I think COVID time needs its own time scale, because COVID time is weird.
Frank Jaskulke08:22
I struggle with this, yeah.
Dr. Bill Morice08:25
But no. So first of all, it's important to remember that what we what Mayo Clinic Labs is part of Mayo Clinic, right. So it has at its core that patient centricity, you know, the needs come first. And also the educational component. You know, one of the things if you are on the Rochester campus and you go over to the Plummer building, you can go into third floor and see where were the Mayo brothers went all over the globe, right, trying to educate on med surgical technique, and medical technique and all those things. And that's really what Mayo Clinic Labs. That's, in essence, we are a continuation of that tradition because we we try and deliver healthcare services, but we really tried to educate, and we do all of that, even though it is a business activity. It's founded in the core principles of doing everything in the best interest of the patient. So come the pandemic, we do have this global network and very much a national network of you know, of logistics that we can employ connections to hospitals to get testing out and really the first testing for COVID, on a scale of complexity, infectious disease testing is not terribly complex. The situation was terribly complex, because no one had to test and tests were in very limited supply. There was you know, we went from a disease that didn't exist to within four or five months, every individual in the United States essentially wanting a test, right? And that's in every individual across the globe. So we really pivoted our machinery, all of our infrastructure to try and grow that testing, the testing capability. And we did that with an Number of industry partners, including Roche early on, right that worked with us on that. And then using our connections to hospitals to make that testing available. In fact, we were selected, you know, March of 2020, I was with a team that went to the White House as part of the American Clinical Laboratory Association board. That's a trade association for labs, which I have now the board chair, actually. So we went to the White House in March of 2020 with that call for testing. You think back to those days, and with the big announcement, we met with Vice President Pence and Dr. Birx and others from that team. We came back with the charge that we got access to testing, we're going to make it available not just to Mayo Clinic patients, but also to use our capacity to the betterment of people across the state and across the country. So we did that. We were able to pivot all of our testing infrastructure for that. We have designed, I mean, when you think about it, when you go into a doctor, and you have so much anxiety, and I've had the experience too about what does the test show? What does it tell me? So we've always designed all of our test delivery to get the test back in the hands of the doctor and the patient as quickly as possible. So that's what we did with COVID. We used our test, as we grew our infrastructure to test, we did make sure that we can get tests out within 72 hours that led most so we actually, we actually turned away some business because we didn't want to take in more business that we can handle. So it wasn't all of our infrastructure to that to have that same delivery for COVID testing that we had for everything else. And then to your point, the other thing we realized right away was that this was a new disease. And there were going to be a lot of questions that doctors need to answer. And particular, who was going to get really sick with COVID? How long would they be sick? So we have a whole innovation infrastructure within the department, in particular, in a location called the advanced diagnostics lab in Discovery Square One. We actually pivoted all of our innovation infrastructure into innovating around COVID. And in that first year, we developed about 20, new tests for COVID, to answer different questions that doctors had about patients with COVID.
Frank Jaskulke12:05
We'll come back to that innovation piece in a minute. But I'm curious now, I don't know how to describe what we're in or where we are today. People say normal, new normal, whatever. But in the world we're in today, that infrastructure that you've built up, are you finding, are you having to re pivot? Are you deploying it in new waysHow are you now adapting Mayo Clinic Laboratories infrastructure to this world that we're either in or entering today?
Dr. Bill Morice12:37
Well, it was, first of all, I mean, it was very much, it was really an all hands on deck. I mean, I have to say, I'm so humbled by the response of our staff, people that volunteered to work night shifts in the COVID testing lab, and they did different things that they, you know, that they had never done before. And their willingness to do that was really quite remarkable. So part of it, of course, is trying to pivot back to, you know, because the reality is that there are many healthcare and testing needs that were neglected, because patients just didn't have access to care during the pandemic. So we need to get back to that. So part of it's kind of going back to where we were. But at the same time, I think that where that watermark lies on what we're doing for testing is going to be different than, you know, the pandemic, to my mind is sort of like a gigantic tidal wave that sits ashore, as it recedes, and it is in a receiving phase, it's not over by any stretch, it's gonna leave the landscape different. I think there's different expectations around testing, that people have a new understanding around testing. There are people who want testing to meet them where they are, the whole concept of testing at home. So really, a lot of it's going back to making sure that we have the tests available to patients that need them, but also looking about how people's expectations around testing and expectations have changed, right? And so that's really where we're thinking now as we look forward with Mayo Clinic Laboratories.
Frank Jaskulke14:00
I might ask you to expand on that. A lot of my work is with our startup community. And for for a long time, things like home based or point of care testing was a very difficult business area to be in. The infrastructure wasn't necessarily there, reimbursement wasn't necessarily there. And I'd say we as patients weren't necessarily in that mindset. That wasn't how we thought about things. The pandemic has changed a lot of the ways we think about how we interact with the world, but with medicine in particular. Did you, maybe just expand on how do you think diagnostic medicine has changed in the last couple of years? And how maybe as we as people see interacting with the medical community or with medicine?
Dr. Bill Morice14:45
Yeah, that's a great question, Frank. And so I think there's really two facets to it. The first is kind of, as you alluded to, for testing to be delivered and available and it's actually a pretty complex healthcare ecosystem, if you will, right. Healthcare delivery ecosystem, probably more accurately in terms of, you know, making the test affordable. Is it covered by, you know, is it covered by CMS and by insurers? Is information presented back to a doctor that's understandable? All those things have to be thought about and, of course, we did in the crucible of COVID. There are some significant — and even the regulatory environment with FDA and others, right. So it was so clear, obviously, that we had to do things differently, that CMS, FDA, healthcare systems all move the dial simultaneously to try and get the testing out as much as possible. We have to understand that as we go forward, because we've even struggled, monkeypox, thankfully is now on the wane as well. But that was another one that hit that the testing capabilities just really struggled to catch up. And I think that kind of systemic approach to how we deliver testing in general, but particularly outside of a hospital setting is now something we really have to think about going forward. And the other flip side of that is, we've had the ability to do home testing for a long time. As was pointed out, one of the gentlemen that I've really been privileged, I've gotten to know so many wonderful people through pandemic that's a silver lining for me. And one is a gentleman named Scott Garrett, who's now at Water Street Capital, a private equity firm as one of the principals there, but was a former CEO of Becton Dickinson. And he, you know, early on, he's like, look, we've had technology to do home testing for years. It's just to your point, people haven't really wanted it. And I think that now, two things. Number one, people are I think getting more comfortable with that, with that creation of information in the home environment and seeing the value of it, when they don't have to go, even now, with home based testing for COVID. You know, if you had to go into a setting to get a test for COVID to be able to go do something, it'd be a major hassle. So people are seeing the value in it, number one. Regulators are seeing the ways pass forward to make sure that it's safe, whether it's a supervised collection, like we had with the fall testing for, you know, saliva testing for COVID in Minnesota. So that all that piece is being put together. Lastly, I do think the economics favor more at home testing, because of course, in the pandemic, and in the height of it, we just had very limited resources to, you know, hospitals were busy and were concerned about getting overwhelmed. So we wanted people to stay away from you know, from the hospital unless they needed it. So home testing made a lot of sense. Well, the reality is that the only way to really deflect the cost curve in healthcare economics is to decrease utilization of the health care system. And as soon as someone shows up in the door of a health care system, they start utilizing the services, right? So you start to think about now. So I think a lot of people with good ideas around home based testing and self collection are going to see a much more fertile environment for those to actually germinate and take root because a lot of things have pivoted societally and in healthcare economics to favor more home based testing.
Frank Jaskulke17:52
Oh, very interesting. You mentioned the advanced diagnostic lab or the ADL. I take it then diagnostic innovation is an area that Mayo Clinic Laboratories is working in. Is that a case, and do you also work then with like outside organizations on the development of new capabilities or technologies?
Dr. Bill Morice18:15
Yeah, so another great question. So if you think about what Mayo Clinic is, you know, we have lots of, you know, you go down, and you can see, you know, the individuals that got the Nobel Prize for for discovering cortisol here, you know, and all those, Doctors Kindle and Hedge. And so we've always been the place where people come for answers when they can't get answers other places, which a lot of those answers come from the lab, which means that the lab continually focused on innovation, to serve the needs of our own patients level. And also now, of course, the business because that's why people are descending to Mayo Clinic labs to get access to that same sort of continuously advancing diagnostic capability, right? And understanding how to fit all that in. The thing that's really, for us, that has changed, and I say us really, I just myself, personally, I mean, so I got done with my training and joined the staff in 2000. And at that time, you know, the wheel on technology turn that such that maybe if you did some innovation, a new piece of equipment, that equipment would be in the lab for five to 10 years even right. And then it would be replaced. Well think about, I mean, gosh, when I started medical school, you know, wristwatches were still a fantasy, right? And in terms of wristwatches, you could talk on the phone, I should say, not wristwatch, but you could talk and give them your schedule. I mean, things that think about how far technology has come in that time. The laboratory and the clinical lab was one area where that technology really intersects with patient care. You know, as you probably know, from your listeners, there's a lot of people innovating technologies, many of them focused on diagnostics. And so it only makes sense that if we really want to innovate in this world, where now the technology turnover is maybe three years, and maybe every five years, there's some really disruptive technology or maybe even less. We have to partner with those that are the purveyors of those technologies to help kind of bring them into our environment, understand the best use cases for them, understand the real value that they bring to healthcare, and then also innovate with them sort of on the implementation sides of these new technologies. So yeah, we do have done a lot. The ADL was created in part to create a physical location for those interactions to occur. And, you know, we've had, we do have companies now, Thermo Fisher being the most significant there, that are actually bringing technologists in there for us to essentially co-innovate on them. And innovation is everything from discovering new to really discovering how to use new in daily healthcare, which is, of course, one of the biggest hurdles and technologies phase.
Frank Jaskulke20:49
Oh that's fantastic. And I'll say to the listeners out there, if you're interested in learning more about Discovery Square, and the activities that are going out there that Dr. Morice referenced, reach out. It is a fantastic development that's going on. If you haven't been to Rochester recently and seen the startups, the innovations that are popping up there, you're missing out.
Dr. Bill Morice21:13
As someone that's raised his family in Rochester, I mean, it's really energizing for me to see those companies come in. And it is, it's really as a substantial change over the last, you know, 10 years, five years particularly accelerated, even through COVID. It's been a real privilege for me as a leader of Mayo Clinic Laboratories to be part of that kind of transformation of our community in a very positive way. And that's part of what's the whole going back to, you know, my new role. And part of the reason for that is that the pandemic really did demonstrate the power of diagnostics, and the desire for outside companies and outside entities to work with Mayo Clinic in understanding and innovating around healthcare needs for patients. And so what we want to do is even be more active participants in that industry, because the reality is that we need companies like Mayo Clinic, and Mayo Clinic Laboratories that are really focused on the needs of the patient to participate in that industry to make sure it always is focused on serving the needs of individuals in society and in health care.
Frank Jaskulke22:15
Yeah, well said. I think that is one of the most unique things about this community. If I go back to the beginning of Medical Alley in 1984, Earl Bakken's idea was, What if we got the payers, the providers and the technology firms together as equals? Might they come up with better ideas to improve patient care and lower costs than if they were siloed? And I think what you just described is living that in reality right now, bringing new technologies that are ultimately going to benefit patients here, but all around the world, in ways that probably would have happened if it was only the technology company, or only Mayo Clinic working on it. So right on and well said.
Dr. Bill Morice23:02
Yeah, thank you. Yeah, I think there's beyond just what you would think of as official healthcare company, right. So whatever the last one of the things with the growth of Mayo Clinic laboratories, of course, and we got to get those 40,000 specimens in to Rochester, right? So FedEx has been a partner with ours along the way to think about what does that mean logistically? We have to get the specimens here, we have to be able to track them. How specimens are identified, we have our own distinct box color. With that we use FedEx, it's still always our preferred kind of vendor or partner, I guess logistical partners in space. Just thinking about that, how specimens are transported, how we track them, all these things that are these, you don't think of them as innovations that you need. But if you're a patient that's sitting in a hospital in Albuquerque, New Mexico, and your doctor says, Yeah, I need to get this test to Mayo Clinic, because I think you might have this condition that they have a test for. Those things all become material. And those innovations become really impactful really quick, right? Because it's a whole deal. That's the beauty of it is there. And I think now because of a pandemic, there is a desire of companies outside of what we think of as traditional health care, to participate in the kind of the creation of the industry.
Frank Jaskulke24:15
Indeed. And shout out to FedEx. A longtime member. The things we have learned about even pre pandemic, the impact of logistics on making healthcare work better are incredible. And the folks in Memphis have done incredible work. And I'm a big fan of seeing the planes landing in Rochester every day.
Dr. Bill Morice24:36
Yeah, me too.
Frank Jaskulke24:38
Yeah, yes, of course. Coming in for landing. I want to shift to a different topic. Some of our listeners are going to be familiar with you already because they've heard you on like KFAN. And I think this was a another big lesson a lot of us got during the pandemic that are close to healthcare where we know about these things. We sometimes speak in a language that isn't always super understandable to those outside of it. You did a lot of work, spent a lot of time speaking to the broader public in different channels and reaching people who maybe weren't hearing the message in the channels we usually think of. I'm just curious, how did the KFAN thing get started? And why did you go about doing so much public health communication in channels that maybe we wouldn't usually think of as the place we got to talk about these issues?
Dr. Bill Morice25:37
There's a lot there. So I'm starting with Dan Barreiro. And I have to say, you know, I was so pleased to see him inducted into the Minnesota Broadcasting Hall of Fame. You know, I listen to his show, I'd read his column back when he was a columnist for the Star Tribune. And I always loved the show, because he didn't sidestep issues, and the breadth of issues that they would cover was the real humanity to it, with humor, you know, which is always good. I was just always drawn to it. So when the media requests were coming through in the March of 2020, you know, when the pandemic really became the story, that was one that came in, I volunteered to do just because I had great respect for the show. And now you're having to get to know Justin Gaard and the way he produces, I mean, there's a real topflight team there. So I called in, I spent an hour. I'm a huge sports fan as well. So that's a big part of it. And I've grown up in Minnesota and my father in law has strong sporting ties in Minnesota. So anyway, so that was part of the draw as well. And so I got done with that first, I'll never forget, we were actually talking about why there were so much variation in what people were saying was going to happen with COVID. And I use kind of the Moneyball analogy, right, that it's all statistical modeling. And so a lot depends on what you put into the model in terms of what the output is. And so that's why we still miss on draft picks, and people still miss out. So because modeling is limited. And so that was a start. And I called in, or I emailed afterwards, and thanked Justin for having me on and said, I really enjoyed it. And he's like, Well, we like having you on. And there's a lot of COVID stories, and not as much sports going on. So I got back on more and more with Dan, and you know, Dan's a very influential person. And so there were others, and particularl a guy by the name of Christopher Gabriel, who has was on ESPN radio and the Central Valley region of California who'd worked with Dan, and now is on I believe a CBS news outlet. there with a listenership. So he had me on because he heard me explaining it. And that then it kind of grew. It turns out sports journalism, particularly sports radio is pretty small community. So I ended up on the Big 10 Network, I end up on ESPN national. And I think a lot of it though, if you step back, it's not a couple of things. Number one, it just shows that when people want information, really we should not be reticent about sharing it and sharing what we know and sharing what we don't know. I think that's a lot of what we — I think it's important not to simplify, but to make things understandable to people. But that doesn't mean oversimplifying, or that doesn't mean canning it in a way that you're trying to just kind of give your view of things. One of the most gratifying comments I've had for this happens, I've had a number of people, I got a chance to join Dan at the state fair a couple of times, and people just came up and thanked me because I was just very balanced. They said you just didn't feel like you had an agenda. Or on Twitter, I have people say I'm on one side or the other. I joke with Dan it means I must be doing it right. The other thing though, it shows the importance of trust in societal institutions, right? I think that's one of the things that's been really sad. There's been a real erosion of trust. And people just had questions around diagnostics that they never had before. All of a sudden diagnostics became impactful for everyone, how they just basically conducted their daily life. And they were looking for a trusted voice as they tried to sort through all that. And Mayo Clinic was an obvious place for them to go. So I think it was really as a lot of it about Mayo Clinic and the shoulders that I stand on here, my proclivity for talking and then the need for people just be hearing an honest voice. And I think that's that it was really those combination of factors.
Frank Jaskulke29:19
Indeed, and I think that might be the piece that will take away from this conversation. I love that of sharing what we know and what we don't know. And that's probably the best thing we can do to help restore trust and societal institutions. So Dr. Morice, I might say at this point, thank you so much for sharing what you do know and don't know with our community, and being a part of this great ecosystem for so long. I really appreciate you taking the time today.
Dr. Bill Morice29:46
Well, thank you. Thanks for having me out. I really appreciate it. I enjoy it and I really enjoy making the connections that things like podcasts because a connected world where we're really understanding each other is a much better one. So thank you for the opportunity to come on.
Frank Jaskulke30:02
Right on, connected world is a much better world. And folks, that's been another episode of the Medical Alley Podcast. If you're not already subscriber, make sure you check out medicaalleypodcast.org, Apple, Spotify or wherever you get your podcast fix. Until next time, have a great day.