New Mayo Clinic CEO most recently led its Florida operation

The Mayo Clinic on Friday named a 30-year insider as the new chief executive at one of the nation's marquee medical centers.

Mayo's board elected to give the top job to Dr. Gianrico Farrugia, a physician who's held a series of leadership positions at the clinic.

Rochester-based Mayo is the largest private employer in Minnesota and continues to draw patients from around the world with its reputation for specialty care. Farrugia will assume his new prominent position in American health care at a time when skirmishes continue over the federal Affordable Care Act and frustration persists over the cost of medical care.

"Health care continues to accelerate when it comes to change," Farrugia said in an interview. "We'll continue to bring even more ingenuity, innovation and fresh approaches, so that we can make sure that Mayo Clinic is able to help the United States move into a better future for health care."

Mayo Clinic employs more than 68,000 people and posts annual revenue of nearly $12 billion. Officials say the clinic cares for more than 1.3 million patients from all 50 states and nearly 140 countries each year.

Farrugia will work alongside current CEO Dr. John Noseworthy through the end of the year. At that point, Noseworthy will be 67, and Farrugia will be 55.

Mayo has a tradition of appointing chief executives who are physicians already on the clinic's medical staff, Noseworthy said. Both attributes, he added, have been written into the clinic's bylaws.

Officials this week said that Farrugia was selected from a pool of strong candidates developed through Mayo's "deliberate rotational leadership model," which incorporates succession planning.

"This seems a perfect time for this seamless transition," Noseworthy said. "Mayo Clinic is rock-solid across our research, education and practice."

Farrugia (pronounced fa-ROO-jah) is a long-serving gastroenterologist at the clinic who also has run Mayo centers for innovation and individualized medicine. He's published a book on the need for innovative changes in health care, plus more than 250 articles on genomics and the treatment of disorders of gastrointestinal motility.

A native of Malta, Farrugia followed in the footsteps of a fellow countryman in coming to Mayo, helping create a tradition of top Maltese medical school graduates coming to Mayo for advanced training. He won't be the first top executive at Mayo born outside the United States.

While the current CEO position doesn't have an equivalent throughout the clinic's history, officials say a comparable institutional leader from the 1930s was Dr. Donald Balfour, who was born in Canada. Dr. William W. Mayo, the man who founded the clinic in the 19th century along with sons Charles and William, was born in England.

Since January 2015, Farrugia has led a staff of more than 6,400 people at Mayo Clinic's campus in Florida. He's credited with helping make the Jacksonville hospital a destination for care in a state that sees competition from some of the nation's biggest names in health care including Cleveland Clinic, Baltimore's Johns Hopkins and M.D. Anderson, based in Houston.

Farrugia's specialty is a gastrointestinal condition where the stomach doesn't properly empty. It's an example, Farrugia said, of a condition that is a relatively niche specialty at most medical centers but one where Mayo offers multiple experts in treating the ailment.

That background helps explain one of his few comments on Twitter over the years. In 2017, Farrugia tweeted: "The gut microbiome is home to over 1,000 different species of bacteria with a multitude of genetic content."

Looking forward, health care in the United States faces challenges with making sure patients have affordable access to the system, Noseworthy said, adding that Mayo must take a leadership position in addressing the problem. Farrugia seconded the point.

"We need to innovate in how we deliver that health care in ways that are affordable to more and more patients, [so] that they also have the advantage of being exposed to Mayo's way of providing care," Farrugia said.

"We're at the point that we've never looked after as many patients, and we've never done it as well as we're currently doing it — both in terms of quality and safety, as well as patient outcomes," he said. "We will be following the Mayo model of care that we've established through the test of time, and we'll continue to use those values and principles going forward."

Noseworthy took the top job in 2010. He replaced Dr. Denis Cortese, a prominent backer of health care reforms at the federal level who served as Mayo Clinic CEO from 2003 to 2009.

Noseworthy announced in February his plan to retire at year's end. In an interview at the time, Noseworthy cited as one of his most important accomplishments a reorganization beginning in 2009 to make Mayo operate as one entity, rather than a holding company with distinct operations in different states. Mayo includes clinics and hospitals in Arizona, Florida, Iowa, Minnesota and Wisconsin.

Noseworthy also oversaw a successful push at the State Capitol for a massive economic development project in Rochester to bolster the region's status as a destination for specialty medical care.

His tenure has not been without controversy, including plans to scale back services at Mayo's hospital in Albert Lea that generated a backlash in the southern Minnesota community.

For 2017, Mayo Clinic reported net income of $707 million, up 49 percent over the previous year, on $11.99 billion in revenue. Over the past 10 years, Mayo has posted annual net income tallies ranging from a low of $333.2 million in 2009 to a high of $834 million in 2014.

During Noseworthy's tenure, the clinic's endowment more than doubled to $4.31 billion.

"We are deeply grateful for Dr. Noseworthy's outstanding patient-centered leadership and inspiration he provided over the past nine years," said Samuel Di Piazza, the chairman of Mayo Clinic's board of trustees, in a statement Friday.