Medical & Science:
Respected chain of medical clinics grew out of one man’s solo endeavor
Kelsey-Seybold grew into a medical powerhouse.
Mavis Parrott Kelsey’s supervisor was dumbfounded when he told him in 1948 that he was leaving his faculty job at the prestigious Mayo Clinic in Rochester, Minn.
“He was surprised and didn’t believe I was really serious,” Kelsey wrote in his book, “Twentieth Century Doctor.”
At the time, the Mayo Clinic was at the forefront of medicine in the United States, according to Bryant Boutwell, a medical professor and historian at The University of Texas Health Science Center in Houston.
“It was unheard of to get to that pinnacle at Mayo and say ‘I’m leaving,’ ” Boutwell said.
While working at the Mayo Clinic, Kelsey had seen the effects of working in “group practice,” where doctors work together in-house, rather than in solo practices referring patients to other specialists.
The comprehensive, teamlike system was relatively unusual at that time, when medicine was undergoing a radical transformation from the days when doctors made house calls to the specialized, technological models of today.
But Kelsey had dreams of setting up a similar clinic in Houston with some of the colleagues he’d met and worked with in Minnesota, including Drs. William Seybold, a native Texan like Kelsey, and William V. Leary, of Owatonna, Minn. At the time, the Texas Medical Center was still a shadow of the medical behemoth that it would become, and the Mayo Clinic’s hallmark “group practice” was still relatively unknown.
Kelsey and his wife packed their bags and returned to Texas and set to work building a solo practice in the fast-growing city, which at the time had about 900,000 inhabitants and 900 doctors. The experience, Kelsey wrote, was “the most challenging ... of my life.” In those initial years, he worked long hours as he struggled to find his place in a new city and grow a practice as a relative unknown.
Within just a few years, however, Leary, Seybold and Kelsey’s younger brother, John, had joined Kelsey in Houston.
The doctors each had their own areas of expertise — cardiology and pulmonology; endocrinology and gastroenterology; and surgery.
“We were able to treat a wide variety of patients,” Kelsey wrote. “We felt free to treat anything we knew to treat.”
The fledgling practice brought a new style of care to the greater-Houston region. It has since grown into a medical giant, with hundreds of doctors at nearly two dozen clinics serving thousands of patients daily.
There were challenges. The Mayo Clinic’s model was fairly revolutionary, and many doctors frowned on “group practice.” Outside doctors were often loathe to provide referrals, so the practice initially grew slowly. But Houston was growing rapidly and with time, so did Kelsey’s clinic.
The clinic added doctors and employees and eventually outgrew Kelsey’s first office space in the Hermann Professional Building. It was moved into a two-story clinic that was soon expanded with four additional floors.
The clinic won contracts to care for employees of large firms and organizations, perhaps the most prestigious of which was its contract to care for NASA employees.
As it grew, the clinic relied on the principles of Kelsey and his other founding partners, said Dr. Spencer Berthelsen, the Kelsey-Seybold Clinic managing director and former chairman.
“It was basically summarized by saying, ‘Hire the best doctors you can, take good care of the patients and the rest takes care of itself,’ ” he said. Employees have looked to that motto over the years, he said.
In 1971, for example, the clinic opened a separate clinic in the Galleria area — a move aimed at treating people near where they lived instead of making them drive long distances.
“There was a lot of tension about this,” John Kelsey told authors of “Kelsey-Seybold Clinic: A Legacy of Excellence in Health Care” in 1998, recalling how doctors initially fought the change to make doctors travel to their patients. “It was a bitter pill for us to get started, but it was highly successful and people loved it.”
It would become the first of many such facilities.
Kelsey-Seybold faced another existential challenge in the 1980s, when a serious oil recession buffeted the region’s economy. With the devaluation of the peso, the clinic lost a significant amount of foreign business, particularly from Latin America. The clinic decided to turn to “managed care,” Berthelsen said, and invested in “Maxicare Texas,” an HMO. It soon had enrolled nearly 100,000 subscribers.
To stay competitive, the clinic built six new primary care facilities across the region in just three years. It also weathered two changes of ownership — first to Caremark International in 1992, and then seven years later to St. Luke’s Episcopal Health System and the Methodist Health Care System. The sale to Caremark allowed Kelsey-Seybold access to money to expand and better negotiate deals with insurance companies, Kellar wrote.
The joint sale to the local nonprofit health systems provided a more formal relationship with two of the region’s largest hospitals.
Then in 2009, Kelsey-Seybold’s doctors jointly purchased the clinic.
By the end of August, the clinic will have opened 20 facilities across the Houston region, from Katy to Pasadena.
The National Committee for Quality Assurance in 2012 named the clinic the first nationally accredited ACO, or Accountable Care Organization, praising its ability “to deliver coordinated, patient-centered care; to improve clinical quality; to enhance the patient experience; and to reduce costs through quality clinical practices.”
Practices across the country now emulate Kelsey-Seybold’s methods.
None of that, however, would have happened without Mavis Kelsey and his colleagues or their gutsy trip back to Houston more than 65 years ago. “He just showed the model (of care) that could be very effective, and others tried to pick it up,” Berthelsen said.