Mayo Clinic

MAYO CLINIC 557 Mayo Clinic, Employer-Petitioner and Hotel, that Mayo Clinic physicians do serve on the medi- Hospital, Restaurant and Tavern Employees, Local cal staffs of these two hospitals. In addition, it also 21, AFL-CIO. Case 18-RM-586 appears from the record that other Mayo Clinic per- November 28,1967 sonnel may at times perform laboratory test, X- rays, and occupational therapy within the hospitals. However, the charges for such services are ad- DECISION AND DIRECTION OF ministered and collected by the Clinic. Similarly, ELECTION when a Clinic patient is required to be hospitalized in either St. Mary's or Rochester Methodist Upon a petition duly filed under Section 9(c) of Hospitals, the charges for the hospital room and the the National Labor Relations Act, as amended, a hospital care and services are administered and col- hearing was held before E. G. Rotenberry, Hearing lected entirely by the respective hospitals. Officer of the National Labor Relations Board.1 Mayo Clinic takes the position that, in practice, Thereafter, the Employer-Petitioner, herein it is operated like a typical physician's office, the referred to as the Employer, Mayo Clinic, or Clinic, only difference being that the Clinic has more facili- filed a brief with the Board. ties immediately available. Thus, when patients The Hearing Officer's rulings made at the hearing come to the Clinic from all over the world, either by are free from prejudicial error, and are hereby af- referral or on their own initiative, each is assigned firmed. to one of the approximately 470 staff physicians Upon the entire record in this case, the Board who consults with the patient. The staff physician finds: has at his disposal the complete diagnostic 1. Mayo Clinic, located in Rochester, Min- resources of the Clinic, including specialists in nesota, is a voluntary, nonprofit, association of many fields of medicine, and highly specialized physicians engaged in the practice of medicine. The equipment. Ambulatory patients, if they elect to Clinic's medical activities are carried on in a com- remain at Rochester, are treated by a Mayo Clinic plex of interconnected buildings; i.e., Mayo Build- physician or physicians on an "out-patient" basis. ing, Plummer Building, Damon Building, the Medi- It also appears that patients have the option, after cal Science Building, and the Harwick Building. A they have been examined, to return home to their board of governors, consisting of 12 individuals, 10 own private physicians or remain for treatment at physicians and 2 administrative members, the Clinic by its staff personnel. Finally, it appears establishes the policies and controls the activities of that 90 percent of the patients utilizing the Clinic the Clinic. The Clinic operates 22 sections of inter- pay for their own medical care.3 and, if necssary, nal medicine; various sections of medical special- the Clinic utilizes the outside personnel, such as ties, such as psychiatry and neurology; and special collection agencies, to collect its fees for such medi- surgical sections. It has approximately 470 staff cal services rendered. physicians and approximately 2,400 paramedical Although the Clinic has engineering, publication, employees in its employ. All of the property and and photography departments which are responsi- equipment utilized by the Clinic is owned by the ble for developing and designing medical devices Mayo Foundation, a nonprofit charitable Min- and recording and disseminating the discoveries of nesota corporation, and is leased to the Clinic. Pur- the Clinic's staff, such operations appear incidental suant to the lease, all of the earnings of the Clinic to the primary purpose of the Mayo Clinic, which is after paying expenses, including salaries to its the practice of medicine. physicians, are paid by the Clinic to the Mayo To service its nearly 200,000 patients each year,4 Foundation. who pay approximately $39,800,000 in fees, the Mayo Clinic has no beds or any other facilities of Clinic purchases in excess of $6,000,000 worth of its own for housing patients overnight. "In pa- supplies and equipment annually, $2,000,000 of tients," that is, patients who need overnight care, which originate outside the State of Minnesota. are treated at two nearby nonprofit hospitals, Saint Thus, in 1966, the Clinic purchased heart valves Mary's Hospital and Rochester Methodist valued at $92,000 from California and Pennsyl- Hospital.2 Mayo Clinic does not operate the afore- vania; chemicals valued at $21,000 from Missouri; mentioned hospitals and has no voice in the formu- syringes, gauze, and bandages valued at $28,000 lation of their policies. It does appear, however, from Illinois; glassware valued at $50,000 from I Pursuant to the Board's Rules and Regulations , Series 8, as amended, the Regional Director issued an order transferring the case to the Board for decision 2 Olmsted Community Hospital and Rochester State Hospital, both government hospitals , are located in Rochester, Minnesota. It appears from the record that Mayo Clinic physicians visit some patients in the aforementioned hospitals from time to time. ' Pursuant to contracts with various airlines, industrial concerns, etc , Mayo Clinic physicians and staff regularly examine the personnel of such airlines and industrial concerns. Moreover, it also appears that the Clinic is doing some research on a contract basic for the Air Force , and is an- ticipating entering into a contract with the Vocational Rehabilitation Ad- ministration for some services to be performed in the artificial kidney pro- gram. 4 Forty-seven percent of the Clinic 's patients come from areas outside the State of Minnesota. 168 NLRB No. 79 558 DECISIONS OF NATIONAL Pennsylvania and Illinois; and X-ray film valued at $600,000 from New York. During this same period, continuing investment in capital improvements required the shipment from points outside the State of Minnesota of furniture ($69,700), steel ($1,000,000), steel rods ($85,000), and cement ($56,000). In addition, the record also shows that staff physicians of Mayo clinic engage in substantial amounts of travel outside the State of Minnesota to attend and participate in meetings of the medical profession as well as to study and observe medical techniques. The cost of such travel, which is paid by Mayo Clinic, is estimated to be between $350,000 and $400,000 per year. In addition, spe- cial facilities have been prepared for the numerous bags of mail and drug samples which are received from throughout the entire country each day. Moreover, the number of long-distance telephone calls made by Mayo Clinic staff personnel to points outside the State of Minnesota has warranted the soon-to-be installed WATS communication system. From the foregoing facts, both Mayo Clinic and the Union take the position that the Clinic is not a hospital- within the meaning of Section 2(2) of the Act, and that the Clinic is not primarily engaged in education and research activities. In addition, both parties urge that Mayo Clinic's operation has a sub- stantial impact on commerce, and that the Board should assert jurisdiction in this case. s An election eligibility list, containing the names and addresses of all the eligible voters , must be filed by the Employer with the Regional Director for Region 18 within 7 days after the date of this Decision and Direction of Election . The list may initially be used by the Regional Director to assist in determining an adequate showing of interest . The Re- gional Director shall make the list available to all parties to the election LABOR RELATIONS BOARD It is clear from the facts set forth above that the operations of Mayo Clinic affect commerce within the meaning of Section 2(6) and (7) of the Act. As the parties agree that the Board should assertju- risdiction herein, and as no claim is advanced, and it does not in this record appear, that Mayo Clinic is a nonprofit hospital and/or is primarily engaged in education and research, we shall, consistent with the request of all interested parties, assert jurisdic- tion in this case. 2. The labor organization involved claims to represent certain employees of the Employer. 3. A question affecting commerce exists con- cerning the representation of employees of the Em- ployer within the meaning of Section 9(c)(1) and Section 2(6) and (7) of the Act. 4. We find that the following employees of the Employer, as agreed to by the parties at the hearing, constitute a unit appropriate for the purposes of col- lective bargaining within the meaning of Section 9(b) of the Act: All diagnostic X-ray technicians employed by Mayo Clinic, Rochester, Minnesota; ex- cluding office-clerical employees, guards, and professional employees as defined in the Na- tional Labor Relations Act, as amended, and all other employees. [Direction of Election 5 omitted from publication.] when he shall have determined that an adequate showing of interest among the employees in the unit found appropriate has been established. No extension of time to file this list shall be granted by the Regional Director except in extraordinary circumstances . Failure to comply with this requirement shall be grounds for setting aside the election whenever proper objections are filed. Excelsior Underwear Inc., 156 NLRB 1236