The Lahey Clinic Foundation

Herbert D. Adams, M.D.

On January 5, 1965 the official press release read: "The Lahey Clinic Foundation Elects a New President."

There was far more behind this line - over three years of considerable thought and effort, a true test of mettle and character.

Don McLean's involvement with the Lahey Clinic began in 1962, soon after I became Director of the Clinic following the retirement of Dr. Richard Cattell. A few years previously we had begun holding informal meetings with five other large clinics (Mayo, Cleveland, Ford, Ochsner, and Lovelace, Albuquerque, New Mexico). These annual two-day meetings were attended by top representatives from the administration and medical staffs. The agendas were simple, practical and very informal. Although several of the clinics had thought seriously about changing their corporate structure to a nonprofit basis, the first to do so was the Cleveland Clinic.

From the beginning of my involvement with administration, I had been dissatisfied with our corporate structure which has been set up under interlocking Massachusetts trusts by Dr. Leahy. Heavy taxes alone had not permitted the setting aside of funds for a new site and facility. It was a pressing issue for us. We had sounded out corporation lawyers in Boston, receiving scant encouragement because it had never been done in Massachusetts. We finally asked our Cleveland Clinic friends for more details, and to our amazement were told they had exactly the same experience in Ohio. Finally one of their trustees adjusted consultation with a corporate lawyer by the name of Donald H McLean, Jr., associated with John D Rockefeller, 3rd in New York. They had worked with him and he had led them to success. Further they were so impressed they had made him a trustee of the new Cleveland Clinic Foundation.

After making an appointment with him, Mr. Arthur Lyman, Chairman of the Lahey trustees, and I went to New York where we are graciously received. Don McLean listened intently to our proposition and then asked several pertinent questions. Before departure he told us he thought it could be done, and further that he would be pleased to join with us in the effort. For our part we were very impressed by his thoughtful reception, the detailed and factual discussion, and the keenness of his mind.

Thus began three long years of continuous consultation, the endless drafting of necessary legal instruments to meet our particular requirements, and most importantly determining how the plan might be put into operation after approval by the Massachusetts Secretary of State and the Internal Revenue Service. A large order indeed. Included of course we're opinions as to what could actually be gained by changing to a nonprofit status. Also an astute survey of our short-term and long-term goals and objectives. Don was at his best in this task, drafting many superb memoranda for study and guidance.

After two years of work it became clear that we could not get approval of the nonprofit status unless the Clinic was headed up by a board of trustees, the majority of who we're laymen. Likewise its president who would be the chief executive officer. I agreed to accept this legal requirement and gave up the directorship on the condition that our new Articles of Incorporation would specifically state that all medical matters would remain permanently under the jurisdiction of the board of governors made up of staff physicians with myself as chairman. In this manner our new corporate structure was finally approved by the Secretary of State and the IRS

We began the search for someone with exceptionally broad qualifications needed for the Clinic presidency. Our search turned up some fine possibilities, but none with the truly broad skills which we considered essential. Finally, Mr. Lyman said, “Really the only person who has all the right qualifications is Don McLean, and I would like to offer the position to him." This we did, and after considerable thought he wrote me a letter dated December 20, 1963 submitting a provisional acceptance. This letter is reproduced in the appendix since it is a typical McLean masterpiece, illustrating perfectly his flair for expressing himself in a thoughtful and convincing manner. Before acceptance, he states the issue with great precision and foresight. At the same time his sensitivity to the personalities involved has him include a proviso for a year of working together to see if "there was mutual compatibility."

At the end of this probation year (1964), the compatibility was evident and Don plunged into his new responsibilities. First we carefully worked outlines of authority - he in administration and I in medical matters. This is of course had been a worry for everyone during the planning stage. We soon found that lines of responsibility did overlap in many medical areas, and frequently we simply had to decide under whose jurisdiction it fell or whether it was a co-jurisdiction. This was done without rancor -  there was just too much to do!

With Don's enthusiastic blessings I concentrated on medical matters: medical staff, manpower and delivery of quality care. We pioneered the provision of group coverage for business and industry. While working in these fields I became very interested in the use of computers, even taking a course for executives offered by IBM. We did computerize our business operations promptly, and soon moved to the area of patient appointments and high-volume diagnostic services. These were beginning steps, but important ones which have helped to lead to the widespread use of the computer in all facets of healthcare today.

One of our major goals after the incorporation was the search for adequate facilities - a top-flight medical center where we could accomplish our major objectives of total medical coverage, quality control, efficiency, and reasonable cost. I relied almost completely on Don in the complicated negotiations to plan a medical complex with the New England Baptist Hospital on Parker Hill in Boston. When this negotiation faltered we decide to go it alone. In all this work a major headache was to be the funding for such a quality facility. Furthermore we were working in the face of almost prohibitive odds - steady encroachment on the right of free enterprise, the dawn of an era of regulation and controls administered by self-styled experts, and a blight of pernicious legal suits coupled with spiraling costs.

We are grateful to this gifted man for his strong and steady hand at the helm through the difficult complicated transitional years which culminated, in his words,"in specific plans for the construction and funding of a consequential medical complex in Burlington, Massachusetts." He retired from the presidency of the Clinic in 1975, but remained on the Board of Trustees. In 1980 he witnessed the move into the superb new medical center where it is one of the best and most successful institutions in the country.

Herbert T Adams, M.D. was President of the Lahey Clinic Trust, becoming Chairman of the Board of Governors when the Lahey Clinic Foundation was formed. A surgeon with widespread medical affiliations, he had been a trustee of both the New England Baptist and New England Deaconess Hospitals.