An executive hired last year by Cleveland Clinic Innovations was faulted for destroying documents, misusing public funds for personal expenses and creating an uncomfortable work environment by having an office romance in his previous job at a Kansas economic development group, according to a recently released audit by the state of Kansas.

However, the $960,000, 900-page audit found that the Kansas Bioscience Authority made sound investments with taxpayer dollars during the tenure of former CEO Tom Thornton, who holds the title of general manager of strategic alliances with Cleveland Clinic Innovations, several Kansas media outlets reported.

Thornton resigned from the Kansas Bioscience Authority (KBA) last April and started with the Clinic almost immediately thereafter. In the wake of his departure, Kansas legislators questioned everything from Thornton’s exit and the way he managed the Kansas organization to the relationship between Thornton and business partners in Ohio — so this controversy is nothing new.

The audit found that Thornton misled the KBA board about a trip he took to Cleveland to interview for the job with the Clinic, but he eventually reimbursed the agency for the cost of the plane ticket. One Kansas government official said the audit suggests that intellectual property belonging to the KBA was taken by Thornton to his new job in Cleveland, the Associated Press reported.

The media outlets reported that Thornton hasn’t returned calls.

The audit of the KBA came about after Kansas lawmakers and Gov. Sam Brownback’s office made accusations of potential fiscal mismanagement and conflicts of interest at the agency. The KBA was created in 2004 to oversee $581 million in tax dollars to build the state’s bioscience industry, according to the Kansas City Business Journal.

The good news for Thornton is that several Kansas lawmakers criticized the cost of the audit and said it was time to move on, a sentiment that Cleveland Clinic and Thornton would surely agree with.

“It was a $960,000 witch hunt, essentially, to uncover, what, was it 4,800 bucks total?” said one legislator, who was referencing the amount ($4,800) that Thornton spent on a plane ticket and artwork for his office, for which he later reimbursed the state.

Dr. Jay Ciezki

Among the three most common types of prostate cancer treatment, external beam radiation therapy is the most toxic and costly, according to a Cleveland Clinic researcher.

Dr. Jay Ciezki and colleagues analyzed the Medicare records of more than 137,000 men who received one of three prostate cancer treatments — external beam radiation therapy; prostatectomy, or removal of the prostate; and brachytherapy, a procedure that involves implanting radioactive seeds in the body.

The three treatments are equally effective in treating patients diagnosed with low- and intermediate-risk disease, “so it comes down to quality of life and cost,” Ciezki told WebMD. According to the researchers’ analysis, that means that brachytherapy is the best option, Ciezki said.

Toxicity rates were nearly 8.8 percent for patients receiving external beam therapy treatment, 6.9 percent for prostatectomy and 3.7 percent for brachytherapy.

In terms of cost, external beam therapy was the most expensive of the three treatment options, at $6,412 annually. Average cost per patient per year was $3,205 for prostatectomy and $2,557 for brachytherapy, according to the study.

Ciezki told The Plain Dealer that some high-risk patients can benefit from external beam therapy. But for the 80 percent of patients diagnosed with low- and intermediate-risk prostate cancer, the other two methods may be more preferable options than previously thought by doctors.

One type of radiation therapy called proton therapy has come under increasing scrutiny as critics question whether it’s worth the expense. Former White House adviser and oncologist Ezekial Emanuel coauthored a New York Times editorial last month that decried the rush to build proton centers as a quintessential example of what’s wrong with American healthcare.

Like more conventional cancer treatment methods, proton therapy uses radiation. The difference is that protons do the bulk of their work beneath the skin where a tumor is located, unlike X-rays, which tend to lose power and cause collateral damage as they penetrate the body’s tissues. In theory, that means proton therapy allows for the more precise targeting of tumors and a reduction in collateral damage.

It’s worth noting that Cleveland Clinic’s top local rival, University Hospitals Case Medical Center, last year announced plans to construct a $30 million proton beam center.

The Cleveland Clinic and Case Western Reserve University will form the Cleveland Traumatic Neuromechanics Consortium, the institutions announced Friday, pairing the Clinic’s talent in medical research, imaging tools and patient care with Case’s engineering expertise, especially in the area of neurology. It will focus on collision injuries from sports, military and automobile accidents.

The Cleveland Clinic was ranked the sixth best hospital in the country for neurology and neurosurgery by U.S. News last year, and it already has a lot brewing in the area of traumatic brain injury. Researchers are developing a biomarker blood test and an iPad2 app that are aimed at identifying concussions in football players, and a mouthguard that could measure the impact of blows to the head among athletes.

The partnership could help the Clinic gain ground in this area on other institutions known for their neurology programs like Johns Hopkins, Massachusetts General Hospital and Mayo Clinic, which announced in 2010 it would work with Intel Corp. to develop computer simulations for assessing the risk of head injuries.

Northeast Ohio also has a variety of companies working on technology for neurological injuries, including high-profile company Athersys, which is developing a regenerative medicine technique called MultiStem for treatment of traumatic brain injury. Cleveland-based Life Core Technologies is also developing a medical device to cool the brain of patients who sustain brain trauma.

Healthcare was nowhere to be found between Budweiser and Clint Eastwood Super Bowl commercials. Instead, healthcare systems chose the local route for their 2012 Super Bowl advertising. If you were in California, Minnesota, Ohio, Virginia or other markets you saw local hospitals and healthcare Super Bowl ads.

The Children’s National Medical Center in Washington, D.C. ran a Super Bowl ad in the pregame show promoting the Parents Letter Project. Sheltering Arms, a rehabilitation center in Virginia, also ran a 30-second Super Bowl ad, and Park Nicollet in Minnesota and Cleveland Clinic  ran Super Bowl ads as well.

Local ads are nowhere near the cost of the $3.5 million for 30 seconds the major national Super Bowl advertisers pay. But the cost of local Super Bowl commercials went up, too. In Rochester, New York, for example, a 30-second local Super Bowl ad was up from $15,000 to $20,000.

National campaigns make sense for the Cleveland Clinics and Mayo Clinics of the world, though perhaps not for $3.5 million a spot. But the lower cost for the amount of audience locally is a no brainer for many health systems, who thrive off grabbing a larger share of local patients.

Know of any other local Super Bowl ads from healthcare besides the ones I have listed? Post links in the comments section below.

Mayo Clinic beat Cleveland Clinic in the much-hyped and highly questionable U.S. News and World Report‘s list of America’s best hospitals.

But at least Cleveland Clinic can take solace in the fact that it’s the clear victor in a comparison of the two heavyweight hospital systems’ websites, according to a recent edition of Website Smackdown at Inc.com.

The author of the post, Jon Gelberg of New York-based web design firm Blue Fountain Media, said Cleveland Clinic’s site does a much better job of serving its users’ needs.

“The Cleveland Clinic website is clearly superior to the Mayo Clinic site,” Gelberg said in an email. “It is far more user-friendly than Mayo’s. Most importantly, it does a better job of providing visitors with information and steering visitors to the care they are seeking.”

Apparently Mayo’s status as King of Hospital Social Media doesn’t extend to such old-fashioned matters as its homepage. In the piece at Inc., Gelberg blasted Mayo’s homepage as offering “virtually nothing … that is designed to help patients, families of patients, or people looking for assistance from the hospital.”

Cleveland Clinic’s homepage, with its more straightforward navigation, makes finding directions or scheduling an appointment much easier, Gelberg said.

When it comes to finding a doctor, it’s a similar story. Mayo’s site, which allows users to search by doctors and department, and nothing else, is “clinical and unfriendly,” Gelberg said. It also features videos that in which Mayo doctors talk about what a wonderful place Mayo is.

Cleveland Clinic, in contrast, offers users five different searches and includes a video that walks users through the search process.”Rather than extol the virtues of the Cleveland Clinic, it provides a real service to site visitors,” according to Gelberg.

So, while there’s room for debate about whether a patient is better off seeking medical treatment at Cleveland Clinic or Mayo, it would appear that there’s little question about which hospital’s website provides the superior user experience.

“If the purpose of a hospital is to care for patients, then that should be the purpose of the hospital’s website,” Gelberg said. “That’s exactly what the Cleveland Clinic’s site does.”

The property developers behind Cleveland Clinic‘s 364-bed hospital in Abu Dhabi project that the hospital will open to patients in the fourth quarter of 2013.

The final phase of construction is due for completion and handover in the second quarter of 2013, with the opening scheduled for later in the year, according to a statement from Mubadala Healthcare, the property developer that will own the hospital. Cleveland Clinic will operate the hospital.

A late 2013 opening date for the hospital represents a significant departure from the original time line set out when the project was announced in 2006. At that time, the Clinic and Mubadala said the hospital was scheduled to be “operational” in three years.

A Cleveland Clinic spokesman said initial plans, which have since been scrapped, called for the Abu Dhabi facility to open in a two-stage process: first to provide outpatient care, and then, later for inpatient care. The original time line referred to the outpatient opening.

Now, the plan is to open Cleveland Clinic Abu Dhabi for both inpatient and outpatient care at the same time next year, the spokesman said.

The hospital, which will be expandable from 364 beds to 490, will be organized into five institutes: digestive disease, eye,  heart and vascular, neurological, and respiratory and critical care.

The Clinic’s former chief medical operation officer, Marc Harrison, was last year appointed as CEO of the Abu Dhabi hospital. Joining him on the leadership team will be Dr. Tomislav Mihaljevic as chairman of the Heart and Vascular Institute.

The Abu Dhabi location is Cleveland Clinic’s first outside of North America.

Cleveland Clinic has opened a new office in Saudi Arabia, with the primary focus of its new location to be medical education and training.

The office in the Saudi capital of Riyadh opened Sunday and employs three Clinic workers, Cleveland Clinic spokeswoman Eileen Sheil said.

“It’s not a clinical office where patients will be seen,” Sheil wrote in an email. “[The] primary purpose is medical education and training programs, e-second opinions, consulting as their healthcare system grows and patient support to Cleveland when requested.”

The Clinic has a long-standing relationship with the Kingdom of Saudi Arabia that stretches back more than four decades, according to a statement announcing the office’s opening. “We have cared for many of their people,” Sheil said.

Thanks to its stellar international reputation, the Clinic for years has attracted wealthy VIPs from the Middle East, but recently has taken steps to establish its own presence in the region. In addition to the Saudi office, the Clinic is planning late this year to open a 360-bed multispecialty hospital in Abu Dhabi.

The Clinic is also actively seeking affiliation partnerships with domestic health systems, such as the heart-care deals it struck last summer with two North Carolina hospitals.

For hospitals, the main benefit of establishing an affiliation agreement with the Clinic comes from the opportunity to improve care and quality through access to and implementation of the Clinic’s best practices and protocols. Affiliate hospitals also are able to use the Clinic’s name in marketing efforts.

“Sharing medical best practices and furthering the Cleveland Clinic’s mission across borders benefits patients worldwide,” Clinic CEO Toby Cosgrove said in the statement.

2011 was likely the best ever for Cleveland Clinic Innovations in its more than a decade of existence.

The Innovations group, which is charged with commercializing medical inventions by Clinic health providers, last year enjoyed its largest-ever exit, pulled in its biggest-ever donation, signed what was touted as a first-of-its-kind deal to provide commercialization services to another health system and made several new hires.

So what’s on tap for an encore in 2012? It appears Innovations will have a tough time matching last years’ impressive success, if only because it was such a strong year.  (The Innovations group declined comment for this article.)

First on Innovations’ Chief Chris Coburn’s wish list is likely another exit like last year’s sale of Intelect Medical for $78 million to Boston Scientific. The Clinic’s take from the deal was $28 million.

The most obvious exit candidate from the Clinic’s stable of spinoffs this year is biomarker company Cleveland HeartLab. The reason? HeartLab could’ve exited last year, but turned down an offer from an unidentified Massachusetts company.

There are plenty of other promising spinoffs, such as regenerative medicine firm Juventas Therapeutics, neurostimulation company Autonomic Technologies and health IT startup Explorys, but 2013 or 2014 seem more likely exit years for those companies. So it looks unlikely this year that Innovations will exceed — or perhaps even match — its one exit from last year.

Another key 2011 accomplishment was a commercialization deal between the Clinic and Maryland health system MedStar Health, which officials billed as the first of its kind when it happened last January. The agreement calls for the Clinic’s Innovations group to do for MedStar what it already does in Cleveland — help doctors turn ideas for medical advancements into products that bring money back to the hospital.

Pressure could mount this year if the Clinic isn’t able to establish any similar partnerships. Innovations last April hired Tom Thornton, former CEO of the Kansas Bioscience Authority who brought some controversy with him to Cleveland, to strike alliances with other healthcare institutions to develop medical technologies. However, the Clinic hasn’t announced any MedStar-like affiliations with other health systems since Thornton came aboard so Coburn is likely looking for his controversial hire to come through with at least one this year.

Of course, no glance at Cleveland Clinic Innovations would be complete without mentioning Coburn’s baby — the annual Medical Innovations Summit in the fall. The 1,000-attendee summit brings a cadre of business and medical technology A-listers to Cleveland like no other event. Last year’s summit on cardiovascular technology featured speeches from the CEOs of Pfizer, Medtronic, St. Jude Medical and General Electric.

This year, the summit’s focus is orthopedics.

[Photo from flickr user ell brown]

Cleveland Clinic is touting itself as one of the few health centers in the country that’s offering a new stent from Covidien that’s designed to divert blood away from aneurysms.

Clinic surgeons have implanted the Pipeline Embolization Device, a flexible stent that’s placed in the carotid artery, in 12 patients thus far, The Plain Dealer reported.

Upon U.S. Food and Drug Administration approval of the device last year, Covidien hyped the Pipeline as a “new class” of embolization device.

That’s because the device works by redirecting blood flow away from the aneurysm to the undamaged part of the vessel and causes the blood that remains in the aneurysm to clot, which prevents the aneurysm from rupturing.

The device is used to treat adults with so-called “large or giant wide-necked brain aneurysms,” the type that are the hardest to treat and that historically have a poor long-term prognosis, according to The Plain Dealer.

Covidien picked up the Pipeline device as part of its $2.6 billion acquisition of Minnesota-based ev3 in 2010.

Covidien CEO Jose Almeida on Monday told analysts at the JP Morgan healthcare conference that the Pipeline device has seen “a tremendous amount of proliferation across the globe,” Mass Device reported.

“It’s doing a great job of pulling coil business into our basket,” Almeida said. “This product is taking off across the globe, China, everywhere.”

In recent years, the renowned health system has drawn attention for pushing deep fryers, sugary sodas and trans fats off its main campus, and for CEO Toby Cosgrove’s controversial comments that American society “protects” overweight people instead of giving them a “social stigma.”

Now, the Clinic has rejected a 6-foot-1, 350-pound corpse as being simply too big for its body donation program, which provides specimens for anatomy classes, MSNBC reports.

“Someone that’s shorter and carrying a lot of weight, that is a problem,” said Richard Drake, director of anatomy and a professor of surgery. “The storage is one issue, but when you are obese, there’s a lot of tissue everywhere. The students don’t get as good a learning opportunity.”

The good news is that the deceased man’s family took it well. “They understood that because, actually, they had tried a few other places,” Drake told MSNBC. “They were sort of checking around.”

Sadly, the situation the Clinic faced isn’t all that uncommon. Officials with body donation programs similar to the Clinic’s reported that they, too, have turned down corpses that were too large to study.

When it comes to body donations, weight and height limits are an unavoidable part of the process.

Cofounded by Dr. Maria Siemionow, the leader of the Cleveland Clinic surgery team that performed the nation’s first near-total face transplant in 2008, Tolera is developing a drug intended to suppress the immune system of patients receiving organ transplants in order to prevent organ rejection. The company has said it also plans to investigate the use of that drug in fighting diabetes and other autoimmune disorders.

Tolera’s monoclonal antibody, TOL101, was granted orphan drug status in June 2010 and the company raised $4 million in a series B round that year to carry it through phase 2 clinical trials, which were expected to be completed in 2011. Previously, the company had raised an $8 million series A round in 2008.

Spun off from the Cleveland Clinic in 2006, Tolera moved to Kalamazoo, Michigan, closer to investors and drug development resources, in 2008. In 2010, the company was named one of  Michigan’s 50 Companies to Watch by Michigan Celebrates Small Business.

Despite increases in the number of transplants performed over the last decade, a limited supply of donor organs continues to hinder the market for immunosuppressants.

A magnet outside the guide tube (A) works with a guide wire and magnet inside the tube (B) to clean the chest tube without breaking the sterile field.

A Cleveland Clinic spinoff that’s developed a self-clearing catheter system has raised its first institutional round of investment funding.

Clear Catheter Systems has landed a $4 million round, led by Aphelion Capital and California Technology Ventures, with participation from Research Corporation Technologies, according to a statement from Bend, Oregon-based Clear Catheter.

Clear Catheter plans to use the funding to commercialize its PleuraFlow Active Tube-Clearance System, which uses magnets and a wire loop to keep catheters clear while draining blood and other fluids from the chest after heart or lung surgery. Passive tubes can clog and pose threats like infection and death, according to the company.

The company about a year ago received U.S. regulatory approval to sell the device, and already had received European and Canadian regulatory approval.

Clear Catheter raised $1.2 million in equity in a 2010 round that was led by the Oregon Angel Fund.

Cleveland Clinic spun off Clear Catheter Systems, then known as PleuraFlow, in 2007. The company closed its initial round of seed investment from the Cleveland Clinic and Bend Venture Angel Investors in August of that year.

Dr. Steven Nissen

Two of the Cleveland Clinic‘s greatest doctors ever, Eric Topol and Steven Nissen, have carved out contrasting views on one of the hottest topics in healthcare: personalized medicine.

The preeminent cardiologists’ opposing viewpoints recently came to light after Nissen, currently the Clinic’s chair of cardiovascular medicine, penned an editorial in the Journal of the American Medical Association, Forbes reported. In the piece, Nissen decries the “unrealistic expectations” surrounding personalized medicine in specialties such as cardiovascular medicine.

“Unfortunately, in the popular press, the concept of personalized medicine has taken on a nearly cult-like following with public pronouncements describing how future physicians will use therapies that reflect the specific genetic makeup of individual patients,” Nissen wrote.

That sentiment puts Nissen in a stark contrast to Topol, formerly Nissen’s boss at the Clinic and currently chief academic officer at Scripps Health, who’s been a staunch advocate of personalized medicine. A recent press release from Scripps hailed Topol’s “current work in personalized medicine and digital technology [that] positions him as a leader in the movement to modernize medical treatment .”

Dr. Eric Topol

While’s there’s almost certainly nothing personal about this clash of professional opinions between Nissen and Topol, the juxtaposition holds additional subtext because both men have been so closely connected to the Clinic’s world-renowned heart program for the last couple decades.

Topol led the Clinic’s cardiology department for 14 years — helping establish it as a world leader — but left the institution in 2006 after he lost the CEO job to rival Dr. Toby Cosgrove, who remains the Clinic’s chief executive. Nissen, who had been Topol’s deputy, took the top spot in the cardiology department after Topol’s departure.

The two collaborated on numerous papers before Topol left the Clinic, but have not collaborated since, Forbes notes.

The personalized medicine dust-up stems from a meta analysis relating to an anti-clotting drug called clopidogrel that was published in the same issue of JAMA. Topol called the study “remarkably misleading.”

Nissen didn’t write the study; rather he wrote an editorial that accompanied it.

The app works by strapping an iPad to an athlete’s waist and then measuring changes to the athlete’s postural stability on hard and soft surfaces.

“The idea behind the ipad concussion assessment app that we’re working on is to try and get a better picture or a better overall assessment of the major symptoms that are associated with concussion,” said Jay Alberts, a biomedical engineer with the Clinic who’s leading the research.

The app is being tested on about 100 football players.

Below, a Clinic-produced video takes a look at the app.

Cleveland Clinic did what all health systems do in mid-December: send out news-you-can-use, 2012 predictions about better health in the coming year. This one included top medical tests people should get in 2012.

Unfortunately, one of the leading media watchdogs on health news treated the tips like a bad infection. And now the release — which I couldn’t find on the Cleveland Clinic’s website — has become a symbol for a hot-button topic among medical professionals and media types: poor and cheesy medical information.

Gary Schwitzer of HealthNewsReview.org took aim on Dec. 19 at the Cleveland Clinic’s news tips. That critique has popped up across health sites since then and most recently on Dr. Val Jones’ GetterBetterHealth.com.

Schwitzer’s site usually targets news media outlets and is dedicated to improving the accuracy of news stories about medical information with the goal of “helping consumers evaluate the evidence for and against new ideas in healthcare.” Its criteria: accuracy, balance and completeness.

Schwitzer’s takedown of the release was merciless, particularly around the tests for men. He quoted the lists and offered his critique afterward (in red).

• “High-sensitive C-reactive protein — High levels of this inflammatory biomarker are predictive for future heart problems.” But the US Preventive Services Task Force, by comparison, states that “the evidence is insufficient to assess the balance of benefits and harms of using high-sensitivity C-reactive protein to screen asymptomatic men and women with no history of coronary heart disease.”
• “Vitamin D level — Low levels are associated with osteopenia, osteoporosis, breast cancer, colon cancer and heart disease.” But the Endocrine Society, by comparison, published a guideline recommending that doctors “screen for vitamin D deficiency in people at risk for deficiency, including obese individuals, blacks, pregnant and lactating women, and patients with malabsorption syndromes. “We do not recommend population screening for vitamin D deficiency in individuals who are not at risk,” the Society’s task force chair said.
• “PSA level — To screen for prostate cancer.” Do we really need to go through this again? The US Preventive Services Task Force doesn’t make that recommendation. The American Cancer Society doesn’t. This kind of blanket recommendation for men of all ages to be screened for prostate cancer does not reflect the growing call for fully informed, shared decision-making to take place regarding PSA testing.

Schwitzer goes on to take on the women’s side of the health tips, in particular: “Women do not have to have the PSA test, but they should have a routine breast exam and pap smear.”

But, by comparison, the USPSTF states that “the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older” and the Memorial Sloan-Kettering Cancer Center states that clinical breast exam “adds little to mammography in reducing breast cancer deaths.”

He ends the entry by saying: “We’re going to see a lot of these ‘what to do in the New Year’ health tips columns. We hope more of them are more evidence-based than this one was. And we hope that journalists don’t act on these news tips without doing their own  homework on the state of the evidence.”

Cleveland Clinic didn’t respond for a request for comment.

Health systems are going to be getting more of this scrutiny, which is typically reserved for journalists or academic journals. Cleveland Clinic’s media relations section actually takes you to a section called the Cleveland Clinic Newsroom. That’s a completely appropriate title, by the way, in an era where hospitals are even more trusted than journalistic enterprises like WebMD.

A review of life science current events reported by MedCity News this week:

The 50 best Mayo Clinic, Cleveland Clinic doctors. Ever. The history of a hospital is written primarily by the actions of its doctors. Here are our choices for the 50 best doctors in the history of Mayo Clinic and Cleveland Clinic.

5 healthcare social media tips that break the mold for pharma, med tech. With Facebook’s recently implemented “wall policy” rules and minding the U.S. Food and Drug administration regulations on advertising, pharmaceutical companies are treading carefully.

Cleveland Clinic’s 5th-highest-paid employees in ’10 hasn’t worked for hospital since July ’09. Despite abruptly leaving the Clinic amidst cloudy circumstances and vague explanations in July 2009, former Chief Operating Officer David Strand was the Clinic’s fifth-highest paid employee in 2010 at $1.3 million. What’s more, he received the largest raise, 18 percent, of any of the Clinic’s employees who were paid more than $1 million last year. (And Cleveland Clinic Millionaire’s Club adds 2 in 2010, grows to 15 members.)

Fishchell stent development co. raises $17 million in series B round. Svelte Medical Systems, a medical device company started by serial entrepreneurs Robert Fischell and his sons David and Tim, has raised $17 million in a series B Round of financing — just under half of its $37 million target to develop its first- and second-generation stents for cardiac surgery.

A brief history of medical technology. A social media strategy firm has created a useful graphic that charts a brief history of medical technology, from the invention of the stethoscope in 1816 to the development of the commercial hybrid PET/MRI scanner to more recent advances.

Charis Eng

Research led by the Cleveland Clinic‘s Dr. Charis Eng has led to the discovery of three genetic mutations that are linked to thyroid cancer.

The research involved nearly 3,000 patients with Cowden syndrome, a rare disorder characterized by multiple noncancerous, tumor-like growths that is related to an increased risk of breast and thyroid cancer, according to a statement from the Clinic.

Cleveland Clinic researchers found that mutations in a gene called the “PTEN” are the foundation of Cowden syndrome. PTEN is a tumor suppressor gene that helps direct the growth and division of cells.

The researchers recommend that the thyroids of children with PTEN mutation-causing, Cowden Syndrome-related disease receive increased surveillance.

Eng placed at No. 31 in MedCity News’ list of the “The 50 best Cleveland Clinic doctors. Ever.”

Despite abruptly leaving the Clinic amidst cloudy circumstances and vague explanations in July 2009, former Chief Operating Officer Strand was the Clinic’s fifth-highest paid employee in 2010 at $1.3 million. What’s more, he received the largest raise, 18 percent, of any of the Clinic’s employees who were paid more than $1 million last year. Not too shabby for a guy who didn’t work one day at the health system the entire year.

In 2009, Strand received $1.1 million from the Clinic, making him the renowned hospital’s sixth-highest paid employee that year. In each of the last two years, Strand has been among the two highest-paid employees at the Clinic who don’t hold medical degrees.

So the obvious question becomes: Why was Strand’s severance so generous? Unfortunately, answering that one isn’t so obvious.

A Clinic spokeswoman declined to answer specific questions about employee compensation, such as whether Strand is due any money from the Clinic in 2011.

A spokesman for Strand’s new health IT company, LifeNexus, didn’t return a call.

Certainly the absence of full transparency on both sides about why Strand left – and the considerable size of his severance payments – invite speculation that he was pushed out. A lack of clarity around his role, plus a strained working relationship and personality conflicts with Clinic CEO Toby Cosgrove, led to Strand’s exit from the Clinic, one source said.

The story of Strand’s departure from the Clinic can’t be told without mentioning his wife, former Clinic Chief Experience Officer and an industry star in her own right, Dr. Bridget Duffy. The Clinic announced Duffy’s departure at the same time it did Strand’s. In public comments, the Clinic would only at the time allow that the Strand and Duffy’s departure was “mutual” and that the two “wanted to move on, move back home to California.” When reached by the Plain Dealer shortly after their departures were announced, the two ex-employees declined comment.

Regardless of the circumstances surrounding their exits from the Clinic, Strand and Duffy seem to have found success in their post-Clinic lives. They cofounded ExperiaHealth, a consulting firm that aims to help hospitals improve the patient experience and was acquired about a year ago by Vocera Communications.

In June, Strand joined Broomfield, Colorado-based LifeNexus as CEO, though he lives in San Francisco, according to his LinkedIn page. LifeNexus has essentially created a credit card that contains a user’s personal health information, such as prescription, insurance and emergency care information. LifeNexus’ personal health card can also be used as a debit card to pay for deductibles and copays.

Here’s a video of the company’s former CEO, and Strand’s predecessor, discussing the card.

Dr. Teresa Ruch

2010 was a good year to be a member of the Cleveland Clinic Millionaires’ Club – although what year isn’t?

The 13 Clinic employees who received more than $1 million in compensation the prior year did it again in 2010. But the club added two new members: John Petre, the Clinic’s director of clinical space and equipment integration, and Dr. Teresa Ruch, a neurosurgeon. Along with former COO David Strand, Petre becomes just the second member of the $1 million-plus club who doesn’t hold a medical degree.

CEO Dr. Toby Cosgrove was again the Clinic’s highest-paid employee, at more than $2.3 million. Cosgrove’s 8 percent raise in 2010 trailed the 11 percent compensation increase he received the prior year.

Most of the other top earners are department heads or chairs of the Clinic’s various institutes. Five of the 15 millionaires appear to be no longer employed by the Clinic.

Cleveland Clinic spokeswoman Eileen Sheil declined to answer specific questions about Clinic employees’ compensation and related documents. “Our executives are compensated fairly given the size and scope of our organization,” she said.

The compensation information comes from the Clinic’s most recent 990, a document most tax-exempt nonprofits are required to file each year with the Internal Revenue Service. (Go to page 98 for compensation information.) The Clinic deserves credit for posting the document on its website, something most of its top-hospital peers choose not to do.

The Clinic’s system-wide revenues for 2010 grew a healthy 9 percent to $6.2 billion. However, revenues less expenses – which would be considered profits if the Clinic were a for-profit organization – declined by less than a percentage point to $361 million.

Below are the 15 employees listed in the Clinic’s 990 whose total compensation exceeded $1 million in 2010. Note that total compensation includes base salary, bonuses, retirement and other deferred compensation and nontaxable benefits, according to the document. For biographical information on members of the Millionaires’ Club, view last year’s edition.

1. Dr. Delos “Toby” Cosgrove, president and CEO, $2.3 million. Last year’s rank: 1.

2. Dr. Bruce Lytle, chair of Heart & Vascular Institute, $1.6 million. Last year’s rank: 2.

3. John Petre, director of clinical space and equipment integration, $1.4 million.

4. Dr. Constantine Mavroudis, former chair of Department of Pediatric and Congenital Heart Surgery, $1.4 million. Last year’s rank: 3.

5. David Strand, former chief operating officer, $1.3 million. Last year’s rank: 6.

6. Dr. Andrew Fishleder, former CEO of Cleveland Clinic Abu Dhabi and former chairman of the Clinic’s Education Institute, $1.2 million. Last year’s rank: 9.

7. Dr. John Costin, chair of Cleveland Clinic Lorain,$1.2 million. Last year’s rank: 8.

8. Dr. Victor Fazio, former chair of Department of Colorectal Surgery, $1.2 million. Last year’s rank: 4.

9. Dr. Joseph Hahn, chief of staff, $1.2 million. Last year’s rank: 7.

10. Dr. Abdul Itani, Department of Neurological Surgery, $1.2 million. Last year”s rank: 11.

11. Dr. Philip Schauer, director of Bariatric and Metabolic Institute, $1.2 million. Last year’s rank: 5.

12. Dr. Daniel Martin, chair of Eye Institute, $1.2 million. Last year’s rank: 10.

13. Dr. Teresa Ruch, Department of Neurological Surgery, $1.1 million.

14. Dr. David Perse, former president of Lutheran Hospital, $1 million. Last year’s rank: 12.

15. Dr. Richard Wyszynski, Department of Ophthalmology, $1 million. Last year’s rank: 13.

Our criteria for the top 50? Physicians who made amazing contributions to medicine and to Cleveland Clinic, and whose names are forever tied to the renowned health system.

Watch the video below.

The history of a hospital is written primarily by the actions of its doctors. From day one in 1921, Cleveland Clinic has always been about the doctors.

The elite health system has spent the last year celebrating its 90th birthday, making this an ideal time for a look back. Below is my list of the greatest 50 physicians who helped write Cleveland Clinic’s history. The list is replete with cardiologists — the Clinic’s signature specialty. But it also includes physicians who are revolutionizing healthcare technology today, who identified carpal tunnel syndrome, or have leveraged their research to create companies that will heal hundreds of thousands for decades.

Fifteen of the 50 are currently working at Cleveland Clinic.

Ranking the greatest doctors over 90 years is like comparing NFL quarterbacks. Who was better: Peyton Manning or Johnny Unitas? How can one physician from the 1920s compare to another in today’s era of healthcare reform and big health systems?

My criteria for the top 50: Physicians who made amazing contributions to medicine and to Cleveland Clinic, and whose names are forever tied to the health system.

Did I leave anyone out? Did I rank someone in the 40s who should have been in the top 10? What’s your list look like? Let me know in the comments or tweet us at @medcitynews.

(If you liked this story read my Twin Cities colleague, Arundhati Parmar’s, list of the greatest 50 Mayo Clinic doctors)

1. F. Mason Sones

The father of coronary angiography, Sones is credited with one of the most important discoveries in the history of cardiology — and it happened by accident. When Sones, who joined the Clinic in the 1950s, was performing a catheterization procedure on a patient, he noticed that the catheter had accidentally entered the patient’s right coronary artery and released some contrast dye. He expected the patient’s heart to begin to beat irregularly. When it didn’t, he knew he’d discovered a way to form a road map of the heart for medicine and surgery.

Injecting dye into the coronary arteries allowed the arteries to show up on X-rays and gave cardiologists the opportunity to identify obstructions in blood circulation. Sones’ innovation made possible, for the first time, accurate diagnosis of coronary disease and set the stage for the modern era of cardiology and cardiac surgery.

Sones was known as a stern taskmaster who wouldn’t hesitate to publicly criticize surgeons or nearly anyone else he encountered. Some nurses were said to hide in the bathroom when he appeared on their floor. He would frequently smoke cigarettes during procedures in the catheterization lab, using a sterile forceps to  hold a lit cigarette that he’d lay on the edge of the instrument table.

2. Rene Favaloro

The Argentinian Favaloro is best known as the pioneer of coronary bypass surgery. The procedure is used to restore blood flow to the heart muscle by diverting the flow of blood around a section of a blocked artery in the heart by using a healthy blood vessel taken from elsewhere in a patient’s body. Favaloro performed the first coronary bypass at Cleveland Clinic in 1967, focusing the attention of the cardiology world on the hospital and significantly raising the organization’s profile.

Favaloro left the Clinic to return to Argentina in 1972, reportedly turning down a $2 million salary. He founded his own medical and research foundation in Buenos Aires in 1975 with the goal of improving cardiology in Argentina.

Despite being recognized as one of the true pioneers of his profession and having performed life-saving operations on thousands of patients, Favaloro’s own life ended in tragedy. He shot himself through the heart in 2000, with his suicide note revealing that he was frustrated by corruption in Argentina’s medical system.

3. Caldwell Esselstyn

Esselstyn is the greatest living physician associated with Cleveland Clinic because he has developed and promoted an approach that heals without the heavy medical intervention hospitals like Cleveland Clinic are known for. In an era of skyrocketing healthcare costs and runaway obesity, Esselstyn’s approach around an austere “heart-attack proof” diet could, decades from now, be considered one of the most important innovations of this era. And it is a supremely benevolent act, since his “Esselstyn Diet” has little revenue for hospitals and prevents reimbursable cardiac medical treatments.

Esselstyn, a surgeon and former Olympic gold medalist rower, claims you can prevent and reverse heart disease by eating a strict vegetarian diet with no meat, poultry, fish, dairy products or oils. “What really keeps me on fire about this is we have an epidemic of disease in this country that doesn’t need to exist,” Esselstyn told The Plain Dealer in 2008. “It’s so ridiculously simplistic to turn around this epidemic, it’s scary.”

His controversial stance has recently received more attention, thanks to lavish praise in the documentary “Forks Over Knives.”

4. George Crile

The most prominent of Cleveland Clinic’s four founding physicians. If alive today, he’d likely have a reality show or sitcom modeled after him. He would bring a phonograph into the operating room. In 1929, a fire tore through Cleveland Clinic that was so awful it nearly toppled the entire hospital system. Crile was in surgery at the time. He finished his surgery as the blaze burned, strode out of the building and led the rescue effort. He later rushed with his other founders to try and save, in vain, fellow Clinic founder John Phillips.

Crile is credited with driving the Clinic’s early success after co-founding the institution in 1921 and pushing a new, collaborative approach to medicine. He was a founding member of the American College of Surgeons, and took a lifelong interest in the treatment of surgical shock, which led him to perform the world’s first human-to-human blood transfusion. He’s also credited with improving anesthesia and streamlining the surgical removal of diseased thyroid glands.

Even near the end of Crile’s life, when he was going blind from glaucoma, he continued to operate on patients, feeling his way through procedures by touch.

5. Eric Topol

Cleveland Clinic owes much of its constant No. 1 ranking in heart care to Topol. His reputation during the 14 years he led the Clinic’s cardiology department, was built partly on his criticism of drug safety, particularly concerning the Merck painkiller Vioxx. He was among the first doctors to raise questions about the cardiovascular side effects of drugs in the so-called cox-2 class of painkillers. Topol’s biography credits him with pioneering the development of many medications that are routinely used in medical practice including t-PA, Plavix, Angiomax and ReoPro.

Topol’s exit from the Clinic happened in 2006, but it was paved by the 2004 decision to anoint Dr. Toby Cosgrove as the Clinic’s new CEO. Long regarded as rivals, Topol and Cosgrove clashed over financial arrangements between industry, each other and other Clinic doctors. Once Cosgrove got the nod in 2004, Topol’s fate with the Clinic was probably sealed.

Topol reinvented himself and further enhanced his global reputation since departing the Clinic. He now touts some of the most cutting-edge digital health initiatives  in the country. “Instead of doctor-knows-best and this paternalistic type of thing — that is on the way out,” Topol said recently. “Doctors have to acknowledge that.”

6. Irvine Page

A pioneering researcher, Page helped shape the modern understanding and treatment of high blood pressure and heart attacks in the 1940s and ’50s. Page’s research helped unravel the complex nature of hypertension and to supplant the widely held concept that high blood pressure could be traced to a single causative agent.

Aside from his hypertension research, Page may be best known for discovering serotonin, a neurotransmitter  that is involved in sleep, depression, memory and other neurological processes. He directed research at the Clinic for 21 years. Before Page, most doctors didn’t even believe high blood pressure was important, and many even thought that lowering high blood pressure could create harm by reducing a patient’s blood flow.

7. Steven Nissen

Unlike most physicians near the top of this list, Nissen isn’t best known for his medical innovations (though he has garnered plenty of renown for his work in the development of intravascular ultrasound). Instead, he fulfills the modern physician’s role of public patient advocate. He’s led the Clinic’s department of cardiology since 2006 and is best known as an outspoken critic of Big Pharma, having taken on drugs like Avandia and Vioxx. In 2007, he was named by Time Magazine as one of the 100 most influential people in the world.

Nissen has also been a target of criticism by other doctors, who charge that his public pronouncements have scared and harmed patients. Nissen seems to fancy himself a bit of an iconoclast and truth-to-power speaker, and traces his public activism and watchdog-like status back to his college days in the 1960s when he was a “political leader” and editor of the daily newspaper at the University of Michigan.

8. Bernadine Healy

Healy was the first woman to lead the National Institutes of Health. But before that, she led research at the Clinic in the mid-’80s. At the Clinic, she led nine departments and helped them more than double in size. Healy later led the American Red Cross.

Healy’s brash style and willingness to publicly challenge critics earned her lots of admirers but also her share of detractors. “She does not back down,” said former Cleveland Clinic CEO Floyd Loop, who was Healy’s husband. “She’s a fighter. I don’t have any problem with her, but I could be in the minority.”

Healy died earlier this year of brain cancer.

9. Toby Cosgrove

Cosgrove has already ascended to one of Cleveland Clinic’s  greatest physicians, even with an incomplete legacy. An amazing innovator, Cosgrove’s true contribution to Cleveland Clinic will be based largely on his legacy as CEO.

Cosgrove has become the public face of today’s Cleveland Clinic and is recognized as among the nation’s leading physician executives. He’s not shy about voicing his opinions, speaking out against key provisions of federal health reform and criticizing an American culture that he believes goes too easy on obese people. His tenure has seen the Clinic’s national reputation ascend to new heights, as the health system was held up as a model of high-quality, low-cost care by President Obama.

The low point of Cosgrove’s time at the Clinic likely stemmed from a 2005 controversy about conflicts of interest between Cosgrove, the Clinic and AtriCure, a medical device company founded in part on Cosgrove’s innovations. (Although the public spat with Topol was no walk in the park, either.)

Cosgrove began establishing himself in 1970s as an innovative cardiologist at the Clinic. He’s viewed as a pioneer in the field of minimally invasive mitral valve repair surgery. Cosgrove has filed 30 patents medical and clinical products used in surgery, more than any other Clinic employee.

10. Willem Kolff

Kolff is a luminary in the history of the medical device industry, and is lauded as the father of the artificial organ. A Dutchman who died two years ago, Kolff is especially renowned as the inventor of the artificial kidney. At the Clinic in 1950s, Kolff led a project that was the first to implant a total artificial heart in an animal. He’s also credited with having developed the first artificial ear and eye, and inspired the first artificial heart, the Jarvik-7.

Kolff cobbled together his original dialysis machine in wartime Holland using an enamel tub, a wooden drum, metal, cellophane sausage casings and an electric motor. “His search for machines to treat disease encompassed the solidly successful and the quirkily quixotic,” the Washington Post said.

11. Donald Effler: Effler was a pioneer of open-heart cardiac surgery in the 1950s and ’60s. The procedure is also known as “stopped-heart surgery” because it requires stopping the heart temporarily while relying on a heart-lung machine to oxygenate and pump blood to the rest of the body. In 1968, he was the senior surgeon on one of the first heart transplant operations in the United States.

12. Rupert Turnbull Jr.: A noted colorectal surgeon, Turnbull was viewed as a top authority on ulcerative colitis. He joined the Clinic in the 1940s and was later recognized as the father of enterostomal therapy, the care of patients with stomas such as colostomies.

13. Harriet Dustan: Dustan joined the Clinic in the late 1940s and became a major figure in the field of hypertension research. She was among the first to suggest that reducing dietary sodium could lower hypertension and cardiac risks. She was the second woman to lead the American Heart Association.

14. Andrea Natale: The Italian Natale was a pioneer in catheter ablation for the treatment of atrial fibrillation, the most common type of heart arrhythmia. His career with the Clinic ended under a dark cloud in 2007, however, as the hospital apparently pushed him out over concerns about his performing medical procedures outside of Ohio without the Clinic’s permission. He’s since joined fellow Clinic castoff Topol at Scripps.

15. James Hewlett: Hewlett led the Clinic’s department of hematology in the 1970s. He pioneered exchange transfusion for a blood disorder called thrombocytopenic purpura, a condition that had previously almost always been fatal.

16. Andrew Novick: The former chair of the Clinic’s Urological and Kidney Institute, Novick was viewed as an innovator in the field of kidney transplant surgery. He’s credited with pioneering a technique of using ice baths to spare kidney function, and a nephron-sparing surgery that is credited with giving many patients longer lives. He died in 2008 at the age of 60.

17. Ralph Straffon: A urologist who enjoyed a 12-year stint as chief of staff, Straffon‘s career with the Clinic spanned four decades. He led a team that performed one of the first successful cadaver kidney transplants in 1963.

18. Victor Fazio: Fazio became chairman of the Clinic’s Digestive Disease Institute in 2008 after 33 years as head of the Department of Colorectal Surgery. An innovator in colorectal surgery, Fazio pioneered numerous surgical techniques in the field.

19. F. Merlin Bumpus: A colleague of Irvine Page, Bumpus joined the Clinic in 1949 and became a leading hypertension researcher. The two scientists led a team that in 1957 synthesized angiotensin, a substance in the blood that causes vessels to constrict and blood pressure to rise.

20. Michael Modic: A neuroradiologist, Modic currently is chair of the Clinic’s Neurological Institute. Modic is a noted spine researcher and is the namesake for “Modic changes,” observations associated with MRIs of degenerative spinal discs.

21. Floyd Loop: A cardiac surgeon, Loop was the Clinic’s CEO for about 15 years, with his tenure ending in 2004. In the 1970s, he identified the mammary artery as the preferred conduit for bypass surgery, still the standard of care today.

22. George Phalen: Phalen was an orthopedic hand surgeon. In the 1940s and ’50s, he identified carpal tunnel syndrome and helped create its diagnostic test.

23. Maria Siemionow: A native of Poland, Siemionow is currently the Clinic’s director of plastic surgery research. She achieved a measure of fame in 2008, when she lead a team that performed the world’s first near-total face transplant. “The wonder of discovery can occur in medical research, tedious as that research might seem when it involves staring through a microscope at tissue from a rat scrotum,” she wrote in her autobiography. Words to live by for anyone who’s ever stared at a rat scrotum.

24. Jay Yadav: Yadav is a noted interventional cardiologist and entrepreneur, often cited for his innovations around carotid stenting. His tenure at the Clinic came to an ugly end (are you sensing a theme in recent years with prominent Clinic cardiologists?) in 2006 over allegations of conflicts of interest related to the commercialization of his innovations. But Yadav had the last laugh, as the Clinic was forced to admit in a 2010 legal settlement that he did, in fact, provide the hospital with the proper disclosures around his commercialization activities. This year, he was named one of Ernst & Young’s entrepreneurs of the year.

25. Russell Haden: Haden took on a leadership position shortly after the greatest tragedy in the Clinic’s history: a disastrous fire and explosion of X-ray film that created toxic fumes and killed 123 people in 1929. After the tragedy, he replaced founder John Phillips as the leader of the Clinic’s medical department. Haden was a renowned researcher in his specialty, diseases of the blood, and became one of the best-known hematologists in the country.

26. Gene Barnett: Barnett joined the Clinic in 1987 and is currently director of its Brain Tumor and Neuro-Oncology Center. He’s a leader in the field of computer-assisted surgery and holds several patents related to technology in neurosurgery. Barnett helped develop the “sonic wand,” a brain-imaging technology that allows surgeons to locate tumors with high accuracy.

27. William Sheldon. Sheldon was the Clinic’s first chair of cardiology in 1975. He’s hailed for practicing some of the most advanced cardiac catheterization techniques of his time.

28. William Kiser: Kiser joined the Clinic in 1964 to help establish a groundbreaking cadaver kidney transplant program. He’s credited with an ambitious construction program that greatly expanded the hospital’s main campus. He led one of the first hospital expansions financed by bonds.

29. Joseph Hahn: Hahn is currently the Clinic’s chief of staff and joined the hospital in 1976. He’s a neurosurgeon who helped develop a brain-mapping technique that uses implantable electrodes to locate the site of seizures in epilepsy patients.

30. Marshall Strome: Strome was previously chairman of the Clinic’s Head and Neck Institute. In 1998, he performed the world’s first total human laryngeal transplant.

31. Charis Eng: Eng is currently chair and founding director of the Clinic’s Genomic Medicine Institute. Her research connected a second gene with Cowden syndrome — a genetic condition that affects about one in 200,000 people — opening the door for even more people to be definitively diagnosed with the disease.

32. George “Barney” Crile Jr.: Known as “Barney” to distinguish himself from his illustrious father, Crile Jr. was associated with the Clinic for about 50 years, retiring as head of the department of general surgery in 1968. Crile Jr. generated controversy with his campaign against radical mastectomy — removal of the entire breast and of surrounding lymph nodes and major chest muscle — which was routinely performed on breast cancer patients for a century. Crile Jr. advocated instead for the simpler and safer lumpectomy.

33. Roy Greenberg: Greenberg is a vascular surgeon who joined the Clinic in 1999. He specializes in stent grafting for aortic disease. Among his innovations is a branched endovascular stent graft specifically designed for the aortic arch.

34. Emmanuel Bravo: A renowned hypertension researcher, Bravo joined the Clinic in 1970. Among his specialties is pheochromocytoma, a rare, usually noncancerous tumor that develops in the core of an adrenal gland.

35. Eric Klein: Klein is chair of the Clinic’s Urological and Kidney Institute. He’s a leader in the biology and management of prostate cancer. His clinical interest is the study of urologic cancers, including those of the prostate, bladder, testis and kidney.

36. Irving Franco: Franco is an interventional cardiologist who’s still with the Clinic, having joined the institution in 1971. He trained under the legendary Sones and subsequently trained two generations of the Clinic’s cardiologists himself.

37. Frank Bunts: One of the Clinic’s founders, Bunts was a gall bladder surgeon. Prior to starting the Clinic, he worked with the other founders in an army medical unit in World War I.

38. William Lower: Another of the founders, Lower was a urology specialist. For a time, he served as president of the American Urological Association.

39. John Phillips: Often referred to as the Clinic’s fourth founder, Phillips was one of the 123 people killed in the 1929 X-ray films fire. The tragedy has been credited with leading to new quality and safety standards for healthcare.

40. Fay LeFevre: In 1955, LeFevre was appointed chairman of the Cleveland Clinic Board of Governors upon the board’s founding. LeFevre’s appointment was significant because it reaffirmed the Clinic’s principle of physician leadership.

41. R.J.F. Renshaw: Renshaw was an early member of the Clinic’s gastroenterology department in the 1930s. He helped lay the groundwork for the emerging field of endoscopy.

42. Michael Roizen: The Clinic’s first-ever chief wellness officer, Roizen has shown an uncanny ability to translate wellness advice into cash. Perhaps more significantly, Roizen has also drawn praise for helping implement a wellness program for Clinic employees that’s improved workers’ health while helping control the Clinic’s costs.

43. Pat Whitlow: Whitlow is director of interventional cardiology in the Clinic’s department of cardiovascular medicine and has held the position since 1991. His specialties include cardiac catheterization, vascular and coronary angiography, coronary and peripheral vascular stenting, and aortic valve replacement.

44. John Eversman: An endocrinologist, Eversman is known more for his business contributions to the Clinic than any medical breakthroughs. He became the Clinic’s first-ever chief operating officer in the early 1980s and was the first member of the Clinic’s staff to be sent to complete an executive MBA program.

45. Hilel Lewis: Lewis was recruited by Loop to the Clinic in the mid-’90s to establish its Eye Institute. At $2.6 million, Lewis was the Clinic’s highest-paid employee in 2008, the same year he left the hospital. He’s now with Columbia University Medical Center.

46. Marc Penn: A cardiologist with strong experience in regenerative medicine, Penn is part of a new breed of aggressive physician-entrepreneurs to come out of the Clinic in the last decade or so. His research has led to the founding of promising startups Juventas Therapeutics, SironRx Therapeutics and Cleveland HeartLab, and he’s led clinical trials by stem cell developer Athersys. Earlier this year, Penn left the Clinic for Akron’s Summa Health System.

47. Martin Harris: Harris joined the Clinic in the late ’90s as its first-ever chief information officer. Harris has guided the Clinic into the world of electronic health records and helped the health system gain recognition as a national leader in the field of health information technology.

48. Carl Wasmuth Jr: Wasmuth chaired the Clinic’s department of anesthesiology before in 1969 becoming the second chairman of its Board of Governors. Wasmuth’s board chairmanship ushered in the Clinic’s modern era, as he was the first genuine physician-manager that the hospital had ever had.

49. A. Carlton Ernstene: Ernstene joined the Clinic as head of the Department of Cardiorespiratory Disease in 1932. He later was chair of the Division of Medicine, adding seven new departments during his tenure.

50. E. Perry McCullagh: The first chair of the Clinic’s Department of Endocrinology, McCullagh specialized in diabetes research. His belief in rigid control of blood glucose levels for diabetics was ahead of its time in the medical profession.

The process, ultrasonic cavitation, requires 60 cc or 2 ounces of fat from subjects to produce hundreds of millions of adult stem cells, much less than the 200 cc that would be removed in a typical liposuction procedure, Dr. Steve Victor of IntelliCell said. Victor said its process significantly reduces research costs over the alternatives currently offered, including sourcing stem cells from bone marrow and enzymatic separation.

IntelliCell plans to license the technology to institutions seeking to use stem cells in their research.

The first indication IntelliCell will pursue is for lower back pain caused by a variety of illnesses, including osteoarthritis. Victor added that its potential applications go far beyond that.

Numoda CEO Mary Schaheen said the company’s clinical trial research technology will be used to collect and manage the research data.

Numoda’s life sciences investment arm, Numoda Capital Innovations, is investing an undisclosed amount in IntelliCell, and has invested in life sciences companies for more than two years.

Last year, Numoda collaborated with the Cleveland Clinic‘s Neurological Institute in a venture to speed effective neurological drugs to market and quickly weed out those that don’t work, while reducing drug development costs.

The vast majority of the donation, $10 million, comes from West Virginia billionaire James Justice II, a coal and farming company executive who ranked No. 375 on Forbes’ list of the 400 wealthiest Americans, The Plain Dealer reported.

The remaining $1 million was from Dr. Thomas Graham, chairman of the Innovations group and a premier hand surgeon who often operates on professional athletes. Graham and Justice struck a friendship at the historic Greenbrier resort in West Virginia, which Justice bought in 2009.

The donation will fund a new chair in medical innovation, as well as patent applications and product development related to discoveries by Clinic doctors.

“They’re going to do things to change the world, and I’d like to be a part of it,” Justice told The Plain Dealer.

The Innovations group in January enjoyed its biggest success to date, the $78 million sale of neurotechnology spinoff Intelect Medical to Boston Scientific. Clinic CEO Toby Cosgrove later said the deal returned $28 million to the hospital.

Cleveland Clinic ranked No. 4 last year in licensing income ($36 million) among U.S. hospitals and research institutions, according to an annual survey by the Association of University Technology Managers (AUTM).

His biography prominently states he is “well known for leading the Cleveland Clinic to become the #1 center for heart care,” among other things. Plus, his not getting the chief executive position at Cleveland Clinic, the subsequent departure and the brouhaha surrounding  it  made national news. Plus,  it  remains a hot (or touchy) topic among cardiologists, Clinic staff members and alumni, as well as other members of the healthcare community.

So, when I met Topol at the mHealth Summit in Washington D.C. I had to ask: “How would Cleveland Clinic be different if you had run the institution?”

He didn’t bite.

“I’m glad the institution is doing really well and I’m having a great time at Scripps (Health),” Topol said. Instead, he focused our discussion almost exclusively on his new book.

Dr. Michael Roizen knows wellness. He also knows commerce.

Cleveland Clinic‘s first-ever chief wellness officer jumped on the wellness trend early. He’s best known as one of the “YOU” docs, thanks to his high-profile collaborations with TV star Dr. Mehmet Oz.

But Roizen has showcased an innate ability to launch new concepts and businesses that leverage his personal wellness image and his affiliation with Cleveland Clinic. His investments and enterprises continue to leverage his YOU-doc status, making Roizen a wellness enforcer, an early-stage investor and the one-time backer of a quick-serve health-drink machine.

Who is Michael Roizen: The Brand? Here’s a list of all his current and past enterprises.

RealAge: Roizen’s ascension as a public face traces back to the success of his RealAge book franchise. A 1999 book “RealAge: Are You as Young as You Can Be?” became a New York Times best-seller — and that sent Roizen off to the races. Other books under the RealAge title followed, focusing on topics like dieting and makeovers.

The books spawned the RealAge website, which is operated by Hearst Digital Media and hawks plenty of books and DVDs, in addition to being packed with wellness and beauty tips.

The YOU Docs: Roizen and Oz have teamed up as the YOU Docs to pen several best-selling books under the “YOU” banner, including “YOU: The Owner’s Manual” and “YOU: The Smart Patient.” Their “YOU: On a Diet” spent 11 consecutive weeks at No. 1 on the New York Times list, according to Roizen’s Cleveland Clinic bio. The YOU Docs also pen syndicated columns that are printed nationwide in newspapers such as the Chicago Sun-Times and Charleston, South Carolina’s Post & Courier.

The RealAge and YOU franchises have helped make Roizen an in-demand guest on talk shows and on the lecture circuit and have yielded several PBS specials and a radio show, establishing Roizen as the King of All Media when it comes to wellness.

Cleveland Clinic. Cleveland Clinic provides Roizen significant additional credibility to launch his businesses. But Roizen has also delivered a whole suite of initiatives for the health system that put it squarely into the wellness movement. Roizen is the face of efforts like Wellness 360-5, a separate wellness portal run by Cleveland Clinic, the hospital’s “Let’s Move It” campaign and has lead the Cleveland Clinic’s addition to the health portal iVillage, among other things.

YOUBeauty.com: Lauched earlier this year with a $3 million investment from Cleveland Clinic and Contour Venture Partners, YOUBeauty.com aspires to teach women how to achieve greater beauty through a healthier lifestyle. The site’s backers are hoping to differentiate YOUBeauty from the plethora of other beauty-focused sites by focusing on science.

“Our job is to gather the best science and make it accessible and actionable to the average consumer,” CEO Steve Lindseth said in July. The site features links to research papers and offers quizzes to help users come up with action plans to improve their beauty and health. Oz and Roizen curate the site’s content, which includes lots of articles from various experts on health and beauty topics.

Enforcer eCoaching: This recent Roizen startup aims to help customers adopt healthier behaviors through guidance, support and wellness advice that the company provides through digital channels. Roizen and Oz are both principals with the company.

On Dr. Oz’s blog, Roizen has referred to himself as “The Enforcer” and described his role under that title as conducting e-mail coaching sessions with employees of a large company. In a tweet in August, Roizen said the company would focus on advice around smoking cessation, weight loss and type 2 diabetes.

Omnifrio Beverage Creations. Omnifrio aims to sell a single-cup, cold-beverage-making machine that’s similar to Keurig‘s time-saving (if overpriced) one-cup coffee brewers and pods. Roizen said he invested in Omnifrio, and the company was sold earlier this year to North Carolina-based Primo Water in a $13 million deal. Omnifrio hasn’t yet completed its product development process, and it must do so “for full earn-out” of its sale, according to Roizen.

Martek Biosciences. Roizen stated in an e-mail that he was the head of Martek’s scientific advisory board. The Maryland-based company that sells nutritional products was acquired for $1.1 billion in 2010 by Dutch chemical and pharmaceutical company DSM. Company officials would like Roizen to still play a role as an advisor, but Roizen said he has no contract “or other part of” the company.

YET2. This is an outlet from which Roizen invests. “YET2 in a managed investment company that I placed some of my money with;  I do not have any decision or other interest in it, but it does invest in startup companies,” Roizen said in an e-mail.

The others: There’s a host of other affiliations Roizen also holds, including the virtually unknown Food for CTRAWFFYE. Roizen also receives royalties from publishers Harper Collins and Simon & Schuster, plus Progenics Pharmaceuticals. He’s a consultant or speaker for Oprah’s Harpo Radio.