Mayo Clinic said Friday it has picked as its next leader a neurologist who currently leads the clinic's fundraising efforts.

Dr. John Noseworthy will become Mayo's president and chief executive when Dr. Denis Cortese retires in November.

As is typical at Mayo, trustees elected a physician who rose through the Mayo ranks.

Noseworthy joined Mayo in 1990 and was chair of the department of neurology from 1997 to 2006. He was born in Melrose, Mass., went to medical school at Dalhousie University in Halifax, Nova Scotia, and trained at Harvard Medical School.

He specializes in multiple sclerosis and has written and edited several books on the disease.

Noseworthy takes over at a tough time for Mayo. The Rochester-based institution barely broke even last year on revenue of $7.2 billion. While the number of patients was stable, income from patient care fell by almost a third. As in many other businesses, Mayo suffered investment losses.

Noseworthy is medical director of Mayo's Department of Development, which works with benefactors. Gifts to Mayo were also down sharply last year, at $236 million, compared with $373 million in 2007.

Mayo leaders tend to keep a low profile outside the organization, preferring to emphasize the clinic's history, medical quality and group practice approach.

However, Cortese had a higher national profile because of his health care reform efforts in the past two years. He traveled to Washington and elsewhere to warn that organizations such as Mayo are under growing financial pressure because they are treating many more Medicare patients than before, and treating them at a loss.

Chen May Yee • 612-673-7434