Mayo’s closure of St. Peter clinic is a symptom of shifting rural health care

Despite its impending closure, Mayo Clinic St. Peter didn’t have the look of a dying primary care clinic last Friday.

A steady stream of patients walked in and used the automated kiosks to check in. When a nurse stepped into the waiting room and asked for Jim, two men stood up.

“Which one do you want?” one of them asked.

Mayo’s announcement last week that by Dec. 10 it would close six clinics in southeast Minnesota, including St. Peter, took people by surprise. The growing community of 12,000 sits just 10 miles from the historic house where Dr. W.W. Mayo set up his first practice in 1859.

“We were just as surprised as our community was when they made the announcement,” said Stephanie Holden, chief experience officer for River’s Edge Hospital and Clinic, the independent hospital on the same campus as the Mayo clinic.

Closures and consolidations have been increasingly common across rural health care in Minnesota because of rising costs and staffing shortages. Although Mayo operates a world-famous medical campus in Rochester and large hospitals in Florida and Arizona, it also runs a network of community hospitals and medical clinics across southern Minnesota and Wisconsin.

In its statement about the local closures, Mayo Clinic Health System cited a lack of doctors and providers as a key reason for its decision, which included the Northridge clinic in North Mankato as well as clinics in Belle Plaine, Caledonia, Montgomery and Wells.

“I think that Mayo no longer thinks that having an extensive network of feeder hospitals and clinics is the right strategy for Minnesota,” he said.

The idea that staffing shortages are forcing the closures doesn’t fit the picture in St. Peter, where the Mayo clinic ranks above average for colon cancer screening rates and blood sugar management in its diabetes patients.

The clinic’s website lists nine doctors or other practitioners who exclusively see patients in St. Peter. A diabetes educator splits time in New Prague and a clinical pharmacist splits time in Mankato.

One of the Jims at the clinic on Friday was Jim Kepka, who lives just down the road in St. Peter and had stopped in for a lab test.

Driving isn’t a hassle for the 63-year-old, who builds generators at the Rolls-Royce plant in Mankato, including those providing backup power for the St. Peter clinic. After Friday’s visit, he was headed to Mankato to see his neurologist. Still, he said he will miss being so close to his primary care doctor and receiving such speedy care.

The closures of the Belle Plaine and St. Peter clinics mean Mayo will no longer have a physical presence in the growing Minnesota River valley between Mankato and the Twin Cities. Mayo had closed its Le Sueur clinic in 2023 when its building lease was up, sending many patients to St. Peter instead.

Part of the overall strategy is to exit buildings that have upkeep or maintenance concerns and to offer patients even more convenient access when appropriate to online forms of care, such as Mayo’s Primary Care on Demand app.

“As we evolve, we will have to think of new ways of reaching our patients,” said Dr. Karthik Ghosh, vice president of Mayo Clinic Health System, a network of 16 hospitals and more than 40 clinics. “We have to think of new ways that are even closer” to them.

Patients of the St. Peter clinic received emails last week promoting the virtual care service that is available 24 hours a day and features “access to care for urgent symptoms, chronic conditions and preventive health – including video visits with a physician."

Mayo was one of several large health systems in Minnesota that acquired or aligned with hospitals and clinics over the past two decades to create hub-and-spoke models. Mayo at different times had even tried and failed to add the River’s Edge hospital to its network.

Mayo’s needs in that region appear to be changing now that the expanded Mankato hospital campus is open, Baumgarten said.

“They are trying to maximize use of that space while reducing their real estate footprint and escaping the problems of operating and staffing clinics in small towns,” he said.

Mayo closed its hospital in Springfield in 2020 but maintained clinic operations there. Last year the health system scaled back services in Fairmont and in 2013 it consolidated its hospitals in Albert Lea and Austin under a single license.

In addition to the clinic closures, Mayo also announced this week that it planned to move elective outpatient surgeries from Albert Lea to its facilities in Austin and Waseca.

The pending clinic closure leaves St. Peter with only one primary care clinic, the physician-owned Mankato Clinic Daniels Health Center.

In Le Sueur, Ridgeview Medical Center expanded primary care services after Mayo’s clinic closure, and it may do the same in Belle Plaine after Mayo closes its clinic there.

Patients leaving Mayo’s clinic in St. Peter weren’t sure what they would do. Whether their doctors moved to Mankato or farther away to New Prague was one factor.

Wanda Kleschult, 75, of St. Peter, left her routine appointment upset on Friday because she’s been going to the same clinic location for care for decades. She never had to consider going elsewhere or checking with her health insurance to make sure other clinics were in network.