Both Dr. Russel Lee and his successor, Dr. Robert Jamplis, held an explicit goal of making the Palo Alto Medical Clinic the "Mayo Clinic of the West" – offering a full range of medical services and top-quality health care through a group practice model.

By design and necessity, the two groups did have major differences. Dr. Lee felt strongly that the Palo Alto Medical Clinic should focus on quality care for its local community ahead of serving as a regional or national referral center, while Mayo held the opposite priorities. Mayo also had a medical school and full residency programs for new doctors, services that in the Bay Area were already provided by Stanford University and the University of California, San Francisco.

Stanford’s proximity also likely contributed to the fact that the Palo Alto Medical Clinic never developed highly subspecialized services such as transplant surgery, which were already offered by the university. And the Clinic did not have an inpatient hospital, despite efforts to build one in the 1970s.

Culturally, however, Palo Alto and Mayo were similar, emphasizing the collegiality and responsibilities of multispecialty group practice. Early on, the Palo Alto Medical Clinic established a link to the Mayo Clinic when it brought in Dr. Al Snell, a renowned Mayo
gastroenterologist. Dr. Lee was so eager to attract this well-respected doctor that he reportedly amended the group’s governing partnership agreement to permit
Dr. Snell a practice outside his work at the Clinic, something that was generally prohibited.

Remembered by those who knew him as a warm and wonderful physician, Dr. Snell established Palo Alto’s Department of Gastroenterology and proceeded to attract patients from all over the country, including some Hollywood celebrities.

In addition, Dr. Snell "must have really helped Russ establish some good connections at Mayo," because over the subsequent decades, the Palo Alto Medical Clinic brought in 22 Mayo-trained doctors who were collectively responsible for establishing nine departments or subspecialty programs, said Dr. Melvin Stevens, who was one of those recruited. As Mayo doctors joined the Clinic, they in turn attracted more of their kind. Another link to Mayo was forged when Dr. Philip Lee, Dr. Russel Lee’s son, served on its board of directors. Dr. Jamplis, a Mayo-trained doctor who joined the Clinic in 1954 and established a program in thoracic surgery, was also a major influence. Over the years, Dr. Jamplis "kept track of what was happening [back at Mayo], and had a lot of influential friends," Dr. Stevens recalled. "So I think he saw the value of many aspects of the Mayo Clinic and sought to develop them here, even though the emphasis here was mainly primary care."

In recent years, the Mayo "pipeline" to the Palo Alto Medical Clinic has slowed. The last Mayo-trained physician to join the Clinic was Dr. Robert Lundahl, a radiation oncologist who arrived in 1998, and the Clinic is now more connected to high-quality local medical schools, such as Stanford and the University of California, San Francisco. The dwindling connections to Rochester as Mayo-trained doctors retire, as well as the difficulty of recruiting physicians to an area with such a high cost of living, may help explain the change. But the mark of the Mayo Clinic remains on the Palo Alto Medical Foundation’s very structure. Since 1919, the Mayo Clinic has been part of a larger, not-for-profit foundation that provides health education and research in addition to health care. Dr. Jamplis’ knowledge of that model may explain why, when he created the Palo Alto Medical Foundation, it included those same three components.