In 2004, the Board of Trustees selected Dr. Toby Cosgrove as CEO and President. Cosgrove tightened the Clinic’s focus on patient care, establishing “Patients First” as the institutional mantra. He promoted quality improvement, improved patient experience, and instituted greater transparency and accountability at all levels of the organization. He oversaw the establishment of Clinic facilities in West Palm Beach County, Florida; Las Vegas, Nevada; Toronto, Canada; and the United Arab Emirates. The Clinic reorganized its clinical services into patient-centered institutes, and appointed the first Chief Wellness Officer and Chief Experience Officer at any major medical institution.