Kaiser Permanente Pittsburg Medical Office – unsung soldier in the postwar health plan battles

posted on July 18, 2016

Lincoln Cushing
Heritage writer

 

Kaiser Foundation medical offices, 242 Diane Ave., Pittsburg, Calif., 1958-03. Scans from Kodachrome slides shot by Dr. Cecil Cutting. Car is 1957 Dodge Custom Royal.

Kaiser Foundation medical offices, 242 Diane Ave., Pittsburg, Calif., 1958. Dodge Custom Royal at right.

When the Pittsburg, Calif., Kaiser Permanente Medical Office opened in September, 1953, it was ground zero in the struggle between Kaiser’s comprehensive, prepaid, group practice model of medicine and the private practice medical establishment.

Wallace “Wally” Cook, one of the founding physicians in the Permanente Health Plan, recalled that epic confrontation in a 1986 oral history*:

When we were trying to grow rapidly, after Walnut Creek had started in 1952-53, Mr. Kaiser was putting a lot of pressure on the health plan. He built this beautiful facility–“he” in quotation marks–and by gosh, we needed members. We marketed the health plan in the steel workers’ union [United Steelworkers Local 1440] in Pittsburg, California… The steelworkers all went to their fee-for-service doctors up there, and here we were recruiting on their turf for members. This was in the summer of 1953. And there was going to be a vote by the steel workers. The fee-for-service doctors’ wives handed out leaflets, anti-Kaiser, anti-Permanente–very, very negative and, in many cases, untrue.

Doctor ad in Pittsburg Post-Dispatch 1953-07-22 [TMPG P1514]

Private practice ad in Pittsburg Post-Dispatch 7/22/1953.

They hired a sound truck to go around the city of Pittsburg, announcing that Kaiser was trying to invade, and let’s keep them out, let’s preserve what you have with your fee-for-service physician. When the vote finally occurred, we got about 95% of the steel workers. So we immediately had an infusion of 10,000 members overnight, and they were going to be members within a month, or something like that.

Well, that put an even greater burden on the recruiting effort. We had to find some place to see these members. So we leased a building that was about to open as a motel in Pittsburg – a U-shaped, old-fashioned 1940s motel, with room, room, room around in a U-shape. And we converted that into an office. You came in the front, and you’d peel off for dermatology, or medicine, or whatever, each motel room complex being an office space. It wasn’t good, but it worked.

Cecil Cutting, MD, who was also from the original Permanente Health Plan cohort, shot these slides of the clinic in 1958. It was a far cry from the elegant “hospitals of the future” that Kaiser Permanente had built in Walnut Creek, San Francisco, and Los Angeles – but it valiantly served an important working-class community.

The KP Reporter laid out the situation in a 1962 article:

Shirley Nelson, at Central Desk in the Pittsburg clinic, has a word with Kenneth, 4, while Kathie Mendoza makes an appointment for his Ma - Mrs. A. N. Franklin. KP Reporter, 1962

“Shirley Nelson, at Central Desk in the Pittsburg clinic, has a word with Kenneth, 4, while Kathie Mendoza makes an appointment for his Ma – Mrs. A. N. Franklin.” KP Reporter, 1962

Sometimes the staff of our Medical Office in Pittsburg wonders if the rest of the Kaiser Foundation Medical Program knows they’re there.

Of course, relations with the Walnut Creek hospital are close and continuous, but Pittsburg is quite a distance from other facilities, and everyone there is so very busy – handling more than 3,100 patient visits a month with a staff of 4 doctors – they regard themselves as the “sheepherders” of our Program.

“When I came here in October, and this office opened,” says Dr. Bulgarelli, Physician in Charge, “each doctor saw about 800 patients a month. Our first purpose was to serve the steelworkers and their families.

“In four months patient visits went up to 1,200 per doctor. Of the original medical staff of five doctors, only Dr. Anna Grinbergs and myself remain. How we worked! And on Sundays, we walked. Or rather, Dr. Grinbergs walked, and still does. Myself, I could not keep up with her. She walks every day before breakfast- gets up at 4 a.m. She is younger today than when she took this job eight years ago.”

Kaiser Foundation medical offices, 242 Diane Ave., Pittsburg, Calif., 1958-03. Scans from Kodachrome slides shot by Dr. Cecil Cutting.

Kaiser Foundation medical offices, 242 Diane Ave., Pittsburg, Calif., 1958.

Membership continued to grow, and in 1954 Dr. F. W. Treubel was added to the staff, in 1955, Dr. B.B. Taylor. In 1956 Lenore Crane came from the Walnut Creek hospital to be clinic administrator. Patient load went over 3,800 a month while 6 doctors were on the staff, but has dropped to 3,200 now that there are only 4 physicians. The Medical Department at Walnut Creek sends a physician each afternoon to help see drop-in patients, who now comprise roughly 60 percent of the patient load at Pittsburg.

The humble motel-as-clinic closed in April 1964 when services were moved to Antioch. Dr. Bulgarelli, physician-in-chief at the new facility, noted the difference in a KP Reporter article January, 1964:

Dr. Rino Bulgarelli, physician-in-charge at Pittsburg, has a warm working alliance with Lenore Crane, clinic administrator. KP Reporter, 1962

“Dr. Rino Bulgarelli, physician-in-charge at Pittsburg, has a warm working alliance with Lenore Crane, clinic administrator.” KP Reporter, 1962

The opening of new Medical Offices in Antioch next month is awaited as eagerly by Health Plan members as by the clinic staff. We outgrew our quarters in Pittsburg where offices had to be scattered about several buildings. One was in the same building with a bar where a juke box kept the customers happy all day long, but was not so pleasing to our patients.

The new building at 3400 Delta Fair Blvd. is a tremendous improvement. It is more centrally located for all the Health Plan members in our area. It is an attractive, modern building, spacious and air-conditioned, where all our services can be united under one roof. And, in addition to those practical advantages, it is surrounded by 5-1/2 acres, and commands a fine view across green fields to the river and the hills beyond.

 

Kaiser Foundation medical offices, 242 Diane Ave., Pittsburg, Calif., 1958-03. Scans from Kodachrome slides shot by Dr. Cecil Cutting. Physicians listed: P.M. Weber, Anna Grinbergs, Rino Bulgarelli, Bill B. Taylor, F.W. Treubel, J.R. Heiman.

Roster, Pittsburg medical offices, 1958. Physicians listed: P.M. Weber, Anna Grinbergs, Rino Bulgarelli, Bill B. Taylor, F.W. Treubel, J.R. Heiman.

Color images are scans from Kodachrome slides shot March, 1958 by Dr. Cecil Cutting.

* Wallace H. Cook, M.D., “History of the Kaiser Permanente Medical Care Program,” an oral history conducted in 1986 by Sally Smith Hughes, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 1987.

 Short link to this article: http://k-p.li/29JhxH0

 

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Sacks against attacks! Kaiser cement at Pearl Harbor, 1941

posted on July 12, 2016

Lincoln Cushing
Heritage writer

 

Sandbagged .30 caliber machine gun emplacement with gun crew on alert, at the seaplane base near Ford Island's southern tip, soon after the Japanese attack. Note wind sock atop hangar at right, PBY patrol plane warming up by the corner of the hangar, another PBY in the center distance, and three SOC floatplanes at left with the beached battleship Nevada (BB-36) beyond. Sandbags are marked Permanente.  Official U.S. Navy Photograph, now in the collections of the National Archives.

Permanente sandbags protecting machine gun crew, Ford Island. Detail of photo below. December 7, 1941.

History keeps revealing itself in unusual ways.

Jill Radke, a Kaiser Permanente employee in Hawaii, recently sent this email to Heritage Resources:

Don’t know if you can use this little bit of history, but I thought it was too good to not share….

I do a lot of historic preservation work in my spare time. I used to work at Historic Hawaii Foundation, which is the statewide partner of the National Trust for Historic Preservation. One of the things I’m most proud of from my time there was preserving the strafing (bullet holes) in concrete along the runways on Ford Island — remnants that tell the story of the December 7, 1941 attack on Pearl Harbor.

One of the strafing runs that always puzzled me is near a seaplane hangar’s entrance. I always wondered, “What were the Japanese pilots shooting at?”

Sandbagged .30 caliber machine gun emplacement with gun crew on alert, at the seaplane base near Ford Island's southern tip, soon after the Japanese attack. Note wind sock atop hangar at right, PBY patrol plane warming up by the corner of the hangar, another PBY in the center distance, and three SOC floatplanes at left with the beached battleship Nevada (BB-36) beyond. Sandbags are marked Permanente.  Official U.S. Navy Photograph, now in the collections of the National Archives.

Full photo, detail above. Sandbagged .30 caliber machine gun emplacement with gun crew on alert, at the seaplane base near Ford Island’s southern tip, soon after the Japanese attack. Note wind sock atop hangar at right, PBY patrol plane warming up by the corner of the hangar, another PBY in the center distance, and three SOC floatplanes at left with the beached battleship Nevada (BB-36) beyond. Sandbags are marked Permanente. Official U.S. Navy Photograph, now in the collections of the National Archives.

To find out, I looked at the attached photo from the National Archives and Records Administration to see what was going on at that site on Dec 7, 1941. Sailors are manning their makeshift defensive positions constructed with sandbags. At one point during my sleuthing process, I had this image on zoom, walked away, and then saw it at a glance later and thought, “Why is a work image on my home computer?”

I’ve seen this photo hundreds of times, but never realized before that the sandbags say “PERMANENTE.”

 

Yes, indeed they do. Here’s the back story.

Starting in the mid-1930s the Kaiser Company engaged in joint ventures with other companies to build major projects such as Hoover Dam, the Grand Coulee Dam, and Bonneville Dam. As a result, Henry J. Kaiser understood the importance of a reliable and economical supply of Portland cement for the construction industry.

Ford Island and Pearl Harbor, 1941

Ford Island and Pearl Harbor, 1941

He took a giant step into the cement supply industry when he won the contracts to supply the cement and aggregate for construction of Shasta Dam in Northern California. The award was made even though he didn’t have his own cement manufacturing capability. To meet the cement requirements of the contract, his staff of engineers and construction personnel built a two-kiln cement plant at Permanente, California, (just north of San Jose) beginning production only seven months after breaking ground. The Permanente Corporation was incorporated in 1939, and the company was known as the Permanente Cement Company. Its name was changed to Kaiser Cement and Gypsum Corporation in 1964.

The makeshift defenses in this photo would have originally been sacks of that Kaiser cement. The U.S. Navy had contracted with Kaiser to supply cement for their Hawaiian facilities. In order to keep costs down he proposed the radical idea of shipping cement in bulk form, rather than in sacks, using pneumatic pressure to move the material. It worked, and between October 1940 and the attack on Pearl more than 400,000 barrels of his cement were in sitting in silos in Honolulu. This industrial material proved essential for rebuilding U.S. defenses after the Japanese attack.

It appears that for local transportation and storage, the bulk cement was bagged on site – and was repurposed for the defense of Ford Island.

 

Short link to this article: http://k-p.li/29C6IZa

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Summer fun for kids – 1944

posted on July 7, 2016

Caroline Horswill
Heritage guest writer

 

Article on summer fun for shipyard kids, Fore'n'Aft, 1944-07-07

No matter the era, summer months beg the same question for every parent: “What will I do with the kids?” In 1944, the recreation department in Richmond, Calif., had the answer that would “get you through the summer without ending up in a nervous tizzy.” The options were shared in an article in the July 7 issue the Kaiser shipyard newspaper Fore ‘n’ Aft.

The programs were plentiful and of many varieties. From playgrounds open from 9 a.m. to 5:30 p.m., to child care centers available for a small fee of $3.60, parents could relax and know their children were well cared for by trained recreation department directors and depleted of excess energy by the time they returned home.

Article on summer fun for shipyard kids, Fore'n'Aft, 1944-07-07Richmond’s recreation department didn’t stop at activities for younger kids. Teens had summer activities available to them including dances on Thursday and Friday nights and youth-directed social groups. Women had the opportunity to take knitting, cooking or sewing classes, others socialized in bridge clubs, drama groups, softball teams, choir groups and family relation discussion groups.

An array of photographs illuminates summertime pleasure for all who participated. One shows three boys developing their archery skills with the help of one of the department directors. In another, a group of teenagers pay a nickel for some tunes at a Richmond recreation hall.

 

Short link to this article: http://k-p.li/29rytlF

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Workplace safety in the World War II Kaiser shipyards

posted on June 28, 2016

Lincoln Cushing
Heritage writer

 

Bos'n's Whistle, OSC, 1944-01-14, OHS

First aid station at Kaiser shipyard, Vancouver, Washington;, from Bos’n’s Whistle, 1/14/1944.

June is National Safety Month, during which we are asked to pay particular attention to something that we usually don’t think about – our own personal safety and that of our loved ones. Yet reducing our risk for injury at work, on the roads, and in our homes and communities is as vital to our health as diet, exercise, and regular checkups.

Kaiser Permanente has a long history in working to protect its employees from harm and injury in the workplace, a commitment that goes back to the World War II home front. At precisely the same time that the conventional industrial workforce of healthy young men went off to fight, everyone else stepped up to produce the materials to arm the Arsenal of Democracy and win the war. Among these unsung heroes were the almost 200,000 people in the seven Kaiser shipyards. Most of them had never engaged in heavy industrial work before. They were housewives, farmers, the disabled, and those too old to serve in the military.

This January 14, 1944, article from the weekly Oregon Kaiser shipyard newspaper The Bos’n’s Whistle does a good job of explaining the challenges:

Infographic "Causes of time loss injuries 1941-1943" Bos'n's Whistle, 1/14/1944. Click for enlargement.

Infographic “Causes of time loss injuries 1941-1943″ Bos’n’s Whistle, 1/14/1944.

Safety pays dividends in shipbuilding production. That is apparent in the safety record of the three Kaiser yards during the past year. In all three yards, from superintendents to laborers, men and women showed more interest in observing safety rules. As a result, sizeable cuts were made in the two major causes of time loss injuries – handling tools or materials, and eye injuries- bring the total percentage of injuries in these two classifications down from 64 per cent to 53 per cent. National Safety Council figures show that, in terms of production, industry last year lost 380 million man days of work because of accidents. And the death rate on the war industry front is still four times higher than on the nation’s battlefronts. First Aid stations in the Vancouver and Swan Island yards treated a total of 704,435 cases during the year.

Bos'n's Whistle, OSC, 1944-01-14, OHS

Kaiser shipyard industrial care article, 1/14/1944

While hundreds of workers manage to stay on the job after an accident, their efficiency is impaired.

That steady progress is being made in the war on injuries is shown in the drop in accident insurance cost. At the start of the program, the cost was $3.75 per $100 of payroll, and the three yard average is now down to less than $1.00 per $100 payroll.

Before the war was over, the successful health plan for Kaiser shipyard workers was opened to the public.  Today at Kaiser Permanente is a leader in occupational health as well as employee and patient safety. “Kaiser On-the-Job,” first started in the Northwest Region in 1991, incorporates prevention, case management, clinical protocols, and return to work programs with impressive results.

Safety still pays. Work safe, be safe.

 

Short link to this article: http://k-p.li/28Ywcw2

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