Archive for March, 2015

Last SCPMG Founding Partner Rene Cailliet, MD, Dies at 97

posted on March 30, 2015
Dr. Rene Cailliet, M.D., 1981

Dr. Rene Cailliet, M.D., 1981

Obituary courtesy Kaiser Permanente Southern California Corporate Communications

 

Rene Cailliet, MD, the last living founding partner of Kaiser Permanente’s Southern California Permanente Medical Group, died at age 97 at his Los Angeles area home on March 14.

Dr. Cailliet became one of the founding partners of SCPMG in 1953 and practiced in the Departments of Physical Medicine and Rehabilitation at Kaiser Permanente Los Angeles and West Los Angeles Medical Centers.

He is widely recognized as a pioneering physician who helped create the specialty of Physical Medicine and Rehabilitation and is also well-known for a popular series of books on musculoskeletal medicine.

Born in Philadelphia on June 10, 1917, Dr. Cailliet was the son of French immigrants. He received his bachelor of science from Villanova College in Pennsylvania and, after graduating from the University of Southern California Medical School in 1943, Dr. Cailliet served in the U.S. Army during World War II.

Dr. Cailliet also served as director of Rehabilitation Medicine at Santa Monica Hospital Medical Center from 1977 to 1993, and in his retirement became professor-chairman emeritus of the Department of Physical Medicine and Rehabilitation at the University of Southern California.

He is survived by his wife of 32 years, Lois Ann, and two sons.

The following is an excerpt of a statement from Dr. Cailliet read by Edward M. Ellison, MD, executive medical director, at SCPMG’s 60th anniversary celebration, which Dr. Cailliet attended in September 2013. It received a standing ovation:

“Sixty years ago 13 doctors really took a chance on an idea. After surviving World War II and returning to Los Angeles, we were ready to try an idea for the delivery of medical care to many people and at an affordable price. This would involve a small prepayment but guarantee good and affordable care for all who participated.

“The prevalent model of medical care was that of private practice for each physician. We felt the new ideas deserved a chance and were worth all the effort and treasure we could put into them.

“That I have lived 96 years, with many complications of my health, is a testament to the ideas we had then. Such quality of care is the essence of Kaiser Permanente. My specialty, Physical Medicine and Rehabilitation, was also a new idea at the time. It was during the war experience that I learned how much was needed to restore the quality of life for the wounded.

“At home, the polio patients also needed help with restoration of function. Much of my time became consumed with lecturing around the country and the world as the 18 books which followed were translated into 11 languages with my own musculoskeletal illustrations. It was the need for education in this area that led me to leave Kaiser after 25 years to devote my time to writing and teaching.

“The dream that we early ‘founders’ had has grown and become a model for medical organizations throughout the country. I salute you all who continue to make this a great organization, which will live on to care for patients in the best possible ways.”

 

Short link to this article: http://k-p.li/1ytLPCl 

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Books and publications about Kaiser Permanente history

posted on March 23, 2015

Lincoln Cushing
Heritage writer

 

If you are interested in learning more about the history of Kaiser Permanente, the books listed here are all good resources. With the exception of The Story of Dr. Sidney R. Garfield and Permanente in the Northwest, these books are out of print, but copies can often been located through libraries and mainstream used booksellers, such as AbeBooks (external), Alibris (external), Barnes and Noble (external), Half Price Books (external) or Powell’s Books (external).

 

In Print

The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care Into Health Care
Tom Debley with Jon Stewart

The first biography of Dr. Garfield tells the story of his long and eventful career, during which he turned his 1930s Mojave Desert industrial health care dream into a thriving and enduring reality that continues to offer a practical model for the future of American health care.

The Permanente Press, 2009, 148 pages

Available from The Permanente Press (external)

 

permanenteinthenorthwestPermanente in the Northwest
Ian C. MacMillan

This book fills a large gap in the history of Kaiser Permanente – the unique contribution made by the Northwest region, especially in the early years. The author, retired Northwest internist Ian C. MacMillan, demonstrates an insider’s insight and enviable access to details that thoroughly enrich this account.

The Permanente Press, 2010, 313 pages

Available from The Permanente Press (external)

BuildEmBuild ‘Em by the Mile, Cut ‘Em off by the Yard: How Henry J. Kaiser and the Rosies Helped Win World War
Steve Gilford

A good overview of the World War II Home Front experience in the Kaiser Richmond shipyards. The book is written for the general reader and includes many personal anecdotes about Home Front life.

Richmond Museum of History, 252 pages, 2011

 

Out of Print

A Model for National Health Care: The History of Kaiser Permanente
Rickey Hendricks

This extensively researched book is the definitive academic history of Kaiser Permanente that tells the story of its growth and impact on American health care.

Rutgers University Press, 1993, 265 pages

Embattled Dreams: California in War and Peace, 1940-1950
Kevin Starr

Part of an extensive history of California series, this book includes discussion of Henry J. Kaiser, his wartime industrial efforts, and the founding of Kaiser Permanente.

Oxford University Press, 2002, 386 pages

Henry J. Kaiser: Builder in the Modern American West
Mark Foster

In this academic biography, historian Foster offers the definitive balanced view of Kaiser, covering his mistakes as well as his colossal strengths and successes.

University of Texas Press, 1991, 358 pages

Henry Kaiser, Western Colossus
Albert Heiner

This very readable biography is by a former Kaiser Steel executive who was an eyewitness to much of Henry Kaiser’s career.

Halo Books, 1989, 434 pages

Kaiser Wakes the Doctors
Paul De Kruif

This book by America’s foremost medical writer of the era was the first ever written about the revolutionary medical care available in the Kaiser World War II shipyards.

Harcourt, Brace & Company, 1943, 158 pages

Kaiser Permanente Health Plan: Why It Works
Greer Williams

The author was commissioned to investigate Kaiser Permanente to assess “what it is, how it works, and whether it is good or bad.”

Henry J. Kaiser Family Foundation, 1971, 92 pages

Can Physicians Control the Quality and Costs of Health Care? The Story of The Permanente Medical Group
John G. Smillie, MD

Smillie, an early Northern California Permanente physician, offers an insider’s view of the beginnings of the Kaiser Permanente medical care program.

McGraw Hill, 1991, 283 pages

The Kaiser Story

When Henry J. Kaiser passed away in 1967, Kaiser Industries published this short book as a tribute to the company’s founder.

Kaiser Industries, 1968, 72 pages

Life Among the Doctors
Paul de Kruif

A collection of essays on people the author regarded as pioneers in medicine, including: Sidney Garfield, MD, in a section titled “The Last Maverick;” Edna Schrick, MD, whom de Kruif quotes as suggesting to Dr. Garfield that “we learn how to teach the well to take care of themselves…to keep away from doctors”; and Herman Kabat, MD, who founded the Kabat-Kaiser Institute, now the Kaiser Foundation Rehabilitation Center in Vallejo.

Harcourt, Brace & Company, 1949, 470 pages

Mr. Kaiser Goes to Washington: The Rise of a Government Entrepreneur
Stephen B. Adams

Historian Adams offers Kaiser’s story as a case study of “government entrepreneurship.” He explores the symbiotic relations forged by Kaiser and President Franklin D. Roosevelt.

The University of North Carolina Press, 1997, 239 pages

The Rich Neighbor Policy: Rockefeller and Kaiser in Brazil
Elizabeth A. Cobbs

Cobbs details how Henry Kaiser’s participation in the Brazilian auto industry impacted U.S. foreign relations and how postwar businessmen sought accommodation with Latin American nationalism by evolving a code of ‘corporate social responsibility.’

Yale University Press, 1992, 273 pages

Historical Review of the Southern California Permanente Medical Group: Its Role in the Development of the Kaiser Permanente Medical Care Program in Southern California
Raymond M. Kay, MD

A history of the SCPMG written by Dr. Raymond Kay, who was Sidney Garfield’s close friend, a pioneer of the Permanente Medical Groups, and the founder of the Southern California Permanente Medical Group.

SCPMG, 1979, 174 pages

 

Other Publications

Kaiser Permanente: A Short History
Gerry Gaintner

Gerry Gaintner, EdD, was a Kaiser Permanente employee for 15 years, all in the Information Technology department. He wrote this concise history in 2010, and upon his retirement, gifted it to KP Heritage Resources.

Unpublished, 2011, 42 pages
Available for download (pdf)

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Supermac! World War II shipyard superhero!

posted on March 18, 2015

Lincoln Cushing
Heritage writer

 

Supermac!

Supermac!

The weekly magazines published in the World War II Kaiser shipyards – Fore ‘n’ Aft for the Richmond, Calif., yards and The Bo’s’n’s Whistle for the Portland, Ore., area yards – offer a remarkable trove of material on home front working culture. And what’s working culture without cartoons?

Labor has always used cartoon art as part of its communications arsenal. From acerbic cartoons of the Industrial Workers of the World, to Fred Wright’s iconic art in United Electrical, Radio, and Machine Workers of America publications, to the “SuperScrubs!” comic in Kaiser Permanente’s own Labor Management Partnership magazine HANK, the cartoon/comic genre has always been a popular medium.

Between September 8, 1944, and March 30, 1945, a comic strip named Supermac ran in Fore ‘n’ Aft. The “super” concept character had already permeated popular culture the iconic Superman first appeared in Action Comics in 1938 – but this Supermac fella was…different.

He was small and scrawny, and struggled to find privacy in a big public yard when changing into his super persona. Over the short span of 26 cartoons strips he fearlessly fought German saboteurs and industrial mishaps. He was the empowered spirit of the home front workforce, appearing in an employee magazine with a circulation of 80,000 copies.

The strip was cryptically credited to “P.T.C.”, which turns out to have been a collaborative effort. We know that one of the contributors was artist Emmy Lou Packard – the “P” – but the identities of the other two creative talents remain a mystery. Based on publication credits, “T” might have been either Rose Thompson or Virginia Thompson; the “C” could have been Mary Chapman, Stan Champion, Mary Lou Clark, or Jack Cook.

Presented here are the first seven strips. The next set can be seen here.

[Disambiguation alert – a subsequent, unrelated cartoon figure also named Supermac appeared in the British press in 1958, skewering British Prime Minister Harold Macmillan (1957 to 1963.)]

These images are from the digital collection of Fore ‘n’ Afts collaboratively produced by Kaiser Permanente Heritage Resources and the Richmond Museum of History.

Short link to this article: http://bit.ly/1O7iKqr

Click on any strip to enlarge.

Supermac

Supermac, 9/8/1944

Supermac, 9/15/1944

Supermac, 9/15/1944

Supermac. 9/22/1944

Supermac. 9/22/1944

Supermac, 9/29/1944

Supermac, 9/29/1944

Supermac, 10/13/1944

Supermac, 10/13/1944

Supermac, 10/20/1944

Supermac, 10/20/1944

Supermac, 10/27/1944

Supermac, 10/27/1944

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Kaiser Permanente physicians tour historic sites

posted on March 13, 2015

Lincoln Cushing
Heritage writer

Tom Debley with KP physicians at Permanente Creek

Retired Kaiser Permanente Heritage Resources director Tom Debley with physicians at Permanente Creek.

What do you get when you put 60 Kaiser Permanente physicians on a bus and visit two of the most important historic sites in our organization? A barrel full of fun and a head full of facts.

The Permanente Federation was holding a Medicine and Management Program in the S.F. Bay Area, and chose to include Kaiser Permanente history as a key feature of the experience. Doctors from all over the country, led by three historians – Tom Debley, Steve Gilford, and yours truly – visited the site of the Permanente Creek in Cupertino, Calif., where Henry J. and Bess Kaiser enjoyed the sparkling waters and chose it for the name of their long-lasting health plan.

We also went to the Rosie the Riveter/World War II Home Front National Historic Park where the Kaiser shipyards provided health care for almost 200,000 workers.

During lunch, retired second-generation Kaiser Permanente physician Dr. David Shearn regaled us with amusing and provocative anecdotes. The National Park staff were gracious and informative, and the event was capped with presentations by genuine WWII Rosies.

Short link to this article: http://bit.ly/1AxEBNB

"Rosie the Riveter" docents tell about WWII experiences in the Kaiser Richmond shipyards

“Rosie the Riveter” docents told about their WWII experiences in the Kaiser Richmond shipyards.

Dr. David Shearn recounts stories of KP history

Dr. David Shearn shared Kaiser Permanente lore and advice.

 

 

 

 

 

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The Atomedic Hospital loses its glow

posted on March 9, 2015

Lincoln Cushing
Heritage writer


Second in a two-part series

Atomedic hospital visionary Dr. Hugh C. MacGuire pitched his proposal hard to Kaiser Permanente’s founding physician Dr. Sidney Garfield. In a letter dated November 25, 1960, he wrote:

You are already in command of a large, well defined medical care program with the backing of one of the most progressive imaginative and creative organizations of our time at your disposal. If we could set up and develop our Atomedic concept within the confines of Kaiser and call on the talent already available there we could have our units covering the globe within a year.

"Hospital of Tomorrow" drawing, 1960

Details of “The Hospital of Tomorrow,” This Week magazine, 1/17/1960. Click to enlarge.

Dr. Garfield then proceeded to educate himself about the medical applications of atomic radiation.

He wrote to Marshall Brucer, M.D., chairman of the Medical Division at the Oak Ridge Institute of Nuclear Studies in Tennessee. In a reply dated December 8, 1960, Dr. Brucer conceded: “Problems of medical sterilization are not as simple as they might appear.” However, he went on to suggest that Dr. Garfield might be asking too small a question:

…All of these problems are minute if you consider that the radiation-producing devices can also be used for every other thing in a hospital. I have suggested to one of the reactor producers that if the hospital were built around a core of reactors, then all of these problems of heat, light, sterilization, and everything else that is necessary in a hospital can be done at remarkably cheap cost.

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Graphic from “Pilot Hospital” for Atomedic Research Center in Montgomery, Alabama; Michael Hack, Associates Architects, 1960

Dr. Garfield requested a copy of Proceedings of the International Conference on the Peaceful Uses of Atomic Energy, held in Geneva 8 August to 10 August, 1955, Volume 15, Applications of Radioactive Isotopes and Fission Products in Research and Industry, which was purchased for him at the United Nations Bookstore in New York City by Charles E. Foster from Kaiser’s Washington, D.C., office.

However, by February, 1961 Dr. Garfield’s enthusiasm for an atomic hospital began to decay.

He wrote to Dr. MacGuire informing him “…the current recession in business makes it practically impossible to stir up any real interest in your new venture with the Kaiser organization at this time.”

There is no further evidence that Dr. Garfield, or Kaiser Permanente, continued to participate in the Atomedic project after this date.

It’s not clear when the Atomedic hospital design lost its nuclear reactor feature and branding; by 1963 there was no mention of it in their literature or in news accounts. Instead, the title was described as referring to its “application of atomic age principles to medicine.”

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Atomedic prototype, a design first installed in Montgomery, Ala. and later at New York World’s Fair, 1964

In 1963 a first prototype hospital – without a nuclear reactor – was built in Montgomery, Ala.; it was later dismantled, transported, and re-erected in Woodstock, Ga., where it operated for more than 20 years. A second prototype was the official hospital of the 1964 World’s Fair in New York.

In their hospital design title Healthcare Architecture in an Era of Radical Transformation by hospital design scholars Stephen Verderber and David J. Fine, the authors noted several serious hurdles for the Atomedic hospital:

First, it was expensive. In 1965, the cost was about $19,000 per bed, and the figure was higher in extreme climates or where local fire codes required automated smoke detectors, sprinkler systems, smoke barriers, or fire-rated doors. Finally, the hospital did not meet Hill-Burton eligibility standards for federal construction funding.

The Atomedic Foundation continues to this day; its motto is “Focused on health through standardization of processes and systems.”

And Kaiser Permanente continues to this day to explore innovative hospital designs and develop alternative energy sources, such as solar and wind.

 

Material for this story culled from The Permanente Medical Group archives.

Short link to this article: http://bit.ly/1EMqqKi

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Atomedics – the future hospital that never was

posted on March 4, 2015

Lincoln Cushing
Heritage writer


Part one of two part series

Letterhead graphic, Atomedic Research Center, 1960; [TPMG P791]

Atomedics logo, from 1960 letterhead; note caduceus in center of atom.

Kaiser Permanente announced on February 18, 2015 that it had joined the ranks of the nation’s top renewable energy users, having completed several agreements to purchase enough renewable energy to reduce its greenhouse gas emissions by 30 percent nationwide by the beginning of 2017 — three years ahead of schedule.

That’s great news. But in the early 1960s, “renewable energy” was not much of a priority, and the industrial juggernaut that propelled the country after the end of World War II was fixated on the alternative power source of the period – atomic energy. The U.S. government and many industries sought ways to exploit the miracle of fission, and hospitals were enticed by this everlasting power.

This issue would attract two parts of Henry J. Kaiser’s far-flung organization – the Kaiser Foundation Health Plan and Hospitals (as cutting-edge users of this technology) and Kaiser Aluminum, since several of the proposals sought to use the new geodesic domes as shells.

One of the primary proponents of combining atomic power and health care was Canadian-born Hugh C. MacGuire, M.D., of the Atomedic Research Center. He was described in news accounts as being a leading pediatric surgeon, and developed the “Atomedic” concept in 1953 with the noble purpose of making health care accessible and affordable.

His prototype aluminum hospital was designed to serve about 90 percent of the average community’s hospital and clinical needs, with the remaining 10 percent of highly critical or specialized cases referred to major medical centers. Atomedic’s lightweight metal construction would make possible an airlift of the entire 22- to 44-bed structure to any site in the world in a matter of hours. After assembly and use, the building could be disassembled and moved to a new location with relative ease, including the self-contained nuclear power plant.

An earlier “Atom Era” hospital such as the proposed new medical center for U.C. Los Angeles in 1949 was also futuristic, but did not include an atomic pile in the basement. There was a plan for an “atomic hospital” to be built that same year at the Brookhaven National Laboratory on Long Island, NY, the first postwar atomic pile in the U.S.; news stories noted “It is impossible to move an atomic energy pile to a hospital, so the Brookhaven scientists plan to do the next best thing: bring the patients to the pile.” In 1967 CBS television’s Walter Cronkite aired a story on the nuclear medicine practiced there.

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Floorplan, Michael Hack Associates. “Pilot Hospital” Atomic Research Center prospectus from Atomedics, 1960. “Reactor” is in the center.

The Atomedic’s architectural details were handled by Atlanta’s Michael Hack Associates. This was a fresh and complex design challenge – a lightweight, strong, and versatile self-contained modern hospital. The nuclear reactor should be “designed so that they may be parachuted into inaccessible areas.” Electronic patient monitoring would utilize state-of-the-art sensors, data processing, and communications systems. The facility would rest on a hollow pontoon foundation that could be filled with air (for floating on water), potable water, or earth.

Atomedic held two earlier “conceptual” symposia in 1958 and 1959, but it was in 1960 that the project began to take off.

On January 17, 1960, This Week magazine (a nationally syndicated supplement in Sunday newspapers between 1935 and 1969) ran a three-page article extolling the virtues of “The Hospital of Tomorrow.” It was endorsed by Lewis M. Orr, president of the American Medical Association, who gushed:

The proposed Atomedic Hospital is an exciting and dramatic concept which has far-reaching implications for the future practice of medicine. The project is geared to the coming space age and geared, also, to the prime objective of medicine – supplying the highest quality medical care at the lowest practical cost.

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Atomic sterilizer detail, “The Hospital of Tomorrow,” This Week magazine,1/17/1960.

The article boasted of cost savings resulting from eliminating staff and streamlining processes. Atomedic would have no laundry (“The Atomedic Hospital will use disposable cellulose-fiber ‘linens’ and disposable eating utensils”) and reduced kitchen staff, replaced by “wall cookers” for frozen food prepared elsewhere. Sanitary? You bet. “The hospital will be kept germ-free with ultra-violet light or a small cobalt-60 radioactive unit, which will sterilize the air and instruments. One graphic was captioned: “Nurse puts instruments on belt which takes them past radiation unit.”

Kaiser Permanente founding physician Dr. Sidney Garfield attended a conference on Atomedics in Montgomery, Alabama, on Nov. 15-16, 1960. Dr. Garfield’s title at the time was “Vice President in Charge of Construction, Kaiser Foundation Hospitals.” Also present was Mr. J.R. Shaw, from Kaiser Aluminum’s Atlanta office.

Dr. Garfield was interviewed in the local newspaper, which led with his endorsement for Atomedic: “A pioneer in non-conventional hospital construction Wednesday termed Dr. Hugh C. MacGuire’s proposed Atomedic Research Center a ‘magnificent idea.’ “

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Brand-new Kaiser Permanente Walnut Creek hospital lobby, 1953.

Dr. Garfield was in fact deeply interested in improved hospital design, and had been ever since 1933 when he began his practice in the remote Mojave Desert. Note the similarity between his 1953 circular lobby for the new Walnut Creek, Calif., hospital and that of Atomedic. Years later he humbly admitted to the New York Times magazine “Hospital design is sort of a hobby of mine.”

Soon afterwards Dr. Garfield wrote to Dr. MacGuire and told him that he would “…discuss the entire subject with the various Kaiser executives.”


Part two:
Did Kaiser Permanente join in building an atomic hospital?

Material for this story culled from The Permanente Medical Group archives.

Short link to this article: http://bit.ly/1NhJpQN

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