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Dr. Sidney Garfield on Medical Care as a Right

posted on August 15, 2017

Lincoln Cushing
Heritage writer

This post introduces a podcast, our new channel for sharing Kaiser Permanente history. Given the rich set of audio materials in our archives, it makes sense to let viewers hear our stories as told by those who were part of it. With these podcasts we will explore audio sources including World War II shipyard launchings, speeches by key figures, and interviews.

So, without further ado, let’s hear our founding physician talk about what he learned about building a medical plan, starting in 1933.

 

Podcast fulltext for “Dr. Sidney Garfield on Medical Care as a Right”

Hello, I’m Lincoln Cushing. Welcome to Kaiser Permanente’s “Earful of History”

Today we’ll hear from our founding physician, Doctor Sidney Garfield. He had some interesting things to say about medical care as a right – and also about the origin of what we now call Permanente medicine.

Dr. Garfield’s talk comes to us from a 1972 lecture he delivered to community medicine students at the University of Southern California Medical School.

Let’s go way back to the Great Depression, when America’s industries were in shambles, people were out of work, and things were really tough.

Dr. Sidney Garfield at Contractors General Hospital, 1935.

In 1933, Dr. Garfield was fresh out of medical school, and he’d set up a small practice in Southern California’s remote Mojave Desert. He was providing industrial medical care for the workers on the Colorado River Aqueduct project.

Dr. Garfield:

I soon found myself in rather serious financial difficulty. Knowing nothing about medical economics, I had tackled the impossible job in those days of trying to take care of a group of workers with none of the usual crutches. There were no rich to pay for the poor. No subsidy. No philanthropy. There wasn’t even a county hospital to which we could send our charity cases.

Dr. Garfield’s problem was the standard business model of industrial medicine where he got insurance reimbursement for treatment after a worker was sick or injured. So he worked out a new deal with the insurance carrier. Dr. Garfield was prepaid a fixed amount per worker, and in turn he guaranteed he’d provide their needed medical care while on the job. This was a win-win solution. It assured Dr. Garfield a steady income to run his clinic, but more importantly, it gave him the incentive to keep the workers healthy instead of making money when they got injured.

The aqueduct project ended in 1938. He was going to go into private practice, but history intervened. Dr. Garfield went up to care for the workers at industrialist Henry J. Kaiser’s huge dam project on the Columbia River in Washington. Grand Coulee Dam, the largest concrete structure ever built.
[Woody Guthrie sings; he was hired by the Bonneville Power Administration to promote the wonders of the new dam].

Mason City hospital (Grand Coulee Dam) after Dr. Garfield’s upgrade, circa 1939.

Dr. Garfield, reluctant at first, became excited at the prospect of fixing up the decrepit local hospital and bringing in a top-notch staff. There, he learned a lesson – a prepaid health plan for whole families can be effective and affordable.

Dr. Garfield:

In the beginning, we took care of the workers with the health plan. And we took care of the families on fee-for-service.

And we soon found out that it didn’t work at all. It was too painful of a situation. The workers could get their care so easily through their health plan. And they had such problems paying for the care for their wives and children. It bothered not only the workers, it bothered the employer. It bothered the unions. It bothered our physicians. And so pretty soon we were being pressured on all sides to start a family plan… fifty-cents a week for the wife, and twenty-five cents a week for each child. [We] started a family plan.

And that worked beautifully too. From then on we had no concern. No problems taking care of the women and the children. But that rounding out of our employee plan to a complete family plan was Coulee’s contribution – greatest contribution to our lessons in medical care.

Bear in mind that until this point in history, health insurance plans didn’t really exist. If you got sick, you hoped you had enough money to pay a doctor, and you often delayed that until things got really bad.

Dr. Garfield:

Prior to the family plan, walking through the corridors of our Coulee Dam hospital, you would see a fair amount of very sick women and children. Terminal pneumonia. Ruptured appendices. Diphtheria cases and so forth. After the plan had been in operation for several months, that picture changed. The level of illness of these people changed. Walking through the corridors now you would see simple appendices, and early pneumonias. And diphtheria disappeared completely with the immunizations we offered with our health plan. And the solution to that was simple. The barrier of cost being removed, these people were coming in earlier for care. We were able to treat them earlier and prevent them from getting complications. And I’m sure preventing many of them from dying. That was a lesson that we’ve never forgotten.

This was the origin of what we now call Permanente medicine. Speaking to the roomful of community medicine students, he reflected on the important medical model he’d developed through his association with Henry J. Kaiser and the efficiencies of the Kaiser Permanente Health Plan:

Dr. Garfield:

In conclusion, in view of our commitment to medical care as a right in this country, this is – comprehensive health services, of high quality, to every person, the importance of this research and potential benefits is self-evident. We can never achieve the goal of medical care as a right without a delivery system that matches the demand of that right.

This new delivery system [I just described] does just that. It provides increased capacity, increased accessibility, appropriateness of service, comprehensiveness of care, continuity of both health care and sick care, efficiency of resource utilization, and is cost-effective. Its new services are relatively easily staffed, and it promises ready transferability and adaptability to most all forms of practice and geographical areas.

It’s impressive that an industrial health plan from the Great Depression would evolve into a robust and effective model of health care for all Americans.

It’s a testament to the persistence of mission and the dedication of thousands of physicians, staff, and administrators, starting with Dr. Garfield.

Thanks for joining us in this Kaiser Permanente Earful of History.

 

This audio is from a 1972 lecture Dr. Garfield delivered to Community Medicine students at the USC Medical School, recorded by Dr. Robert Tranquada and donated to Kaiser Permanente Heritage Resources.
Podcast producer: Juan Aguilar.

Short link to this page: http://k-p.li/2wb8axr

 

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Rosies Rocked Richmond Again

posted on August 14, 2017

Lincoln Cushing
Heritage writer

The third annual Home Front Festival and Rosie Rally was held in Richmond, Calif., on Saturday, August 12. The event honored those who contributed to the World War II home front, especially the women who stepped up – as they always do.

The highlight is always the contest for number of people dressed as Rosie. This year’s certified attendance of 2,229 didn’t top our own Guinness-record-setting count of last year, but we kept our lead over our counterparts at the Willow Run plant in Michigan. Whew.

Thank you, Rosie the Riveter Trust, staff at the National Park visitor center, and all the women who showed up. It was truly inspiring.

 

Short link to this article: http://k-p.li/2i1GmGm

 

‘Good Medicine Brought Within Reach of All’

posted on August 10, 2017

Lincoln Cushing
Heritage writer

 

“Tomorrow’s Health Plan – Today!” by Paul de Kruif, The Reader’s Digest May 1943.

“Tomorrow’s Health Plan – Today!”

That was the title of Paul de Kruif’s seminal article in The Reader’s Digest (also called simply Reader’s Digest) May 1943 edition. The bright red subhead proclaimed “Henry Kaiser and California physicians are proving that ‘good medicine’ can he brought within reach of all.”

Reader’s Digest was founded in 1922 by DeWitt Wallace, and its distinct format of condensed and rewritten material from a wide range of publications became very successful; it is currently the largest paid circulation magazine in the world.

This was the first national article on the industrial health care plan organized by Sidney Garfield, MD, for the 190,000 workers at Henry J. Kaiser’s six West Coast shipyards and his steel mill in Fontana, Calif. The plan was still new – it had only been started just over a year earlier, in March 1942 – but already it was making waves. That same year de Kruif devoted an entire book to the Kaiser health plan, Kaiser Wakes the Doctors, where he coined the description of the plan as the “Mayo Clinic for the common man.”

Paul de Kruif, from cover of The Sweeping Wind: A Memoir, 1962; photo circa 1926.

De Kruif (1890-1971) was quite a character. Born in the Netherlands, he moved to the United States and received a degree in microbiology. But his passion was policy change, not medical research. He published Our Medicine Men in 1922, followed by The Microbe Hunters in 1926. He spoke and wrote passionately about health care reform, railing against the limitations of private practice and fee-for-service. The Associated Press quoted him in 1939 as saying, “The essential principles of the proposed health law articulated by Mr. de Kruif would call for the establishment of adequate medical care as the ‘fifth human right,’ taking its place alongside the rights to food, shelter, clothing, and fuel.”

Initially a proponent of socialized medicine, by the early 1940s de Kruif came to favor the alternative model practiced by Henry J. Kaiser and Dr. Garfield. His four-page article in Reader’s Digest glowed about the efficiencies of the health care offered to the Kaiser shipyard workers:

All medical and surgical care is centralized under one roof. That’s the reason for both its effectiveness and its economy. The doctors are all handy to the laboratories, X-ray, surgeries and to each other.

Reviewing the Permanente Health Plan (now called Kaiser Permanente) at the early stage that he did, he noted that it did not include workers’ families. Although Kaiser and Garfield had developed and run a successful prepaid family plan a few years earlier at Grand Coulee Dam, the incredible pace of expansion in the shipyards after the Japanese attack on Pearl Harbor made it impossible to cover nonindustrial care for employees (a hugely popular option offered starting August 22, 1942) for anyone but employees. De Kruif noted that this gap was taken up by the California Physicians Service.

May 1943 issue of The Readers Digest

Created in 1939, the CPS (later called Blue Shield of California) was run by the California Medical Association and became the state’s first statewide prepaid plan. By mid-1943 shipyard families were admitted into the Permanente Health Plan, and the relations between private practice physicians and those working for Dr. Garfield begin to fray. The hostility of the medical establishment accelerated as the war ended and the Permanente Health Plan was opened to the public.

De Kruif’s opening salvo touting the benefits of the Permanente Health Plan was the first in Reader’s Digest, but certainly not the last. Permanente physicians continue to be quoted in their articles – just this year we saw “15 Ingredients Medical Doctors Always Add to Their Meals,” “Stomach Hurt? 12 Things Your Stomach Is Trying to Tell You,and “13 White Foods that Are Way Healthier Than You Thought.”

 

Short link to this article: http://k-p.li/2wMhZ1U

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Skateboarding – That Dangerous “Fad”

posted on July 27, 2017

“Doctors Concerned Over Skateboard Fad,” Planning for Health, 1965

Throwback Thursday

“Doctors Concerned Over Skateboard Fad”
Planning for Health
[Kaiser Permanente member newsletter], Fall 1965.

Skateboarding, a growing menace among many Bay Area residents, is beginning to concern orthopedic doctors, who are now treating many difficult fractures and head injuries as a result of the fad.

Skateboard patients normally range from age nine to twelve years old. Usually they sustain fractures of the extremities which can sometimes be serious. When a skateboarder loses his balance, the board tends to shoot off in one direction, the rider in another. Unlike the surfer who falls into water, the skateboarder hits hard pavement.

Even adults apparently succumb to the challenge of a skateboard. Among a group of patients recently treated at the San Francisco hospital Orthopedic department for skateboard fractures, were nine adults, including three fathers and two housewives.

Photo caption:

“Health Plan member, Elaine McLeish, demonstrates how to use a skateboard. The recent fad has caused concern on the part of some doctors who are now treating many injuries as a result of it.”

Editor’s note:

California Vehicle Code section 21212, passed in 2003, requires that a person under 18 who rides on a skateboard is required to wear a helmet. Even adults like Elaine would be wise to observe common sense in wearing protective gear. Please ride safely.
-Lincoln Cushing, Kaiser Permanente Heritage Resources

Short link to this item: http://k-p.li/2v1Qiou

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Tunnels, Trains, and Tubes: Kaiser’s Role in Building an Accessible Transit System

posted on July 14, 2017

Lincoln Cushing
Heritage writer

 

BART trans-bay tube built by Kaiser Steel being barged down Napa river, 1968.

Kaiser Steel was the backbone of San Francisco’s mighty Transamerica Pyramid in 1972. And, Kaiser Steel, and Kaiser Permanente, were both also involved in another major Bay Area construction project that opened the same year – the Bay Area Rapid Transit, or BART.

Henry J. Kaiser built the first West Coast integrated steel mill in Fontana in 1942 to supply plate for his seven shipyards, and by the 1960s he had fabrication facilities all over the world. The closest to San Francisco was located south of the town of Napa on the Napa River. Today it’s the Napa Pipe Corporation.

Kaiser Steel won the contract to build the transbay tubes, the tunnel through which the trains scoot back and forth between Oakland and San Francisco. The tubes were prefabricated sections 330 feet long, 48 feet wide, and 24 feet high. They were much more complex than a simple drain culvert, having to endure deep water pressure and earthquakes. Special Teflon-coated seismic joints allowed up to a foot of motion without damage.

BART also required tunnel liner rings – 27,000 of them. These were 36-foot-diameter behemoths weighing 6,500 pounds. Each one was composed of six giant fitted parts, and they reinforced 13 miles of tunnel.

A 2002 article in the Napa Valley Register burst with local pride in this accomplishment. Harold Halterman, Vice President of Kaiser Steel’s Fabricating Operations in Napa and Fontana, was quoted as saying “We kept a couple hundred people busy for five years. It was a fascinating time. People came from (all over the world) to see what we had done.”

And when Kaiser Steel was finished, a Kaiser Permanente employee took on a leading role in making BART accessible to all people

Harold Willson on new BART car with Easter Seal poster boy Eric Staley, 1972.

Harold Willson was coal miner with a crushed spine who arrived at the Oakland Permanente Foundation Hospital from West Virginia in 1948. At the Kabat-Kaiser Institute of Neuromuscular Rehabilitation in Vallejo, Calif., he regained mobility and went on to work for the Kaiser Foundation Health Plan. In the mid-1960s Willson, as a volunteer with the Easter Seal Society, became a staunch advocate for making the then-new BART more accessible. This included services we now take for granted, such as station elevators, ramps, chair-high water fountains and telephones, accessible bathrooms, lowered hand railings, and “kneeling” buses.

While BART was under construction, in 1968 California Governor Ronald Reagan signed Assembly Bill 7, into law, requiring public utilities constructed with state funds to be usable by the physically disabled. This added to BART’s projected costs – just adding elevators (originally, only escalators had been planned) at 28 to 33 stations was projected at $7 million. The city of Berkeley stepped up and offered to pay for the elevator in its Ashby station as a trial.

And it was worth it.

By 1972, an article in the San Francisco Chronicle boasted that “BART Leads Way in Transit System Aid to Handicapped.”

Whatever the strengths and weaknesses of the Bay Area Rapid Transit system, it can claim one admirable distinction- BART is the first rapid transit system in the world to offer 100 per cent usability, at almost every station, for the handicapped. This claim was made proudly today by Harold L. Willson of Alamo, himself handicapped, partly responsible for the installation of special facilities for the handicapped and elderly along BART’s 75-mile system.

According to Willson, “Accessible transportation is often the deciding factor between being dependent on society, friends or family and being independent within society. I’ll never forget that sense of freedom I experienced boarding a BART test train for the first time.”

Henry J. Kaiser was a doer, and once told his long-time attorney Paul Marrin “Don’t tell me what I can’t do.  Figure out a way to do it.” Although Kaiser had already passed away in 1967, surely he would have been proud of Halterman’s and Willson’s accomplishments.

 

Short link to this article: http://k-p.li/2vm4mFU

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Mending Bodies and Minds – Kabat-Kaiser Vallejo

posted on July 7, 2017

Lincoln Cushing
Heritage writer

 

Physical therapy at Kabat-Kaiser Vallejo

Mark Wellman fell from a cliff and broke his spine in 1982 at the age of 22. A well-known mountain climber, Wellman went on to scale Yosemite’s El Capitan seven years later despite his injuries, and was the first person to climb the 3,000-foot cliff using only his arms. Two years later, he summited Half Dome, and later became the first person with paraplegia to sit-ski across the Sierra Nevada.

Wellman received physical therapy and rehabilitation treatment at the Kaiser-Kabat Institute in Vallejo, Calif. (also called the Kabat-Kaiser Institute of Neuromuscular Rehabilitation), now the Kaiser Foundation Rehabilitation Center and Hospital which is still in operation. The work in Vallejo built upon the distinctive and important physical rehabilitation work done under the direction of Herman Kabat, MD, at the Kabat-Kaiser Institute in Santa Monica, which operated from 1947 to 1962.

Henry J. Kaiser had purchased the Vallejo Community Hospital in March 1947 from the

Permanente Hospital, Vallejo, circa 1948

Federal Works Agency to serve the growing Permanente health plan membership in that corner of the San Francisco Bay Area. The innovative facility had been designed by noted architect Douglas Dacre Stone (1897-1969), who’d also designed Children’s Hospital Oakland and Peralta Hospital. The facility was larger than needed, and in June part of the campus was allocated to the new Kabat-Kaiser rehabilitation program. There was also a Kabat-Kaiser clinic at the Permanente Foundation Hospital in Oakland, but after living quarters were built in Vallejo in late 1947 the Oakland clinic only served outpatients.

Kabat-Kaiser Vallejo, from Collier’s article, 1950

A key impetus behind Kaiser’s involvement in physical rehabilitation was in response to his youngest son Henry Junior (1917-1961) contracting multiple sclerosis in 1944 and being successfully cared for by program director Dr. Kabat. The first Kabat-Kaiser Vallejo administrator was Felix Day, and the medical director of the physical therapy school was physiatrist Ora Leonard Huddleston, MD.

The center in Santa Monica primarily treated patients with polio and multiple sclerosis, but Vallejo handled a much wider population of patients with disabling conditions including stroke and spinal cord injury. A 1954 brochure for the Kaiser Foundation Health Plan specifically noted “Members are entitled to rehabilitation and treatment for polio after the acute and contagious state, provided they have had continuous membership since the condition arose, and it originated after April 1, 1954.”

UMWA patients arriving by Pullman train for Kaiser physical therapy, 1948

Interestingly, this last group included coal miners from rural mining communities in the Midwest and East. In 1947 legendary United Mine Workers of America leader John L. Lewis and the UMWA Welfare and Retirement Fund partnered with Henry J. Kaiser and the Kabat-Kaiser Institute to provide top-quality medical care and rehabilitation for injured miners. They came across the country on the Southern Pacific’s elegant “Gold Coast Limited,” and when they arrived some had to be handed out through windows because they could not be lifted from their berths onto gurneys.

One of the mine workers to benefit from rehabilitation at Vallejo was Harold Willson, who arrived in 1948 with a crushed spine. There he met his nurse and future wife, regained mobility, and went on to work for the Kaiser Foundation Health Plan. Willson became a staunch advocate for making the then-new Bay Area Rapid Transit more accessible with elevators, ramps, chair-high water fountains, accessible bathrooms, lowered hand railings, and “kneeling” buses.

Maggie Knott and Dr. Kabat, Kabat-Kaiser Vallejo, from Collier’s article

It was in these early years that great strides were being made in the use of physical therapies to treat neuromuscular disabilities. Dr. Kabat received national publicity in the early 1950s for his work at the Vallejo facility, including a major spread in the popular magazine Collier’s Weekly. The institutes, under the direction of Dr. Kabat and physical therapist Margaret “Maggie” Knott, pioneered the therapy called “proprioceptive neuromuscular facilitation.” Maggie Knott and another physical therapist, Dorothy Voss, published the first textbook on PNF in 1956. PNF has become internationally recognized as one of the most widely used and effective treatments for certain injuries and illnesses.

Wheelchair square dance, from Kabat-Kaiser article in Collier’s

It was also during these years that some in the medical establishment attacked the Permanente Health Plan as “socialized medicine.” Left-sympathetic Dr. Kabat became a casualty, and he resigned from KKI in 1954 to pursue private practice and engage in research. (Also targeted but never harmed was Rene Cailliet, MD, certified in physical medicine and rehabilitation and chief of Kabat-Kaiser Santa Monica). Sedgwick Mead, MD, from Harvard University, was appointed medical director of the Vallejo KKI facility and it was renamed the California Rehabilitation Center.

KKI programs included a range of occupational training such as shoe and watch repair. One of their more popular recreational programs was wheelchair square dancing. And a local sports page on March 16, 1950, noted that the Fifth Annual Hayward Area Open Basketball Tournament would host the “First civilian wheelchair basketball team in the world” the “Wheeling Warriors” from KKI, where they would tangle with the National Guard 49ers.

Outdoor physical therapy at Kabat-Kaiser, Vallejo, circa 1960

Because the PNF method works so well, the program at the Kaiser Foundation Rehabilitation Center in Vallejo continues to draw graduate students from all over Europe, South America, and Asia. Just as in the early years, all productive approaches are welcome in physical and emotional therapy. A recent article highlighted several patients whose recovery was greatly enhanced by the healing power of visual art.

Kabat-Kaiser Vallejo – mending bodies and minds since 1947.

 

Short link to this article: http://k-p.li/2tS1jbn

 

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No Getting Round it: An Innovative Approach to Building Design

posted on June 23, 2017

Lincoln Cushing
Heritage writer

 

What is it about circular architecture in Henry J. Kaiser’s facilities?

We know that Henry J. Kaiser was a geodesic dome pioneer. Kaiser Aluminum and Chemical Corporation built two of the first civilian domes in 1957, one in Virginia and one in Hawaii. There’s another plan from the same year (never built) for a “Medical office building for the Kaiser Foundation Hospitals with Kaiser Aluminum dome.

The Permanente Foundation hospital at Panorama City (1962-2008) featured seven double circular floors, an example of Dr. Sidney Garfield’s “circles of service” concept. Dr. Garfield explained that in a 1974 interview:

In the center was a work space for the personnel, the supervisor right in the middle, with the public or patients coming in from an outside corridor – the peripheral corridor, central workspace concept. This would permit us to keep the central area clean, as the contaminated areas go out the outside corridors so you don’t get any cross traffic. It kept the orderlies and all the people who moved stretchers out of the central work space and so forth and the supervisor is right there so she can see everything.

Kaiser Child Service Center at Swan Island, circa 1943.

Yet there’s one more – the Portland Child Service Centers built in 1943 for the workers at the Oregonship and Swan Island shipyards. The center at Oregonship opened for children on November 8, 1943, Swan Island Center soon afterwards on November 18.

These structures represented an innovative approach to building that carries over to present at the Kaiser Permanente, although the organization is no longer builds round things – or does it?

Current hospital and building designs focus on environmental stewardship and patient safety, with a healthy dose of aesthetic brilliance thrown in. A news article on how design and healing go hand in hand called out the award-winning 2016 Kaiser Permanente, Kraemer Radiation Oncology Center in Anaheim, Calif., as featuring “fritted glass that evokes a forest and provides both light and privacy.” And it’s round, or at least rounded.

Frank Stewart, Administrator; George Wolff, Architect, Dr. Wallace Neighbor (pointing); Northern Permanente Foundation Hospital, circa 1942.

The 1943 Portland buildings were designed by the Portland, Ore., architectural firm of Wolff and Phillips (George M. Wolff and Truman E. Phillips), creators of several important Kaiser and Permanente facilities.

George Wolff (1899-1978) was a personal friend of Henry Kaiser’s son Edgar, and through that connection drew the firm into designing the worker’s housing at Bonneville Dam in Washington in 1934. In they created the 1942 Northern Permanente Foundation Hospital to serve the workers in Kaiser’s three northwest shipyards, as well as the wartime city of Vanport of almost 40,000 people.

After the war, the firm designed the conversion of Ford’s Willow Run plant in Michigan when Henry Kaiser took it over to produce automobiles, and later they designed the 1953 state-of-the art Kaiser Foundation Hospital in Los Angeles.

Playground core, Oregon child service center.

Unlike the more conventional design of the Maritime Child Development Center in Richmond, Calif., the Oregon centers put classrooms in a circle around six separate playgrounds.

We hear about this idea in a March 1944 article “Designed for 24-Hour Child Care” in Architectural Record, where Wolff and Phillips credited the facility design to the “ring school” concept originally conceived of by modernist architect Richard Joseph Neutra.

Neutra (1892 –1970) was an Austrian-American architect who spent most of his career in Southern California. Like Wolff and Phillips, his style was “modernist” with plentiful natural light and open space, and during the mid-1920s was evolving a radial site layout for public facilities.

Richard Neutra’s Ring Plan School project model, circa 1926.

A March 2000 article in UCLA Today explains more about Neutra’s role in this design concept:

Perhaps the most striking examples of this belief were the various schools designed by Neutra in Los Angeles. His project for a Ring Plan School, with its ring of classrooms around a play area and a running track on the roof, was adopted in 1934 by the Los Angeles School Board and built in the Bell district. The building was much celebrated for its qualities of light, relationship of classrooms to outdoors and color of materials.

One of his ring plan schools was built in 1960 at Lemoore Naval Air Station near Fresno; it’s now the Neutra Elementary School.

The design of the Portland Child Service Center was innovative, effective, and exemplary. A 2009 historic building assessment of the Portland public schools noted:

The building’s form and details rejected the architectural conventions that characterized the previous era of school construction. The Portland Child Service Center (demolished) captures the ideals that would be explored in Portland’s public schools in the post-war period.

Rejecting conventions and capturing ideals – that would be a good characterization of Henry J. Kaiser’s approach to solving national problems.

 

Short link to this article: http://k-p.li/2t4sIH8

 

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Henry J. Kaiser Jr. on Fathers and Family

posted on June 16, 2017

Lincoln Cushing
Heritage writer

 

Henry J. Kaiser, Jr, circa 1948

Henry J. Kaiser, Jr., (1917-1961) was Henry J. Kaiser’s younger son. On December 17, 1942, he spoke at a huge gathering of Kaiser Industries leaders under the theme “Together We Build.”

His comments resonate through the years on this Father’s Day 2017:

There has never been a time in my life when I could not turn to my father when I was in trouble and ask for counsel, no matter what he was doing. He had time enough, strength enough, to give me new strength, and new perspective. Dad, Edgar, and I have always talked things over. It is never one of us who fixes a problem, it is all of us.

And what is true of our personal family is true of every Kaiser enterprise. And we are the family, those of us here tonight, dependent on each other’s counsel.

Short link to this article: http://k-p.li/2sHcbrP

 

Kabat-Kaiser: Improving Quality of Life Through Rehabilitation

posted on June 14, 2017

Lincoln Cushing
Heritage writer

 

Kabat Kaiser Santa Monica, 1952, publicity photo with film and television actor Howard Keel.

Polio and multiple sclerosis. These disabling diseases of the nervous system posed daunting medical challenges as the Permanente Health Plan emerged from World War II and the nation looked toward an improved quality of life. Until a polio vaccine was developed in the mid-1950s, it was considered one of the most feared diseases in the United States, and MS is the most widespread disabling neurological condition affecting young adults in the world.

California’s first polio epidemic broke out in 1934-1935, with a second following in 1948. And, on a very personal note, Henry J. Kaiser’s youngest son Henry Junior (1917-1961) contracted MS in 1944.

Margaret “Maggie” Knott, PT, and Herman Kabat, MD, Washington, DC, 1947.

Henry J. Kaiser was determined to find the best therapy available, and through a 1946 Readers Digest article learned of Herman Kabat, MD, and his successful treatments. Kaiser sent Dr. Sidney Garfield, the founding physician of his successful World War II shipyard health plan, to assess the situation. Impressed with Dr. Kabat’s work, Dr. Garfield joined him to treat the younger Henry with considerable success. The rehabilitation program was deemed worthy of greater institutional support, and the Kabat-Kaiser Institute was born in Washington, D.C. (where Dr. Kabat practiced) in 1946. It was dedicated to “the restoration of the physically handicapped and to rehabilitate them to their optimum capacity, socially, economically, and physically.”

Eventually there would be two centers in California, providing the largest non-governmental civilian rehabilitation program in the United States for patients with neurological disorders. The Washington facility was followed by one in Vallejo (August, 1947) and a second in Santa Monica shortly thereafter. There was briefly a center connected to the Kaiser Oakland hospital, and the Washington facility was closed soon after 1950 when Dr. Kabat moved to Vallejo to direct the program.

Kabat-Kaiser Santa Monica (large middle building)

The Santa Monica facility started out as the Edgewater Beach Hotel around 1925. In 1944 it was called the Ambassador Hotel and taken over by Army Air Corps as a Redistribution Station to rotate men out of combat. After the war, it became a private club, but not for long. The Permanente Foundation bought the building in October 1948 and opened it the next month as the Kabat-Kaiser Institute. A hospital ward was added January 1949.

A news account from 1952 described the setting:

First impression on entering the Santa Monica institute is that of stepping into a luxurious beach resort. A large swimming pool, beautifully furnished lounge, and inviting glassed-in beach-front patio are located on the ground floor. Shorts, pedal pushers, swim suits, and jeans are the principal attire. Second impression hits one like an avalanche. Every person in sight is either in a wheel chair, walking with crutches or body braces; or being pushed along on a gurney. Everyone appears happy and busy, going to or from a water therapy room, a physiotherapy section or exercise room.

“Many Will Rise and Walk” article by Paul du Kruif about Dr. Kabat, Readers Digest, February 1946.

Many volunteer welfare and social organizations contribute to the entertainment and special needs of the patients. Recreation includes nightly programs of moving pictures, “wheel-chair” square dances, bingo, water volley ball or variety shows.

Given the center’s proximity to Hollywood, it was often the site of cameo appearances by movie stars. But that relationship took a deeper step when the actress Ida Lupino directed (and co-wrote, and co-produced) a film there. Never Fear (1949, also titled The Young Lovers), a story about a beautiful young dancer with a promising career who contracted polio and struggled to recover, had personal meaning for Lupino, who had contracted polio herself in 1934. Lupino made the film to combat the public fear of polio during the 1948-49 epidemic, and captured the power of the center’s program using actual patients and, yes, a wheelchair dance.

Maggie Knott with patient, Kabat-Kaiser Institute, 1951.

The centers were busy; in 1950 the D.C. center was treating almost 200 patients, Vallejo saw over 400, and Santa Monica served almost 600. The staff at Santa Monica included over 60 therapists, psychologists and consulting physicians. Margaret “Maggie” Knott was the exceptional lead physical therapist who became world famous, along with Herman Kabat, for developing, practicing and teaching the technique of “proprioceptive neuromuscular facilitation.” PNF is a form of flexibility therapy that involves stretching and contracting targeted muscle groups.

Joel Bryan (1937-2005) was the Founder and Director of Disabled Students’ Services at UC Riverside and UC Davis. He was also a patient at Kabat-Kaiser Santa Monica from 1951 to 1954, and recalled his treatment in a 2000 interview:

Three months after I arrived there I could get up in a wheelchair for the first time. My spine was fused later, which straightened out my very significant scoliosis. I was 5’4″ when I got polio, and by the time I was sixteen or seventeen I was 6’2″ or 6’3″ – stretched out. There’s a lot of growing that occurs, and my back just wouldn’t support it. Those things got straightened out. I wound up with the use of my fingers on my right hand and the bicep on my left arm.

Station wagon for transporting patients to recreational activities donated to Kabat-Kaiser Institute in Santa Monica by the Federation of Women’s Telephone Workers of Southern California, 1952. Standing left is Raymond T. McHugh, K-K administrator, next to Mary V. Marsteller, president of the FWTWSC.

In 1955, Dr. Kabat left the organization. The Kaiser Foundation Hospitals assumed complete control and renamed the two facilities the California Rehabilitation Centers. In 1962 the name was changed to Kaiser Foundation Rehabilitation Center to avoid confusion with state institutions with a similar name.

Santa Monica’s rehabilitation portion closed in 1962, the convalescent facility remained open until patients could be reassigned, and the site was demolished in 1964. The Kaiser Foundation Rehabilitation Center and Hospital in Vallejo continues to this day.

 

Also see: The story of Kabat Kaiser Vallejo.

Short link to this article: http://k-p.li/2t2tSPU

 

 

Edmund (Ted) Van Brunt, Former Kaiser Permanente Research Director and Pioneer of Electronic Health Records, Dies at age 91

posted on June 9, 2017

“Dr. Edmund Van Brunt, resident in Medicine at our Geary St . Hospital (center) answers questions of Jack Katzow, intern, and Mrs. Emily McEvoy, RN, about modern resuscitation equipment which all professional staff are instructed how to use in emergencies involving cardiac arrest.” Reporter, May 1961.

 

Excerpted from the Kaiser Permanente Division of Research obituary by Janet Byron

 

 

Edmund (Ted) Van Brunt, MD, former director of the Kaiser Permanente Division of Research and a pioneer in the use of electronic health records in medical science, died at his home in Berkeley on May 19, 2017.  A native of Oakland and longtime Berkeley resident, Dr. Van Brunt’s medical career with Kaiser Permanente spanned 36 years, from his appointment as staff physician in the Department of Internal Medicine in Kaiser Permanente’s San Francisco medical center in 1964, to his retirement as director of the Division of Research in 1991.

“Dr. Van Brunt’s devotion to research helped build our Division into a nationally respected group,” said Tracy Lieu, MD, MPH, current director of the Division of Research. “He was revered for his steadiness and breadth of vision.”

“Dr. Van Brunt demonstrates proper utilization of cardiac treatment equipment.” Planning for Health newsletter Summer 1967.

In 1966, Dr. Morris Collen appointed Dr. Van Brunt as project chief of the Medical Data System in Oakland and San Francisco, a computer-based patient medical record system with a database designed to support both patient care and health care delivery research. The Medical Data System project developed a multifacility, computer-based system to support the medical data requirements of one million health plan members, 1,000 physicians, and numerous professional and paramedical support staff. The system consisted of two IBM mainframe computers, and medical data from Kaiser Permanente’s multiphasic physical exam was recorded on punch cards for processing.

 

Short link: http://k-p.li/2snbzaB