Early Permanente physicians: making do with makeshift facilities

posted on February 4, 2011

By Laura Thomas

Heritage correspondent

The first Kabat-Kaiser Institute was housed in this Washington, D.C. mansion.

In the early days of Permanente medicine, co-founder Dr. Sidney Garfield had to be nimble at getting the resources needed to take care of newly signed-up plan members. Working quickly to add new groups just after the war, often Garfield had to scramble to hire doctors and set up care facilities. Sometimes that meant occupying whatever building was available immediately – however seemingly unsuitable.

From the late 1940s into the 1950s, thousands of union workers in the Bay Area joined the Permanente plan and were able to get care at the new Kaiser Foundation Hospital on MacArthur Boulevard in Oakland. But the Bay Area was growing beyond the towns on the bay shore in the wake of the war’s great westward migration, and the medical plan had to grow with it.

Thus, when Henry Kaiser and Garfield took on members too far away to make an easy drive to central Oakland, the physicians moved into any building deemed workable. The health plan took over many wartime health facilities and small hospitals, but at different times, Permanente doctors and nurses saw patients in examining rooms fashioned out of the bedrooms of a motel and a once-stylish, turn-of-the-century hotel, the offices and storerooms of a San Francisco office building, the tight quarters above a modest dress shop and a ranch house on an historic estate.

First postwar facilities at Vallejo military-style hospital

Kaiser’s first opportunity to extend the health plan beyond the shipyards came right as the war ended.  Residents of the apartments and dormitories built for the workers that flooded Vallejo to work at Mare Island and the Benicia Arsenal had laid the groundwork in 1944 by lobbying for a government-sponsored hospital.

Vallejo military-style Permanente hospital in 1948

They succeeded in getting the Vallejo Community Hospital, which was built – military cantonment style – between a slough and a hillside on the north edge of town. Now that the war was ending, the barracks-like facility was slated for closure and the tenants re-grouped. They appealed to Permanente to come to Vallejo to care for up to 25,000 people living in eight housing projects.

In September 1945, the doctors moved into an infirmary downtown near the corner of Fourth and Maryland streets. The facility, which had been used by the U.S. Public Health Service during the war, was renamed the Permanente Medical Center. With only 60 beds, the makeshift hospital was temporary.

By 1947, Permanente re-opened the nearly new Vallejo Community Hospital and  – with the ample space it provided in several single story buildings spread over 30 acres – was also able to bring to Northern California the Kabat-Kaiser Institute, now called the Kaiser Foundation Rehabilitation Center. The original institute was established in Washington, D.C., at Henry Kaiser’s behest to help victims of neuromuscular disease, including his son, Henry J. Kaiser, Jr., who had multiple sclerosis (MS).

Later when a new Vallejo hospital was built in 1972, the campus continued to house the outpatient departments. In 2010 the newest Vallejo medical center was completed with 248 beds, a state-of-the-art rehabilitation wing with two gymnasia, and halls filled with natural sun light and the works of North Bay artists.

Next stop San Francisco

 The first doctors recruited by Garfield had no grandiose expectations. Most were committed to the ideal of health care for the masses, accepted the salary offered and the challenge of making do. It was all about “good humor and team spirit,” as long-time allergy supervisor Renee Owyang recalled in 1982 as she reflected on her early years in the first San Francisco clinic.

This former ambulance company building at 331 Pennsylvania St. in San Francisco was renamed Permanente Harbor Hospital in 1948.

In 1946, while the Alameda-Contra Costa County Medical Society was preparing an attack on Permanente medicine and its prepaid, group practice health model, shipyard workers at Hunters Point joined the health plan. To avoid attracting controversy in San Francisco, Garfield’s doctors took over a small clinic that had served the workers during the war on the third floor of an old lower Market Street office building and put the name of Dr. Cecil Cutting on the door.

In 1948, the Permanente Foundation acquired a 35-bed hospital in the Bayshore District of San Francisco near Hunter’s Point Naval Shipyard. The old structure at 331 Pennsylvania St. had been previously owned by an ambulance company. Garfield had the picturesque building refurbished and re-named it Permanente Harbor Hospital.

For years before the Market Street clinic merged with the new hospital on Geary Boulevard, the San Francisco staff saw patients and even began an allergy department in a loft area that was served only by stairs and a freight elevator. “We often served as elevator operators for our allergy patients who were unable to climb the stairs,” Owyang said. She remembers putting out several buckets on rainy days to catch drops falling in the waiting area from the roof and enjoying the various tunes created by the rhythmic plops: “often we were tempted to rotate the buckets to get a new tune.”

Rambling ranch house turned into Walnut Creek clinic

This Arts&Crafts style home in Walnut Creek was converted to a Permanente medical clinic in 1952.

In 1952, Henry Kaiser, who lived in Lafayette, was eyeing the small, but bustling town of Walnut Creek as the place to locate a new hospital and found a 5-acre site along Newell Avenue. The owner was Edward Counter, soon to be mayor of the town, who lived there in an old, rambling Arts&Crafts style house he and his wife had turned into a cultural center. “It was kind of a collecting place for all the little (old) ladies of Walnut Creek, you know, and they had a tea room,” remembered the hospital’s administrator, Jack Chapman, in 1982.

Chapman also noted in an oral history that the price had been fixed at $75,000, but the ever impatient Kaiser was seen at the property. “He couldn’t wait, you know, he stomped around here one night and somebody saw him and automatically it went up 25,000 bucks.”

The house that had once been surrounded by orchards was turned into a clinic, with an older home at the back becoming the housekeeping department and a swimming pool turned into a morgue, Chapman recalled. When the clinic opened, he was joined by a gardener, to take care of the grounds, a nurse, receptionist and three doctors. By the end of 1953, a new clinic and hospital had been built on the property and 35,000 people trooped through it during an open house that lasted two weeks.

And not a minute too soon, for in the same month (September), Local 1440 of the steelworkers union up the road in Pittsburg voted to join Kaiser –  after a bitter campaign by local doctors designed to dissuade them — and suddenly 10,000 more people became Permanente members. “They demanded then that we open a clinic,” Chapman said.

A motel on Los Medanos Street behind Pittsburg Post-Dispatch building was purchased and used for nine years until a larger clinic was built in Antioch. “So we bought this funny little building that was about to be a motel,” said Dr. Wallace Cook in 1982 “and turned each motel room into an office. It had a courtyard so you peeled off and went to surgery or medicine or wherever, depending on which motel room your doctor was in.”

Southern California coastal group finds space above a dress shop and in posh hotel

San Pedro Permanente medical offices expanded to Pacific Avenue over a dress shop in 1951.

In 1950 Ira “Buck” Wallin MD hurriedly set up shop in a medical office in downtown San Pedro when longshoremen union members joined the health plan. The interim clinic was pulled together in two weeks with Harry Bridges, leader of the International Longshoremen and Warehousemen’s union, breathing down Garfield’s neck.  

There were 3,000 new members to handle and, within seven months, 30,000 retails clerks were added to the Southern California membership rolls, many living in the San Pedro-Long Beach communities. Busting at the seams, the plan found space for several more doctors and the administrative offices above a dress shop on South Pacific Avenue.

By 1954, a new clinic was opened in a large Victorian house on Atlantic Avenue in Long Beach, which had room for five internists, including a pediatrician, and had an X-ray department, but no laboratory. It became popular immediately and another site was opened in the turn-of-the-century Kennebec Hotel, which had been a center of action in Long Beach’s heyday as a beach resort.

Remodeled in 1950, the guest rooms were equipped with toilets and showers and accommodated surgery, internal medicine OB/Gyn, pediatrics and physical therapy.

The old Kennebec Hotel, across from The Pike amusement park, was used as a Permanente Long Beach clinic in the early 1950s.

“It was hot in the summer and cold in the winter but had a good view of The Pike,” said staffer Hannah Wilson. The Pike, the mile-long boardwalk and amusement park that was still roaring in the 1950s featured such attractions as a large indoor swimming pool, carousel, rollercoaster and 10-cent rides for children on Wednesdays.

In 1992, the Long Beach clinic relocated a fourth time to its present site on the Pacific Coast Highway, just before the traffic circle. On most days, members and staff have a clear view of the city’s high rise buildings and the Walter Pyramid at California State University, Long Beach.

The clinic is modern and efficient, but no doubt it has little of the charm of those earlier facilities, none of the pink bordello walls, warm ocean breezes or shrieks of delighted children, that the staff and doctors remember from the old Kennebec.

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One Response to “Early Permanente physicians: making do with makeshift facilities”

  1. Don Lattin says:

    Great piece of writing, showing how there is nothing new about vested medical interests opposing health care for the masses…

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