Posts Tagged ‘Clayton Christensen’

Replacing ‘Sick Care’ with ‘Health Care:’ Dr. Sidney Garfield’s Ideas in the National Reform Dialogue

posted on April 5, 2010

By Tom Debley, Director, Heritage Resources

It was fascinating to me to research and write a book about the life of Kaiser Permanente’s founding physician, Sidney R. Garfield, but it has become even more so to observe how visionary he was in his time as discussion continues in the wake of President Obama’s signature on health care reform.

Dr. Sidney R. Garfield, a surgeon, co-founded prevention-focused Kaiser Permanente with industrialist Henry J. Kaiser.

A month ago, I wrote a blog about Harvard Business School Professor Clayton Christensen, who argued in the pages of Business Week that health care needs business models like Kaiser Permanente—health care systems in which doctors and insurers are on the same side of the ledger as the patient. I observed that this was an idea Dr. Garfield put forward as the model for Kaiser Permanente in a speech in Portland, Oregon 65 years ago Sunday (April 4).

This Monday (April 5), I was struck by a quote in an article by Robert Pear in the New York Times.

“We don’t have a health care system in America,” said Senator Tom Harkin, the Iowa Democrat who chairs the Senate health committee. “We have a sick care system. If you get sick, you get care. But precious little is spent to keep people healthy in the first place.”

First Lady Eleanor Roosevelt, visiting World War II Home Front patient, asked Dr. Sidney R. Garfield to tell her about prevention-focused medical care.

Harkin’s statement is an interesting juxtaposition with an event exactly 67 years earlier—April 5, 1943—when First Lady Eleanor Roosevelt visited a World War II Kaiser Industries shipyard worker, a woman with a seriously injured left leg, as shipyard manager Edgar F. Kaiser looked on in Vancouver, Washington.

Whatever Mrs. Roosevelt heard about Dr. Garfield’s focus on injury and illness prevention efforts as he built the largest civilian medical care program on the Home Front of World War II, she was immediately intrigued. Returning to the White House, she dictated a note to Dr. Garfield, “I am interested in getting medical care, both preventive and curative, at the least cost to the people. What is your program on the preventive side?”

“Your expression of interest in preventive medicine is rather closely allied with our thoughts for medical care,” Dr. Garfield responded in a letter detailing his ideas.

What Dr. Garfield did on the Home Front is, of course, one of the historical stories told at the Rosie the Riveter / World War II Home Front National Historical Park in Richmond, Calif.

Dr. Garfield spent his whole professional life on these ideas. It was not easy, but his vision was central to the evolution of Kaiser Permanente as—in Dr. Garfield’s words—a “total health” system of care.

In the first 15 years of toil after World War II, Dr. Garfield’s big frustration was how challenging it was to move from a “sick plan” to a “health plan,” but he never gave up. His big breakthrough came 50 years ago next month, and I will write about that story in a blog in May.

In the meantime, if you are interested in learning more about Dr. Garfield, my book, “The Story of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care,” is available from the publisher, The Permanente Press, as well as from Amazon.com in both book form and on Kindle.

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