Posts Tagged ‘Dr. Wallace “Wally” Cook’

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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Clarence Mayhew – early Kaiser Permanente architect

posted on May 31, 2016

Lincoln Cushing
Heritage writer

Part one of two parts – Walnut Creek, Dragerton, and Fontana

 

 “Hospital design is sort of a hobby of mine.”
—Sidney Garfield, MD, New York Times Magazine, April 28, 1974.

Sidney Garfield and architect Clarence Mahew, looking at drawing of planned Panorama City hospital, 1965 [circa]

Dr. Sidney Garfield and architect Clarence Mayhew looking at illustration of planned Panorama City hospital, circa 1965

Although Kaiser Permanente’s founding physician certainly had a passion for hospital design, and often served as a consultant, professionals were hired when it came to actually bringing these complex structures into being. One of the organization’s most significant architects was Clarence William Whitehead Mayhew (1906-1994).

Mayhew’s career began in 1922 as a draftsman at the San Francisco firm of Arthur Brown, Jr.. He traveled abroad to study at Paris’ Ecole des Beaux-Arts between 1922 and 1925, and returned to the Francisco Bay Area, where he graduated from the University of California at Berkeley School of Architecture in 1927.

He remained in the Bay Area began a long and distinguished career. Mayhew designed homes, including two in scenic Big Sur and Los Angeles for Lucille and David Packard (co-founder of the multinational information technology company Hewlett-Packard). Among his institutional commissions were the Aurelia Henry Reinhardt Alumnae House at Mills College (Oakland, Calif.), the Alumni House at U.C. Berkeley, and a racetrack in Lima, Peru.

But it was his design of early Permanente Foundation hospitals that is the foundation of his legacy.

Planning for Health newsletter  1952-10

Sketch of future Walnut Creek Medical Center, Planning for Health newsletter October, 1952

Mayhew’s first Permanente hospital was the 76-bed Walnut Creek Medical Center, which opened in April, 1953, one year after the flagship Kaiser Permanente Los Angeles hospital. Dr. Garfield was listed as “functional designer and medical consultant.” It, and the subsequent Kaiser Permanente Fontana Hospital, were part of a “small city” hospital movement; the larger and more urban Kaiser Permanente hospitals in San Francisco and Los Angeles were called “dream hospitals.”

Walnut Creek, along with Los Angeles and San Francisco (opened August 1953), were considered marvels of hospital design. Kaiser Permanente’s member newsletter Planning for Health of October 1952 gushed about its charms:

"Today's Most Talked About Hospital..." article on Kaiser Walnut Creek hospital, Architectural Forum, 1954-07. [Also source tiff files saved separately] [TPMG P1288]

“Today’s Most Talked About Hospital…” detail from article on Kaiser Walnut Creek Medical Center, Architectural Forum, July, 1954.

Many unusual innovations have been incorporated to make the hospital outstanding in the service it will render. The usual central corridor has been converted into a private corridor for nurse, doctor and employees, with a nurse’s station located for approximately each eight beds. This keeps the public away from the service area and bring the nurse, supplies and equipment in close proximity to the patient for more efficient care. Visitors reach the rooms via an outer corridor. Each patient enjoys a private or semiprivate room enclosed on one side with glass, affording the patient a pleasant view of landscaped grounds and trees.

Another progressive feature is the maternity wing. Here the central nursery has been eliminated and replaced with an individual nursery behind the bed-wall. At any time the mother, or visitors, can view the baby through a glass window beside the bed while the baby is actually attended by the nurse. Whenever the mother wants her baby beside her, she need only pull out the bassinet and her baby is there.

Even more impressively, the hospital was featured in an eight-page article in the July 1954 issue of Architectural Forum. It was titled “Today’s Most Talked-About Hospital…for four good reasons,” which it articulated:

1: Its architecture is part of the cure
2: Its corridors are actually long workrooms
3: Its bedrooms are designed for patient self-help, and
4: Its economics make it self-supporting at low rates.

Although many of those functional features were Dr. Garfield’s ideas, the aesthetics of the design were credited to Mayhew: “Note the easygoing grace with which Architect Mayhew has imbued a necessarily machinelike plan.”

Immediately on the heels of Walnut Creek were two smaller facilities built in 1954, one at a remote World War II Kaiser Steel coal mining location in Dragerton, Utah, and the other as a civic expansion of the hospital in the city of Fontana, Calif., where Henry J, Kaiser’s wartime steel mill was located.

Detail from blueprint for alterations and additions to Dragerton, Utah hospital, lot bounded by Center Street, Third Street, and Whitmore Drive. Original hospital built 1952. 1953-02-25. [TPMG P2640]

Detail, 1953 alterations and additions to Dragerton, Utah hospital, (Center Street, Third Street, and Whitmore Drive.)

The War Production Board had built a hospital at Dragerton (now called East Carbon City), which was later purchased by a physician who soon afterwards was charged with medical and fiscal mismanagement. United States Steel asked Henry J. Kaiser to take over the hospital in early 1952. Miners were desperate for proper care, and the team of Permanente physicians – which included shipyard doctor Wallace “Wally” Cook – was swamped. Mayhew designed a simple hospital, for which Dr. Garfield was listed as “consultant.”

Although a Permanente health plan was never established in the region, the hospital remained as Utah Permanente Hospital until 1966. However, this commitment to serving working people would eventually re-emerge as a plea for expansion from stakeholders in Colorado, which Kaiser Permanente began to do in 1969.

Architectural drawing, Fontana Kaiser Foundation Hospital, 9961 Sierra Ave., completed 1954. Clarence Mayhew, architect. Plans 1953 [circa]. [TPMG P1479]

Architectural drawing, Fontana Kaiser Foundation Hospital, 9961 Sierra Ave., completed 1954. Clarence Mayhew, architect.

In Fontana, a wartime hospital existed on the steel mill site, but once the Permanente Health Plan was opened to the public after the war it made more sense to locate a hospital in town. At first Dr. Garfield considered simply expanding the hospital at the steel plant, but in late 1953 Kaiser Steel Corporation Vice-president and General Manager Jack L. Ashby wrote to Dr. Garfield and told him:

I am advised that last month alone some 9,000 to 10,000 people visited the existing clinic now at the steel plant. The overcrowded condition is constantly a problem… In our opinion, not to build the clinic in the City of Fontana would be like building a beautiful automobile without an engine.

The San Bernardino County Sun published an article August 19, 1954, announcing a three-day open house:

The Kaiser Foundation’s newest “hospital of the future,” bringing to the Fontana area the last word in comfort and efficiency for patients and the hospital staff, will be introduced to the public next week.

The new medical facilities, initially containing 42 beds, are located on a 15-acre site at 9961 Sierra Ave., corner of Marygold Ave. They will complement the existing 88-bed Foundation hospital at the nearby steel mill of Kaiser Steel Corp., which donated $300,000 to help finance the new structure. The hospital, in the center of the expanding Fontana-Bloomington-Rialto-Etiwanda area of 60,000 population, is a community hospital open to the general public and to all qualified physicians and their patients, as well as Kaiser Foundation Health Plan members.

The one-story, “T” shaped building, of steel construction and utilizing vast amounts of glass, is the second of the Foundation’s concept of the ideal “small city” hospital.

Three hospitals in two years – that’s a pretty remarkable pace. But Mayhew was just getting started.

 

Next: More California hospitals 1955-1973: Harbor City, Panorama City, and San Rafael.

 

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