Posts Tagged ‘ILWU’

Permanente traditions advance with total health assessment campaign

posted on December 29, 2010

By Ginny McPartland 

Longshoremen line up for their health assessment or "physical" in 1961

I recently took an online total health assessment (THA) through the healthy lifestyles program on Kaiser Permanente’s members Web site, kp.org. This was my second time (in three years) so I knew the drill: answer quite a few questions about my health and lifestyle habits and find out where I stand health-wise. I did it for me, but I had another motive. By taking the assessment, I earned $50 for charity.

When I first heard Kaiser Permanente was offering its employees a $50-to-charity incentive to take the THA, I wasn’t that impressed. I didn’t think the donation would convince people to participate in KP’s initiative to build a healthier workforce. I also didn’t think $50 would go that far. I have to admit I was WRONG!

By mid-December, more than 22,000 (14.5%) KP employees nationwide had taken the THA and by that small action collectively raised an impressive $1.1 million. Now that will go a long way. How far? For starters, each $50 could buy 700 pounds of fruits and vegetables or 77 dozen eggs for the hungry. Or it could provide 10 pediatric flu shots for needy kids. Multiply those items by 22,000 donors and you get the picture. 

The money raised by the 2010 THA incentive program will go to community healthy eating initiatives and to support health care for disadvantaged people and families, especially the homeless, the disabled and those living with HIV/AIDS.  The KP region whose employees raise the most money will receive an extra $50,000 for charities in their communities. The winner will be announced in January; the money will be awarded in March.* 

1951 brochure announcing Longshoremen assessment program. Image courtesy of the ILWU.

I think it says something about the KP culture that so many employees were motivated to raise money for others less fortunate than themselves. If they hadn’t felt compelled to take the assessment for their own sake, they were motivated to help others. Of course, Kaiser Permanente has given millions to good causes over the years through its Community Benefit programs.†

Total health assessment by any other name

Given our history as a preventive care organization, it shouldn’t come as a big surprise that Kaiser Permanente has been a champion of the total health assessment for over 60 years. In 1950, such an assessment was called the “multiphasic examination,” and it was initiated when labor leader Harry Bridges of the International Longshore and Warehouse Union (ILWU) demanded it for all members of the union. 

The ILWU members lined up at the waterfront for preventive clinics that included blood and urine screening tests, chest X-ray, electrocardiogram, and other tests to search for chronic disease. Each member also completed a health questionnaire similar to today’s THA. The recording and archiving of test results became the impetus for Kaiser Permanente to acquire its first computers in 1960. 

These records, still accessible today, have supported long-term health research related to heart disease and other chronic diseases. One such study, “Characteristics of Longshoremen Related to Fatal Coronary Heart Disease and Stroke” by Paffenbarger et al., was published in the “American Journal of Public Health,” in 1971. 

Robert Feldman, MD, and Sidney Garfield, MD, confer on the health assessment program launched in the late 1960s.

In the late 1960s, Permanente founding physician Sidney Garfield launched a program called “The Total Health Care Project” to expand the multiphasic programs in Oakland and San Francisco. Garfield and Robert Feldman, MD, hired and trained KP’s first nurse practitioners to run the program that included the use of computerized lab machines that yielded results while the patient was still at the clinic. Their goal was to collect baseline health data that could be used to identify health risks and to prevent disease. 

Today’s iteration of the multiphasic exam is a system of chronic disease screening programs designed to detect symptoms early and identify risk factors. The total health assessment questionnaire challenges participants to scrutinize their lifestyles and work with their doctors to figure ways to head off diseases such as diabetes, heart disease and cancer. 

For me, the THA results are a reminder of what I need to do to stay healthy. I’m also hoping I can improve my sleep by following through with the online insomnia program. But most of all, I feel glad that my co-workers saw fit to get involved for themselves and to raise money to improve the health of others less fortunate. 

*Benefit-eligible Kaiser Permanente employees and physicians may earn the $50 charitable donation by taking the THA by Dec. 31.  Go to the Healthy Workforce site to participate. 

†Click here for more information about Kaiser Permanente’s Community Benefit Program

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Kaiser Permanente’s LA Harbor Area Blossoms after Humble 1950 Start

posted on June 21, 2010

By Ginny McPartland 

Kaiser Permanente’s post-World War II public health plan was but an embryo in 1950 when famed labor leader Harry Bridges asked Dr. Sidney Garfield to provide medical care for West Coast longshoremen. The International Longshore and Warehouse Union (ILWU) had just adopted a health and welfare plan for its members, and Permanente’s prepaid health coverage fit Bridges’ vision. 

The health plan, then called Permanente, already had services in the San Francisco Bay area, so covering the six or seven thousand Northern California dock workers was no problem. But Permanente’s only presence in Southern California was at the Fontana Steel Plant, 70 miles inland from the Los Angeles harbor area where the roughly 3,000 longshoremen lived. 

Kennebec medical clinic in the 1950s

Garfield didn’t have to ponder Bridges’ offer for long. The struggling health plan needed members – desperately. After saying “yes!” to Bridges, Garfield flew into action. He hired a physician to run the longshoremen clinic, found a suitable building in the Port of Los Angeles town of San Pedro and opened for business in about two weeks. 

Today, Kaiser Permanente’s South Bay service area, boasts about 190,000 members, a 255-bed medical center, and medical offices in Long Beach, Torrance, Harbor City, Lomita, Carson, and Gardena. The KP South Bay community is celebrating its 60 years of history on Wednesday, June 23, in Harbor City. 

It’s been a rough ride 

The Harbor area health plan’s six decades of existence can be characterized as a roller coaster ride with its ups, downs, and unexpected turns. The years have brought growth, at times unmanageable, stopgap solutions to facility needs, the San Pedro murder of a popular doctor, and a fire that disrupted operations for a year – not all roses and sunshine. 

The early medical group, led by Ira “Buck” Wallin, MD, worked out of a small clinic in San Pedro and had to fight for legitimacy and for staff privileges at any of the area hospitals. They were blackballed by the local medical community for practicing what was called “socialized medicine” when the “Red Scare” was the order of the day. This contention was typical of the anti-group-practice atmosphere anywhere Permanente Medicine established itself. 

In the beginning, and for many years, the doctors made house calls and took turns sleeping overnight in a blood draw room in the clinic. They were at the beck and call of the longshoremen and their families. Over the first five years, the ILWU became steadily more impatient with the health plan for delaying construction of a sorely needed Harbor area medical center.

Early Parkview clinic in Harbor City

 Meanwhile, the group had expanded to Long Beach – first to an old house and then to the old posh Kennebec Hotel across from the Pike, a popular amusement park in Long Beach. The health plan also opened a Los Angeles clinic and then a hospital on Sunset Boulevard. From 1953 when the Sunset Hospital opened until the Harbor City hospital was built in 1957, patients were shuttled to Los Angeles for hospital care.

After a tussle with the ILWU that threatened the loss of the group, Sidney Garfield and Buck Wallin got the funding to build the Harbor City medical center. The first medical office building, called Parkview, was opened adjacent to the hospital in 1958.

South Bay no stranger to innovation

The South Bay/Harbor City movers and shakers contributed more than their share of innovative ideas over the years. Some examples:

  • In 1964, Harry Shragg, who later became area medical director, was the first in Southern California Kaiser Permanente to perform outpatient surgery, a practice that would become prevalent for its economy and medical soundness.
  • In 1964-65, Buck Wallin and Chief of Medicine William Fawell pursued the idea of discharging patients sooner and providing follow-up medical care in their homes. When Medicare came along in 1965, suddenly (home health care) became one of the ‘in’ things to do.
  • In the early 1970s, Harry Shragg, Internist Jay Belsky, and Medical Group Administrator Ed Bunting worked together to develop a new exam room layout that would leave more room for the patient and the examination table. “It was such a big success that it was adopted and became standard for all of Southern California, Bunting said.

The good, the bad and the ugly

  • In 1967, Dr. Shragg saw the opportunity to help disadvantaged Harbor City people through a local program funded by the federal Office of Economic Opportunity. Kaiser Permanente used its community service funds to provide medical care for 100 participant families.
  • In 1960, Leon Quattlebaum, a well-liked and respected 36-year-old Harbor City OB-GYN, was killed in San Pedro by a local tough who, unprovoked, punched “Q” in the jaw, knocking him to the cement floor and fracturing his skull. The prosecutor at the murder trial said the only reason for the killing was the murderer’s “malignancy of heart.”
  • In November of 1973, a night fire of unknown origin collapsed the three-story Parkview engineering tower and threatened to destroy Harbor City’s medical records and appointments data. The medical offices and appointment center were up and running again in about a week, said MGA Ed Bunting. But it took about a year to rebuild the burned out section at the center and make the complex whole again.

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Harry Bridges and Sidney Garfield: Synergistic Collaboration

posted on March 31, 2010

Harry Bridges at ILWU meeting 1960

By Ginny McPartland
During the Cold War, the average American scorned any ideas that even hinted at socialism. Going against mainstream politics in the 1950s was fraught with danger.

Henry J. Kaiser and Sidney Garfield, MD, took their licks from the conservative medical establishment for their nontraditional ideas of health care. They were called “socialist” even though both were adamantly opposed to “socialized medicine.”  

Their contemporary– and sometimes collaborator — militant labor leader Harry Bridges was accused of being a communist, which he was not, as he fought hard and dangerously for bargaining power for dock workers.  

Marking the 20th anniversary of Bridges’s death this month brings to mind the groundbreaking 20th century achievements of these working class heroes. Despite the opposition, they didn’t back down.  

For Harry Bridges, elevating the worker to the bargaining table was a lifetime passion. His heart was with the “working stiff” who was considered almost like property of the employer before unions. “The basic thing about this lousy capitalist system,” Bridges declared, “is that the workers create the wealth, but those who own it, the rich, keep getting richer and the poor get poorer.” 

Born in Australia in 1900, Bridges was inspired by Jack London’s books to go to sea. He jumped ship on his first job because he disagreed with the skipper on the treatment of the seaman. He landed in San Francisco and soon began to organize the waterfront workers.  

His work culminated in 1934 in the San Francisco dock workers strike that resulted in the death of two men, casualties of police bullets. Union members refused to work until they could negotiate higher wages and a method of getting work on the docks without having to pay a kickback. The strikers won and Harry Bridges was set for 40 years as the president of the International Longshoremen and Warehousemen’s Union (ILWU) starting in 1937.  

“A Working Class Hero Is Something to Be” — John Lennon

By 1950, the ILWU had become a strong advocate for its members, and its leadership worked to spread unionism to other industries. The ILWU pioneered health and welfare benefits for its members. 

Enter Sidney Garfield: 
After the War when the Richmond shipyards closed, Kaiser and the Permanente doctors were ready, willing and able to take care of people. Both men had track records of providing affordable care to the working man. The health plan had been opened up to the public in 1945 but the enrollment was small. 

Enter Harry Bridges: 
It was a marriage with great potential. Bridges needed a health plan for his members and Henry Kaiser needed health plan members. Instant symbiosis.
  

In many ways, the goals of the two organizations converged. Bridges wanted all of his workers to have a health assessment and screenings to prevent disease. Kaiser Permanente’s Garfield saw how to accomplish the “multiphasic” examinations for all twenty thousand workers and later set up a way of collecting the results, at first on paper, and then in KP’s pioneering computerization of medical records. In effect, the ILWU members were guinea pigs for what has grown and expanded into KP’s electronic medical records prowess.  

Young Harry Bridges aboard ship about 1920.

Along the way, Bridges helped Kaiser Permanente by writing editorials in the ILWU newsletter supporting the health plan physicians. In 1953 Bridges assailed the San Pedro Community Hospital in Los Angeles for refusing privileges to KP doctors. In 1954, he criticized the American Medical Association for trying to block group medicine. “Group medicine is here to stay,” he wrote. 

In turn, Permanente physicians at times provided medical care on credit for striking ILWU members. Henry Kaiser was in favor of unions. In 1954, Kaiser said problems can be averted “simply by genuine recognition that the right of collective bargaining . . . is sound, essential human relations. I agreed a long time ago that unions are here to stay.” 

In 1965, Kaiser received the AFL-CIO’s highest honor for his achievements in voluntary medical care, housing and labor relations. Previous winners included former President Harry Truman and former First Lady Eleanor Roosevelt.  

To view Arlo Guthrie’s tribute to Harry Bridges on Youtube: http://tinyurl.com/y87jt34
 

Top photograph by Otto Hagel, from Men and Machines, 1963; reproduced by permission of the Center for Creative Photography; © 1998 The University of Arizona Foundation
Ship photo courtesy of ILWU Archives, Anne Rand Research Library, International Longshore and Warehouse Union, San Francisco

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