Posts Tagged ‘Kaiser Permanente diversity’

Dr. Eugene Hickman – First black Kaiser Permanente physician in Northern California

posted on April 27, 2015

Lincoln Cushing
Heritage writer

Who was Kaiser Permanente’s first black physician? Given our enduring commitment to member and care provider diversity, such a question is important. Medical practice after World War II was still overwhelmingly white. It was also private – physicians hung up a shingle and arranged for privileges with local hospitals. Group practices, as run by the Permanente Foundation Health Plan, were rare. Once each group grew beyond the original medical partners, new physicians were hired to be part of a team. Physicians hired physicians.

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Dr. Hickman conducting training session at KP Oakland Medical Center, circa 1970, photo courtesy John Hickman

In 1954, the racially diverse International Longshore and Warehouse Union (more commonly known by its initials, ILWU) expressed a desire for the Southern California Permanente Medical Group to hire black physicians. Although the physician leaders didn’t like being told whom to hire, they wanted to serve the medical needs of their large union membership. They hired radiologist Raleigh C. Bledsoe, MD (1919-1996), who had already achieved a distinguished career in the U.S. Army while completing his medical education and training. Even within the relatively progressive setting of the SCPMG, Bledsoe’s acceptance as a partner was controversial. But he was brought in, and stayed more than 30 years. In 1965 he transferred to the newly opened West Los Angeles Medical Center and served as chief of Radiology until his retirement in 1986, becoming the longest serving chief in Kaiser Permanente’s history at the time.

Five years later, in 1959, the Northern California Permanente Medical Group would hire its first black physician, Dr. Eugene Hickman.

Eugene A. Hickman was born in 1921 in Alton, Ill. He served as a trumpeter in the U.S. Navy band stationed in Hampton Institute, Virginia, and graduated from Nashville’s Meharry Medical School (the second oldest medical school for African Americans in the nation) in 1949, specializing in radiology. Looking for opportunity, he moved west to California. There he practiced in Los Angeles, first briefly in a traditional partnership, then with the Los Angeles City Health Department, Mt. Sinai Clinic (now Cedars-Sinai Medical Center), and the Veterans Administration hospital.

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Dr. Hickman at Mt. Sinai Clinic in Los Angeles, circa 1955; photo courtesy John Hickman

Dr. Hickman wrote an unpublished memoir of his life that describes his experience of choosing to move to Northern California and work for the Kaiser Permanente Hospital in Oakland:

I was hired by Dr. James Davis at the Veterans’ Hospital on Sawtelle, near UCLA. I became the chief of Radiology at the branch for the mentally impaired. This hospital had an excellent staff. Again I was treated with cordiality and respect. Seldom was the work really interesting, so I spent a lot of time reading.

It occurred to me that I would lose the skills I had acquired and that this would be a dead end. My wife Eunice encouraged me to move on and asked me if I didn’t think I was worth more than I was being paid. I had a major problem. Hospital radiology departments were, and still are, staffed by a group of radiologists, invariably white. It would not have been a good decision, from a financial point of view, for them to hire me.

I found a copy of the annual Journal of the American Medical Association in which was listed medical facilities throughout the U.S. and names of persons to contact when searching for employment. So again I wrote a few letters.

One was to Dr. Irving Lomhoff, who was then the chief radiologist at Kaiser Hospital, Oakland, Calif. I had seen a Life magazine article about the showcase Kaiser Hospital, Walnut Creek, Calif. Otherwise I knew absolutely nothing about the Kaiser Permanente system. Dr. Lomhoff responded to my inquiry and suggested I come to Oakland for an interview. I was still living in Los Angeles. I had received so many rejections, I found it difficult to take Lomhoff’s invitation seriously. Eunice very strongly suggested I forget the past and go for it. I needed that push.

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[l to r] Dr. Hickman; Dr. Irving Lomhoff and his wife; Eunice Hickman, relaxing at Lake Tahoe circa 1960; photo courtesy John Hickman

I arrived [by train] in Oakland on a Monday morning, midsummer 1959 at about 8:00 a.m… [and] called Dr. Lomhoff. Of course he told me to take a bus up Broadway and get off at MacArthur. I did just that, then started walking because I didn’t see anything resembling the hospital I had envisioned. I entered the MacArthur- Broadway Bldg. and called Lomhoff again. He told me he was a big stout red haired Jew and would stand on the front porch to greet me on my arrival.

Well, he was across the street and came out and stood on the porch of a building that I had not recognized as a hospital. In fact, I believe if I had seen a picture of this hospital beforehand, I probably would not have made the trip. Lomhoff greeted me very cordially and took me for coffee and pastry. Then we went to his office for a fairly long interview.

At that time there was not, nor had there been, a black physician on the hospital staff, but this was not to be a factor in the interview or its outcome. He gave me a tour of the facility and introduced me to many of the staff members. He warned me that I would probably encounter difficulty finding a place to live. How correct he was…

 

Dr. Eugene Hickman, TPMG directory of physicians, 1980

Dr. Eugene Hickman, TPMG directory of physicians, 1980

Dr. Hickman’s reception by fellow Kaiser Permanente physicians was not without struggle. He described experiencing hostility and condescension from some doctors, and even ugly rumors that members might leave the plan due to his hiring. But Dr. Lomhoff stood by him and things settled down. Dr. Hickman had a long career at Kaiser Permanente, becoming president of the hospital staff and later chief of the department of radiology. He ended his 30-year tenure  in 1989.

 

Dr. Hickman also experienced discrimination of a different type, one entirely unrelated to his skin color:

Before I started working at Kaiser Permanente, I didn’t know anything about the organization, nor about the attitude of the local medical society vis-a-vis Kaiser, but I soon found out. I had been a member of the L.A. County Medical Association for several years. I wanted to transfer my membership to the Alameda Contra Costa Medical Association. I was informed that I would have to be interviewed by one or several members of the ACCMA. At the interview at an office on “Pill Hill” I was strongly advised against affiliating with Kaiser. I was assured Kaiser Permanente was a front for socialized medicine, if not in fact a communist cabal. ACCMA was not accepting physicians allied with the Kaiser organization. I was not enlightened as to the basis for this charge.

Because of the history of racial discrimination/segregation in this country there were also medical associations for black doctors, the one in Oakland named Sinkler-Miller in honor of two outstanding black physicians. [The Sinkler Miller Medical Association was formed in 1969 by physicians located in Alameda and Contra Costa Counties] This group accepted me for membership, but insisted on characterizing me as some sort of traitor to the black physician community. I didn’t let that be a problem for me.

Years later, ACCMA changed its policy and in fact had a member of Kaiser-Permanente as president. There were members of ACCMA who were not in accord with the Association policy regarding Kaiser and with whom we had good relationships, educationally and socially.

 

Dr. Hickman passed away in 2013 after a short illness, survived by his wife of 64 years and two sons. We honor his courage and persistence in helping Kaiser Permanente provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

 

Thanks to those who helped with this story, including retired Kaiser Permanente physicians who remembered Dr. Hickman. A special thanks to Dr. Hickman’s son John, for generously sharing his father’s legacy.

 

Short link to this story: http://k-p.li/1QC88RD

 

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Edgar F. Kaiser – Kaiser Permanente civic leader

posted on January 29, 2013

Edgar F. Kaiser, president, Kaiser Industries Corporation; Henry J. Kaiser, founder and chairman of the board. Photo, 1962.

Lincoln Cushing, Heritage writer

 

Recently the Heritage team was asked to provide inspirational quotes from Kaiser Permanente’s founders for inclusion in a public sculpture park in Oakland, California. (We will have more to say about the park later this year.) We weighed in and uncovered something timely in sync with the Dr. Martin Luther King, Jr. Day of Remembrance. The quote comes from Edgar F. Kaiser (1908-1981), Henry Kaiser’s eldest son, who served on President’s John F. Kennedy’s Committee on Equal Employment Opportunity.

“The only kind of intolerance we can afford is intolerance of ourselves if we fail to bring forth from our own hearts and minds every last ounce of ingenuity and imagination and hard work needed to make equal employment opportunity not just the law of the land, but to make it the spirit, the intent and the actuality of our actions.”
— Edgar F. Kaiser

Edgar is largely obscured in the shadow of his illustrious father, but he was a man of civic mind and of no small accomplishment in his own right. Back in 2008, Tom Debley, formerly Director of KP Heritage Resources, called out Edgar’s induction in the organization’s Diversity Hall of Fame in the internal newsletter, KP Chronicles.

“Edgar F. Kaiser was inducted into the Kaiser Permanente Diversity Hall of Fame at the 30th annual National Diversity Conference in December 2007. Edgar Kaiser was co-founder Henry J. Kaiser’s eldest son who, among other things, brought his father together with founding physician Sidney R. Garfield.

His role in early diversity efforts included hiring the first woman shipyard worker in U.S. history as well as workers with physical disabilities during World War II. He succeeded his father as chairman of the KP Health Plan and Hospitals Boards of Directors.”

In addition to the KP diversity award, in 1969 Edgar was awarded the national Presidential Medal of Freedom for his contribution to low-income housing. He served four U.S. Presidents. John Kennedy named him to the President’s Committee on Equal Employment Opportunity. Lyndon Johnson chose him to head the President’s Committee on Urban Housing and to serve on his Advisory Committee on Labor-Management Policy. Gerald Ford appointed him to the President’s Advisory Committee on Refugees, and Jimmy Carter selected him for the Advisory Committee on National Health Insurance Issues. We look forward to bringing his many accomplishments to light this year in these pages.

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Experts highlight progress in HIV/AIDS research and quality of care

posted on November 30, 2011

By Laura Thomas

Heritage correspondent

Greg Millett, White House advisor, speaks at KP diversity conference in San Francisco.

Kaiser Permanente’s 34th Annual National Diversity Conference, held recently in San Francisco, culminated in the presentation of the HIV/AIDS Diversity Awards, along with White House policy advisor Greg Millett’s battlefront assessment of the 30-year war against the disease in the U.S.

Millett noted the year-by-year drop since the 1990s of new HIV cases and a decrease in the public’s alarm over the disease. He contrasted that success with the continuing problem of delivering adequate care for the poor and minorities in urban areas where the prevalence of HIV is still high.

Bringing care to these victims is crucial, he said, because many studies show that beginning to treat an infected person in the early stages of HIV reduces the risk of transferring it to another by 90 percent or more.

“The road to treatment in the U.S. is fraught with difficulties,” he told the audience. “This is nothing new to any of us.” Millett, who is also a researcher at the Centers for Disease Control, lauded the Kaiser Permanente study published in 2009 that showed the risk of dying from AIDS didn’t differ between ethnic groups when there was equal access to care.

“You don’t see that nationally,” he said. “Kaiser Permanente is doing a very good job of suppressing HIV. This is exactly what we would like to see happen nationally.”

KP’s HIV leader shares Millett’s visions

Michael Horberg, MD

Millett’s words were well-received by Dr. Michael Horberg, Kaiser Permanente’s national director for HIV/AIDS, who announced the Diversity Award winners and was on stage with Millett and Diane Gage-Lofgren, senior vice president for KP Brand Strategy, Communications and Public Relations (BSCPR).

Appointed to Obama’s Presidential Advisory Council on HIV/AIDS (PACHA) in 2010, Horberg hopes to make Kaiser Permanente’s best practices a part of national policy. Practicing at Michael Reese and Northwestern Memorial hospitals in the Chicago area for 10 years before coming to California, he has spent most of his medical career in the fight against the disease.

He is one of those lucky people whose life both on and off the job is fueled by a strong sense of purpose. In the early 1980s, as the first patients infected by the HIV virus were being treated at Boston City Hospital where he was in his third year of medical school, he already knew he was gay, but it was still a little too early for him to declare himself.

“It was the fear of rejection, the fear of being ostracized, even in the medical community, of not being able to attract any patients,” he recalled.

AIDS outbreak spurs Horberg to action

Ironically, the onset of the AIDS crisis is what finally helped to liberate him. As patients with HIV symptoms, including some of his close friends, began coming to him in private practice, he realized stepping out of the closet would help them get the care they needed and allow him to be a more powerful advocate for specialized care.

The timing was good.

“There was no hiding any more. I was true to the world and it was true to me,” he wrote in California Medicine in 1997. “And it paid off in a number of ways. For one thing, because I was a gay doctor with a large gay and lesbian patient population, Northwestern Community Medical Group (affiliated with Northwestern Memorial Hospital) invited me to merge my practice with theirs.  And because I had a high patient satisfaction rating, managed care companies came courting as well.”

KP's Michael Horberg (fifth from right in front row) serves on Obama’s Presidential Advisory Council on HIV/AIDS (PACHA).

Dr. Horberg began specializing in HIV care in Chicago where he grew up. Early on, he knew he wanted to be a doctor. Both the science and the humanism involved appealed to him, and both values were part of his family heritage. His uncle was a physician and a great-aunt had attended medical school and practiced in the 19th century in Estonia and the Ukraine.

Being able to help his gay and lesbian brothers and sisters has fulfilled that early desire to meld technical skill with compassion. Especially early in the crisis “when there was a limit for what we could do for patients, really caring, really showing love was critical,” he said.

Research key to improving care

Both the science and the compassion have continued to motivate Dr. Horberg in his work: He was an early proponent of experimental drug trials and has devoted much of his research to improving the delivery of care as well as exploring the source of the disease.

Horberg was recruited by Kaiser Permanente for his work with HIV and was happy to leave the muggy hot summers of Chicago in 1996 for the Bay Area’s temperate climate. He worked briefly at South San Francisco before taking charge of the HIV/AIDS program at KP Santa Clara where he handled patients, began his work as a scientist in Kaiser Permanente’s Division of Research while studying for a master’s degree in research (MAS) at the University of California at San Francisco.

He has since worked on numerous studies using data from the records of 50,000 HIV patients who have been treated by Kaiser Permanente since 1981. His studies have focused on many aspects of caring for HIV patients, from the management of antiretroviral drug therapy and allied infections to issues of ensuring quality of care and equal access to care.

Dr. Horberg collaborated on the study that sought to determine whether equal access to care would result in a similar outcome for HIV patients of different races. The study – lauded by Millett in his remarks to the Diversity Conference – was the first to break out statistics for Hispanics and it found no disparity in the clinical outcomes between white, black and Hispanic KP patients, with Hispanics having a slightly lower mortality rate.

Leading the charge for best HIV/AIDS care

During his years in California, he was a tireless advocate for HIV patients in his roles as physician, researcher and leader of initiatives to improve and standardize care. Horberg chaired the central research committee for the Northern California region, and led the HIV Interregional Initiative.

Last year, working with the National Committee on Quality Assurance (NCQA) and other interested groups, the HIV Initiative developed 17 measures for quality HIV care – including patient retention, screening and prevention for infections, immunization, and initiation and monitoring of antiretroviral therapy – that are intended for nationwide implementation.

“We really have done a very good job,” he says of Kaiser Permanente.  “We can do better. We are not going to rest on our laurels. We know where there is room for improvement. . . We are willing to analyze our care. We are the first managed care organization to develop a set of care metrics. And from that we asked our other research questions that have led to policy changes. We have really compassionate care. We give a damn.”

Early this year, Dr. Horberg moved to Maryland to become executive director of research for the Mid-Atlantic States Permanente Medical Group. Dr. Horberg had to let go of seeing patients when he made his move to the east and that was hard to give up, but leading research, his other love, is also about people, he says. “The science we do at KP is the science of caring for patients and how to do that in the most effective way is really what we study.”

Fortunately, he left with his true love, husband Chip Brian Horberg, whom he married in 2008 while gay marriage was legal in California. The couple, whose birthdays are July 10 (Chip) and July 12 (Michael), were married July 11 under a traditional Jewish huppah on the rooftop of their condominium in San Francisco, surrounded by family and friends, including a large contingent of Kaiser Permanente colleagues.

This is the first of two articles about Kaiser Permanente’s response to the HIV/AIDS crisis. There’s more about KP’s history of taking care of HIV/AIDS patients at the Center for Total Health.

Next time: Kaiser Permanente’s early struggle to stand up to AIDS.

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