Posts Tagged ‘kaiser permanente’

Taking a gander back to year-ends of Kaiser Permanente’s past

posted on December 20, 2012

By Ginny McPartland
Heritage writer

Kaiser Permanente School of Nursing students caroling at Oakland Foundation Hospital, KP Reporter, December 1962.

The year 1962 is as good a time as any to begin a year-end reflection on Kaiser Permanente’s past. The 1950s and early 1960s were the days when the Health Plan was still getting established, and its pioneers were counting the blessings that kept their enterprise going.

KP Heritage Resources’ expansive archive of newsletters and magazines from previous decades provide the fodder for a historical review. We can trace the concerns and triumphs of each era from the words and pictures that appear on the pages of the December editions. Some issues are remarkably like the ones we face today; others are no longer worries.

In the December 1962 issue of the KP Reporter, you can find a photo of the white-uniformed and cap-clad student nurses’ choir that strolled through the corridors of the Oakland Kaiser Foundation Hospital singing carols during the holiday season. The Kaiser Foundation School of Nursing choir also entertained at San Francisco and Vallejo hospitals, area nursing homes and the Business and Professional Women’s Club holiday party.

In the same issue, a visiting lecturer talked about the dangers of radiation exposure: “There is evidence that radiation causes something akin to aging, a shortening of the life span due to the loss of hereditary material, and damage to chromosome and malfunctioning of cells. This brings on death,” said Irwin Oster, PhD, of the Institute of Cancer Research in Philadelphia.

Medicare emerges onto the scene

Skip ahead to 1965 and you can read about the new program called “Medicare” just enacted by the federal government. Planning for Health, the member newsletter, carried an article introducing members to Medicare: “If you are 65 or over on July 1, 1966, your Health Plan coverage will be changed . . . Medicare covers a broad range of benefits.” Members were urged to tell their friends about the new coverage.

In the winter of 1968, Planning for Health had articles about KP’s $80 million, four-year plan to build new facilities and to update others. This program called for a new medical center in South San Francisco, and additions to those in Oakland, Hayward, Vallejo, San Rafael, Walnut Creek and Sacramento. New medical centers were planned for West Los Angeles and San Diego, and additions were planned for four Southern California medical centers and for one in Portland, Ore

Planning for Health editors ran a cover story in the winter of 1969 edition about the 1960s as the “Decade of Change for Medicine.”  The article’s author wrote: “Experimental organ transplants, Medicare and The Pill collected headlines during the past decade, but medicine made gigantic strides forward in less glamorous areas as well. . . examples are the almost complete eradication of polio through universal immunization (and) the development of vaccines for mumps, measles, and Rubella (German measles) . . . ”

Membership in the Northern California Region alone increased from 375,000 in 1960 to over 920,000 by the end of the 1960s. In all other regions, membership increased from 807,000 to nearly 2 million.

The winter 1975 issue of Planning for Health carried a story about research involving 11,000 sets of twins. “(Twins) offer the unique opportunity to examine how heredity and environment interact to affect the total health picture,” the article reported.

Are you having fun jogging?

Stuart Frank, MD, wrote an article for the winter 1977 issue of Planning for Health about the pros and cons of jogging. Praising the activity for its many benefits, Frank admits: “I stopped jogging when it . . . was no longer fun.” Enjoying yourself is the only good reason for jogging, he said. “Life is too short to inflict this regular punishment on your feet and psyche if you don’t enjoy it.”

In the 1980s, the new Reporter (for employees) emerged with magazine-style articles that reflected the changing role of women and other social issues of the time. In December 1984, Molly Prescott interviewed three pregnant KP managers about how they coped with work and family life. “I told my boss not to treat me any differently just because I was pregnant,” Cora Tellez, an accounting manager, told Prescott. “He took me at my word, and didn’t cut down on his demands or expectations of me.”

The same issue carried a story by Kaaren Poole, who interviewed KP employees about using personal computers for the first time. There was also a first person story by staffer JoAnn Lieberman, “On being Jewish at Christmas.”

Remembering year’s sad events

Northern California KP employees contributed to the Names Project, a patchwork quilt memorializing people who died from AIDS. KP Reporter photo, 1987.

The December 1987 edition highlighted KP’s part in the “Names Project,” the creating of a quilt whose pieces commemorated individuals who had died from AIDS. KP South San Francisco employee JoAnne Melody said: “The quilt project gives us all a chance to look at this disease with a little more heart, to see the (patients) as people, not just statistics.”

The Loma Prieta Earthquake in October 1989 prompted an article on disaster preparedness in the winter 1989-90 issue of Planning for Health; the winter 1990 issue of Spectrum (for employees) carried a story about the 50 KP employees who suffered significant financial losses in the quake. Funds were created to help employees, including 27 whose homes were severely damaged.

The 1991 year-end issue of the employee newsletter Contact reported that relief funds were set up for the victims of the Oakland/Berkeley Hills fire. Homes belonging to 80 KP physicians and employees were among the 3,800 dwellings destroyed by the firestorm. “Our thoughts and best holiday wishes are with all the people of Kaiser Permanente, especially those affected by the fire,” the Contact editor wrote.

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Kaiser Permanente celebrates its commitment to high-quality care

posted on December 14, 2012

By Ginny McPartland, Heritage writer

Jack Cochran, MD, executive director of The Permanente Federation, speaks during the National Governors Association conference in Washington, D.C., in 2010. Dr. Cochran was on the bill right before First Lady Michelle Obama. Kaiser Permanente is a founding partner in Mrs. Obama’s Partnership for a Healthier America, a campaign to fight obesity. Photo by Ted Eytan, MD.

Kaiser Permanente founding physician Sidney Garfield had good advice for his Northern California colleagues in 1974. He basically told them to stick together. “Keep your arms on each other’s shoulders and keep your eyes on the stars for innovation and change for the future.”

The executive medical directors took that sage advice in 1997 and created The Permanente Federation (the Federation) to serve the collective interests of the physicians to deliver the highest quality medical care through partnership with Kaiser Foundation Health Plan.

This year, the Federation marks the 15-year anniversary of this collaboration, which has contributed to Kaiser Permanente’s high-performing integrated care delivery system, the creation of a cutting-edge national electronic health records system, a formal sharing of best medical practices, and a shared vision for the future of health care.

In his talk to KP physician leaders 38 years ago, Garfield was speaking from the perspective of someone who had locked horns with traditional fee-for-service medicine over prepaid group practice. He understood that in order for physicians to be able to deliver the highest quality care, they need to be well-positioned to advocate for their patients.

Creating a balance

Permanente physicians have rubbed elbows with Washington movers and shakers over the years. Here, Sidney GarfieldThe alignment of KP’s medical groups created an effective model for collaboration with the eight Kaiser Permanente regional Health Plans and Hospitals. Today, this collaboration continues to drive ongoing dialog through the Kaiser Permanente Program Group, the joint strategic leadership body, and is recognized for its balanced leadership and shared commitment to patient-centered care.

Sidney Garfield, MD, receives an award from Lady Bird Johnson, wife of President Lyndon Johnson, 1977.

In the inaugural issue (summer 1997) of The Permanente Journal, KP’s peer-reviewed medical journal, Oliver Goldsmith, MD, first chairman of the Federation’s Executive Committee, described the need for physician alignment: “We must assure the value (of putting patient interests first) remains central and (we must) prove incorrect the creeping notion that group practice does not offer an appropriate solution to our nation’s health care problems.”

In the June 2002 issue of Managed Care magazine, former KP CEO and President David Lawrence, MD, noted that new opportunities for collaboration through the Federation represented a change necessary to KP’s continued success. “. . . We now can start to take advantage of our intellectual scale, this incredible experience that occurs across all the geographic areas with all the clinicians and all the Health Plan executives,” Lawrence told the magazine.

Federation progresses toward its goals

On the Federation’s 10th anniversary in 2007, Jay Crosson, MD, the first Federation executive director, gave his evaluation of its success: “In the areas of quality and service improvement, IT development, external relations, and other endeavors, the renewed partnership among the Federation, Health Plans, and organized labor (through the Labor Management Partnership) has been a historic contribution to maintaining KP’s reputation for excellence and superior value.”

Today, the Federation represents approximately 17,000 physicians in eight Permanente Medical Groups nationwide, caring for more than 9 million Kaiser Permanente members.  Jack Cochran, MD, the current executive director, offers his perspective on the Federation’s first 15 years:

“Over the years, the partnership between the PMGs and the Federation to leverage advanced technology, create innovative ideas, and share best practices has advanced our clinical quality. Ingrained in KP’s physician culture and rooted in Sidney Garfield’s leadership and vision, is our commitment to provide excellent care through evidence-based medicine that puts the patient first, always.”

CMI helps transform care delivery

The Care Management Institute, also established in 1997, partners with the PMGs and the Kaiser Foundation Health Plan to realize Kaiser Permanente’s vision of consistent, high-quality care.

CMI works with physicians and researchers in all eight Kaiser Permanente regions to gather new epidemiological research and outcomes information and to develop evidence-based best practices to share with all KP physicians and other health care professionals.

“CMI was established to optimize care quality, to further KP’s mission in improving the health of its members, and to transform its health care culture,” said CMI’s Executive Director Scott Young, MD. “We spread clinical best practices, develop integrated care delivery models with regional partners, and support the national program by working with physicians, clinical experts and leaders throughout KP.”

Looking ahead

In his 1997 Journal article, Dr. Goldsmith summed up the potential of KP’s partnerships: “A truly national Kaiser Permanente, with a growing Kaiser Foundation Health Plan and a growing Permanente medical practice across the United States, can be the most powerful contribution to improving American health care in our organization’s storied history.”

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Blood supply key to world campaign to eradicate HIV/AIDS

posted on November 29, 2012

By Lincoln Cushing
Heritage writer

“They [Red Cross] make it so easy for you to donate blood,” comments Kaiser-Permanente’s Director of Special Marketing Programs, Tom Hussey. Photo from Factors, Pacific Northwest Regional Blood Services newsletter (American Red Cross) June/July 1984

World AIDS Day – set for December 1 every year – was established in 1988 by the World Health Organization to draw attention to the need for international medical and governmental cooperation in addressing this catastrophic disease.  

The WHO adopted one theme for the years 2011 to 2015: “Getting to zero: zero new HIV infections. Zero discrimination. Zero AIDS-related deaths.” One focus of “Getting to zero” has been a global effort to ensure a safe and ample supply of that renewable potion of life – human blood.

In its 67 years of operation, Kaiser Permanente has been an active partner in the ongoing quest to keep blood available and free of dangerous contaminants.

In 1948, three years after the Permanente Health Plan was opened to the public, the Permanente Hospital in Oakland started its own blood bank. It was the only private hospital in the San Francisco Bay Area to offer such a service to patients. The single requirement was that blood recipients had to arrange to replace the blood. Members could give blood ahead of time to ensure availability when they needed it.

KP gets out of blood bank business

By the mid-1960s, however, 80 percent of the blood used in KP’s Northern California hospitals came from community blood banks, costing $25 a pint. KP offered a Permanente Medical Group Blood Transfusion Insurance Program, which credited the donation of a single pint against unlimited blood needed by that member for two years, or one year if applied to a family.[i]

Graphic used on cover of the Permanente Medical Group Blood Program brochure, October 1967

The math worked out – Permanente Medical Group Executive Director Cecil Cutting, MD, noted: “. . . Participants are a relatively healthy lot of members whose transfusion requirements account for fewer than 3 percent of total Health Plan transfusions, while their contributions are running equivalent to 30 percent of the total blood used.”[ii]

In the past four decades, blood bank operators have been faced with the reality that the use of donated blood – its drawing, storing and administering – poses risks for transmission of disease, such as HIV/AIDS and Hepatitis B and C.  In 1971, blood banks began to test donated blood for Hepatitis B.

Keeping blood supply safe

In 1983, U.S. blood banking groups issued their first warnings about AIDS. This action was taken after researchers learned HIV/AIDS was a blood-borne disease that could be transmitted by blood transfusion, as well as by sexual contact and shared hypodermic needles.

This blood donation illustration appeared in the “AIDS update” published in the KP member publication “Planning for Health” in the Fall 1988 edition.

In 1985, immediately after the U.S. Food and Drug Administration licensed the first test to detect the antibody to HIV, Red Cross Blood Services regions began testing all newly donated blood for HIV. Since then, there have been an estimated 10,000 cases of HIV in the United States resulting from contaminated whole blood administered to patients between 1978 and 1985. (A heat treatment developed in 1985 renders blood plasma safe.)iii

In 1988, the federal Centers for Disease Control notified Kaiser Permanente that community blood banks in KP’s Bay Area service areas had not screened blood donations properly to prevent contamination in the supply.

Kaiser Permanente, not responsible for independent blood bank procedures, contacted Health Plan members who had received blood from local banks between 1978 and 1985. Affected members were told that the risk of transmission of HIV might be higher than the nationwide average due to the blood banks’ improper and inadequate blood screening.

KP encouraged these members to obtain free HIV screening tests. iv The 1985 cutoff date reflected the increased blood screening that virtually eliminated transfusion transmission.

KP has also aggressively reduced other HIV blood transmission risks, such as hospital staff needle sticks, but addressing member risk through contaminated blood was a major first step. The task of addressing the epidemic was huge, but KP took the challenge seriously.

By 2000, a KP Northern California spokesperson could safely affirm: “Our efforts make a difference. Kaiser Permanente is making profound efforts to stop the spread of AIDS.” v

 

Editor’s note: Heritage writer Lincoln Cushing is a regular blood donor and encourages all readers who are medically able to donate as well. This crucial renewable resource depends on volunteer donors. Blood agencies regularly schedule mobile units at large institutions. Please step up when you have the opportunity.



[i] Permanente Medical Group Blood Program brochure, 1967.

[ii]Newsletter from the Desk of the PMG (Permanente Medical Group) Executive Director (Cecil Cutting, MD), October, 1967.

iii “Prevention of AIDS transmission through screening of the blood supply,” Annual Review of Immunology. 1995; 13:201-27. Galel SA, Lifson JD, Engleman EG.

iv “AIDS Update,” Planning for Health, Fall 1988

California Wire, 11/20/2000

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When the (poker) chips are down, Sidney Garfield plays it cool

posted on November 20, 2012

By Steve Gilford
Senior consulting historian

Gerald “Jerry” Searcy, center, with nurse Winnie Wetherill (later Neighbor), at left, and an unidentified nurse outside of Mason City Hospital in the late 1930s.

In 1938, when Permanente founding physician Sidney Garfield recruited surgeon Cecil Cutting to join him at Grand Coulee Dam, Dr. Cutting persuaded nurse anesthetist Geraldine “Jerry” Searcy to come along.

Cutting had confidence in Searcy, having worked with her at San Francisco General Hospital after he completed his medical training at Stanford University in the mid-1930s.  He knew she would be an asset to the medical care program set up for Henry Kaiser’s 5,000 construction workers.

Searcy remained with the program from 1938, through the Second World War, until her retirement from the Oakland Medical Center 34 years later. Jerry Searcy told me an anecdote about a personal experience that reflected Dr. Garfield’s managerial style. She liked the story because it helped her to explain why the medical staff was so fond of him.

‘Garfield not bossy’– Geraldine Searcy, 1985. KP Reporter photo.

Her story begins one evening in the Permanente Foundation Hospital in Oakland during the War. The normally busy hospital was unusually quiet that night with little for the staff to do. On that slow night, head physician Garfield just happened to drop by the ward where Searcy was working. His unexpected visit found the staff taking advantage of the quiet by playing a spirited game of poker.

For poker chips, the crew was using pink and white aspirin tablets they’d taken from the supply cupboard. Searcy recalled that Garfield was upset because this misuse of medication was a waste of hospital supplies. He asked them to stop and of course they did – immediately.

The next day the poker players waited somewhat anxiously to see what additional disciplinary measures they might have to face. Garfield surprised them, though. Instead of criticizing them further or meting out some sort of punishment, he donated a set of real poker chips to the hospital.

“From then on,” Searcy remembered: “staff members on call could play poker without disturbing hospital supplies.”

Garfield ‘not at all bossy’

Searcy, who died in 1993, was quoted in a February 1985 KP Reporter edition honoring Dr. Garfield following his death:

“I remember Sid as a very friendly, humble man, not at all bossy, although he did believe in hard work and discipline. Nothing was beneath him, nor beyond him. Once at Grand Coulee, Sid was walking around the hospital without his white coat, looking very youthful with his bright red hair and casual clothes.

“A patient saw him and shouted, ‘Boy! Would you take care of this?’ pointing to his bedpan. Sid wasn’t at all offended. He laughed and emptied the bedpan. Of course the patient had no idea who Sid was,” she said.  She continued:  “Dr. Garfield liked to sing ‘My Heart Belongs to Daddy’ while performing surgery at Grand Coulee.

“To me Sid was a colleague and a friend. He must have been a leader, though he never waved a flag or beat a drum.”

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KP physician helps stamp out breast cancer

posted on October 31, 2012

By Bryan Culp
Heritage Resources director

We cap October with a story for National Breast Cancer Awareness Month, the annual campaign to increase awareness of the disease and raise funds for research into its cause, prevention, diagnosis, treatment and cure.

“I was stamping holiday cards and preparing for a lecture on the history of breast cancer surgery when suddenly it occurred to me, ‘Why not have a stamp to raise money for breast cancer research?’ ” – Ernie Bodai, MD, Kaiser Permanente, Sacramento, California

Did you know that Ernie Bodai, MD, a Permanente surgeon and director of the Breast Cancer Survivorship Clinic at Kaiser Permanente, Sacramento, California, was the driving force behind the creation of the U.S. Postal Service’s Breast Cancer Research Stamp?

Since 1998, post offices in big cities and small towns across America have sold 950 million of these first-class postage stamps. Letter-writers and patrons like you and me have raised $85 million for breast cancer research through the purchase of this special postage stamp. More in a moment about the stamp and its genesis.

The Centers for Disease Control and Prevention reports that in the U.S. alone over 210,000 women are diagnosed with breast cancer every year, and 40,000 women die every year from the disease. It is the leading cause of death from cancer among Hispanic women, and the second leading cause of death from cancer among white, black, Asian/Pacific Islander, and American Indian/Alaska Native women.

Good news about breast cancer rates

If there’s any good news in these rather jarring and unsettling facts it is that the incident rate has been declining since 1999 and the death rate since 1990. Early detection, mammography screening, and improved therapies have helped to lower mortality rates.

New knowledge through research offers a brighter tomorrow in the fight against breast cancer. The National Cancer Institute reports that advances in cancer genomics and cell biology are leading to the development of less toxic therapies that are tailored to an individual’s genetic profile.

Analysis of “gene expression,” the process by which a gene gets turned on in a cell to make RNA and proteins, has led to the identification of five subtypes of breast cancer, each subtype possessing distinct biological features and each responding differently to clinical therapies. Also, new knowledge of the immune system led to the development of several promising breast cancer treatment vaccines that are currently under clinical evaluation.

A stamp is born

That people like you and me could help fund breast cancer research of this magnitude through the simple purchase of a postage stamp was a novel idea.

The Breast Cancer Research Stamp, now in its fifteenth year, sells for 55 cents; that’s 10 cents over the current rate of first-class postage. By law, the net amount raised from the sale of the stamp is earmarked for breast cancer research at the National Institutes of Health and the Medical Research Program at the Department of Defense.

The three-year journey from day of conception to the first day of issue began in December 1995. “I was stamping holiday cards and preparing for a lecture on the history of breast cancer surgery,” said Bodai, “when suddenly it occurred to me, ‘Why not have a stamp to raise money for breast cancer research?’

“A quick analysis of the United States Postal Service in 1996 revealed that 180 billion pieces of mail were handled, one third of which were first-class items utilizing a 32 cent stamp. If half of those stamps were sold at 33 cents, $300 million would be generated annually, nearly equaling the entire National Cancer Institute’s budget for breast cancer research.”

Bodai contacted Postmaster General Marvin Runyon who tersely rejected the idea on the grounds that the U.S. Postal Service was not a fundraising organization. Bodai then solicited members of Congress proposing legislation to authorize the stamp. He received no replies.

Surgeon cuts through red tape

So he brushed-up on how Congress works and off he went to Washington. He lobbied the 48 women in the House of Representatives and 11 women in the Senate. He started a grass roots campaign and earned endorsements from prestigious organizations including the American College of Surgeons and the American Medical Association. He won over legislative champions Sen. Diane Feinstein (D-CA) and Rep. Victor Fazio (D-CA) who sponsored and shepherded bills to authorize the postage stamp.

In July of 1997,  the ‘‘Stamp Out Breast Cancer Act’’ passed the House (422-3), and a similar version passed unanimously in the Senate. President Bill Clinton signed the bill into law (PL 105-41) in August 1997.

“After developing the line work of Artemis reaching back for her arrow, I realized she was mimicking the stance taken when doing a breast self-examination.” – Whitney Sherman, illustrator

With the passage of the law the U.S. Postal Service needed a stamp. Art director Ethel Kessler and illustrator Whitney Sherman were commissioned for its design.

Sherman says of her work, “After many sketches, one idea was taken to final review, the image of Artemis, the Greek goddess of the hunt.” Sherman found in the Artemis of classical depiction, bow in hand and with a quiver slung over her shoulder, “a figure larger than any single nationality, race or age.

“After developing the line work of Artemis reaching back for her arrow, I realized she was mimicking the stance taken when doing a breast self-examination.” This was an unexpected “visual bonus.”

Kessler, a breast cancer survivor, added the cheerful, vibrant colors and the slogan “Fund the Fight. Find a Cure” to evoke hopefulness and spirit for battle. The stamp debuted in July of 1998 in Los Angeles.

The winter holidays are upon us and soon we’ll be mailing cards to family and friends. When you drop by the post office for that cache of stamps, consider the Breast Cancer Research Stamp. For just a few cents more you too can “fund the fight to find a cure.”

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Disabled KP financial analyst changed course of public transportation

posted on October 24, 2012

By Lincoln Cushing
Heritage writer

Harold Willson, KP employee from 1957 to 1977, getting off a wheelchair-accessible BART train. Willson convinced officials to alter the system design to accommodate disabled passengers. Photo from Accent on Living magazine.

Next month, Kaiser Permanente leaders and staff will gather for the 35th year to celebrate the diversity of its work force, its selected vendors and its membership. “Diversity Excellence: A 21st Century Game Changer” will be in Long Beach on November 1 and 2.

KP’s embracing of diversity goes back to its beginnings in the World War II shipyards, and its ranks have included many disabled individuals who made significant contributions despite their handicaps. Harold T. Willson, a wheelchair-bound KP financial analyst, was one such person.

Willson, disabled in a 1948 mining accident, successfully lobbied leaders of the San Francisco Bay Area Rapid Transit District (BART) to make the high-speed train system accessible to the disabled.

BART, celebrating its 40th anniversary this year, was under construction in the early 1960s when Willson learned that the plans did not call for disabled access. He raised his objections and insisted on alterations.

Willson’s quiet persistence made BART leaders stop and listen. This relentlessness was characteristic of Willson’s approach to life. His story is one of triumph over tragedy.

Slate slide crushed young miner

Willson was 21 years old when his entire life changed. The son of a mining engineer, he turned to mine work for income, as many young men do in West Virginia. His father had died two years earlier, and he was supporting the family and saving for college.

BART public phones were mounted lower to be convenient for passengers in wheelchairs. Photo from Accent on Living magazine.

He describes his last day of going down 500 feet to work at the mine owned by the New River Coal Company in Summerlee:

“On Friday, the 13th day of February, 1948, I went to work the ‘hoot owl’ shift, and early the next morning just after my lunchtime, at 3:30 a.m., I was caught in a slate fall. I was badly crushed, ribs and back were broken with severe spinal damage.”

Willson was fortunate to be a member of Local 6048 of the United Mine Workers of America (UMWA). Soon after his accident he was sent to the Kabat-Kaiser Institute in Oakland, California, for rehabilitation (the facility was later located in Vallejo).

Kaiser rehabilitation center opened to miners

Just a few months earlier, legendary UMWA leader John L. Lewis and the UMWA Welfare and Retirement Fund had partnered with Henry J. Kaiser and the Kabat-Kaiser Institute to provide top-quality medical care and rehabilitation for injured miners.

United Mine Workers of America patients arriving by Pullman train for Kaiser physical therapy, 1948. Kaiser Permanente Heritage Archives photo

Vocational institutions in the rural mining communities in the East were badly underfunded, and the California facilities offered a perfect venue for the union’s commitment to social welfare.

Willson was among the first group of miners to take the long trip west in three railroad cars, eventually followed by hundreds more. In an early instance of KP’s community benefit practices, the Permanente Health Plan continued to provide care even when the miners’ fund ran out of money.i

At Kabat-Kaiser Willson participated in physical therapy, played wheelchair basketball, and fell in love with his nurse and future wife. He got a job at the Bank of America, earned a bachelor of science in business administration, and then took a position as a senior financial analyst with the Kaiser Foundation Health Plan, retiring in 1977.

Willson put his persuasive powers to work

While employed by KP, Willson was a powerful advocate for urban design and construction that would accommodate disabled people. As volunteer consultant to BART, he put in long hours over a 10-year period to ensure its accessibility for the disabled and elderly. He insisted that adequate transportation was often the deciding factor for disabled independence.

Special ticket gates were designed to allow wheelchairs to pass through. Photo from Accent on Living magazine.

A feature article on his work in the 1973 issue of Accent on Living described it this way: “The original concept [of BART] in 1962 did not include the provisions for people with severely restricted mobility.

“At that time, Willson initiated a campaign to secure the present facilities, starting with endorsements from the elderly, the handicapped and the general public. The project was not “sold” with fanfare and publicity but by person- to-person contact.”

A.E. Wolf, General Superintendent of Transportation for BART, was won over by Willson’s approach. He noted: “His suggestion was novel for rapid transit, no one had tried it; it posed all kinds of problems; cost was significant. Our staff, including myself, was hardly enthusiastic.

“But, he did not threaten, nor picket, nor sulk, nor lose patience. Instead he was professional, pleasant, firm and persistent. As a result, he won support of each of our board members while maintaining a friendly relationship with our staff. This helped his cause immensely.”

KP backed Willson’s advocacy

In keeping with its policy to support efforts to improve opportunities for the disabled, as well as other minority groups, Kaiser Permanente gave Willson the freedom to pursue his accessibility campaign.

“It is appropriate here to commend Kaiser [Permanente leaders] . . . because of their interest, encouragement and public service philosophy,” Wolf also noted. “The willingness to arrange time for an employee to participate in this community project was necessary for its success.” ii

Willson agreed: “. . . Since our Medical Care Program is one of the largest providers of health services . . . we should assume the leadership role in promoting and participating in activities and programs that will create a barrier-free environment for the handicapped and elderly.”

Willson’s specific recommendations included large elevators at every stop, accessible restrooms, wide parking spaces, narrow gaps between trains and platforms, and loudspeaker announcements.

His broader vision was perhaps best articulated in a statement he made before the American Public Transportation Association in 1976: “We must exert every effort to . . . create a barrier-free transportation environment for those that are handicapped and for the non-handicapped destined to become disabled such as yourselves.”

 

i The charitable nature of this relationship is described in A Model for National Health Care by Rickey Hendricks: “When the union fund suffered a financial setback in late 1949, the Permanente Hospital Foundation continued to transport and care for miners at Permanente expense. Kabat-Kaiser continued through 1952 to run on a deficit of almost $100,000.”

ii Comments by A.E.Wolf, General Superintendent of Transportation, Bay Area Rapid Transit District, to Workshop number 3, Transportation Environment, 1972 National Easter Seal Convention, Chicago, Illinois, November 9, 1972.

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KP Richmond’s new outdoor art tells wartime story

posted on October 14, 2012

By Ginny McPartland
Heritage writer

Shipyard workers from World War II are the stars of the new KP Richmond public art display on Macdonald Avenue. Photo by Ginny McPartland, Heritage Resources

“We came from everywhere” was the theme that inspired the selection of wartime shipyard worker portraits for the newly installed Kaiser Permanente Richmond public art display on Macdonald Avenue, the main street of Richmond, California.

Truly, the Kaiser Richmond Shipyard workers did come from seemingly everywhere – from Louisiana, Mississippi, Alabama, Iowa, Nebraska, New York, Chicago, California, and many more places. They were white, black, Hispanic, Native American, Middle Eastern and Asian. They came to build ships to supply the war effort, and many of them stayed, remarkably influencing the demographics of today’s San Francisco Bay Area.

With the Macdonald Avenue art installation, KP Richmond seized the rare opportunity to add to the abundance of public art springing up in Richmond of late and to highlight the connection the health plan has to the community.  Kaiser Permanente’s first patients were shipyard workers, and the health plan has been caring for its Richmond members continuously since 1942.

One of the modern-day faces of Kaiser Permanente in Richmond, California. Photo by Ginny McPartland, Heritage Resources

The project started as a condition of approval for the development of a KP parking lot on Macdonald Avenue at 8th street.  The city of Richmond, deeply committed to beautifying the community, asked for a façade that would blend in with the improvements already made on the city’s main street and obscure the view of a surface parking lot.

The condition turned into an inspired effort to help tell the story of Richmond’s role in the Second World War.  Local artist Ron Holthuysen of Scientific Art Studio was selected to design the installation, which is made up of ceramic tiles carrying photographic images. Holthuysen also created the “Memories of Macdonald,” historical photographic stands that were placed along Macdonald Avenue in 2006.

Images for the new display were picked from the hundreds of Richmond Shipyard photos archived in the Henry J. Kaiser Collection in the Bancroft Library at UC Berkeley and from the Richmond Public Library. The pictures that represent modern-day Kaiser Permanente were selected from KP Richmond’s collection of photos of members and community activities.

Richmond artist Ron Holthuysen with his KP artwork in progress in his studio. Photo by Ginny McPartland, Heritage Resources.

KP Richmond will host a dedication of the new public display this Tuesday (Oct. 16) from 4 to 5 p.m. at Macdonald and 8th Street (in the parking lot). The community is invited to participate and to take a tour led by artist Ron Holthuysen.

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Weekend home front festival celebrates Bay Area history

posted on October 11, 2012

By Ginny McPartland
Heritage writer

The USS Potomac, President Roosevelt’s “Floating White House” will be open for tours at the Richmond home front festival Saturday, October 13. Wikimedia Commons photo.

This Saturday, October 13, Kaiser Permanente will celebrate its beginnings as the workers’ medical care plan in the World War II Kaiser West Coast Shipyards. We’ll gather with thousands of Bay Area residents, many living in Richmond, to reminisce about the days when Richmond hosted Henry J. Kaiser’s monumental shipbuilding operation.

The small waterfront city was transformed during the war by the arrival of thousands of people from around the country who came to work in the shipyards.  Transplanted workers from the South, the Mid-West and the Northeast brought their faith, their lifestyles, and their music and art to the Bay Area. Their contributions changed the demographics and cultural landscape remarkably.

The sixth annual Richmond Home Front Festival by the Bay showcases the rich culture of Bay Area life that is largely the legacy of World War II. The festival takes place at several sites on and near the former Kaiser Shipyards. The main events will be in the Craneway Pavilion, the former Ford Assembly Plant and wartime tank and jeep depot at the south end of Harbour Way (1414 South Harbour Way).

New Rosie park visitors center open

Sherman Tanks for World War II were assembled at this plant in Richmond, California. The home front festival this Saturday (October 13) will be in the restored plant, which is now called the Craneway Pavilion. Photo courtesy of the Richmond Public Library.

New this year is the amazing and beautiful National Park Service Visitors Education Center, which has historical exhibits and films that tell the story of Richmond and the home front. The center, operated by the Rosie the Riveter national park staff, is the renovated and remodeled brick oil house where the fuel to power the nearby vehicle assembly plant was stored. Tours of the center are free.

Also new this year is a chance to take a free tour of the USS Potomac, the rescued and restored presidential yacht of wartime President Franklin Delano Roosevelt (FDR).  The yacht, model AG-25, served as the U.S. Coast Guard Electra until 1936 when Roosevelt claimed it as his “Floating White House.” The yacht is permanently docked at Jack London Square in Oakland, California. Festival-goers can take a free 1940s shuttle bus ride from the Craneway to the dock of the former Shipyard 3, which is off Canal Boulevard, to see the Potomac.

The SS Red Oak Victory, operated by the Richmond Museum of History and also docked at Shipyard 3, will be open for tours. The Red Oak, one of the ships built in Kaiser’s Richmond Shipyards, has been restored by the museum and is often the site of film showings and other events. World War II memorabilia and books are available for purchase in the museum gift shop.

USO dance Friday night

This welder worked in the Kaiser Shipyards in World War II. Her photo is part of the new KP exhibit of shipyard photos to be dedicated next Tuesday, October 16, at Macdonald Avenue and Eighth Street in downtown Richmond. Photo courtesy of the Richmond Public Library.

The night before the festival, Friday, October 12, Lena Horne will be honored in a 1940s USO dance featuring Junius Courtney’s Big Band. The dance will be from 7 to 10 p.m. in the Craneway Pavilion, 1414 South Harbour Way, Richmond. Admission is $20 per person in advance, $25 at the door. Advance tickets available until 5 p.m. Thursday.

Other festival events include: Duck (Amphibious Truck) Tours of Marina Bay to view the historic shipyards, the YMCA Home Front 5K & 10K Fun Run beginning at 9 a.m., kids rides, music, a karaoke stage, and lots of food and beverages to purchase.  The festival begins at 11 a.m. and closes at 5 p.m.

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KP will celebrate Richmond again at 4 p.m. on Tuesday, Oct. 16, when we dedicate our addition to Macdonald Avenue art and cultural displays. KP Richmond Medical Center has created an outdoor public art display that features shipyard workers of World War II and honors today’s Richmond citizens. The art installation is on Macdonald Avenue at Eighth Street.

 

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Brisk daily walks keep retired KP CEO Jim Vohs in the pink

posted on September 21, 2012

By Ginny McPartland
Heritage writer

Jim Vohs created this outdoor portrait of his red-headed grandsons in the autumn red leaves in his front yard. This framed portrait hangs in his home.

I had the pleasure one day this summer to take an early morning brisk walk with Jim Vohs, retired Kaiser Foundation Health Plan and Hospitals CEO. Formerly a marathon runner of some note, Vohs enjoys the physical benefits of walking, as well as the time it affords him for reflection. He subscribes to KP CEO George Halvorson’s belief in the power of walking. “Every Body Walk!” is the mantra of Halvorson’s current campaign to get people moving.

I had heard through the grapevine that Vohs, who retired in 1991 and is in his 80s, was an avid walker. So I called to see if I could talk to him about his daily walking routine. He invited me to walk with him at 7 in the morning a few days later. On the phone, I asked: “What if I can’t keep up with you?” He said: “I can adjust to your pace.”  OK! I was up to it.

I met him outside his Piedmont home at the appointed hour. The charming gentleman came out of the gate wearing beige casual pants, white walking shoes, a stylish sweatshirt – and a nice, welcoming smile. My first time to meet him was smooth and relaxed. We began to walk the gentle hills around his neighborhood at a clip talking as we went. He shared with me his thoughts on retirement, his time as leader at Kaiser Permanente, and his views on exercise.

This cartoon appeared in Harper’s in December 1978. Fun-loving friends added “J.V.” to the male jogger’s shirt and presented their version to Vohs. Cartoon and prayer by famed writer of “The Right Stuff (1983)” and “Electric Kool-Aid Acid Test (1968)” Tom Wolfe.

He confided that he used to look down his nose at walkers, considering them “wimps” who weren’t serious about their fitness. He later showed me a cartoon from Harper’s magazine featuring a runner with the initials “J.V.” on his chest who recited Tom Wolfe’s “The Joggers’ Prayer”:

“Almighty God, as we sail with pure aerobic grace and striped orthotic feet past the blind portals of our fellow citizens, past their chuck roast lives and their necrotic cardiovascular systems . . . past their inability to achieve the White Moment (jogger’s high) or slipping through The Wall . . . help us . . . to be big about it.”

Today, however, Vohs has changed his mind and believes walking can be the best kind of exercise, indeed for everyone. “What are the benefits of walking for you? I ask him. “Everything that George (Halvorson) says in his missive on walking,” he replies, referring to Halvorson’s weekly letters to KP colleagues.

The number of benefits of walking 30 minutes a day is astounding. They include: lowering the risks of diabetes, stroke, hypertension, breast cancer and its recurrence, colon cancer, prostate cancer, hip fracture and gallstones. Such a regimen can also boost high density cholesterol, lowering the risk of heart attacks and stroke.  Walking helps people to lose weight and makes them feel better psychologically. The list goes on and on.

After our 30-minute walk, we returned to the Vohs home, and he invited me in for breakfast and to meet his wife, Eileen. The fare consisted of decaffeinated coffee, bananas, blackberries, yogurt and muesli. Basically, very healthy, it goes without saying.

The display case for Vohs’ KP service pins was also made of Koa wood by his Hawaiian friend. Koa wood, found only in Hawaii, is prized for many uses, including fine furniture and guitars.

Jim Vohs was the CEO of Kaiser Health Plan and Hospitals from 1975 to 1991. He is credited with many accomplishments at the helm of KP, including initiating an active Board of Directors Quality of Care Committee, expanding the Health Plan into new geographical regions, supporting a rigorous Affirmative Action policy, and defending the core values in times of change. The annual Vohs Award for Quality was established in his name when he retired in 1991.

In reflecting on his KP career, Vohs says he wishes he would have thought of the health plan’s current focus on healthy lifestyles as exemplified by the Thrive advertising campaign, started in 2004. He was  opposed to advertising when it was first suggested in the 1980s because he did not want the not-for-profit Kaiser Permanente viewed as just another commercial organization and says he only agreed to it if the people featured in commercials were actual KP members or staff.

Keeping KP from becoming a commercial enterprise was a no-brainer for him. “We started out as a nonprofit organization providing care that people could afford. I fought against us becoming a profit-making business. That’s not who we were (are).”

Mail Room Clerk Travis Bailey and KP President Jim Vohs show off the March of Dimes TeamWalk trophy — a bronzed shoe worn by baseball star Willie McCovey — from 1985. KP Reporter cover photo by Jaime Benavides, July 1985.

While KP CEO, Vohs was heavily involved with local communities and charitable organizations and urged KP staff across the regions to participate in public events.  In 1985 and 1986, he served as Alameda County chairperson for the March of Dimes’ TeamWalk and marshaled 900 KP walkers in 1985 and 1,000 in 1986.

With Vohs in the lead, the KP team raised $35,000 in 1985 and $60,000 in 1986. Vohs is quick to note that the March of Dimes walk – 32 kilometers for more energetic participants – wasn’t a promotion of walking. “That was different. We were walking to raise money, not for fitness.”

The KP walking team attracted staffers from all over Northern California. As the top team, KP won the traveling trophy, which was a bronzed shoe originally worn by baseball star Willie McCovey. “Once again we proved we’re number one.” Vohs said at the time.

Of his athletic pursuits, Vohs is most proud of his success as a marathon runner. He competed in the Avenue of the Giants 26-mile marathon, which only accepts 1,000 qualified runners, and two full-length Oakland Marathons when he was in his 50s. He stopped running a few years ago when he developed plantar fasciitis, a condition affecting his feet. He continues to play golf, walks the course and carries his own bag.

This clock of Koa wood was made for Vohs by a friend and Hawaii Permanente Medical Group physician. He treasures it and keeps it on display in his study.

After retirement, Vohs maintained a KP office for about five years and continued his participation on a number of boards, including the Federal Reserve Bank in San Francisco, the Oakland Coliseum, Holy Names College and the Oakland Port Commissioners. “My wife (Janice) said I failed retirement,” he offered, half joking. “She said it was like I was still working because I went into the office every day.”At a certain point, he vacated the office to spend more time at home.

Vohs has four daughters, among them a couple of runners who have entered the Bay to Breakers with him over the years.  He also has nine grandchildren. Grandpa Vohs snapped a beautiful photo of two of his grandsons playing in the autumn leaves in a season that has long passed. The boys’ thick red hair blends with the leaf baskets’ contents to create an impressively artful photograph. Vohs has a large framed print of the scene hanging in his family room.

In his study, Vohs displays two special mementos from his KP days – a hand-crafted clock and a display case for his service pins, both made of Koa wood by a Hawaii Medical Group physician and friend. The case shows all his pins from his Kaiser Permanente career under glass. The last one marks his 40 years with the company.

 

Vohs and his boating friends have a running joke about this papier mache-covered shoe and the memory of a mishap when their boat was swamped.

Another prized object is a tennis shoe preserved with papier mache to remind him of a water excursion with friends that ended with a swamped boat. He and his fellow boaters have a running joke that involves sneaking the shoe back into each other’s possession.

Sadly, Vohs lost his wife of almost 50 years to cancer about 10 years ago. He remarried recently after renewing his acquaintance with Eileen Galloway, a college friend, at a UC Berkeley alumni reunion. Eileen sometimes walks with Jim, but mostly she likes to walk later in the day and a bit slower.

“I want to enjoy myself and appreciate my surroundings,” she said. “And I don’t want to get out of bed at dawn.”

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1990s spawn research and refinement of KP addiction care

posted on August 30, 2012

By Laura Thomas
Heritage correspondent

Old stereotypes don’t accurately represent people who have trouble controlling alcohol consumption. Fotosearch photo

Second in a series
Northern California KP found itself scrambling in the early 1990s to enhance its substance abuse treatment program to meet new government mandates and employer group expectations. But a dedicated and innovative team of psychiatrists and psychologists soon caught up with the trend to treat addicts with the latest methods.

Mimicking the KP Southern California chemical dependency program established in the 1970s gave the Northern California programs upgrade a jumpstart.  Since then, The Permanente Medical Group (TPMG) has conducted studies and pilot programs to improve care and “mainstream” alcoholics and addicts into the primary care program for early intervention.

Charles Moore, MD, now chief of addiction medicine at KP Sacramento, and Lyman Boynton, MD, who had begun the alcoholism program in KP San Francisco, headed south in the early 1990s for consultations with Don Gragg, MD, and Tony Radcliffe, MD, at Fontana Medical Center and at the outpatient chemical dependency program at the Los Angeles Medical Center.

“We literally stole their design. We made copies of all the written documents they used for patient care in their facilities and used it as a template to design our programs,” Moore said.  Psychiatrist David Pating, MD, Moore, and psychologist Steve Allen, PhD, who cheerfully refer to themselves as “dinosaurs,” were all involved in setting up Northern California’s programs in the early 1990s.

Exxon Valdez spill prompts new regulations

The Exxon Valdez whose captain was asleep below the deck ran aground shortly after leaving the Port of Valdez near Alaska in 1989. This picture was taken three days later just before a storm. The captain had reportedly been drinking alcohol and asked the third mate to pilot the tanker. Photo courtesy of Wikipedia

All health plans were compelled to offer these services after the Exxon Valdez oil spill disaster propelled Congress to pass the Omnibus Transportation Employee Testing Act of 1991.

With the mandate to test employees and get serious about treating employees’ drug and alcohol problems, major employers threatened to “carve out” (go elsewhere for) the behavioral health portion of their employees’ health insurance coverage if Kaiser Permanente didn’t offer more extensive treatment.

“It was a confluence of pressures that brought about a concerted effort to build an integrated care system for treating addiction,” remembers Pating, chief of addiction medicine today at Kaiser Permanente San Francisco.

They hired new staff and got busy trying out new ideas. “There was a certain frenetic excitement that we had,” Pating recalled. “We would redesign the program and curriculum until we could get it to be really the best.”

Pilot programs began at KP San Francisco and Sacramento, and then expanded to Vallejo, Santa Clara and Oakland; in 2006, departments were established at Hayward, Santa Rosa, Fresno, Walnut Creek and Modesto.

What emerged in the ensuing years was a more comprehensive curriculum of individual and group work led by trained counselors that focused on helping addicts confront their illness and work on recovery over an extended period. 

Success for intensive day treatment

Treatment might begin with 40 hours a week of intense day treatment, followed by weeks of group therapy, tapering off over one to three years.  Patients requiring detoxification were managed by primary care physicians or sent to contract facilities.

Outpatient group therapy is a key element of the updated KP chemical dependency programs. Fotosearch photo

“We argued our model would be more effective than a 28-day or 30-day (inpatient) program,” said psychologist Steve Allen, who helped set up the program in KP Vallejo, “because with (28-day treatment) there is a high relapse problem.” The response (to intense day treatment) was so positive, he remembered, that employers who had carved out their behavioral health coverage returned to Kaiser Permanente, and “employee assistance programs were advising (companies) that did not have Kaiser Permanente to sign up.”

In addition, fewer chemically dependent patients showed up in the emergency room (ER). “We managed detox as an outpatient (service) better than we thought, and ER responded positively,” Pating said.

Chemical Dependence Recovery Program (CDRP) staffers moved on to work with the psychiatry department to coordinate care for patients with the dual diagnosis of depression and addiction. They also put into place Northern California KP’s innovative Early Start program for pregnant women with drug or alcohol problems, which began in 2003.

Today, 42 KP prenatal clinics in Northern California have a team of specialists who do initial screening and then follow women throughout their pregnancy with a program to counsel and support them in reducing their use. Based on continuing evaluation of the results in baby birth weight and other factors, with the help of the Division of Research (DOR), the program has been expanded to the Hawaii Region and part of Southern California since 2006.

Ambitious research to validate treatment methods

In the intervening years, the “dinosaur” pioneers also began a partnership with TPMG’s Division of Research to study the quality of substance abuse care and possible costs savings realized by providing this type of treatment.

In the October 2000 issue of Health Services Research, TPMG researchers, led by Connie Weisner, doctor of public health, published a study of outcomes for patients who began treatment in KP’s Sacramento alcohol and drug treatment program from 1994 to 1996.

The study, “The Outcome and Cost of Alcohol and Drug Treatment in an HMO: Day Hospital Versus Traditional Outpatient Regimens,” compared the success and costs of an intensive six-hours-a-day program to a two-to-eight-hours-per-week program.1

KP programs offer hope for recovering addicts. Fotosearch illustration

In 2001, Weisner, Moore and others studied the benefits of integrating primary care with substance abuse services at KP Sacramento. They found that substance abuse patients who were mainstreamed were more likely to be abstinent at six months. They continued to track those patients for another nine years and found those who continued to get primary care were less likely to be hospitalized or use the emergency room. 2

It’s taken a lot of research, numerous pilot programs and persistence on the part of Pating and his colleagues, but Kaiser Permanente is moving forward along with the nation in mainstreaming substance abuse treatment.

The research team recently obtained a $2.5 million National Institutes of Health grant for primary care medical teams to screen for substance abuse, offer brief interventions, and study the results.

Health care reform’s impact on addiction care

Full integration will require overcoming the reluctance of primary care doctors to take on increased workloads and to acquire new skills associated with treating addiction, Pating said. But he predicts that in the next five to 10 years there will be major changes in this arena, pushed by mandates in the 2010 Affordable Care Act that require parity between the treatment of substance abuse and other chronic medical conditions.

Pating et al. recently compiled an analysis of the future of substance abuse programs in the new climate created by the health care reform act. The report, published in Psychiatric Clinics of North America in June 2012, reviews current systems and examines the expansion of addiction treatment to include new methods and settings. The report also discusses changing technology, new financing/payment mechanisms and expanded information management processes.

In the journal report, Pating notes that about 23.5 million American adults have a substance abuse disorder, but only 10.4 % receive the addiction treatment they need. He adds that integrating these patients into the primary care setting may be the only hope for some who won’t seek addiction treatment due to societal stigma.3

 

1 “The Outcome and Cost of Alcohol and Drug Treatment in an HMO: Day Hospital Treatment Versus Traditional Outpatient Regimens,” Kaiser Permanente Division of Research staffers Constance Weisner, doctor of public health; Jennifer Mertens, MA; Sujaya Parthasarathy, PhD; Charles Moore, MD, MBA; Enid M. Hunkeler, MA; Teh-wei Hu, PhD, UC Berkeley; and Joe V. Selby, MD, former DOR director, October 2000, Health Services Research.

2 “Integrating Primary Medical Care With Addiction Treatment: A Randomized Controlled Trial,” DOR researchers Constance Weisner, doctor of public health; Jennifer Mertens, MA; Sujaya Parthasarathy, PhD; Charles Moore, MD, MBA; and Yun Lu, MPH, 2001 Journal of the American Medical Association (JAMA).

3 “New Systems of Care for Substance Use Disorders. Treatment, Finance, and Technology under Health Care Reform,” David R. Pating, MD, Kaiser Permanente Division of Research; Michael M. Miller, MD, University of Wisconsin; Eric Goplerud, PhD, MA, University of Chicago; Judith Martin, MD, BAART Turk Street Clinic, San Francisco, CA; and Douglas M. Ziedonis, MD, University of Massachusetts; Psychiatric Clinics of North America, June 2012.

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