Posts Tagged ‘multiphasic’

Widow of Permanente pioneer shares fond memories of Garfield

posted on January 24, 2011

By Steve Gilford 

Senior KP History Consultant 

Ira "Buck" Wallin, MD, pioneer of Southern California KP

A recent phone call brought me the sad news that Jeanne Wallin, wife of the late Ira “Buck” Wallin, MD, a Southern California Permanente Medical Group pioneer, had passed away this month at the age of 89.  

I first met Jeanne a bit more than ten years ago when my interest in recording first hand accounts of the origins of Kaiser Permanente led me to her and Buck Wallin, one of the first Permanente doctors on the ground in Southern California. 

In 1950, after just a few weeks at the Permanente hospital at the Kaiser Steel plant in Fontana, Calif., Permanente founder and executive director Sidney Garfield enlisted Wallin to open medical offices to care for longshoremen at Los Angeles harbor in San Pedro. This was the first expansion of the program into Southern California outside of the steel plant and the beginning of the Southern California Region.  

After Buck’s death in 2002, I remained in occasional contact with Jeanne. A cheerful, articulate woman with an easy manner, she enjoyed reminiscing about “the old days.” Unlike others I had talked to about Dr. Garfield, Jeanne Wallin knew him neither as family nor as physician. He’d been a friend with whom she, her then-husband, Joe Lydon, and a group of other couples, would often share weekend afternoons and evening parties. 

Permanente founder had movie star quality 

Jeanne Wallin, at left, playing cards with Sidney Garfield, MD, on Sea Star about 1976

Jeanne, a native of Oakland, Calif., had married Wallin in 1987 after the death of Lydon, a marketing consultant.  It had been Lydon who, in 1972, had introduced her to Dr. Garfield. Before Jeanne met Sidney Garfield, Lydon told her, “You’ll like this man, he’s such a gentleman; everyone likes him.” Soon Jeanne and Joe had become close friends with Sidney, his wife Helen, Health Plan Regional Manager Karl Steil and Karl’s wife, May. 

“Almost every weekend, Sid and Helen came down (to Alameda) so we spent a lot of time together.” What they all had in common was a fondness for boats and so much of their social time together was aboard either the Steil’s boat or their own, berthed near each other at Alameda’s Ballena Bay Yacht Club.  

According to Jeanne, Dr. Garfield had a movie star quality. “He reminded a lot of people of Spencer Tracy . . . The women adored him.” Even so, she recalled, “He was very, very quiet around me.” However, after they’d become better acquainted, he began to open up a little. 

“One day, we were cruising somewhere.  He and I were sitting out in the cockpit and he told me all about designing the Oakland hospital. . . . and how originally he wanted to be an architect.  He had a very quiet way about him.  He was utterly charming.  I could see why women liked him so much.” 

Garfield pushed good health, not health plan 

Dr. Garfield didn’t mind that she and her husband were not members of the Permanente Health Plan. In the 1970s when Jeanne mentioned to him that she and Joe were planning a trip to Europe, he insisted that they have a medical checkup before they leave.  “You cannot go until you have a ‘multiphasic,’” he said. 

The multiphasic program was basically a battery of screening tests that was offered to Kaiser Permanente members. The advantage was that in a short period of time, with minimal inconvenience, a patient could get a complete health examination. Sidney told them that if they went through the multiphasic examination before they left, they could leave the country knowing that they were in good health. 

Garfield arranged simultaneous appointments for the couple at the Oakland Kaiser Permanente hospital. “Of course, my husband went one way and I went the other . . . Sid personally took me through the whole multiphasic. We’d have little stops: open a door and go in and there’d be cake and cookies and a cup of coffee.  It was the most wonderful way to get all these physicals done and over with.” 

Garfield as architect and planner collaborated with Wallin 

She remembered another one of the Garfield innovations she’d seen that afternoon: colored lines painted on the medical center floors to help patients find their way easily from one test station to the next. “Well, I thought it was fantastic, following the lines.  He told me how he’d invented all this stuff. 

“Then he showed me through the whole hospital and how he designed the rooms to be between the central corridors and the outside ones off of the center corridors.  It was so charming of him to share this with me, and you could tell the great pride he had in it.  Great pride. I felt very honored,” she related. 

In the mid-1950s, Dr. Garfield collaborated with Medical Director Wallin on the design of the 56-bed Harbor Hospital in Harbor City.  When membership grew, Wallin and Garfield worked together to plan that hospital’s expansions.  In the early 1960s, the two men again collaborated to plan and launch the new Bellflower service area, including the layout of the hospital, the budgeting and selection of the 60-physician staff. 

In 1966, when the health plan took over the financially troubled San Diego Community Health Association, Wallin became the founding medical director there.  Dr. Wallin served on the board of the Southern Permanente Medical Group until 1973. He stayed on in San Diego as a member of the staff there for several more years until he moved to the Bay Area. 

When Jeanne met and married Dr. Wallin, she took great pride that Buck had played an important part in what had become the largest private medical care program in the world. Following her death, her family paid her a high tribute, “Jeanne embraced life in both difficult and joyous times.”

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Today’s Research and the Earliest Computer Medical Records

posted on August 4, 2009

Did you catch any of the news stories about the researchers who reported that elevated cholesterol levels in midlife significantly increase the risk of Alzheimer’s disease and dementia later in life? This was a collaborative piece of work by researchers from Kaiser Permanente and the University of Kuopio in Finland. And I’ll I bet you didn’t know that it was only possible because they could track almost 10,000 patients over four decades because of some of the earliest computer medical records in history!

Let me share the back story.

Recently, my colleague, Bryan Culp, and I got to spend an afternoon with Dr. Lester Breslow. He is the great public health leader in California who invented the “multiphasic exam” after World War II. The idea was to develop and use mass screening techniques to improve public health. He later became director of the California State Department of Public Health and served as dean of the School of Public Health at UCLA.

Dr. Breslow shared his memories of how an illustrious Permanente physician and classmate from the University of Minnesota Medical School, Dr. Morris F. Collen, adapted the “multiphasic exam” for use with thousands of longshoremen who joined Kaiser Permanente in 1951. Within a year, the exams were being expanded to other patients.

But the big news came in 1963-64 when, with partial support of a grant from the U.S. Public Health Service, Dr. Collen replaced paper records with a computerized “automated multiphasic screening program” that provided a total of a half million examinations in its first decade. Those were among the first computerized medical records in history and have been providing important long term medical information for researchers for more than four decades.

So, how does that relate to the new study? Well, the research findings came from tracking the medical data of members of Kaiser Permanente’s Northern California Region from 1967 to 2007 by using those very multiphasic testing records pioneered by Dr. Collen, who is widely regarded worldwide as pioneer of the field of medical informatics.

–Tom Debley

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