Posts Tagged ‘San Pedro’

Early Permanente physicians: making do with makeshift facilities

posted on February 4, 2011

By Laura Thomas

Heritage correspondent

The first Kabat-Kaiser Institute was housed in this Washington, D.C. mansion.

In the early days of Permanente medicine, co-founder Dr. Sidney Garfield had to be nimble at getting the resources needed to take care of newly signed-up plan members. Working quickly to add new groups just after the war, often Garfield had to scramble to hire doctors and set up care facilities. Sometimes that meant occupying whatever building was available immediately – however seemingly unsuitable.

From the late 1940s into the 1950s, thousands of union workers in the Bay Area joined the Permanente plan and were able to get care at the new Kaiser Foundation Hospital on MacArthur Boulevard in Oakland. But the Bay Area was growing beyond the towns on the bay shore in the wake of the war’s great westward migration, and the medical plan had to grow with it.

Thus, when Henry Kaiser and Garfield took on members too far away to make an easy drive to central Oakland, the physicians moved into any building deemed workable. The health plan took over many wartime health facilities and small hospitals, but at different times, Permanente doctors and nurses saw patients in examining rooms fashioned out of the bedrooms of a motel and a once-stylish, turn-of-the-century hotel, the offices and storerooms of a San Francisco office building, the tight quarters above a modest dress shop and a ranch house on an historic estate.

First postwar facilities at Vallejo military-style hospital

Kaiser’s first opportunity to extend the health plan beyond the shipyards came right as the war ended.  Residents of the apartments and dormitories built for the workers that flooded Vallejo to work at Mare Island and the Benicia Arsenal had laid the groundwork in 1944 by lobbying for a government-sponsored hospital.

Vallejo military-style Permanente hospital in 1948

They succeeded in getting the Vallejo Community Hospital, which was built – military cantonment style – between a slough and a hillside on the north edge of town. Now that the war was ending, the barracks-like facility was slated for closure and the tenants re-grouped. They appealed to Permanente to come to Vallejo to care for up to 25,000 people living in eight housing projects.

In September 1945, the doctors moved into an infirmary downtown near the corner of Fourth and Maryland streets. The facility, which had been used by the U.S. Public Health Service during the war, was renamed the Permanente Medical Center. With only 60 beds, the makeshift hospital was temporary.

By 1947, Permanente re-opened the nearly new Vallejo Community Hospital and  – with the ample space it provided in several single story buildings spread over 30 acres – was also able to bring to Northern California the Kabat-Kaiser Institute, now called the Kaiser Foundation Rehabilitation Center. The original institute was established in Washington, D.C., at Henry Kaiser’s behest to help victims of neuromuscular disease, including his son, Henry J. Kaiser, Jr., who had multiple sclerosis (MS).

Later when a new Vallejo hospital was built in 1972, the campus continued to house the outpatient departments. In 2010 the newest Vallejo medical center was completed with 248 beds, a state-of-the-art rehabilitation wing with two gymnasia, and halls filled with natural sun light and the works of North Bay artists.

Next stop San Francisco

 The first doctors recruited by Garfield had no grandiose expectations. Most were committed to the ideal of health care for the masses, accepted the salary offered and the challenge of making do. It was all about “good humor and team spirit,” as long-time allergy supervisor Renee Owyang recalled in 1982 as she reflected on her early years in the first San Francisco clinic.

This former ambulance company building at 331 Pennsylvania St. in San Francisco was renamed Permanente Harbor Hospital in 1948.

In 1946, while the Alameda-Contra Costa County Medical Society was preparing an attack on Permanente medicine and its prepaid, group practice health model, shipyard workers at Hunters Point joined the health plan. To avoid attracting controversy in San Francisco, Garfield’s doctors took over a small clinic that had served the workers during the war on the third floor of an old lower Market Street office building and put the name of Dr. Cecil Cutting on the door.

In 1948, the Permanente Foundation acquired a 35-bed hospital in the Bayshore District of San Francisco near Hunter’s Point Naval Shipyard. The old structure at 331 Pennsylvania St. had been previously owned by an ambulance company. Garfield had the picturesque building refurbished and re-named it Permanente Harbor Hospital.

For years before the Market Street clinic merged with the new hospital on Geary Boulevard, the San Francisco staff saw patients and even began an allergy department in a loft area that was served only by stairs and a freight elevator. “We often served as elevator operators for our allergy patients who were unable to climb the stairs,” Owyang said. She remembers putting out several buckets on rainy days to catch drops falling in the waiting area from the roof and enjoying the various tunes created by the rhythmic plops: “often we were tempted to rotate the buckets to get a new tune.”

Rambling ranch house turned into Walnut Creek clinic

This Arts&Crafts style home in Walnut Creek was converted to a Permanente medical clinic in 1952.

In 1952, Henry Kaiser, who lived in Lafayette, was eyeing the small, but bustling town of Walnut Creek as the place to locate a new hospital and found a 5-acre site along Newell Avenue. The owner was Edward Counter, soon to be mayor of the town, who lived there in an old, rambling Arts&Crafts style house he and his wife had turned into a cultural center. “It was kind of a collecting place for all the little (old) ladies of Walnut Creek, you know, and they had a tea room,” remembered the hospital’s administrator, Jack Chapman, in 1982.

Chapman also noted in an oral history that the price had been fixed at $75,000, but the ever impatient Kaiser was seen at the property. “He couldn’t wait, you know, he stomped around here one night and somebody saw him and automatically it went up 25,000 bucks.”

The house that had once been surrounded by orchards was turned into a clinic, with an older home at the back becoming the housekeeping department and a swimming pool turned into a morgue, Chapman recalled. When the clinic opened, he was joined by a gardener, to take care of the grounds, a nurse, receptionist and three doctors. By the end of 1953, a new clinic and hospital had been built on the property and 35,000 people trooped through it during an open house that lasted two weeks.

And not a minute too soon, for in the same month (September), Local 1440 of the steelworkers union up the road in Pittsburg voted to join Kaiser –  after a bitter campaign by local doctors designed to dissuade them — and suddenly 10,000 more people became Permanente members. “They demanded then that we open a clinic,” Chapman said.

A motel on Los Medanos Street behind Pittsburg Post-Dispatch building was purchased and used for nine years until a larger clinic was built in Antioch. “So we bought this funny little building that was about to be a motel,” said Dr. Wallace Cook in 1982 “and turned each motel room into an office. It had a courtyard so you peeled off and went to surgery or medicine or wherever, depending on which motel room your doctor was in.”

Southern California coastal group finds space above a dress shop and in posh hotel

San Pedro Permanente medical offices expanded to Pacific Avenue over a dress shop in 1951.

In 1950 Ira “Buck” Wallin MD hurriedly set up shop in a medical office in downtown San Pedro when longshoremen union members joined the health plan. The interim clinic was pulled together in two weeks with Harry Bridges, leader of the International Longshoremen and Warehousemen’s union, breathing down Garfield’s neck.  

There were 3,000 new members to handle and, within seven months, 30,000 retails clerks were added to the Southern California membership rolls, many living in the San Pedro-Long Beach communities. Busting at the seams, the plan found space for several more doctors and the administrative offices above a dress shop on South Pacific Avenue.

By 1954, a new clinic was opened in a large Victorian house on Atlantic Avenue in Long Beach, which had room for five internists, including a pediatrician, and had an X-ray department, but no laboratory. It became popular immediately and another site was opened in the turn-of-the-century Kennebec Hotel, which had been a center of action in Long Beach’s heyday as a beach resort.

Remodeled in 1950, the guest rooms were equipped with toilets and showers and accommodated surgery, internal medicine OB/Gyn, pediatrics and physical therapy.

The old Kennebec Hotel, across from The Pike amusement park, was used as a Permanente Long Beach clinic in the early 1950s.

“It was hot in the summer and cold in the winter but had a good view of The Pike,” said staffer Hannah Wilson. The Pike, the mile-long boardwalk and amusement park that was still roaring in the 1950s featured such attractions as a large indoor swimming pool, carousel, rollercoaster and 10-cent rides for children on Wednesdays.

In 1992, the Long Beach clinic relocated a fourth time to its present site on the Pacific Coast Highway, just before the traffic circle. On most days, members and staff have a clear view of the city’s high rise buildings and the Walter Pyramid at California State University, Long Beach.

The clinic is modern and efficient, but no doubt it has little of the charm of those earlier facilities, none of the pink bordello walls, warm ocean breezes or shrieks of delighted children, that the staff and doctors remember from the old Kennebec.

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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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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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