George Halvorson was chairman and CEO of Kaiser Permanente from 2002 to 2013. In a recent oral history, he outlined his support for the role of the organization in celebrating and sharing its heritage.
“History is an asset to Kaiser Permanente for a number of reasons. One, it’s a good thing for us to have a sense of who we are and what our values are. I’ve talked about culture a number of times, but when people are making decisions in their day-to-day context, if people have a sense of what the culture is and what the historical legacy is, that helps guide the decisionmaking in positive ways. It’s good for people’s morale to have a sense of being part of an organization that has a history and a culture and a legacy. It gives people a sense of us, to be part of a culture and to be part of a legacy.
“I gave a talk in Washington state a short while ago … I said, ‘Anybody in this room from Kaiser Permanente?’ A couple of people raised their hand. I said, ‘Do you know the story of Sidney Garfield and the nails?’
[This is the anecdote about how Dr. Garfield’s commitment to accident prevention for the workers on the Colorado River Aqueduct Project in the 1930s led him to have staff pull dangerous nails from boards on the site, a preventive routine he carried forward at Grand Coulee Dam in Washington.]
They both said yes. They got it, and I said, ‘I should have you tell the story,’ but I told it. The story is told often enough because it says, ‘Sidney is our founder, Sidney is our giant, Sidney didn’t just look at after-the-fact heart attacks. He looked at how you go upstream.’ The nail story is a good story.
“Another thing that really is positive about the history is because we’re an organization with history, people in important jobs actually will periodically do important things in a good way because they’re thinking of their historical record. I’ve heard many people talk about my role in the history, when the history of Kaiser Permanente is written, I want it to show that I did this.
So, people knowing that we have a history—a legacy and a history—care about what their position’s going to be in that history. I think we benefit from that because I think some people do better, smarter, brighter, more effective things because they’re positioning themselves for their description in the history of Kaiser Permanente. So, I think our history benefits us as an inspiration for doing good things.
“We have a department that provides historical pieces. You could have a staff meeting and use the history of Kaiser Permanente as an example of why we should do a particular thing. The fact that we were the first people to put medical information on punch cards comes up with some regularity, and it’s used as evidence that this is a good trajectory for us to be on, and in fact, it’s one we’ve been on for a long time.
Those stories get told deliberately by people to make their points, to illustrate their points, and they also get told in the internal publications. It’s one of those things that once you read one of those stories, you’re likely to remember it. It’s a paradigm-changing story, to know that we had rooms full of punch cards as we were trying to build the very first generations of medical records, that is a memorable thing and it makes the point that this is a good thing for us to do. It’s the right context for us to be in.”
Excerpted from “George Halvorson: Kaiser Permanente Leader and Health Care Advocate” conducted by Martin Meeker in 2013-2014, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 2016.
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When the Pittsburg, Calif., Kaiser Permanente Medical Office opened in September, 1953, it was ground zero in the struggle between Kaiser’s comprehensive, prepaid, group practice model of medicine and the private practice medical establishment.
Wallace “Wally” Cook, one of the founding physicians in the Permanente Health Plan, recalled that epic confrontation in a 1986 oral history*:
When we were trying to grow rapidly, after Walnut Creek had started in 1952-53, Mr. Kaiser was putting a lot of pressure on the health plan. He built this beautiful facility–“he” in quotation marks–and by gosh, we needed members. We marketed the health plan in the steel workers’ union [United Steelworkers Local 1440] in Pittsburg, California… The steelworkers all went to their fee-for-service doctors up there, and here we were recruiting on their turf for members. This was in the summer of 1953. And there was going to be a vote by the steel workers. The fee-for-service doctors’ wives handed out leaflets, anti-Kaiser, anti-Permanente–very, very negative and, in many cases, untrue.
They hired a sound truck to go around the city of Pittsburg, announcing that Kaiser was trying to invade, and let’s keep them out, let’s preserve what you have with your fee-for-service physician. When the vote finally occurred, we got about 95% of the steel workers. So we immediately had an infusion of 10,000 members overnight, and they were going to be members within a month, or something like that.
Well, that put an even greater burden on the recruiting effort. We had to find some place to see these members. So we leased a building that was about to open as a motel in Pittsburg – a U-shaped, old-fashioned 1940s motel, with room, room, room around in a U-shape. And we converted that into an office. You came in the front, and you’d peel off for dermatology, or medicine, or whatever, each motel room complex being an office space. It wasn’t good, but it worked.
Cecil Cutting, MD, who was also from the original Permanente Health Plan cohort, shot these slides of the clinic in 1958. It was a far cry from the elegant “hospitals of the future” that Kaiser Permanente had built in Walnut Creek, San Francisco, and Los Angeles – but it valiantly served an important working-class community.
The KP Reporter laid out the situation in a 1962 article:
Sometimes the staff of our Medical Office in Pittsburg wonders if the rest of the Kaiser Foundation Medical Program knows they’re there.
Of course, relations with the Walnut Creek hospital are close and continuous, but Pittsburg is quite a distance from other facilities, and everyone there is so very busy – handling more than 3,100 patient visits a month with a staff of 4 doctors – they regard themselves as the “sheepherders” of our Program.
“When I came here in October, and this office opened,” says Dr. Bulgarelli, Physician in Charge, “each doctor saw about 800 patients a month. Our first purpose was to serve the steelworkers and their families.
“In four months patient visits went up to 1,200 per doctor. Of the original medical staff of five doctors, only Dr. Anna Grinbergs and myself remain. How we worked! And on Sundays, we walked. Or rather, Dr. Grinbergs walked, and still does. Myself, I could not keep up with her. She walks every day before breakfast- gets up at 4 a.m. She is younger today than when she took this job eight years ago.”
Membership continued to grow, and in 1954 Dr. F. W. Treubel was added to the staff, in 1955, Dr. B.B. Taylor. In 1956 Lenore Crane came from the Walnut Creek hospital to be clinic administrator. Patient load went over 3,800 a month while 6 doctors were on the staff, but has dropped to 3,200 now that there are only 4 physicians. The Medical Department at Walnut Creek sends a physician each afternoon to help see drop-in patients, who now comprise roughly 60 percent of the patient load at Pittsburg.
The humble motel-as-clinic closed in April 1964 when services were moved to Antioch. Dr. Bulgarelli, physician-in-chief at the new facility, noted the difference in a KP Reporter article January, 1964:
The opening of new Medical Offices in Antioch next month is awaited as eagerly by Health Plan members as by the clinic staff. We outgrew our quarters in Pittsburg where offices had to be scattered about several buildings. One was in the same building with a bar where a juke box kept the customers happy all day long, but was not so pleasing to our patients.
The new building at 3400 Delta Fair Blvd. is a tremendous improvement. It is more centrally located for all the Health Plan members in our area. It is an attractive, modern building, spacious and air-conditioned, where all our services can be united under one roof. And, in addition to those practical advantages, it is surrounded by 5-1/2 acres, and commands a fine view across green fields to the river and the hills beyond.
Color images are scans from Kodachrome slides shot March, 1958 by Dr. Cecil Cutting.
* Wallace H. Cook, M.D., “History of the Kaiser Permanente Medical Care Program,” an oral history conducted in 1986 by Sally Smith Hughes, Regional Oral History Office, The Bancroft Library, University of California, Berkeley, 1987.
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History keeps revealing itself in unusual ways.
Jill Radke, a Kaiser Permanente employee in Hawaii, recently sent this email to Heritage Resources:
Don’t know if you can use this little bit of history, but I thought it was too good to not share….
I do a lot of historic preservation work in my spare time. I used to work at Historic Hawaii Foundation, which is the statewide partner of the National Trust for Historic Preservation. One of the things I’m most proud of from my time there was preserving the strafing (bullet holes) in concrete along the runways on Ford Island — remnants that tell the story of the December 7, 1941 attack on Pearl Harbor.
One of the strafing runs that always puzzled me is near a seaplane hangar’s entrance. I always wondered, “What were the Japanese pilots shooting at?”
To find out, I looked at the attached photo from the National Archives and Records Administration to see what was going on at that site on Dec 7, 1941. Sailors are manning their makeshift defensive positions constructed with sandbags. At one point during my sleuthing process, I had this image on zoom, walked away, and then saw it at a glance later and thought, “Why is a work image on my home computer?”
I’ve seen this photo hundreds of times, but never realized before that the sandbags say “PERMANENTE.”
Yes, indeed they do. Here’s the back story.
Starting in the mid-1930s the Kaiser Company engaged in joint ventures with other companies to build major projects such as Hoover Dam, the Grand Coulee Dam, and Bonneville Dam. As a result, Henry J. Kaiser understood the importance of a reliable and economical supply of Portland cement for the construction industry.
He took a giant step into the cement supply industry when he won the contracts to supply the cement and aggregate for construction of Shasta Dam in Northern California. The award was made even though he didn’t have his own cement manufacturing capability. To meet the cement requirements of the contract, his staff of engineers and construction personnel built a two-kiln cement plant at Permanente, California, (just north of San Jose) beginning production only seven months after breaking ground. The Permanente Corporation was incorporated in 1939, and the company was known as the Permanente Cement Company. Its name was changed to Kaiser Cement and Gypsum Corporation in 1964.
The makeshift defenses in this photo would have originally been sacks of that Kaiser cement. The U.S. Navy had contracted with Kaiser to supply cement for their Hawaiian facilities. In order to keep costs down he proposed the radical idea of shipping cement in bulk form, rather than in sacks, using pneumatic pressure to move the material. It worked, and between October 1940 and the attack on Pearl more than 400,000 barrels of his cement were in sitting in silos in Honolulu. This industrial material proved essential for rebuilding U.S. defenses after the Japanese attack.
It appears that for local transportation and storage, the bulk cement was bagged on site – and was repurposed for the defense of Ford Island.
This humble but essential building material would continue to serve throughout the war. As author Arthur Herman noted in his excellent book Freedom’s Forge: How American Business Produced Victory in World War II, “Only two things stood between defeat and captivity … on Wake Island [in the face of a Japanese attack]. One was the Marines’ four surviving Wildcat fighters. The other was the two batteries of five-inch guns … reinforced with Henry Kaiser’s cement.”
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Heritage guest writer
No matter the era, summer months beg the same question for every parent: “What will I do with the kids?” In 1944, the recreation department in Richmond, Calif., had the answer that would “get you through the summer without ending up in a nervous tizzy.” The options were shared in an article in the July 7 issue the Kaiser shipyard newspaper Fore ‘n’ Aft.
The programs were plentiful and of many varieties. From playgrounds open from 9 a.m. to 5:30 p.m., to child care centers available for a small fee of $3.60, parents could relax and know their children were well cared for by trained recreation department directors and depleted of excess energy by the time they returned home.
Richmond’s recreation department didn’t stop at activities for younger kids. Teens had summer activities available to them including dances on Thursday and Friday nights and youth-directed social groups. Women had the opportunity to take knitting, cooking or sewing classes, others socialized in bridge clubs, drama groups, softball teams, choir groups and family relation discussion groups.
An array of photographs illuminates summertime pleasure for all who participated. One shows three boys developing their archery skills with the help of one of the department directors. In another, a group of teenagers pay a nickel for some tunes at a Richmond recreation hall.
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