By Lincoln Cushing, Heritage writer
Part of a series about our regional origins
When Henry J. Kaiser’s shipyards closed at the end of World War II, the Permanente doctors lost almost all of their patients. Roughly 200,000 members had been employed in the seven West Coast shipyards and most were covered by the Health Plan.
To survive in the postwar era, Kaiser Permanente needed to gain a large number of new members in a competitive market.
A handful of Permanente physicians in the Pacific Northwest had caught group practice fever and were inspired to stay on despite the uneven odds against their success. Six or seven (nobody recalls for sure how many) out of 45 wanted to give it a go.
Charles Grossman, MD, one of those who hung on, recalled:
“All of us were firmly committed to the prepaid, group health concept, and we decided to rebuild Northern Permanente rather than allowing it to close down,” Grossman told Portland historian Michael Munk. The Permanente physicians judged their wartime hospital to be in good enough shape to withstand a few more years of service.
A cool reception from traditional medicine
Not only were the doctors at first without patients or income, they were given the cold shoulder by the leaders of both the Oregon and Washington medical societies, the states in which Permanente hoped to offer care.
The traditional fee-for-service physicians, unaccustomed to the concept of salaried physicians practicing as a group, branded Kaiser Permanente as “socialized medicine.”[i] The Health Plan and its doctors in all regions faced this type of criticism for decades in the 20th century. The Multnomah County Medical Association of Oregon didn’t accept Permanente physicians until 1963.
Meanwhile, Northern Permanente opened its first clinic in 1947 on Broadway in Portland, Ore. In 1959, the Health Plan opened the Bess Kaiser Hospital in Portland to its 25,000 members; membership doubled to 50,000 in the next two years. In 1975, Kaiser Permanente Sunnyside Medical Center was completed in Clackamas County, southeast of Portland.
Today, the Kaiser Permanente Northwest Region has about 470,000 members. Its newest hospital, green-award-winning Westside Medical Center, opened Aug. 6 in Hillsboro, Ore., on the west side of the Portland Metro Area.
Innovation a hallmark for Northwest
Over the years, the Kaiser Permanente Northwest Region has been at the forefront of innovative and successful health care practices. Below are some examples of the region’s innovations.
- Dental coverage – Head Start children residing in the Model Cities area of Portland were eligible for dental care through an Office of Equal Opportunity pilot program offered in the Northwest Region in 1970. The program was so successful that dental coverage has continued to be offered as an optional benefit to all group members in the region.
Study of health care delivery for the poor and elderly – Kaiser Permanente Northwest took part in a Medicare and Medicaid demonstration started in 1984 to identify the best ways to integrate acute and long-term care for patients covered by prepaid, per-person, per-month (capitation) financing arrangements.
- Testing of an occupational health model — With the goal of decreasing injured employee lost work time and reducing medical costs related to workplace injuries, the region started Kaiser-on-the-Job in 1991. Between 1990 and 1994, the region reduced average lost time per claim by more than two days and achieved a cost savings of $666 in average cost per claim. The occupational medicine program, separate from the Health Plan, covers more than 300,000 workers through their employers in the Northwest Region.
- Sunday Parkways – Recognizing not everyone can succeed in challenging athletic pursuits, Kaiser Permanente’s Northwest Region helped launch a special, less taxing mobility event with the city of Portland in June 2008. Six miles of local streets were closed to traffic from 8 a.m. to 2 p.m. In 2009, up to 25,000 Portland area residents walked, biked, jogged and skated in three summer Sunday events.
- Sustainable use of resources – The Kaiser Permanente Westside Medical Center, new this year, has already received Leadership in Energy and Environmental Design Gold certification from the U.S. Green Building Council. Westside is the second Portland-area hospital to receive the LEED Gold designation and one of just 36 hospitals nationally to earn the honor.
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[i] “Present at the Creation: The Birth of Northwest Kaiser Permanente,” unpublished interview edited by Portland historian Michael Munk, 2013.