Posts Tagged ‘Avram Yedidia’

Celebrating 50 Years of Medicare

posted on July 29, 2015

Jennifer Downey

Healthgram 1965-Winter

Kaiser Permanente member newsletter, 1965

On July 30, 1965, President Lyndon B. Johnson signed the Medicare Bill into law, immediately granting 35 million older and disadvantaged Americans access to the medical care they needed. He praised the country’s aging World War II veterans as the nation’s “prideful responsibility [who] are entitled … to the best medical protection available,” and thanked former President Harry S. Truman, one of the program’s original architects, for “plant[ing] the seeds of compassion and duty which have today flowered into care for the sick, and serenity for the fearful.”

Although “medical care as a right” was a boon to those who would receive coverage, the question of exactly how a national health insurance system would function in terms of administration, organization and approach of care delivery quickly enmeshed government and private sector, industry and commerce, in a heated debate that continues today. And Kaiser Permanente, as one of a number of private health plans established prior to Medicare’s inception, was swept up into a national health care tornado.

An aging population

Following 16 years of depression and war, 1946 was a turning point as America’s peacetime economy boomed. The workforce filled jobs and factories, and most workers received health coverage through their employers or unions. The aging and disadvantaged segment of the population, however, was falling behind. Accessibility and affordability of health care had quickly become out of their reach, yet their numbers continued to grow: A health care crisis was looming.

No one argued that there wasn’t an urgent need for large-scale care; however, the debate over how to structure and administer it was just ramping up, and would intensify over the next decade.

The Medicare proposal

The Medicare program was characterized by 1) government administration of the program and funding through payroll taxes, and 2) a continuation of the prevailing fee-for-service model of health care. This second characteristic directly conflicted with Kaiser Permanente’s model of prepaid health care. The organization saw the fee-for-service system not only as a challenge for its own structure to integrate, but maybe more importantly, as a faulty approach to delivering health care.

“Under the prevailing fee-for-service system, income of doctors and hospitals is directly related to the volume and price of the services they provide. Illness produces income,” read Kaiser Permanente’s 1965 annual report.

Scott Fleming, Kaiser Permanente attorney and executive, echoed that sentiment: “[T]he industry’s purpose is wrongly conceived; the industry should develop the capability of delivering comprehensive health care for people rather than merely providing episodic treatment for patients.”

Kaiser Permanente’s approach of total health — health care versus sick care — influenced the national debate early on. Other private and voluntary health plans also joined the fray, as they braced for the impact Medicare would bring.


Visitors at Kaiser Permanente Sacramento Hospital open house, 1965

Medicare enacted July 30, 1965

While key Kaiser Permanente personnel remained active in policy dialogue around Medicare’s structuring, the organization had been intensely preparing for the program’s integration into its own (very different) system. Its priority was to maintain its standard of excellent care for all members through the coming transition — a shift that would bring an influx of new Medicare beneficiaries and see the conversion of a portion of its existing members to Medicare covered. Kaiser Permanente’s health plan reached out to members, encouraging those who were eligible to enroll in Medicare, and adapted benefits and coverage to maintain best care for beneficiaries.

It also undertook a massive training effort in its facilities to ensure that staff was prepared and the integration was smooth. The effort paid off — implementation was a huge success. Life magazine’s Sept. 3, 1965, issue reported how catastrophic Medicare implementation was for most medical facilities, but spotlighted Kaiser Permanente as a success story.

An evolving program

Medicare has evolved greatly in the five decades since its enactment. It has seen major reforms, amendments, new legislative acts and bills, and has been the subject of ongoing scrutiny around budgetary, administrative and quality issues. The heated debate continues — how best to administer it, fund it, and ensure that it’s efficient yet effective.

That the argument continues isn’t surprising, given the mammoth, complex system that it is.

Today’s seniors benefit from early visionaries

In 1958, Kaiser Permanente consultant and health care economist Avram Yedidia voiced the imperative to “face the responsibility of providing health care or protection for [those] which we presumably show the most concern — the sick, the unemployed, the retired, and the aged.”

Despite Medicare’s growing pains over the last 50 years, older and disadvantaged Americans continue to benefit from accessible, affordable health care through the program. They receive resources and coverage, guaranteed, just as the program’s early architects envisioned.

As a participant in Medicare since the program’s inception, Kaiser Permanente has been influential in improving the program’s service model to deliver better coverage and care to seniors. For example, it pushed for a capitation model — resulting in Medicare Advantage — which serves as a substitute for fee-for-service, and it helped develop the Medicare Star Quality Ratings, which rewards health plans for excellent service and care.

Over the past five decades, Kaiser Permanente has delivered high-quality health care to millions of Medicare members throughout their lifetimes. As a recognized frontrunner of leadership and innovation in Medicare, Kaiser Permanente has and continues to build initiatives, programs and institutes for the improvement of health care and coverage for seniors. Its Medicare plans in California consistently receive top national ratings for excellence in care and service from the U.S. Centers for Medicare & Medicaid Services, and its health screening rates are among the best in the nation, according to the 2014 National Committee for Quality Assurance’s Quality Compass® data set.

The bold call for compassion by Medicare’s early visionaries fundamentally changed the shape of health care for older Americans today and beyond — and at 50, Medicare continues to serve those who need it most.


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Kaiser Permanente’s History of Nondiscrimination

posted on July 24, 2015

Lincoln Cushing
Heritage writer

Final essay in a series on Kaiser Permanente’s 70th anniversary

Lobby at Richmond Field Hospital, circa 1943

Lobby at Richmond Field Hospital, circa 1943

One of Kaiser Permanente’s key features is that it is an “Integrated health care system” – meaning it seamlessly provides care and coverage together and provides a wide range of services under one roof, whether in a Kaiser Permanente medical office or hospi­tal or at a contracted facility. But in 1945 “integrated” also held another important meaning when the health plan was opened to the public – it reflected a deep commitment to being one of the first health care providers in the United States to have racially integrated hospitals and waiting rooms, as well as an ethnically diverse workforce, including physicians and allied health professionals.

During World War II, compliance with federal law (such as the Fair Employment Practice Committee) as well as decent best practices meant that employees were treated without institutional discrimination. An estimated 20,000 African Americans, along with many Chinese Americans, Native Americans, and Hispanic Americans, worked in the Kaiser shipyards. Kaiser Industries took great pride in this ethnic and racial diversity, featuring stories in the shipyard newsletters. A caption for a photo of an elegantly attired African-American female shipyard worker launching the Liberty ship S. Hall Young boasted: “How’s this, Adolf? It’s Richmond’s answer to your efforts to split America into warring racial groups.”

Industrial health care covered all workers, and the affordable supplemental health plan that Sidney Garfield, M.D. created for workers and their families in the Kaiser shipyards were equally open. In a time when the Civil Rights movement was just coalescing, racism in America was pervasive. Access to health care was no exception, yet the Permanente Foundation Hospitals took the high road.

Journalist Nick Bourne wrote about the Permanente Health Plan in the San Francisco News on October 7, 1943. He noted:

Illness knows no color line here. Red-helmeted men, women welders, Negroes lined up for a checkup by the busy young doctors. In one double room was Miss Katherine Rossi, shipyard loan office employee, here from Duluth, Minn., for six months; ill six months from skin trouble. A Negro woman was in the adjoining bed. “So help me!” declared Miss Rossi. “I’ve been in hospitals before, but never one like this. It’s sure swell. I don’t know what I would have done.”

The International Longshore and Warehouse Union newspaper The Dispatcher favorably remarked in 1945:

“The hospital’s facilities are open to all groups with no segregation of patients because of creed or color.”

Nurse attending shipyard worker, Oakland hospital, circa 1943

Nurse attending shipyard worker, Oakland hospital, circa 1943

In 1946, the year after the Health Plan was opened to the public, several local policemen visited the Oakland hospital with an eye to join. Permanente medical economist Avram Yedidia recalled the event:

“. . . The police chief said to me, ‘You know, when we walked through, I saw that you had some Negroes and whites in the same room. I don’t think we like that.’ “As I can recall, I responded, ‘Do you know this plan started that way, with blacks and whites in the shipyards, and that’s the way it goes. They worked together, and they were sick together.’ ” I told the police chief: ‘Those who don’t like it shouldn’t join the plan.’ ”

Diversity and inclusion continues to be a guiding principle at Kaiser Permanente. In 2013 Diversity Inc. magazine ranked Kaiser Permanente third in their “Top 50” national corporations, noting a workforce that at all levels reflects high percentages of women, Blacks, Latinos and Asians and has a diverse board of directors. This year Kaiser Permanente moved up to #2. Ronald Copeland, MD, Kaiser Permanente’s chief diversity and inclusion officer, recently affirmed the organization’s progress and challenge:

We must robustly, and in a systematic way, embrace multiculturalism and differences of our workforce and our member population to make sure that everybody’s meaningful needs are met in a personalized way…That is a journey we have been on for nearly 70 years and much progress has been made, but we still have a ways to go in order to become truly inclusive.

It’s about understanding and owning your own talents and vulnerabilities, and being comfortable and humble enough to share with and learn from others. It is about seeing and respecting the value in other people who are different than you and expecting them to do the same in return.

Over the past 70 years Kaiser Permanente’s commitment to nondiscrimination has moved well beyond race and ethnicity, to include gender, generation, sexual orientation, physical, and cognitive abilities in the pursuit of equality without exception. And, as a testament to the acceptance and support for such practices, 10 million people have chosen to “join the plan.”

Happy 70th anniversary, Kaiser Permanente.


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Old Oakland hospital holds memories of Kaiser Permanente’s dynamic past

posted on June 20, 2014

Rebuilt Oakland Medical Center
to open for business July 1

This is a view of the old Fabiola maternity wing that was to become Kaiser Permanente's first Oakland hospital.

This is a view of the old Fabiola charity hospital’s maternity wing, built in 1923. This structure was transformed into Kaiser Permanente’s first Oakland hospital, opened in 1942.

By Ginny McPartland
Heritage writer

If the walls of Kaiser Permanente’s soon-to-be-replaced Oakland Medical Center could talk, they would tell an epic story with many dramatic chapters.

The structure – cobbled together with many additions over seven decades – might channel the spirit of the Victorian-era nurses who tended to the sick and injured at the Fabiola charity hospital that sat near the corner of MacArthur Boulevard and Broadway from 1887 to 1932.

The first Kaiser Permanente Foundation Hospital, which opened in Oakland in 1942, might also reverberate with the heart-wrenching tales of injured World War II Kaiser Richmond shipyard workers whose lives were saved in a refurbished wing of the old Fabiola hospital.

For 40-plus years, the medical facility radiated with the passion of a wiry, red-headed, daring and dashing surgeon who teamed up with larger-then-life industrialist Henry J. Kaiser to set up an innovative, prepaid health plan, first for Kaiser’s workers and then for the public.

Physician founder Sidney Garfield’s ideas were incorporated into the design of the original Fabiola hospital refurbishing; in fact, over the next two decades he would play an integral role in designing most Kaiser Permanente facilities.

For his part, Henry Kaiser made sure the care Kaiser Permanente delivered was color-blind; the health plan embraced all people, despite the fact other hospitals in the Bay Area were segregated.

View of the maternity ward at Oakland hospital 1945.

View of the maternity ward at the old Oakland hospital in the early days.

Kaiser Permanente pioneer Avram Yedidia tells a memorable story about several local policemen who visited the Oakland Medical Center in 1946 with an eye to join the Health Plan. Yedidia recalls in his UC Berkeley Bancroft Library 1985 oral history:

“. . . The police chief said to me, ‘You know, when we walked through, I saw that you had some Negroes and whites in the same room. I don’t think we like that.’

“As I can recall, I responded, ‘Do you know this plan started that way, with blacks and whites in the shipyards, and that’s the way it goes. They worked together, and they were sick together.’ ” Yedidia told the police chief: ‘Those who don’t like it shouldn’t join the plan.’ ”

Phenomenal growth and change in 70 years

The seed Garfield and Kaiser planted in the war years has grown exponentially into Kaiser Permanente as we know it, with 9.3 million members and its significant presence in the national health care landscape of today.

Sidney Garfield, just 36 years old when he and Kaiser opened the hospital, had a vision for preventive care and total health for Health Plan members – a vision that played out in many ways in Oakland.

After the war ended in 1945, Dr. Garfield focused on improving the health plan’s quality by creating educational opportunities for physicians and nurses, encouraging research, and setting up ways members could learn how to stay healthy.

Avram Yeddia on the day he retired.

Avram Yedidia, Kaiser Permanente health plan pioneer and consulting economist, on the day he retired in 1982.

In 1947, Henry Kaiser and his wife, Beth, established the Kaiser Foundation School of Nursing and soon the halls of the medical center – expanded by then to 230 beds – were bustling with white-capped student nurses and their strict mentors, all clad in crisp white uniforms and sensible shoes.

Among their leaders was the legendary Dorothea Daniels, who set Kaiser Permanente’s high nursing standards in the early years.

Computer age begins

The Oakland Medical Center also witnessed the queuing up of burly, yet well-dressed longshoremen and other Health Plan members who followed the hospital’s version of the “yellow brick road”, a color-coded tape path that led them through the facility to stations where various tests were performed.

Initially called the “Multiphasic,” these screening tests marked the beginning of Kaiser Permanente’s pioneering work in automated laboratory testing and compilation of electronic medical records, and the Health Plan’s foray into the use of computers in the 1960s.

In 1965, the Oakland Medical Center opened its first specialized cardiac care unit with physicians and nurses trained to use the latest heart monitoring equipment to care for patients.

Nurses use monitoring system in cardiac care unit, circa 1965

Nurses use monitoring system in cardiac care unit, circa 1965

In 1970, physicians in Oakland began a progressive nurse practitioner certification program; specially trained nurses were assigned to see patients who needed routine primary care but didn’t need to see a physician unless a problem emerged.

In 1972, the 12-story hospital tower, which was built on top of the wartime structure, was opened. That extra space allowed Garfield to open Kaiser Permanente’s first Health Education Center, the precursor to today’s healthy living centers.

The Oakland patient education facility was stocked with books, pamphlets, films and tapes that patients could borrow to learn how to prevent and manage chronic illness.

In 1980, new radiology services, including ultrasound and CAT scans, opened on the Oakland campus. In subsequent years, hospital officials established a pediatric intensive care unit and new Magnetic Resonance Imaging and Lithotripsy centers on the Oakland campus.

Garfield separates the well from the sick

In 1981, Garfield was instrumental in the opening of a new primary care center, which was part of his mission to encourage members to take measures to stay healthy and avoid chronic disease, such as diabetes, heart problems and cancer.

Sidney Garfield, MD, Permanente founding physician, walking the walk in Mojave Desert near site of Contractors General Hospital, 1980

Sidney Garfield, MD, Kaiser Permanente founding physician, walking the walk in the Mojave Desert near the site of the first hospital he built, Contractors General Hospital, in 1933. Kaiser Permanente photo, 1980

Sadly, in 1984, Garfield died while still working on his “Total Health” research project. His colleagues finished his endeavor, whose results laid the foundation for the organization’s focus on Total Health that continues today.

The hospital tower that allowed Total Health to spread its wings in the 1970s was doomed in 1994 when the state of California passed seismic safety legislation that required a retrofit of the Oakland main hospital building.

Kaiser Permanente officials decided to replace the hospital with the new Oakland Medical Center across MacArthur Boulevard from the original 1972-built tower. The new Medical Specialty Office Building facing MacArthur opened in January: the new Oakland Medical Center will open on July 1.

Garfield’s Total Health philosophy can still be seen in ways great and small at the Oakland Medical Center, right down to a weekly farmers’ market – founded in 2003 – that served as a template for 50 such markets that operate in communities across the nation today. As the historic structure is abandoned and its memories fade, the passion of its original architect will live on.

Garfield summed up his philosophy of Total Health: “Remember, good health is a way to get more out of your life – more energy, more enjoyment, more potential, more purpose, more life.”

Photo history of the Oakland hospital




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Avram Yedidia: Handling loads of steel like books in a library

posted on January 9, 2014

By Lincoln Cushing
Heritage writer

Imagine the chaos of a thousand boxcars of steel destined for ship production sitting in and around Richmond, Calif., in 1942. How could managers

Avram Yedidia handled steel in the Richmond Kaiser Shipyards like books in a library.

Avram Yedidia handled steel in the Richmond Kaiser Shipyards like books in a library.

unravel the mess and get the far-flung steel to the right place at the right time and avoid production delays?

The solution was obvious to Avram Yedidia, a native of Israel who later made his mark as a Kaiser Permanente consultant and economist:  Handle steel like books in a library.

Yedidia earned a bachelor’s degree in education at Hebrew University in Jerusalem and did graduate work in economics and philosophy at Columbia University and the University of California, Berkeley. In 1937 he learned library science by the seat of his pants so he could lead efforts to archive the huge Adolph Sutro special collection in San Francisco.

The Sutro Collection, part of the California State Library system, is made up of documents chronicling the Mexican Revolution and the British “poor laws” of the 16th and 17th centuries.

Yedidia applied the principles of library science to create an effective process for unloading, storing and delivering steel to the job sites. He was a shipyard expediter, charged with ensuring timely deliveries of equipment and materials to meet the “just in time” production pace of the yards, a task made especially challenging by wartime shortages.

In 1945 he was hired by Dr. Sidney Garfield as a representative for the Kaiser Foundation Health Plan, responsible for signing up groups of workers and their dependents. Between 1957 and 1982 Yedidia was a consultant for the Kaiser health plans in northern California, Hawaii, and Ohio, as well as other health maintenance organizations (HMOs) nationwide. He was a champion of the “dual choice” concept, asserting that wherever the Kaiser plan was offered another medical plan must be available to employees.

For Yedidia, this was a carryover from shipyard days when he let his 400 employees know they were not required to sign up for the Kaiser Health Plan.

“Tell them it is voluntary,” Yedidia told the supervisors who presented the plan to workers. The plan cost 50 cents a week ($2.60 a month).  They all signed up within 24 hours, except one Danish woman. “She didn’t understand what it was. Once she understood, she signed up too,” Yedidia recounted in his oral history.

Yedidia was a graduate of Hebrew University in Jerusalem and studied economics and philosophy as a postgraduate at Columbia University and the University of California, Berkeley.

In 1959, he established his own consulting service in the organization of health care services and advised Kaiser Permanente for the next 31 years. Yedidia and his son Peter consulted with the program on the organization of geriatric services in the late 1980s.

Yedidia’s influence on health care financing and delivery extended beyond Kaiser Permanente. He earned an international reputation as a medical economist and a consultant on employee health benefits.

He was instrumental in the establishment of the Community Health Foundation in Cleveland, which later became Kaiser Permanente’s Ohio Region. He was also involved with the reorganization of the Health Insurance Plan of Greater New York.

Yedidia passed away in 1990.


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Iron nurse Dorothea Daniels had a soft spot for nursing students

posted on March 21, 2011

Daniels at right, Lisker second from right, 1950 Permanente Foundation Nursing School capping ceremony in Oakland, California. Note Daniels' Phillips Beth Israel cap.

By Ginny McPartland
Heritage writer 

Read almost anything about Permanente Foundation School of Nursing’s first long-term leader Dorothea Daniels, and a caricature of a stern, tough-shelled, by-the-book and proper nurse comes to mind. Daniels, a product of New York, rattled her students, nurses and many physicians with her exacting demand for perfection in all things related to patient care and protocol.

She made the nurses work and study hard in restrictive conditions and she didn’t hesitate to correct a physician who displeased her. “She came from a different cut of cloth,” wrote John Smillie, MD, in his history of the Permanente Medical Group. “She regarded herself, and I think quite properly, as a peer of any of the doctors she was dealing with.” 

Migrating to California from New York City after the war ended in 1945, Daniels brought to Permanente her solid education (a doctorate in education from New York University) and experience running a nursing school in that city. From 1936 to 1945, Daniels was the director of the Phillips Beth Israel Hospital School of Nursing. 

Daniels imposed strict rules for student lifestyle

Not unlike other nursing schools of the time, Phillips stressed the students’ need to conform to strict standards of behavior, dress and health habits. House mothers hovered over the students to make sure they didn’t misbehave. “Nurses were not permitted to marry while in training, and subsequent marriage was grounds for instant dismissal,” according to the school’s current Web site. 

At Phillips, nursing students worked six days a week and curfews were rigorously enforced. Pupil nurses were disciplined if they stayed out all night. “Dress inspections took place in the dining room, and students were weighed once a week to make sure they did not ‘get too heavy’ since there was a professional necessity for nurses to ‘look well.’ 

Kaiser Foundation School of Nursing in an old hotel building on Piedmont Avenue near the Oakland hospital, 1948 to 1976

“Hospital director Daniels insisted on student nurses who looked healthy and fit, believing that if students were overweight, they could not work hard and take care of patients,” the school historians reported. “There was concern (during the 1930s) that nurses did not get enough exercise and recreation…’” 

Daniels gets support for her view of fitness in a textbook for orienting student nurses in the 1930s: “Curative medicine gives place to preventive medicine, so must (the nurse) be prepared to understand and apply intelligently the principles of prevention…“The nurse of the future must exemplify health, and teach it. Humanity is ready to cast off sickness.” 

Encouraging nurses to spend leisure time wisely

In 1940, Daniels embarked on a study to assess Phillips students’ leisure time activities, including physical activities. “What Ninety Girls Like to Do in Their Free Time,” authored by Daniels, was published in the National League of Nursing Education publication. A softer side of Daniels emerges in her discussion of the study results. 

“These young women (19 to 24 years for age) have developed abilities of discernment and judgment in their avocations as they develop in the school. While they are learning to assume increased responsibility, they seem to be learning how to spend their leisure time more wisely,” she wrote. She said many subscribed to a professional nursing journal, and “The most thorough inspection of the nurses’ quarters never reveals magazines of the ‘true story’ category.” 

The survey results conclude that the younger girls are spending an average of six hours a week on exercise and the older girls 7.3 hours. “Within a short walking distance there is a tennis court, a swimming pool, a roller skating rink and bicycle-riding areas. “Little equipment is necessary. Sport dresses are the only necessary paraphernalia for hiking, bicycle riding, and roller skating…these types of exercise are easy to learn and give one a sense of well-being and feeling of grace,” Daniels wrote. 

Once the anonymous surveys were compiled, Daniels returned them to the students and asked them to send them back with identification so she could: “aid in fulfilling the wishes stated on the papers. We found it possible to send some students to their first legitimate play; and some 25 were sent to concerts. Our physical education director was instructed to work out her program to include activities for which there were expressed preferences.” 

Bringing her ideals to California

Permanente Foundation Nursing School graduation 1951. Dorothea Daniels at far left, Clair Lisker, third from right.

When Daniels came to California, Permanente Foundation hired her as director of nursing in the Oakland hospital. That position grew in 1948 to include the job of director of the nursing school established in 1948. As expected, Daniels incorporated into the school policies many of the ideas she had adopted in New York. 

The first Permanente School of Nursing student handbook, developed in 1948, prescribed the dos and don’ts for students to get along well at the school. “Your ability as a nurse is reflected in the way you keep your room…Students must be in their own room at 10 p.m., and all lights will be out at 10:30 p.m…Guests may be entertained only in the living room between 8 a.m. and 10 p.m. (Exceptions were made if a mother came to visit.) 

“Pre-clinical students will be in the residence at 8 p.m. each day, Monday through Thursday, unless otherwise specified by the director of nurses…Your window shades will be kept drawn at night when the lights are on…Every student is expected to be adequately clothed when going through the halls…Students are expected to be tidy and well groomed at all times…The conduct of the student nurse on and off duty must be such as will not reflect discredit on herself, her chosen profession, nor her school.” 

In a 1961 nursing school report, a revised philosophy of the school was detailed. Revisiting the fitness theme, one stated role of a successful nurse was: “A teacher of healthful living.” A decade later, the Kaiser Foundation Nursing School brochure stated under Personal Qualifications required for admission: “General appearance is one of the considerations in the selection of students. Applicants must weigh within normal limits of the range established for height and structure.” 

Daniels helped students pursue bachelor’s degree

Daniels, at left, as a hospital administrator. Daniels was the first woman to serve as a hospital administrator in the Kaiser Permanente health plan.

Daniels left the school in 1953 to become administrator of the Los Angeles Permanente Foundation Hospital, making her the health plan’s first woman hospital administrator. She later returned to Northern California to take over as administrator at San Francisco Medical Center. Clair Lisker was one of Daniels’ early students who rose within KP hospital nursing administration. In a 2002 oral history, Lisker credits Daniels with “paving the way for all of us. She was in San Francisco, and she was at Sunset in Los Angeles, two major facilities. 

“She was a tremendously powerful woman, intellectually. I don’t ever remember seeing her sit down,” said Lisker. Daniels encouraged her best students to earn a bachelor’s degree in addition to an RN degree, believing that a well-rounded education would ensure a promising future. Lisker was one of those students. 

“Dorothea was encouraging me to go and enroll in Holy Names College in Oakland, which was then down by the lake (Merritt) where the Kaiser building is now,” recalled Lisker. “She wanted me to get the basics, like English 1A and 1B, and whatever else I needed, philosophy…I basically said: ‘I can’t afford it…she said ‘well, what I’ll do is I’ll pay your fee, and I will get reimbursed. I’ll take $5 out of your allowance (stipend) every month.’ ” Lisker remembers $5 being deducted from her stipend once but doesn’t believe Daniels ever claimed the rest of the $30 advanced ($10 per course unit). 

Kind, generous and impeccably dressed

“She was very kind and generous to those student nurses, and for a good student she would find scholarship money for that young lady to go on to get a degree, so (the student) would become a leader in nursing,” Smillie recalled. Avram Yedidia, a health plan leadership pioneer, said of Daniels: “Her dedication to patient care was as unblemished as her uniform, which miraculously never wrinkled.” 

“She wore these white starched uniforms with a little pointy hat with a black band, and a little pleated organdy cap on her head,” Lisker recalled, noting the cap was from the Phillips Beth Israel school. Daniels’ penchant for a proper nurse’s uniform was no doubt formed in her early years in New York. While she was at Phillips, student nurses were required to adhere to strict dress standards. 

The Phillips Web site: “Students wore black stockings, long sleeves, bibs, aprons, ankle length blue-check dresses, tight cuffs and a bishop’s collar. During the senior year, what was black became white: socks, stockings and dresses became the uniform of the professional nurse. Students wore no caps until the senior year.” 

To make sure they got the uniform right, the administration consulted etiquette expert Emily Post on the proper attire for student nurses on an outing. “Hats and gloves were de rigueur on field trips,” Phillips historians reported. 

The memory of Dorothea Daniels, who passed away in 1968, will always be of a woman to be reckoned with. Lisker summed it up: “Dorothea’s (attitude) was: ‘I’m in control. I’m in charge’…But she also had her other (tender) side, which she didn’t display very often…She loved her dog. She brought (Snuffy) to work every day, and the dog slept in a drawer in her desk…She was a wonderful lady, but she was a character.”

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