, Heritage writer
The space was christened “Garfield’s Café” to honor our founding physician and Kaiser Permanente’s long-standing commitment to nutrition as a component of good health. The menu features a wide variety of healthy options, ranging from oatmeal to daily paninis, veggie bowls and salads. The architects of this new café hope patrons will also sink their teeth in history of Kaiser Permanente and the Northwest region.
The space is near a display mounted in 2015 that includes key moments in Kaiser Permanente history in the Northwest. Oversize panels on the café wall highlight Dr. Garfield and the programs in the Portland area during World War II to feed the home-front workforce. These include photos of “Victory Gardens” in the worker-housing projects and employees dining at the huge Kaiser Oregonship cafeteria at St. Johns in 1942.
A large photograph of Dr. Garfield at Contractors General Hospital in the remote Mojave Desert is captioned with a quote from a 1980 letter to the 12,000 members who were part of his Total Health Care Program:
“Remember, good health is a way to get more out of your life — more energy, more enjoyment, more potential, more purpose, more life.”
Also, perhaps another cup of coffee and tasty bowl of oatmeal!
Short link to this article: https://k-p.li/2Oxlkue
Exercise as a vital sign prompts fitness
conversations in the exam room
, Heritage writer
Thirty years ago, Kaiser Permanente founding physician Sidney Garfield, MD, was as anxious as anyone is today to encourage members to maintain a healthy lifestyle.
Dr. Garfield knew that people could better stave off chronic illnesses such as diabetes, heart disease and cancer if they ate healthy foods and exercised for weight control and cardiovascular health. He wanted them to achieve (what he called) Total Health – physical, mental and social well-being.
But how could he get people’s attention?
First, he had to round up members to help them assess their health status before they became sick.
The elegant electronic health records system Kaiser Permanente providers have at their fingertips today wasn’t invented yet. So Garfield and his collaborators had to do it the old-fashioned way:
They mailed letters to new members and asked them to come in for a physical examination. Members completed the total health assessment questionnaire with pen on paper and handed the document to providers.
Members responded to questions such as: “Do you smoke? How many servings of fruits and vegetables do you eat each day? How many minutes do you exercise each day?” The lifestyle questionnaire content formed the basis for each individual’s preventive care plan.
Total health assessment continues
Today, the same process takes place, but advanced computer technology – Kaiser Permanente’s HealthConnect®, the organization’s electronic health records system – makes it easier, quicker and better.
With software available in KP HealthConnect®, physicians work with members to assess body mass and to have a conversation about the member’s physical activity level.
At Kaiser Permanente, both BMI and exercise as a vital sign are considered “vital signs” as important as the traditional measures of blood pressure, pulse and temperature.
BMI calculation, a ratio of height to weight, has been part of the Kaiser Permanente clinical routine for about the past five years. Southern California Permanente physicians piloted and studied EVS results in 2009, and in 2013 the Permanente medical groups in all regions added the physical activity measure to the recommended clinical routine for all facilities.
EVS study results promising
In December 2013, Kaiser Permanente researchers published in the Journal of General Internal Medicine results of an 18-month study conducted at four medical centers in Northern California. Clinicians at the study sites asked patients how many days a week they exercise and for how many minutes.
Researchers began collecting data in April 2010 and followed patients’ weight loss and blood sugar reduction progress through October 2011. The study involved more than 696,267 Kaiser Permanente members who were seen in more than 1.5 million office visits.
Investigators compared the members’ weight loss progress and blood sugar control at the four study sites with nine other medical centers that had not yet implemented exercise as a vital sign.
Even though patients who were asked the exercise question recorded a weight loss of only .02 more pounds than members of the control group, researchers were encouraged by the findings.
“Asking an individual about how much daily exercise he or she (gets) helps our providers learn about what matters to our patients and prompts patients to think about healthier habits,” said Lisa Schilling, RN, MPH, vice president for Kaiser Permanente’s Care Management Institute.
Help for personalizing exercise choices
Currently, members who need help in starting a personalized exercise regimen can consult with a wellness coach by telephone, make an appointment with a behavioral-change specialist, and take advantage of online healthy lifestyle programs.
Kaiser Permanente is the sponsor of the public health campaign “Every Body Walk!” that encourages Americans to incorporate walking in to their daily fitness routine.
In his day, Sidney Garfield was indisputably a visionary in taking advantage of then-budding technology that he believed could improve medicine. As prescient as he was, he could never have predicted the changes that would provide the tools to realize his dream of Total Health. The current edition of The Permanente Journal carries an article about the status of Total Health that would make Garfield feel gratified.
Rebuilt Oakland Medical Center
to open for business July 1
, 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.
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.
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.
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.
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
, Heritage writer
Most new medical center openings are big. But the 1953 grand opening of the Kaiser Foundation Hospital in Los Angeles was really big.
With major support from unions, the Kaiser Foundation Health Plan membership was growing rapidly and the plan needed to expand its facilities, especially in Southern California where the longshoremen and retail clerk unions were swelling the ranks.
In 1953, founding physician Sidney Garfield, MD, presided over the opening of three state-of-the-art hospitals in California; one in San Francisco, one in Walnut Creek, and one in the heart of Los Angeles.
Kaiser Permanente’s move to expand its Southern California presence caught the eye of a rising star in the glamorous, show business city of Los Angeles.
Years before Chet Huntley (1911-1974) would become a trusted household name as a television news anchor, he was a radio reporter for the American Broadcasting Company. At 5:30 p.m. on June 24, 1953, Huntley told the country about the spanking new Kaiser Foundation facility.
Here are excerpts from his broadcast:
“It isn’t very often you see a new hospital these days. Our rate of building new hospitals, in spite of the tremendous need for them, is decidedly not one of our national strong points. So I was interested to see the new 3-million-dollar Kaiser-plan hospital in Los Angeles.
“The use of labor-saving devices, the use of light (both natural and artificial), the furnishings, the gadgets, the décor, and the personnel are all combined to make the new Kaiser Foundation Hospital something special.
“The plan is working so well that continued expansion of the Kaiser medical program seems certain. The hospitals and clinics are operating in the black by a margin sufficient to attract splendid medical talent.
“You can, however, listen to the debate and the controversy and perhaps ultimately you’ll decide that the best place to go for a reliable opinion is to the fellow who is paying for the Kaiser Foundation Health Plan and who is using it.
“Down the line, the customers go for it. Where else, they ask, could they get treatment, care, and medical attention like this for less than the daily cost of a bottle of milk, considerably less than the cost of a package of cigarettes.
“Although this isn’t true of all health plans, the Kaiser program allows the patient to choose his doctor from those on the staff. As one patient said, “What do you mean, doctor-patient relationship? There are 250 doctors here and surely out of that many I can find one with whom I can get along.”
In the ensuing decades, Kaiser Permanente has built many a new and evermore sophisticated medical center. This year, three brand new Kaiser Permanente hospitals have opened or are opening, including an amazing high-tech and green hospital in San Leandro, Calif.
Short link to this article: http://bit.ly/1nPHZTP
By Steve Gilford
Senior consulting historian
As an independent historian with a long-standing interest in Kaiser Permanente, I was fortunate to be invited to the daylong 60th anniversary celebration of the Southern California Permanente Medical Group, held recently in Anaheim, Calif.
The event was to mark the medical group’s formal start in 1953 when 13 Permanente physicians, including Ray Kay, the first medical director, signed a partnership agreement that officially formed SCPMG.
The group’s origin actually goes back to 1943 when Henry J. Kaiser asked Permanente co-founder Sidney Garfield, MD, to establish a health care plan for workers of the Kaiser Steel mill in Fontana.
Today, SCPMG has more than 6,000 physicians practicing in 14 accredited Kaiser Foundation Hospitals and more than 190 medical office buildings.
Pride a theme of celebration
As I observed the events of the day (Sept. 28, 2013), I heard Permanente physicians express pride in the organization and its legacy. But at first I wasn’t entirely sure the expressions were genuine, or if it was similar to the type of pride shown for a football team or one’s alma mater.
As the day unfolded, it became increasingly clear that this was an authentic professional pride rooted in SCPMG’s 60-year history of trials and triumphs.
Pride in the organization can be traced back even further, to the tiny 12-bed hospital Sidney Garfield built in 1933 on a parched and lonely piece of desert land in one of the most physically inhospitable places in the United States.
The organization that sprang from that little frame building in the Mojave Desert, with its one doctor and one nurse, was being celebrated by thousands gathered together in one of the most populous and powerful metropolises of the nation.
Roll call gets vociferous response
Edward Ellison, MD, the SCPMG executive medical director, began the day by calling the roll of Southern California’s medical centers represented at the gathering. Each medical center team responded to the call with a spontaneous cheer that resonated across the large hall.
There was no question that these physicians were enthusiastic, but it was not yet clear to me just why they were responding with such vigor. Was it like the way people in a talk-show studio audience react when someone mentions their hometown?
Was it just because they had found a comfortable place to practice medicine outside the increasingly stormy arena of fee-for-service medicine, relieved to be insulated from some of the stresses their professional colleagues were facing?
Or was it truly because they were recognizing that they were a part of an organization that was truly special, with a leadership that encouraged them to practice preventive care and to take great care of their healthy members, as well as their sick patients?
Celebrities tout Permanente’s national role
As a part of the proceedings, there were dramatizations featuring Henry Kaiser, Sidney Garfield and even Rosie the Riveter – all well done and entertaining. They set the stage for Kevin Starr, noted California historian and author, and Nancy Snyderman, MD, chief medical editor, NBC News, and award-winning journalist.
The celebrities’ presentations put the achievements of Kaiser Permanente into perspective, each emphasizing the contribution of the organization to the nation’s health care.
Starr and Snyderman were the stars of the day, but for me the day’s high point was an onstage discussion by the four surviving SCPMG executive medical directors – Frank Murray, MD, 1982-1993, Oliver Goldsmith, MD, 1994- 2004, Jeffrey Weisz, MD, 2004-2011, and Edward Ellison, MD, current executive director.
They presented the organizational challenges that they had faced in their time and told how they had overcome them.
Through all their recollections flowed a strong streak of natural idealism that had helped them shape their responses to the challenges of their time at the helm. Their remarks – more than any other presentation – made it clear that SCPMG leaders created and passed on a strong legacy that was to be treasured, defended and enhanced.
As the day drew to a close, Dr. Ellison summed up what he felt was special about Permanente Medicine and SCPMG. “We are building infrastructure for the future . . . I am confident that our approach to achieving the total health of our patients in mind, body and spirit is the successful path to that future.
“Our conquering, enduring spirit, combined with our passion for medicine and our caring from the heart, will sustain us for the next 60 years,” he told the group.
Often, when you hear such presentations made by leaders in front of their staffs, if you listen carefully you can hear quiet undertones of mildly cynical scoffing or snickering from the rank and file who may have a quite different perspective on the relation between idealism and reality.
That afternoon I was listening closely for that tell-tale buzz from among the 3,000 people in the hall. I didn’t hear it.
What I did hear was enthusiastic agreement with what Dr. Ellison was saying. I understood then that the pride I had sensed in the responses to his morning roll call of the medical centers had been genuine and had only been enhanced by the day’s focus on the achievements and potential of Permanente Medicine.
I left Anaheim with a renewed sense of pride in my association with Kaiser Permanente, for my modest part in searching out, saving and communicating its history to new generations of physicians who will preserve and expand the legacy begun by its founders.
by Ginny McPartland, Heritage writer
Healthy living benefits, women’s progress, and nursing history among past year’s blog subjects
In 2013, the quest to bring to light the best episodes in Kaiser Permanente’s history led us to a wide range of topics.
Our blog subjects included World War II Home Front stories, a little known saga about pioneering nurse practitioners in Sacramento, and the highlights of the 60-year career of Kaiser Permanente researcher/physician Morris Collen, MD, who turned 100 this fall.
We covered a special event featuring actor Geena Davis that showcased women, including a few Kaiser Permanente leaders, who overcame gender and ethnic discrimination to achieve success.
We got to unearth little known facts about Henry J. Kaiser’s part in the construction of the San Francisco- Oakland Bay Bridge, and we found buried video assets in our archive to tell the Bay Bridge story in film for the first time.
We were also able to produce a video clip capturing scenes of the medical staff who worked with Sidney Garfield, MD, caring for workers at the Grand Coulee Dam site in Washington State in the 1930s.
Healthy lifestyle promotion has deep roots
In our collaboration with the National Park Service, we enjoyed an opportunity to revisit the surprising benefits of food rationing during World War II. We also carried stories of the Rosie the Riveter Trust and its funding of community projects in Richmond, Calif., including “Rosie’s Girls”, an initiative to motivate girls from low-income families in their career choices.
Also, in Richmond, we participated in the 2013 Martin Luther King, Jr., volunteer day with Urban Tilth, a growing community garden project that harvests a crop of fresh fruits and vegetables for local consumption. Healthy lifestyles also got a push with a blog about the health benefits of walking.
Mining for history nuggets
For Lincoln Cushing, a highlight of the year was the opportunity to interview Jim Gersbach, Senior Hospital Communication Consultant for the Kaiser Permanente Northwest Region.
Gersbach, who was with Kaiser Permanente for 27 years, lived through much of our history and has an amazing understanding of the organization.
The Gersbach interview will find its way into Kaiser Permanente’s collection of its leaders’ oral histories, many developed by UC Berkeley Regional Oral History Office. Here’s a taste of the conversation with Gersbach:
“Having worked (at Kaiser Permanente) for a quarter century, I strangely enough find that I have personal memories about what have now become historical periods of time.
“We’ve been doing this for 20, 30, 40 years, even back in the 1940s. (Looking back on our history), it’s really about asking, “What are (Kaiser Permanente’s) consistent values that don’t change over time?”
Collaborating to tell our story
Over the past year, we’ve collaborated with our partners at the Rosie the Riveter/World War II Home Front National Historical Park to help tell the Kaiser Permanente origins story in the permanent museum displays to be unveiled in the spring. In 2014, we will carry stories in our blog about news and events at the budding park.
We also look forward to sharing the stories about the opening of the Oakland Medical Center’s historical displays within the state-of-the-art hospital to open in 2014.
We’ve worked with the medical center staff to congregate assets for dynamic displays to tell the multifaceted 75-year history of Kaiser Permanente, including a section on the Kaiser Foundation School of Nursing.
Heritage staff has supplied historical photos and factual material for other publications, including the Kaiser Permanente Procurement and Supply Department’s print newsletter, The Source, which won a national award.
We also contributed to materials developed by the Kaiser Permanente Latino Association and the Labor Management Partnership, which carried several short articles about labor history in the magazine Hank.
Other assets surfacing this year in Kaiser Permanente archives allowed the detailing of Henry J. Kaiser’s role in construction of the Caldecott Tunnel and his pioneering in broadcasting during the 1960s.
We’ve also found material that allowed us to tell tales of Kaiser’s strong personal interest in speedboat racing, and to offer glimpses into his exploits in the manufacture of cars, such as the racing Henry J and the Darrin sports car that caused a stir in the 1950s.
By Ginny McPartland, Heritage writer
Cecil and Millie Cutting, a couple that looms large in Kaiser Permanente’s early history, met in Northern California at Stanford University in the early 1930s. He was training to become a physician; she was a registered nurse with a degree from Stanford. They met on the tennis courts and married in 1935.
During her husband’s nonpaid internship, Millie Cutting worked two jobs – for a pediatrician during the day and an ophthalmologist in the evenings – to pay the bills. He was making $300 a month as a resident when Sidney Garfield, MD, contacted him about joining the medical care program for Henry Kaiser’s workers on the Grand Coulee Dam in Washington State.
At Grand Coulee, Millie Cutting exhibited her strength as a staff nurse and as a community volunteer. Probably her most significant contribution was the development of a well-baby clinic in a community church.
Well-baby clinic supported by madams
As a volunteer, she organized the clinic and went door to door soliciting funds for its operation. She had no qualms about knocking on the portals of the town’s brothels.
“The madams were very friendly,” Cecil Cutting told fellow physician John Smillie, author of a history of The Permanente Medical Group. “The community church provided the space and the houses of ill repute the money – a very compatible community.”
The Grand Coulee Dam was completed in 1940, and the medical staff and their families scattered. The Cuttings settled briefly in Seattle where Dr. Cutting set up a surgery practice.
But it wasn’t very long before World War II broke out and Dr. Garfield was called upon again to assemble the medical troops for a program at the Richmond, Calif., Kaiser Shipyards. Cecil Cutting was enlisted as the chief surgeon.
Garfield’s right hand ‘man’ at wartime shipyards
Millie Cutting volunteered to work side by side with Sidney Garfield to get the medical care program up and running and to take charge of any job that needed to be done.
She recruited, interviewed and hired nurses, receptionists, clerks, and even an occasional doctor, to staff the health care program that was set up in a hurry in 1942. She smoothed the way for newcomers and helped them find homes in the impossible wartime housing market.
Thoroughly adaptable Millie drove a supply truck between the Oakland and Richmond hospitals and the first aid stations and served as the purchasing agent for a time.
As she had done at Grand Coulee, Millie set up a well-baby clinic for shipyard workers’ families, and she opened her home in Oakland as a social center for the medical care staff.
By Steve Gilford, Senior Consulting Historian
Southern California physicians to replace plaque dedicated in 1992 to commemorate Sidney Garfield’s Contractors General Hospital
I’ve recently returned from Southern California where I assessed the damage vandals and thieves wreaked to the historical marker near the site of Dr. Sidney Garfield’s 1933-built Contractors General Hospital.
This location is significant because it’s where Kaiser Permanente’s pioneer physician first discovered how prepaid, preventive medicine could make health care more affordable.
The 110-pound bronze plaque, placed at the historical site 21 years ago, has been pried off its base and stolen, presumably for the value of the metal. This is another occurrence of the national trend of thieves dismantling historical markers to turn bronze to cash.
I traveled to the desert not only to evaluate the loss but also to arrange for a replacement plaque. My journey was successful: I found a safe location for a new plaque and an enthusiastic benefactor to pay the bill.
In 100-plus-degree heat that is usual for the area, I surveyed nearby Chiriaco Summit, an active way station for desert travelers, with Margit Chiriaco Rusche, the daughter of founders Joe and Ruth Chiriaco. We found an appropriate site for a new plaque in an island of green vegetation which many visitors pass.
Locating historic hospital site
For me, this mission was personal. Twenty-seven years ago, I uncovered the hospital site where, in 1933, Kaiser Permanente’s founding physician had started his prepaid health plan for workers on the Colorado River Aqueduct Project.
In 1986, Stanley Ragsdale, self-described “desert rat” and owner of Desert Center in Southern California, accompanied me on an expedition to find the long lost site of Garfield’s hospital, six miles west of the little town on Interstate 10.
As we approached the area, we could make out the foundation outlines, which were all that remained of the facility abandoned in the late 1930s. As someone with experience in archeological digs, I headed for the nearby garbage pit, in which I found medical artifacts that positively identified the site.
With this information and other research, I prepared an application and supporting materials for the site’s designation as a historical landmark. The California State Historical Commission unanimously authorized an official plaque recognizing the importance of the tiny hospital to American medicine.
In a 1986 ceremony, Sally Garfield Blackman, Dr. Garfield’s elder sister, unveiled the bronze plaque attached to a boulder near the spot where the once bustling hospital had stood.
Southern California physicians sponsor replacement plaque
Over the past two decades, the dusty town of Desert Center, with its two-block long main street, has fallen on hard times. The restaurant, gas station, general store, and ice cream stand are all gone. With no one around the abandoned town, the plaque was easy pickings for thieves, and several weeks ago they struck.
I mentioned the loss to Paul Bernstein, MD, San Diego area medical director for the Southern California Permanente Medical Group. Bernstein (Twitter: @sdthinkbig), personally interested in the history of Contractors General, is as chagrined as I am by the marker’s disappearance.
He approached the Southern California Permanente Medical Group, and they have agreed to replace the plaque as part of SCPMG’s 60th anniversary celebration in September. This year also marks the 80th anniversary of the hospital’s founding.
Chiriaco motorist stop fitting site for new historic marker
Joe and Ruth Chiriaco founded their first store the same year that Dr. Garfield opened Contractors General Hospital; they knew the hospital and Dr. Garfield well.
Ruth Chiriaco, a registered nurse, had worked in nearby Indio with Betty Runyen, Dr. Garfield’s first nurse. Having met the Chiriacos in my previous research, I was pretty sure the family would be amenable to putting the new plaque near their business that includes a store, restaurant and gas station.
This fall, Dr. Garfield’s favorite nephew and closest living relative, Dr. Robert Blackman, and Blackman’s two sons will participate in the dedication, as will nurse Betty Runyen’s three children. Betty’s daughter Susan, a nurse with Kaiser Permanente in Hawaii, has just finished a novel based on her mother’s life at Contractors General Hospital.
By Lincoln Cushing, Heritage writer
Garfield’s design of ‘dream hospital’ features unconventional and efficient layout
1953 was a big year for expansion in Kaiser Permanente. The fledgling Health plan opened state-of-the-art hospitals in three communities – Los Angeles and Fontana in Southern California and Walnut Creek in Northern California.
The Los Angeles Medical Center (on Sunset Boulevard) was the first to open, on June 16, 1953. The dream hospital design was inspired by Kaiser Permanente founding physician Sidney Garfield who worked with architect of record George M. Wolff.
The new hospitals debuted the concept of separate corridors for visitors and staff. Visitors could enter a patient room from an outside walkway, staying out of the way of busy medical staff moving along the interior corridor.
Garfield’s design called for decentralized nursing stations with one for every four rooms (one nurse per eight patients) instead of one per floor. Patient rooms had an individual lavatory with hot, cold, and iced water.
The futuristic concept of the “baby in a drawer” – a sliding bassinet that let a tired mom pass her newborn through for care in the nursery – was also introduced in the 1953 dream hospitals.
LA Times touted new medical center
The Los Angeles Times gushed about the $3 million facility, describing it as “sorely needed.” It also noted: “The Kaiser Hospital, operated by the non-profit Foundation, is open to the public, a fact not generally known. In addition to Health Plan patients, it also accepts private patients and charity patients referred by social welfare agencies.”
But that public aspect did not sit well with the Southern California medical establishment whose members resisted the arrival of prepaid, group practice medicine. The next month the Los Angeles County Medical Association sent out a questionnaire to its members with the header caption “This is the most important notice ever sent to you by the LACMA.”
Medical association resisted group practice
The cover page made clear the medical association’s concerns:
“Points have been raised as to whether this (Kaiser Permanente) is really a corporation practicing medicine, whether the ‘captive’ patients of the plan forced to join by their union is good for the welfare of the people, whether the patients receive adequate medical care, whether it is proper for a layman to control physicians, etc.”
Opposition reached a fever pitch in August 1953 when Paul Foster, MD, president of the medical association, condemned the Kaiser Permanente program as “unethical.”
These were difficult times for the fledgling Permanente group. The successful practice of high-quality medicine in gleaming new facilities like Sunset eventually wore down the opposition. By 1960, the local medical society attacks on the program had come to an end.