Kaiser Permanente Medical Care Oral History Project / Project Themes and Interviews

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Kaiser Permanente Medical Care Oral History Project

[1970 - Present]


About the Project

Project Themes and Interviews

	Year 1: Evidence-Based Medicine

	Year 2: Kaiser Permanente "Core Values"

	Year 3: Diversity and Culturally Competent Care

	Year 4: Government Regulation and Public Policy

	Year 5: A Viable Economic Model

KP Founding Generation

Relevant Resources

Project Themes and Interviews—Year 1: Evidence-Based Medicine

Year 1 Overview

Narrator Transcripts

Morris Collen, MD: Dr. Collen’s history with KP goes back to 1942 when he began as chief of medical service at the first Kaiser hospital in Oakland. A previous interview with Dr. Collen covers his career in broad sweep. This interview is more closely focused on the intellectual underpinnings of the multiphasic health testing program he developed and the research office he founded, which later evolved into the KP Division of Research in Oakland; this interview also touches upon the Garfield’s Total Health Project. Approximately 3 hours, 45 minutes; interview conducted by Martin Meeker.

Cecil Cutting, MD: Dr. Cutting’s engagement with Sidney Garfield’s approach to prepaid group practice medicine dates to 1938 when he was asked to serve as a physician on Kaiser Industries Grand Coulee dam project in Washington state. This very brief interview touches upon Dr. Cutting’s professional relationship with Dr. Garfield; a more complete interview with Dr. Cutting was conducted as part of the KP Founding Generation series. Approximately 52 minutes; interview conducted by Martin Meeker.

David Eddy, MD, PhD [transcript in process]: After earning his MD from the University of Virginia, Dr. Eddy discovered his true passion was applied mathematics; he went on to earn his doctorate in that field, from the Department of Engineering-Economic Systems at Stanford University in 1978. This wide-ranging interview covers Dr. Eddy’s work as a leader in the development of clinical, “evidence-based” guidelines, a term that he coined; Eddy also discusses his work as a long term consultant for Kaiser Permanente and the development of the Archimedes Model, a complex software program that allows medical researches to model patient and population response to treatments. Approximately 4 hours; interview conducted by Martin Meeker.

Vincent Felitti, MD: A graduate of Johns Hopkins Medical School, Dr. Felitti joined the Southern California Permanente Medical Group (San Diego) in 1968. This interview focuses on Felitti’s Health Appraisal program which helped determine the medical needs of patients in a preventive health context; the interview further covers Felitti’s more recent research into the impact of childhood abuse on adult health. Approximately 6 hours, 40 minutes; interview conducted by Martin Meeker.

Gary Friedman, MD: A veteran epidemiologist with the Framingham heart study and the US Public Health Service, Dr. Friedman began in 1968 as an epidemiologist in Dr. Collen’s Department of Medical Methods Research (later the Division of Research); he served as director of that division from 1991 through 1998. This interview looks critically at the multiphasic health testing program initiated by Collen; it further explores the development of computerized medical records, research ethics and methodologies, and Garfield’s Total Health Project. Approximately 3 hours, 55 minutes; interview conducted by Martin Meeker.

Oliver Goldsmith, MD: Dr. Goldsmith joined the Southern California Permanente Medical Group (SCPMG) in 1969 after graduating from UCLA Medical School. Although committed to work as a clinical physician, Goldsmith moved into a leadership role in 1973 as a member of the SCPMG board of directors; he eventually became SCPMG Medical Director in 1993 and served in that capacity until 2003. This interview explores KP internal politics and external challenges to the organization since 1970; a fair portion of the interview focuses on Dr. Goldsmith’s management philosophy. Approximately 5 hours, 10 minutes; interview conducted by Martin Meeker.

Merwyn 'Mitch' Greenlick, PhD: Dr. Greenlick’s background is in public health. In 1964 he founded the Center for Health Research (CHR) as part of Kaiser Permanente, Northwest Region, and served as director from 1964 until 1995. This interview explores the history of the CHR and, in particular, research conducted under its auspices related to medical care delivery; the interview also touches upon the HMO act, interregional relations, and politics. Approximately 7 hours, 10 minutes; interview conducted by Martin Meeker.

Robert Klein, MD: Starting at KP as a staff specialist in urology in 1975, Dr. Klein switched gears to focus primarily on medical management and administration in the 1980s. Topics covered in this interview include: marketing of medical care (including the “Thrive” campaign), Garfield’s Total Health Project, and the 1990s adult primary care redesign initiative. Approximately 2 hours, 25 minutes; interview conducted by Martin Meeker.

Frank Murray, MD: After working as a physician in a small practice in Wauwatosa, Wisconsin, Dr. Murray joined the Southern California Permanente Medical Group in 1971. Murray moved quickly up the ranks of the organization, eventually serving as SCPMG Medical Director from 1982 to 1993. The interview offers a broad overview of the idea of “Permanente medicine” and KP medical management practices and approaches; Murray also touches upon issues relevant to the debates in the 1990s over KP “core values.” Approximately 5 hours, 50 minutes; interview conducted by Martin Meeker.

Joe Selby, MD, MPH [transcript in process]: After establishing a neighborhood-based health project in east Oakland, Dr. Selby came to the KP Division of Research as an epidemiologist in 1985. In 1998 he became director of the division and continues to serve in that capacity today (2006). The interview looks broadly at the work of the Division of Research and focuses on the continued use of data from Collen’s multiphasic health testing program and, to a lesser extent, on the Total Health Project, the adult primary care design initiative, and the impact of race on research design. Approximately 3 hours, 15 minutes; interview conducted by Martin Meeker.

David Sobel, MD, MPH: Dr. Sobel is a leader in preventive health and health education. This interview focuses on those two related pursuits in the context of his work on behalf of the Permanente Medical Group (northern California); the interview also touches upon culturally competent approaches to care and medical marketing, including the “Thrive” campaign. Approximately 2 hours; interview conducted by Nadime Wilmot.

Paul Wallace, MD: Dr. Wallace was pursuing a largely academic approach to medicine when he accepted a position in hematology and oncology at KP northwest that allowed him to pursue both research and clinical interests; in 1999, Dr. Wallace was brought to Oakland to work in the Care Management Institute, in which he served as director from 2000 to 2005. This interview looks broadly at the development and practice of evidence-based medicine in KP, focusing on the development of clinical practice guidelines, the electronic medical record, and future directions of evidence-based medicine. Approximately 4 hours, 30 minutes; interview conducted by Martin Meeker.

Al Weiland, MD: Dr. Weiland joined Northwest Permanente Medical Group as an OB/GYN in 1977, but moved into medical management and administration in the 1980s, eventually serving as regional Medical Director from 1993 to 2000; he also served on the founding board of the Permanente Federation. This interview focuses on the emergence of clinical quality evaluation and, in particular, on the development of the electronic medical record in the northwest region that became the basis for the system-wide KP HealthConnect. Approximately 5 hours, 50 minutes; interview conducted by Martin Meeker.