Project Themes and Interviews—Year 2: Kaiser Permanente "Core Values"

Year 2 Overview

Narrator Transcripts

Richard Barnaby: Richard Barnaby began his career with Kaiser Permanente as a clerk but retired 37 years later as President and Chief Operating Officer of the Kaiser Foundation Health Plan and Hospitals. This interview covers that entire period of nearly four decades, during which time Barnaby worked both for the health plan as well as a medical group (Southern California Permanente Medical Group); he also worked in several regions, including Northwest, Georgia, and North Carolina. The bulk of the interview looks at Kaiser Permanente in the 1990s in the context of the national managed care crisis and the related internal financial and structural difficulties experienced by the organization. Approximately 4 hours, 45 minutes; interview conducted by Martin Meeker.

Jay Crosson, MD: [NOTE: This transcript is not available online. It will soon be available to researchers at The Bancroft Library and the UCLA Library.] Francis J. Crosson was born in Staten Island, New York, and raised there and in Connecticut. He received both undergraduate and graduate school education at Georgetown University, earning his MD in 1970. While participating in the Berry Plan, Crosson was stationed at the Bethesda Naval Hospital where he gained an interest in pediatric infectious disease. After working in a research position at Johns Hopkins University, Crosson and his spouse, Dr. Sharon Levine, were recruited by The Permanente Medical Group, and they moved to California in 1977. Crosson took on administrative tasks early on and within ten years was named Associate Executive Director the The Permanente Medical Group. In this position he was in a good position to view the continually negotiated relationship between the medical groups and the Kaiser Foundation Health Plan and Hospitals. In the mid-1990s, Crosson played a key role in establishing the National Partnership Agreement and the Permanente Federation, of which he served as the first executive director. Approximately 10 hours; interview conducted by Martin Meeker.

Bob Erickson, JD: Robert Erickson attended law school first at Hastings College of the Law in San Francisco and then graduated from Harvard Law School. Upon graduation he joined Kaiser Permanente in 1958. He served as the Chief Counsel for Kaiser Foundation Health Plan and Hospitals for over twenty years, between 1971 and 1993. During that period of time Erickson attended board meetings of the health plan and played a key role in lobbying and public policy work. Although this interview touches upon both politics and public policy, it focuses on the role of the board of directors and how it changed under the leadership of CEO James Vohs and his successor David Lawrence, MD. Approximately 4 hours; interview conducted by Martin Meeker.

David Lawrence, MD: David Lawrence is a native of the Pacific Northwest, where he was raised and attended high school. He attended Amherst College in Massachusetts as an undergraduate and then medical school at the University of Kentucky, graduating in 1966. At Kentucky, he took advantage of that medical school’s then-unique program in community medicine, which eventually led to assignments in Bolivia and the Dominican Republic with the Peace Corps. Lawrence then advised the Chilean government on public health for two years before returning to the United States where soon earned his MPH from the University of Washington. After serving as Medical Director for the Multnomah County, Oregon, Department of Human Services, Lawrence joined the Northwest Permanente Medical Group in 1981. Moving from the medical group to the health plan side of Kaiser Permanente in 1985, Lawrence served as Regional Manager for the Colorado and then Northern California Regions. He eventually became CEO and Chairman of the Kaiser Foundation Health Plan and Hospitals in 1992 until retiring from that position in 2002. This interview explores Lawrence’s career, with a particular focus on how he responded to challenges faced by the organization in the 1990s. Approximately 9 hours, 30 minutes; interview conducted by Martin Meeker.

Dave Pockell: [in process] Approximately 6 hours; interview conducted by Martin Meeker.

Robert Ridgley, JD: Robert Ridgley was educated at Cornell University and then at Harvard Law School. After graduation, he and his family headed out west for Portland, Oregon. He worked for many years in a law firm doing corporate law, including as outside counsel for the Kaiser Foundation Health Plan and Hospitals in the Northwest Region. After becoming CEO of Northwest Natural Gas Company, Ridgley joined the national board of directors for Kaiser in 1987. This interview focuses on the opportunities and challenges presented to Kaiser Permanente, especially in the 1990s, from the perspective of this board member. Approximately 3 hours, 45 minutes; interview conducted by Martin Meeker.

Bruce Sams, MD: Born and raised in Georgia, Dr. Sams came to California in 1956 as a resident at UCSF. While at the university hospital, he first encountered Kaiser Permanente. In 1962 he joined The Permanente Medical Group and soon emerged as a physician leader at the San Francisco Medical Center. He served as director of The Permanente Medical Group—the chief physician in Northern California—between 1976 and 1990. This interview looks broadly at the notion of Kaiser Permanente “core values” and how those values were both challenged and reinforced in the 1970s and 1980s. Approximately 4 hours; interview conducted by Martin Meeker.

Edgar Schoen, MD: Born and educated in New York City, Dr. Schoen joined Kaiser Permanente as a pediatrician in 1954. He served as chief of pediatrics at Kaiser Permanente Medical Center/Oakland between 1966 and 1990. This relatively short interview looks at the concept of core values in the early years of Kaiser Permanente but then focuses on a 1996 editorial published in the New England Journal of Medicine pronouncing the death of non-profit health plans, and Dr. Schoen’s critical response to that editorial. Approximately 1 hour, 45 minutes; interview conducted by Martin Meeker.

Dan Wagster: Daniel Wagster was born in Kelso, Washington, just north of the Columbia River, in 1927. Raised by foster parents, Wagster was a high achiever and was admitted to Yale to study as an undergraduate. A few years after graduating, he gained employment with Kaiser Industries in the field of industrial relations. He was then transferred to the Kaiser Foundation Health Plan and Hospitals (KFHP/H) in southern California to work as a health plan manager. Over the next three decades, Wagster held managerial positions in many of the regions served by Kaiser, including northern California, the Northwest, Hawaii, and the Mid-Atlantic. This substantial interview examines issues such as the process by which KFHP/H became a federally qualified health maintenance organization and the relationship between KFHP/H and the Permanente medical groups. Approximately 7 hours; interview conducted by Martin Meeker.

Allan Weiland, MD: This interview follows up on the substantial interview conducted with Dr. Weiland in year 1 of this project about the development of the electronic medical record. This subsequent interview examines the managed care crisis on the 1990s and the turbulence within the Kaiser Permanente organization during the same period. The interview focuses on the relationship between the medical groups and the health plan under the leadership of CEO David Lawrence; it also details the creation of the Permanente Federation and the National Partnership Group and Agreement. Approximately 3 hours, 45 minutes; interview conducted by Martin Meeker.