Trading a hotel for health care

While the all-purpose family doctor who made house calls has gone the way of the typewriter, the single physician practice is also at risk. More and more doctors are combining in partnerships or joining forces with an existing clinic. Here on the Peninsula, we witness the expansion of the Palo Alto Medical Foundation and Stanford Hospital clinics. Gone is the Mills Hospital of yesteryear where my children were born. It is now combined with Peninsula and part of the large Sutter Health system.

Not to be outdone is Kaiser Permanente which is also building a new hospital in Redwood City and opening new medical clinics throughout the state. The one in San Mateo has just received a Sustainable San Mateo County award. Kaiser serves about 50,000 in the greater San Mateo-Burlingame area and 100,000 when you include its Redwood City hospital and clinics.

The San Mateo facility is tastefully built and decorated with soothing complementary colors (I definitely felt relaxed on the tour but I wasn’t going to the doctor). Black and white are out. It’s a one-stop for outpatients who can get their eyes examined and glasses, buy prescription and non-prescription drugs, see a doctor who specializes in pediatrics, ob-gyn, sports medicine, physical therapy, radiology, etc. and get their lab work done all in one place.

If you need hospital care or more intensive treatment you are sent to Redwood City where there will be 149 beds in the new building. Of course with new medical offices you expect the latest state-of-the-art technology and it’s all there including motion detecting lights to save energy and X-rays taken without film (cuts down pollution). The 20 physicians on site are all connected on line to share information and collaborate on a patient’s care.

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Kaiser was the pioneer in managed care or health maintenance organizations. Its history began in 1933 in a tiny hospital in a small town, Desert Center, CA. Kaiser and several other large construction contractors had formed an insurance consortium to meet their workers’ compensation obligations. Then in 1938 a consortium led by the Kaiser Company started work on the upper half of the Grand Coulee Dam in Washington state. They were now responsible for thousands of workers who had worked for many different companies on the first half of the dam. Henry Kaiser’s son, Edgar, was in charge of the project. A decrepit hospital was renovated and seven physicians were hired. The union insisted that family members be covered, too, and this led from a shift in industrial medicine to family practice. Some of the basic principles of Kaiser Permanente were born.

In 1942, Kaiser opened it offices in Oakland to provide care for 20,000 workers (Kaiser was the nation's biggest shipbuilder during World War II). This was quickly followed by the creation of the Permanente Health Plan which included preventive medicine and education for members about maintaining their own health. In 1944, Kaiser decided to continue the program after the war and open it up the general public. Meanwhile, the American Medical Association, which opposed managed care, tried to stop demand by promoting the rapid expansion of the Blue Cross and Blue Shield preferred provider networks. Today Kaiser, Blue Shield and Blue Cross are all expanding but it is the Kaiser model which has the most promise of keeping medical costs down.

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We’ve all heard the Kaiser radio ads about keeping fit and healthy. And the message is all over the new San Mateo medical offices. There are bike racks for staff and throughout the hallways photos of a young boy flexing his impressive biceps (I go to the Y every day and I can only dream about developing muscles like that.) While the luxury hotel W was a much desired addition, the new Kaiser offerings make more sense.

Sue Lempert is the former mayor of San Mateo. Her column runs every Monday. She can be reached at sue@smdailyjournal.com.