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Geoffrey C. Nunes, MD

Arch Surg. 2002;137:1034-1036.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Henry J. Kaiser developed an extensive and complex industrial empire. During the construction of the Grand Coulee Dam in Washington, he began an association with Sidney Garfield, MD, that resulted in the prototype of the modern health maintenance organization. Kaiser Permanente, directed by Garfield, survived a confrontation with organized medicine in the postwar years and then expanded rapidly in the 1950s and 1960s. At the same time, an internal struggle for control and responsibility of Kaiser Permanente led to a successful reorganization of its health care system. Today, Kaiser Permanente is Henry Kaiser's most enduring legacy.

Ted O'Connell is the first president of the Pacific Coast Surgical Association (PCSA) to be affiliated with Kaiser Permanente. Although health maintenance organizations (HMOs) currently play a major role in American health care, many people are unaware of how these organizations began and Kaiser's role in this process. Thus, it . . . [Full Text of this Article]

Dr Nunes lives in Spokane, Wash.

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