History
1940 - 2007
- 1940 - 2007
In 1940, with World War II threatening, Dr. I. M. Lipson and his son-in-law Dr. William S. Neal were established in Visalia as one of two small medical partnerships, but with the departure of Dr. Harry Falk for service with the U. S. Army Medical Corps, they were left alone. These two physicians had offices on the second floor above Newberry's store, across from the Main Drug Store. Upon Dr. J. H. Brady's arrival in 1941 the Group was destined to become the Visalia Medical Clinic. The other group: Preston, Betts, Weiss, and Powell had much more pretentious offices on West Willow Street across from the Visalia Municipal Hospital. After many years, this group was to become the Kaweah Medical Group. The physicians in these two groups comprised more than half the physician population of Visalia, which then had a total population of less than 8000. During the 1940's, since the hospital had no Lab or Xray facilities, all such services were performed by those 2 groups. Merrill Johnson, Xray Tech. who joined Dr. Lipson in 1940, operated both the Xray and Laboratory service, with Dr. Neal's help, for several years, after taking a short course on blood typing, etc., in Fresno.
When Dr. Falk left, just months prior to the Pearl Harbor episode, Dr. J. H. Brady filled the $350.00 per month vacancy, in July 1941. Dr. Brady arrived fresh from his residency at Norton Memorial Infirmary, Louisville, KY. with his wife and 2 children. His first surgical experience, just hours after arrival was the closure of a perforated duodenal ulcer, the operation being performed in the old Visalia Municipal Hospital, where many other operations were to be performed during the next 25 years.
And now a word about this 68 bed hospital, which then functioned as one of only three city-owned and -operated hospitals in California. The ownership and operation was to change about 1957 with formation of the Kaweah Delta District Hospital, created by vote of the people residing in the area contained within the present Visalia Unified School District boundaries. This new entity has of course continued the operation to the present, including building of the new and demolishing of the old hospital in 1968.
Because of the large population area served by Visalia then (and now), the office and hospital practice of medicine was booming, and the wives of Dr. Neal and Brady acted as night and weekend answering service. All 12 physicians in Visalia were extremely busy. It was quite obvious that much better facilities and locations were necessary. So, early in 1942 the new building destined to become the Visalia Medical Clinic was begun at 311 S. Floral Street where the present Kaweah Delta District Hospital now stands. Originally, this consisted of a 4000 sq.ft. brick structure, built to accommodate 4 physicians, laboratory and X-ray, and of course a business office.
Early in 1946, after Drs. Neal and Brady returned from the War, an official partnership was formed, consisting of three partners, who promptly began recruiting. They first obtained the services of Dr. A. Walden Klaus, Internal Medicine and Psychiatry; then Dr. Charles Suits, Generalist; and Dr. Robert J. Leo, OB-Gynecologist.
With 6 physicians, it was soon obvious that more room was needed. The building was expanded to 6000 square feet in 1948 to accommodate 2 more physicians and a new Physiotherapy department. In addition to the permanent recruiting of Dr. Herman Audino, G. P. in 1948 and Dr. Lyle E. Osgood, Internist in 1949, several other changes occurred about this time. Two Generalists, Dr. Brubaker and Dr. Haumeder joined for brief periods in 1947 and 1949, and Dr. Suits left because of illness.
By 1952 the clinic was functioning as a 3-man partnership with 5 employed physicians. Dr. Patricia Tudbury, Internist, had been added in 1951. Thus there existed departments of Surgery, General Practice, Internal Medicine-Psychiatry, and OB-Gynecology, along with Physiotherapy, Laboratory, and Xray departments, and again the building was extremely crowded. Mark Karstaedt was hired as our first full time Administrator and remained with the clinic for 22 years.
- 1953-57
Many events were to occur during the years 1953-57. Dr. John W. Gates, Ob-gyn joined permanently in 1953. Dr. Neal decided to return to Governor's Island Hospital, New York City, for a 2-year residency in Pediatrics, and during his absence, Dr. Bob Watson, Pediatrician, joined the group temporarily. In 1955 Dr. Tom Davis, Internist, began his 6-year stay as an employed physician, and Dr. Tudbury left. In 1956 Dr. Hamilton R. Fishback (Del), Radiologist joined, to remain permanently. This was also the year Dr. Neal returned, only to disagree with Dr. Lipson concerning the type of administration, with the result that Dr. Neal and family moved to Australia for 6 months, to return to a rather cool reception by Drs. Lipson and Brady. With his leaving, the 3-physician partnership ended and during early 1957 the clinic struggled along as a 2-man partnership, being further crippled by Dr. Watson's departure.
Things then rapidly changed for the better in mid-1957 with the permanent addition of Dr. George Tiss, who rejuvenated the Department of Pediatrics. By late 1957, with 8 physicians occupying space built for only 6, it was obvious that not only were new and expanded facilities needed, but also a new form for the medical association must be considered. Thus a new partnership was conceived consisting of 8 doctors, including Doctors Brady, Klaus, Audino, Leo, Osgood, Gates, and Fishback, but not including Dr. Lipson, since he felt that any partnership of more than three was doomed to failure.
With the prospective coming of Dr. Robert Havard, Pediatrician, in 1958 and with Dr. Brady again serving as building committee chairman, construction of a new facility at 1821 Meadow Lane was rushed by the owner and contractor Lauren (Red) Miner, and was actually completed about the time Dr. Havard arrived. The new building, with area of 13,500 sq.ft. was to accommodate 12 physicians, Laboratory, Radiology, Physiotherapy, Pharmacy, and Business Services, and was leased briefly from the builder to the 8-physician partnership with option to buy.This option was exercised later in 1958 by a new entity, ViClinco, Inc. which consisted of 8-physician-stockholders.
The inclusion of space for a Pharmacy in the new building, though not officially an integral part of the Clinic, proved to be a most valuable and convenient adjunct, and a local Pharmacist, Boyd Goodell leased and operated Boyd's Pharmacy both in that location and continuing in the Hillsdale building, until Boyd's retirement in 1984. Since then it has been owned and operated by Bob Badgley.
A number of changes occurred soon after the 1958 move to the new facility. In 1960 Dr. Edward Grothaus, Surgeon, joined for 1 year. Dr. Gordon Smith, Ob-Gyn, joined permanently and Dr. Bob Leo left to join Dr. Russell Mitts. Because of these changes, the new building was not fully occupied until 1962, even though two Internists, Dr. Max Rohrbacker and Dr. Robert Montgomery joined in 1961, and Dr. Tom Carroll, Ophthalmologist joined for 7 years in 1962. Those who left during this period were Drs. Grothaus, Leo and Davis, who left for other locations and Dr. Lipson who died in 1961 at the age of 71. Since the Ophthalmologist required specialized facilities and since business services again needed expansion, a new addition was built to the north and west of the 5-year old clinic building in 1963. This addition was built in spite of the fact that income per physician had actually declined by several thousand dollars a year due to higher rental, vacant offices, and rapid physician turnover during the years 1959-62. Fortunately, for the next 5 years the income was to increase approximately 10-15% each year to finally reach a more respectable level by 1967. During the years 1963-64 the building was fully occupied, and few changes occurred.
In 1965 Dr. Charles Ziehl, Surgeon, and Dr. George Skaff, Pediatrician, were added and in 1966 Dr. Robert Phillips, Internist, came - so now there were 15 physicians in 16,000 sq.ft. including the ancillary departments.
With the need for more expansion, and the "grow or perish" philosophy, some long-range proposals were considered during 1965, with some new policies being formulated, including the decision to keep on expanding with the community, which now had a population of some 20,000. So active recruitment was again begun, specifically for Surgeons, Surgical Specialists, particularly ENT and Orthopedic Surgeons, and of course more Internists, especially those with sub-specialties. New income distribution policies were mandatory in order to interest these specialists, and in place of equal distribution, which had prevailed up to that time, new production formulas were tried and altered from year to year.
In January 1968 Dr. Robert Geiger came as an addition to the General Surgery Department and Dr. Malcolm Hadden, Orthopedist came temporarily. In July of that same year, Dr. T. A. (Pete) Akin, ENT Specialist, came and this required sudden remodeling and addition to the south end of the building, which was now just 10 years old. Also, this required the acquisition of the Mooney Blvd. (doghouse) property as well as 6 lots to the south for additional parking area.
In 1969 Dr. D. L. Heiges, Internist with specialty in Hematology, arrived as a permanent member. (Dr Heiges retired in 1997). There were now 17 physician partners in 17,125 sq.ft. Our entire bookkeeping department had to move to an annex building, and we even considered moving the Administrator into one of the lesser used toilets, such as he had occupied at 311 S. Floral, but finally located him in the front portion of the Dog House along with the Physiotherapy Department.
In 1970 Dr. Michael Florio, Orthopedic Surgeon, joined, to become the first super-producer, but he was to remain only 3 years, when he left to join a local single-specialty group of Orthopedists. By 1973, with the 1971 addition of Drs. James Reed, Dermatologist, and Dr. Louis Ling in Ob-gyn Department and then the 1972 arrival of Drs. Kenneth Dunn, Pediatrician, and Dr. R.S. Gardner, Endocrinologist, the Meadow Lane Clinic building (including two major expansions) was stretched to the limit. 18 physicians occupied space built for 12, and it became urgent for the group to seek larger quarters.
Visalia population now numbered 30,000 and since the group unanimously felt that we should continue to expand, a 41-acre plot was purchased on Akers Road, 3 miles west of the city, just off Highway 198. Here construction of a 44,000 sq. ft. new clinic building was begun on a 5-1/2 acre parcel, with office suites for 24 physicians, adequate space for ancillary services, and plenty of room for parking and for eventual expansion. On completion in May 1974 the massive move to the new facility included 22 physicians, all personnel, equipment, furnishings and all ancillary services of the newly incorporated Visalia Medical Clinic, Inc. This was accomplished even though the carpet for the main floor had been "stolen" during delivery, and that floor remained bare for 2 months.
During the years just before and after the move, Dr. Ed Feldmayer, formerly of Exeter, rendered extremely valuable locum tenens service as a Generalist during vacation times.
Rapid changes then occurred after occupying the new facility. The Radiology department added xerography equipment and other sophisticated diagnostic units with particular emphasis on screening for cancer of the breast, and the Staff was increased that first year by the addition of Dr. Stuart Garrison, Radiologist, whose wife, Virginia, also a Radiologist joined in 1976. Dr. Don Higgins, Generalist from Delano, also joined the Clinic for 1 yr. In July 1977 Dr. Robert Havard, Pediatrician, died of acute leukemia at age 53 after a brief illness, and was replaced in mid-1978 by Dr. James Simpson, Pediatrician.
- Visalia City
In 1975, Mark Karstaedt, Clinic Administrator for 23 years retired, being replaced by John Heinsohn, an experienced Medical Administrator from Wisconsin. Assistant Administrator Greg Hund replaced David Cates, Business Manager in 1976. Other Assistant Administrators ('76-'90) included Kris Kummerfeld, Craig Landers, and Jay Collier. John Heinsohn retired as Administrator in 1990 after 15 years and was succeeded by Gerald Moore, also an experienced Medical Administrator.
During the first few years, the new building's beauty and versatility served the staff well, but by 1976 new computer services and expanding chart files required some remodeling in the business area, and with the addition of 5 new doctors that year, additional doctors suites had to be provided immediately. Architect's plans for a second floor addition were shelved and the Pediatric Department was revised to accommodate Dr. Mike Nagatani, Pediatrician. The Physiotherapy Department had to be squeezed to create a suite for Dr. Klaus, who vacated some space on the second floor to accommodate Doctors Martin Yasuna, Gastroenterologist, and Robert Sansom, Internist. The Surgery Department proved adequate to accommodate Dr. Benny Lee, Thoracic and Vascular surgeon, and Dr. Gary Bingham, Generalist, who also arrived in 1976.
Additional upgrading of the facilities occurred during the years 1976-1984, but also medical advances required the purchase and use of much new technical and diagnostic equipment. Special blood and chemistry diagnostic units were added. Exercise electrocardiography, spirometry, and complete resuscitation equipment was made available as well as emergency carts for each floor and all employees were instructed in cardiopulmonary resuscitation techniques. Soon more sophisticated sonographic imaging equipment was added for non-invasive vascular, cardiac, and surgical diagnostic use. In 1978 the west parking lot was developed making space for 151 additional cars. With lights and landscaping, this project cost $70,000.
Ancillary Services required frequent upgrading, and remodeling, especially in the Laboratory Department during the 1970's, 80's and 90's, with much more sophisticated equipment required. Don Fisher, Bioanalyst, from 1958 to 1994, along with George Lewis, Laboratory Technologist, 1962 to present (1997), directed this growth, including major expansions each time new units were added to the original building in 1987 and 1994. Robert Thompson, RPT directed the Physiotherapy Department, from 1963 until 1985, when the space was remodeled into a second doctor's suite, and Physiotherapy services were discontinued. The X-ray Department had three most dedicated technicians, Boots Logan and her sister, Dorothea Breidjford from 1953 until 1977, and Wayne Luallen from 1974 to the present (1997).
In the Nursing Department, during the 60's and 70's the late Nola Torkelson, R.N., Darl Rector, R.N., Ann Allen, and others gave outstanding leadership. Other personnel who contributed many years of devoted service include Ione Froseth, Ruth Redemer, Shirley Wheeler, Mary Watson, and others. More recent retirees, with their length of service are: Edith Morgan (Receptionist 25 years), Lorraine Rivers (Ins. 26 years). Kay Reid (PBX 22 years), Ellen Ice (Med. Sec. 19 years), Lee Reilly (Clerk 18 years), Maxine Rice, R.N. (18 years), Jeanne Savage, M.A. (17 years), Shirley Edwards (15 years), Helen Rebello (13 years), Christy Mann, R.N. (22 years), Nettie Springer, L.V.N. (22 years), and Lydia Herrera, Nurse (21 years).
Other faithful employees for 15 years or more are: Don Fisher (Lab 35 yrs), George Lewis (Lab 35 yrs.), Margot (Mitchell) Rona (Executive Secretary. 25 yrs. deceased 1996), Jim Shepherd (Bkkpr/printer 25 yrs. deceased 1994), Sue Dreo (30 yrs.), Gayle Kubik (25 yrs Retired.), Kathy Kelly (28 yrs.), Lyn Van Winkle (30 yrs.), David Hougham (20 yrs.), Martha Rustan, M.A. (25 yrs.), Judy Osborne, R.N. (25 yrs.), Renda Liden, (Adm. Assist. 24 yrs.), Goldie Frederick (24 yrs.), Lynn Glispey (23 yrs.), Jerry Ashford (Maintenance 18 yrs.), Wayne Luallen ( Xray 23 yrs.), Rose Marie Ervin (17 yrs.), Bonnie Franks, M.A. (20 yrs.), Donna Luallen (22 yrs.), Paul Brown (22 yrs.),Edward Serna,(20 yrs), Johanna Houk (20 yrs.), Pat Sewell ( 16 yrs.), Shirley Dotzler, R.N. (18 yrs. total), and Rosane Hein (18 yrs. total). There are many others with 10 years or more.
By 1990 the 25+ yr. veteran group consisted of Dr.'s Brady, Klaus, Audino, Osgood, Gates, Fishback, Tiss, Smith, Montgomery, Rohrbacker, Ziehl, and Skaff. The first six of these physicians retired at age 65 as stockholder-physicians, but remained active in the clinic for variable terms. Dr. Audino retired in 1986 after coronary angioplasty with 39 years of service. Dr. Fishback retired in 1985 after 30 years of service. Dr. Klaus retired in 1976 with 30 years service, moved to a retirement center and died in 1990 at age 81; Dr. Osgood retired with 31 year's service, in 1977, moved to Los Osos and died in 1983; Dr. Gates served half-time as Medical Education Director at KDDH Hospital for about 6 years and still continues on a half-time basis with 38 years of service; Dr. Montgomery, Internist, took early retirement in 1986, after 25 years; and Dr. Reed and Dr. Rohrbacker retired in 1989. At the time of this update in 1997, Dr Brady was still active part-time in his 56th year with the group, after by-pass surgery. Others who have joined the senior group are: Dr. George Tiss with 40 years service (died June 1996), Dr. Gordon Smith, with 37 years service, Dr. R.C. Ziehl and Dr. George Skaff, each with 32 years, Dr. Robert Geiger, and Dr. T.A. Akin, each with 29 years, and Dr. Lynn Heiges, with 28 years.
- Sequoia Tree
By 1985 with a net increase of 15 physicians in 10 years, and expansion of computer, business and ancillary services, the Hillsdale (Akers Road) building was bursting at the seams. Physician recruitment for medical and surgical subspecialists continued and soon plans were begun for a 3-level building addition to accommodate 12 physician and ancillary services. Completion of this additional facility in 1987 enhanced the image of the Visalia Medical Clinic as the birthplace and hub of a booming medical, dental, professional, and residential development at the shifting western edge of Visalia. With the Visalia population booming to 74,000 by 1990 and to 90,000 plus by 1996 the new decade brought the Visalia Medical Clinic into a much different health care situation. Instead of the former close doctor-patient relationship our entire staff became more involved as providers of health care, under contracts with so called Amanaged care@ organizations, such as IPO=s, PPO=s, HMO=s, Capitation, etc. Primary Care Physicians became Agatekeepers,@ which sometimes caused delay and confusion in furnishing urgent specialty care. This new method of furnishing health care also caused the Clinic to begin recruiting proportionally more Internists and Family Care Physicians, which in turn required additional office space, as well as complete revision of management and business practices. So in addition to the 1986, 3-level addition to accommodate 10 physicians and some business services, by 1994 a second 3-level addition to accommodate 12 more physicians, Lab, X-ray and Pediatric expansion was built bringing us to 96,000 sq.ft of building. Once again, it became crowded with a total of 58 physicians by 1997.
Recent years brought change in administrators and assistants, with the coming of Gerald Moore in 1990 to relieve John Heinsohn, who retired. Mr. Moore later updated the title to Chief Executive Officer and retired in mid 1997. William Brouwer, previously of Mayo Health Systems Albert Lea Clinic in Minnesota, assumed the Chief Executive Officer role in 1997. Richard Strid replaced William Brouwer as Chief Executive Officer in 2003 from his previous role as Chief Operating Officer.
- Kids
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With Visalia's population growth of 5% per year, the decade of the 90's has shown an increase of 25,000 to 30,000 persons, approaching the 100,000 mark by the year 2000. In order to keep up with this expanding population and to integrate into a new generation of "providing health care" instead of "practicing the medicine" and surgery of the 60's and 70's, the Visalia Medical Clinic family continued its growth in professional personnel, supportive personnel, and technological advances, with great change in the provision of healthcare for HMOs, PPOs and new capitation plans, and changes in Medi-Cal and Medicare. It is already involved in the new medical language of Third Party Providers, Coding Practices, Prior Authorization, Peer Review, and the Medicare and Medi-Cal red tape, etc. etc.
During the year 1991, VMC celebrated its Golden Anniversary with special events and public festivities involving our Clinic personnel, the City of Visalia, the Kaweah Delta Hospital District, Tulare County Medical Society and other related agencies and organizations. The 5-plus years since then have been a bustle of activity, with recruiting, new physician arrivals, building addition and remodeling. Our Visalia Medical Clinic has stood as the birthplace and anchor for a booming medical, dental, professional, residential and commercial development at the shifting western edge of Visalia, and will undoubtedly continue to expand with the community.
John H. Brady, M.D.
Note: This 1997 edition (and my final edition), compiled with the capable assistance of Renda Liden, represents many happy memories of my 56-years as part of the Visalia Medical Clinic, Inc.
Dr. Brady passed away the summer of 1999. His spirit lives on with the current dedicated staff of VMC. He will be sorely missed.