BMJ 2003;326:654 ( 22 March )

Education and debate

Kaiser Permanente: a propensity for partnership

Francis J Crosson, executive director. 

Permanente Federation, 1 Kaiser Plaza, 27L, Oakland, CA 94612, USA

Jay.Crosson@KP.org

The first 150 words of the full text of this article appear below.

Fifty years ago, the belief that physicians and managers could effectively share responsibility and accountability for overall performance of health systems brought the wrath of the American medical establishment down on the first generation of Permanente physicians, who were excluded from their local medical societies. Then, the hard work of making such a partnership succeed nearly destroyed Kaiser Permanente in its first decade.

The outcome became the key to the success of Kaiser Permanente today, as well as one of the organisation's most distinctive characteristics: an organisational culture that transcends the traditional conflicts between "medicine" and "management." That culture has been nurtured over decades of continuous negotiation by hundreds of committees and leadership councils that jointly manage the organisation on a daily basis. Today, the mutual commitment to an exclusive partnership between the physicians and management is deeply ingrained in the organisation. Many factors may be credited for this success, . . . [Full text of this article]

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