Press Releases: Northern California

Mar 4 2008

Cecil C. Cutting, Kaiser Permanente Pioneer, Dies At Age 97; Helped Shape Modern Health Care

Cecil C. Cutting, MD, a pioneer physician who helped establish Kaiser Permanente and was the first and longest serving Executive Director of The Permanente Medical Group, died Sunday, March 2, at the age of 97.

His death came one day after 2,500 physicians of The Permanente Medical Group and their family members came together to celebrate the 60th anniversary of the founding of the group, and to honor his contributions and the Medical Group's achievements.

Dr. Cutting was the first physician hired by Dr. Sidney R Garfield when Dr. Garfield joined forces with the industrialist Henry J. Kaiser to provide prevention-oriented, prepaid medical care for Kaiser's workers building the Grand Coulee Dam starting in 1938.

When the U.S. entered World War II, the small team moved to Richmond, California. There, the formal program that was to become Kaiser Permanente was established to provide medical care for Kaiser's 200,000 workers at wartime shipyards in Richmond, Calif.; Vancouver, Washington; and Portland, Oregon, as well as at Kaiser's Steel Mill in Fontana, Calif. Kaiser Permanente officially opened to the public when the war ended in 1945.

In 1948, Dr. Cutting along with Dr. Garfield and a handful of other physicians founded The Permanente Medical Group. Dr. Cutting became the first Executive Director and, under his leadership, it grew into the largest medical group in the United States.

Meanwhile, Kaiser Permanente (the partnership of Permanente physicians with Kaiser Foundation Health Plan and Hospitals), became the largest non-profit private health care program in post-war America with three original regions and Permanente Medical Groups. With the first expansion outside of the far west, Dr. Cutting played a key advisory role in the founding of the Ohio Permanente Medical Group.

Dr. Cutting was born in 1910 in Campbell, California, then a rural town in the Santa Clara Valley near Cupertino. He was reared there with his elder brother of two years, Windsor, who also became a physician, a Dean of Stanford Medical School, and ultimately Dean of the John A. Burns School of Medicine at the University of Hawaii.

From his earliest memory, Dr. Cutting dreamed of a career in medicine, recalling once "having never given a serious thought to any other profession." In the fall of 1928, Dr. Cutting entered Stanford University, earned an A.B. in 1931, and then his M.D. from Stanford Medical School in 1935. He completed his residency at Stanford Lane Hospital and San Francisco County Hospital in surgery and orthopedics in 1938.

Dr. Garfield that same year was in Los Angeles and starting to recruit staff for Mason City Hospital at the Grand Coulee Dam construction site when a friend recommended that he contact Dr. Cutting, who was completing his residency requirements at San Francisco County Hospital. Dr. Cutting accepted Garfield's offer to be Chief of Surgery.

Dr. Cutting did so despite an admonition from then Stanford Medical School Dean Loren Chandler that he "could never permit Cecil to get mixed up in such an operation. Prepaid medical group practice at the time was new and opposed as "unethical" by private practice doctors of that era. Dr. Cutting, however, liked Garfield's "quiet sincerity . . . and honest enthusiasm," along with his ideas for how to combine the concepts of prevention, prepayment and group medical practice into a program of care. He formed a collegial and professional association with Dr. Garfield that endured the span of Dr. Cutting's professional career.

Dr. Cutting was a talented surgeon and served as Chief of Surgery and Chief of Staff in Kaiser Permanente's Hospitals in Oakland and Richmond. His clinical reputation allowed him to recruit a medical staff of talented physicians. For 20 years he served as The Permanente Medical Group's first Executive Director; and in retirement, he was medical advisor to the Kaiser Foundation Research Institute.

With Dr. Garfield, Cecil Cutting became one of the country's thoughtful advocates of group practice and prepayment, assuming the responsibility for the organization of medical services without lay managerial control, and focusing the benefits of health education, prevention and the early detection of disease through allied robust research and educational programs.

"We wanted to create a medical environment in which the doctors' work would be interesting and stimulating, where they would have reasonable income and security, and very importantly, where we fit into the accepted framework and code of ethics of American medicine, while at the same time develop an effective and efficient alternative to fee-for-service practice," he once said.

With Garfield in the early 1950s, he helped the fledgling program weather opposition and threats from The Alameda County Medical Association and the AMA, and rise to the challenge they presented to physician recruitment. He was a guiding light for regional expansion, for the founding of The Permanente Medical Group Division of Research and for the beginning of Kaiser Permanente's surgical and medical residencies.

Dr. Cutting was an invited guest to the White House Conference on Health in 1965 and on the occasion encouraged health care policy makers to shift the emphasis in public debate toward keeping people well: "We ought to promote an enthusiasm for taking care of ourselves."

That same year he addressed the American Association for the Advancement of Science (AAAS) and forecast the arrival of the electronic medical record, encouraging his peers not to feel threatened by computers.

In the dawn of the computer age, he predicted that "all [medical] histories and findings would be recorded by computers and made available to the physician” in his talk to the AAAS. "This mechanization must not be construed as an impersonalization of the relationships between the physician and his patient. The challenge is to do quite the opposite. By increasing the physician's knowledge of the patient . . . his time with the patient should be much more constructively utilized to know the patient as a person and to guide him through sickness."

But above all else, Cutting is remembered for his loyalty to The Permanente Medical Group, for his moderation and patience, and as a peacemaker when points of governance strained the compact with Kaiser Health Plan.

Dr. Cutting retired in 1977, but his influence continues to contribute to the success of Kaiser Permanente today. Dr. Robert Pearl, the current Executive Director and CEO in remarks made recently to the physicians of The Permanente Medical Group noted that "the organizational DNA which Dr. Cutting helped to create 60 years ago can be seen today in our outstanding quality outcomes and our national leadership in disease prevention, cardiovascular care, genetic research, advanced IT systems and healthcare policy."