Twenty-two years ago, on June 24, 1979, Dr Morris Collen retired from The Permanente Medical Group's Executive Committee, where he had served for 30 years, 24 of them as Chairman. Dr Collen was one of the most renowned of the handful of Permanente pioneer physicians who founded The Permanente Medical Group (TPMG), 37 years ago. Today he is still receiving some of medicine's most prestigious awards; the most recent being the Cummings Psyche Award from the Nicholas & Dorothy Cummings Foundation.

In his nearly four decades with TPMG, Dr Collen was a trailblazer in the areas of medicine, cybernetics, automation, and computerization of clinical and research data. Best known as the "father" of multiphasic health checkups in the early 1950s, he later leveraged on his early training as an electrical engineer to lead a vast, early
initiative to computerize the multiphasic data for preventive and research purposes, thereby creating one of the largest, richest clinical databases in American medical research. As the first director of the Medical Methods Research department (which became the Department of Research), he utilized the data for a series of groundbreaking research studies and more than 100 scientific articles.

In the years that followed his retirement, Dr Collen's already formidable reputation has only increased as he has taken on leadership roles and responsibilities with numerous organizations committed to improving the practice, professions, and delivery of high-quality health care in America. Those organizations range from the Institute of Medicine and the National Library of Medicine to the American Medical Informatics Association (which gives out an annual Morris Collen Prize) and the International Health Evaluation Association, which awarded him the prestigious Morgan Prize.

This year, Dr Collen was named to receive the distinguished Cummings Psyche Award, considered the most prestigious in the field of mental health. The award is given "in recognition of the pioneers who have in some significant way furthered integrated, collaborative practice ... Awardees are recognized for their significant and enduring contributions to behavioral health care practice, especially for pioneering efforts that have made possible the new organized systems of behavioral/primary health care."

According to Nicholas Cummings, MD, of the Nicholas & Dorothy Cummings Foundation, Dr Collen was selected for "providing the first venue for the integration of psychotherapy into primary care" back in the 1950s and '60s. Dr Cummings, who also practiced with TPMG in the early days, recalled in an interview that Dr Collen could always be counted on for sound advice: "Whenever I was stuck, I would go to him. He would always say, 'Stand on your head and look at it upside down, and it'll come.'"

The award, including a bronze statue and a check for $50,000, tax free, was presented on October 24, 2001 at the National Managed Health Care Congress in Boston.

In recognition of Dr Collen's ongoing achievements and contributions to Permanente Medicine, we reprint here some advice he offered to the TPMG Executive Committee on the occasion of his retirement 22 years ago--advice that has grown even more relevant to the success of Permanente Medicine with each passing year. As he wrote at the time: "I feel some obligation to pass on basic concepts and lessons, which I have learned in this committee during these eventful years. Accordingly, I have prepared guidelines, which I believe in and try to practice. I call them the 'Ten Commandments for a PMG Executive Committee Member.'" [We have taken the liberty to tweak the title.]

 

Ten Commandments for Permanente Medical Group Physician Leaders Firstly, represent PMG as a whole; and secondly your local area. Be proud of your organization's heritage and accomplishments, and be humble in the knowledge of your organization's deficiencies and problems; in this context, work together to defend and support The PMG for it's a unique medical care organization, since if you do not, others surely will work to destroy it. Respect outside competition since it will keep you humble; monopoly is power which breeds arrogance. Always vote what in your heart you believe to be best and right for PMG even though others speak to the contrary, thus the organization shall endure even though politics, personal fame and fortune are fleeting (as exemplified by our annual voting for officers); thus you will not be tempted to sacrifice honor and integrity for personal gain or ambition, and be willing to eat crow if necessary to achieve a worthy organizational goal since you will be respected by all for self-sacrifice. Respect one another as coworkers in a private service organization, remembering that you are not a democracy supported by public taxes. Respect your superior but do not withhold dissent; since silence implies assent, then if you disagree, silent assent is a disservice to both. Acquire the best personnel who know more than you, since they will become our future leaders and thus preserve and improve the quality of the organization. Dedicate yourself to the patients' welfare and medical care services, but always remember that good quality care depends upon continuing supportive education and research. Never abrogate the physician's time-honored responsibility for the care of the sick (sick care) and the prevention of disease in the well (well care), neither to non-physicians nor to non-PMG entities. Set an example of good leadership: by judicious balance of quality versus costs of care, remembering that poor quality care is expensive; by perceiving problems as opportunities; by studying and practicing management science as a supplement to medical science; and by using group percentiles for management analyses rather than reporting averages, which automatically will make fifty percent of our partners feel below average. -- Morris Collen, MD

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