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KP in the Community Produce to the People | to pdf>> The Kaiser Permanente Medical Center in Oakland, California, the birthplace of Kaiser Permanente (KP), has been growing, changing, and providing medical care for hundreds of thousands of people for more than 60 years. It is also the site of what may be the first hospital-based farmers' market with organic produce. Established in May of 2003, regular shoppers include the staff, representing almost every specialty and tertiary care subspecialty; the neighborhood; and our patients and visitors. For years, the Oakland Medical Center has housed the usual hospital lobby vendors common to many institutions. While walking past one of these displays in the summer of 2002, I wondered what we could sell to be more consistent and supportive of the mission of our health care program. What could be more closely related to health than what we eat? With growing public concern about the use of pesticides and hormones in the food industry, organic growers, in particular, are in increasing demand. At our outdoor markets the very best and most diverse locally grown, organic produce can be found. Farmers' markets provide a sense of community in that people from all segments of our diverse society join together in praise of asparagus in February or blueberries in May. Why not bring a market to a population of people of predictable size? Despite the large and growing number of markets in Northern California, there is a two- to three-year waiting list for some growers to secure space in a market. Most growers welcome more locations and opportunities to sell their produce directly to the public and could staff more markets throughout the week. Some important questions arose: Are there enough staff, patients, and visitors on site to support a market? Could a market survive the vacation season? These and other questions had to be answered. As there were no other markets at hospitals to be found and no local markets at a major place of employment, we had to make our own map. A few phone
calls about the idea to Kaiser Foundation Hospitals/Health Plan (KFH/HP),
leadership, including the service area leader, the operations support
leader, security, community and government relations, public affairs,
and the legal department, met with quick, unanimous, and enthusiastic
support. Basic premises in our planning included the market's use of KP
property at no cost, minimal need for KP resources, ensuring no competition
with the hospital cafeteria and coffee cart, and avoiding the sale of
perishable and prepared foods. The market would need its own insurance.
Parking for the vendors had to be arranged and the market scheduled on
days with the least pressure on the parking garage. Cleaning up after
itself, the market would ensure no negative impact from its presence.
The neighborhood restaurants, grocery stores, and neighborhood associations
would need to be supportive. This first market would only feature growers
who were approved by the California Certified Organic Farmers Association,
thereby focusing the market on the promotion of sustainable agriculture.
Knowing nothing about the management of farmers' markets, I needed to connect with an expert in the field. At the Jack London Square farmers' market in downtown Oakland, I met Mr John Silveira, the director of the Pacific Coast Farmers' Market Association. He agreed to work with me and our hospital; he envisioned the natural relationship between his work and mine. His nonprofit organization manages 25 markets in Northern California. His Board of Directors' mission is to deliver the very best local produce. He believed that he could find growers willing to try something different and come to our hospital. Some growers were skeptical, but they were willing to take the chance. And they haven't regretted it. It was agreed that spring would be the best time to launch our market. This gave us time to work out the details, such as drafting a legal agreement with the market association and eliciting the support of civic leaders and the neighborhood associations. Wherever the market was discussed, people were supportive. Ms Jeanne Perry, our Oakland Medical Center concierge, and I constituted the "committee" planning the market. With posters, a big KP blue banner welcoming everyone to the "Friday Fresh Farmers' Market," balloons, spectacular sunshine, and a warm breeze, our market opened on a Friday in May 2003. JolaVonne Simmons of the Lone Oak Ranch in Fresno, a fourth-generation family farmer and first-generation all-organic farmer, took the chance to come to our market and said that our market was the most successful market her farm had attended so far that year. My questions were being answered. Over the ensuing Fridays, our staff, patients, visitors, and shoppers from the neighborhood were sampling different kinds of peaches, nectarines, and pluots. The Royal Café, a local restaurant near the hospital, offers the KP Friday Fresh omelette of the week. Patients say they now schedule their appointments on Fridays. Some patients' gifts to doctors have changed from chocolate to berries and cherries. Our market
has continued to be one of the favorite markets for the growers. Even
on "slow" days, the amount of business has been well worth it
for them. Many of us are learning about fruits and vegetables The Oakland Medical Center's Farmers' Market supports the KP focus on healthier eating and weight management. We are launching a major weight management program for our staff. The lessons learned will be extended to the care of our patients. It is clear from several studies that even modest weight loss can reduce the risk of diabetes mellitus, hypertension, and heart disease.1 Prescriptions written for five servings of fruits and vegetables daily may also result in a decreased incidence of stroke and cancer.2-8
Although there is not yet any evidence that our market has resulted in an actual reduction in the average BMI, fasting blood glucose, or LDL cholesterol of our population, the market is clearly making another type of impact. KP San Francisco opened its market in August 2003. I have spoken with interested individuals from other KP facilities in Northern California, Hawaii, Southern California, Oregon, and Denver. Recently, a potential market was discussed with a physician at the University of Michigan. Each medical center has its own personality: A small clinic on the north shore of Oahu might open a kiosk selling local fruits and vegetables in conjunction with the pharmacy while a market in Harbor City within our KP Southern California Region might provide the only fresh produce for miles around. Several Northern California KP markets are in the final stages of planning to open in the spring, when the strawberries are the sweetest. Because our market has resulted in happy growers, peach juice on the faces of the staff, patients understanding the components of a healthy diet a little better, and corporate goodwill in the neighborhood, the potential for the addition of markets to even more medical centers is great. For now, at our little market, we all benefit from knowing personally who grows our food. References
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