July 21, 2020

Diagnostic and preventive care is in our DNA

A routine screening helped detect Bill Walsh’s cancer before it became a problem. During our 75th year, we remember an early diagnostic tool: the multiphasic exam.

When Kaiser Permanente member Bill Walsh went in for a routine checkup, he never dreamed his doctor would find evidence of potential prostate cancer.

“I really thought he was overreacting,” Walsh said, “because I had no symptoms. I never felt bad.”

And yet, the follow-up biopsies confirmed it: intermediate-risk prostate cancer.

Together, Walsh and his Kaiser Permanente physician weighed the treatment options. After consulting with his family, Walsh decided on robotic surgery, which is minimally invasive and uses a series of small incisions.

The surgery was a success, and Walsh continues to be in good health today.

A longtime focus on diagnostic and preventive care

Diagnostic screenings like the one that helped Walsh’s doctor identify and treat his cancer before it became a problem have been an integral part of our preventive care focus since our earliest years. One innovation that propelled this important work forward happened in 1951, when one of our founding physicians, Morris F. Collen, MD, pioneered a revolutionary concept.

The name was a mouthful — the multiphasic exam — but the idea was relatively simple: Give large groups of new patients a battery of tests that can alert doctors to trends and red flags in a patient’s health. With that data, doctors could focus their attention on the sickest patients and have the most impact.

Members of the West Coast chapter of the International Longshore and Warehouse Union were the first to have access to the multiphasic exam, and the results were overwhelmingly positive.

At a dinner for all the people who worked on the project, Permanente Health Plan director Dr. E. Richard Weinerman said the health test program was a “complete success … The fact that this program was the first to be organized by a union, the first to provide so comprehensive an array of tests, and the first to assure complete medical follow-up through the health plan, made it an outstanding contribution to the field of preventive medicine.”

Longshoreman Rudolf Christofferson as he moves through the multiphasic exam at the ILWU Local 10 hall at Pier 18 in San Francisco.

Longshoreman Rudolf Christofferson is greeted as he moves through the multiphasic exam at the ILWU Local 10 hall at Pier 18 in San Francisco. 

Evolution of the multiphasic screening concept

For many years, the multiphasic exam remained a popular tool. By 1964, Dr. Collen’s multiphasic team was manually screening 25,000 patients per year.

The test included about 20 procedures, measuring everything from hearing to heart function Eventually, Dr. Collen’s team automated the test, funneling each person’s results into a powerful computer and creating Kaiser Permanente’s first computerized database.

With the wealth of health information available in that database, it was only natural that the Kaiser Permanente Division of Research emerged. The multiphasic database provided material for more than 500 papers published in more than 75 medical journals over 16 years.

The automated multiphasic exam database also led the way to a pilot of Kaiser Permanente’s first computer-based patient medical record system, an early precursor of our current electronic health record system.

A legacy lives on

While the multiphasic exam is now a thing of the past, replaced by other diagnostic tools like recommended health screenings, it’s easy to see how one innovative idea becomes a springboard for so much more. Kaiser Permanente’s strong commitment to preventive care, dedication to research, and passion for providing personalized care lives on, especially through those, like Bill Walsh, who experience more healthy years because of it.


A history of leading the way

In 2020, our 75th year, we’re recognizing how our leadership in health and health care along with our focus on innovation — past, present, and future — support our mission of delivering high-quality, affordable health care. Our vision is to help our members and the people in our communities experience more healthy years. Learn more about our history of leading the way.