Palo Alto Weekly

News - July 16, 2010

Ailing Medical Foundation leader David Druker speaks about health care

Battling lung cancer, executive confronts his own future while discussing America's health care prospects

by Jay Thorwaldson

David Druker, president and CEO of the Palo Alto Medical Foundation and a key architect of the nonprofit organization's expansion in the South Bay and coastal communities, is near death at his Los Altos Hills home following a battle of several years with lung cancer.

But he took time recently to speak of his vision for health care in America.

Druker, a non-smoker, said in what he acknowledged was a final interview June 29 that he has been scaling back his duties as he has grown less able to handle the physical demands of overseeing both the medical foundation operations and broader responsibilities for Sutter Health, of which Palo Alto Medical Foundation is an affiliate. He resigned a regional vice presidency for Sutter last year.

But he emphasized that his vision for providing high-quality outpatient health care remains as strong as his belief in the "multi-specialty group practice" model for providing health care. He believes that it should become a national pattern for efficient but thorough community-based health care contrasted to single-specialty referral groups or hospital-based and solo-practice models.

Druker said he would like to see the group-practice model of the Palo Alto Medical Clinic, founded in 1930 by the late Dr. Russel van Arsdale Lee, coupled with two components: innovations in how groups are organized and self-monitored; and modern communications technology among providers and with patients.

Under Druker's leadership, the medical foundation has grown from about 120 physicians to more than 950. It now includes the Sunnyvale-based Camino Medical Group, a Santa Cruz medical group, the Fremont Center, the Los Altos Center, the Redwood City Center and more recent affiliations in San Carlos and Burlingame.

Druker was a key participant in designing the 1993 affiliation with Sutter Health, then a predominantly hospital-based organization in Sacramento and the Central Valley. He said one of his regrets was the failure of two years of affiliation talks with Stanford University Medical Center that preceded the Sutter linkage.

Druker has pushed for creation of a "Center for Innovation" within the foundation, and there is talk of naming it in his honor.

The foundation is planning a $500 million campus in San Carlos that includes a community outpatient clinic and 95-bed hospital. (The project has been delayed by the economic recession, however.)

Druker said the concept for the San Carlos facility is to further the foundation's longtime research into improving outpatient care, as opposed to the more common "bed counts" to measure the success of hospitals.

He has long envisioned such an integrated facility where treatment methods could be integrated, tested and refined.

"It's actually been my dream. When we first joined Sutter, in 1993, I laid out a vision. First we would build a physician infrastructure so we would be in a position to provide care for the communities we're in.

"For decades we've been learning how to keep people out of the hospital while providing quality care."

He said when he was named executive director of the clinic in 1989 he confronted a rapidly increasing demand for primary health care in the region, due to growth and an aging population.

"The implications were that we had to have many more primary-care doctors versus specialists, and we began to work on how to achieve that," despite a national shortage.

"This took us back to the vision of expanding the primary-care infrastructure. Then we would have the luxury of deciding whether to build or buy beds," depending on whether there were existing hospitals in various communities. His vision includes building health care teams of physicians, physician assistants and registered nurses tightly integrated through electronic medical records and communications.

Despite his illness and declining health, Druker said in a comfortable den in his Los Altos Hills home that he still counts his life as being one guided heavily by good luck. In an interview shortly after he was named executive director of the Palo Alto Medical Clinic in 1989, he described his life as "one big accident. So much of what happens to us is the result of good luck and timing. I've been blessed with a lot of both."

He was raised in Marshalltown, Iowa, and went to Harvard University believing he would follow in his father's footsteps and become a lawyer. He was accepted at the University of Michigan Law School but abruptly changed his mind.

"Since I liked people, and the idea of being my own boss really appealed to me, I decided to switch to a career in medicine."

He was admitted to the University of Iowa Medical School on condition he complete required undergraduate courses. He spent a full year catching up on science classes, cramming 90 percent of the pre-med requirements into that year.

"It was a fun year," he recalled ruefully.

He and his wife, Karen, were married in 1966, and have two children, Daniel and Ellen, and five grandchildren. He has two sisters, Hannah and Leah.

He spent two years in the U.S. Army at Fort Leonard Wood, Mo., then completed his dermatology residency at the University of Oregon in the early 1970s. He was in private practice in Portland when he heard of an opening at the Palo Alto Medical Clinic then a private physician partnership and not yet a component of the nonprofit medical foundation.

He said that, too, was luck. His sister Leah lived in Palo Alto, and when visiting he drove past the clinic's former large blue building at 300 Homer Ave. and thought, "Gee, that looks like a nice place to work." He joined the clinic in 1975, later serving as head of the Business Affairs Committee and vice executive director, before being named executive director. He was later named chief operations officer for the foundation and finally was named president and CEO following the retirement of Dr. Robert Jamplis.

For years, Druker continued to see a normal full load of about 30 patients a day, declaring "I would never want to give up my dermatology practice. That's the thing I enjoy most. It's what I'm trained to do."

But he also derived satisfaction from "being able to contribute to something I believe in," such as multi-specialty group practice and innovation.

He has been a clinical professor of dermatology at Stanford School of Medicine, has written several books on dermatology and medical administration and has held state and national offices in professional organizations.

In his June 29 interview, Druker noted that he has been a Republican but nevertheless supports the underlying notion of some form of universal health care in President Barack Obama's reform package. Most physicians support that notion, also, he believes.

He is pessimistic about reform overall due to its complexity, cost and politics: "As a whole it is destined to fail," he said.

Yet he believes the most promising aspect of the reform package is embodied in the term, "accountable-care organization," replacing the older "managed care" term that people often interpret as rationed care. Accountable care means "aggregating doctors into some kind of functional group that takes responsibility for providing a broad range of health care services to a community or region."

Weekly Editor Jay Thorwaldson worked with Dr. Druker at the Palo Alto Medical Foundation for more than 18 years. He can be e-mailed at jthorwaldson@paweekly.com.

Comments

Posted by barbara, a resident of Barron Park
on Jul 16, 2010 at 10:32 am

What a loss this will be to the community. I was a patient of his many years ago and have watched with great admiration all he has done for PAMF.


Posted by Leonorilda, a resident of South of Midtown
on Jul 16, 2010 at 11:15 am

Dr. Drucker did very much to establish the Palo Alto Medical Foundation as a caring place that reached out to the community. However, THAT kind of effort was in the past. Since PAMF affiliated with Sutter Health, the organization has been less interested in caring and responsive medical attention and increasingly more concerned about the $bottom line$. If the clinic ever had a sense of "social responsibility," the current administrators have long since lost any semblance of it. It is, indeed, sad that "Republican" values permeate the clinic's treatment of patients, sad as well that employeees there are allowed to create voice messages that espouse right-wing Christian ideologies, sad too that physicians are less responsive to patients' needs and way, way more responsive to making sure the clinic collects its bills. In spite of Dr. Drucker's "Republicanism," I do think that if he had ever examined the more recent day-to-day operations of the clinic, even he would be saddened by some of what happens there.


Posted by Louis, a resident of Midtown
on Jul 16, 2010 at 11:55 am

I was Dave Druker's patient for over 25 years and regretted his promotion to President and CEO, since he was a such a caring and compassionate physician. Over that long a time, a patient and doctor become "friends." Dave's sense of humor made even the more difficult treatments easier.
His has been a life well spent!


Posted by Tyler Hanley, online editor of Palo Alto Online
on Jul 16, 2010 at 11:55 am

Tyler Hanley is a registered user.

The following comments were moved from a duplicate thread:

----------

Posted by Marilyn, a resident of the Green Acres neighborhood, 17 hours ago:

Dr. Druker is a great physician. He has always been so grounded, compassionate, and common sensical. The medical community needs more doctors like Dr. Druker.

----------

Posted by Resident, a resident of Another Palo Alto neighborhood, 5 hours ago:

He is pessimistic about reform overall due to its complexity, cost and politics: "As a whole it is destined to fail," he said.

Then how does he suggest the U.S. provide health care to the 34 million uninsured?

Republicans who are so negative on the new health care initiative, do not seem to have any alternatives to suggest other than to neglect the poor and uninsured. At least Obama is trying to do something. Got any suggestions?


Posted by Right On "Resident", a resident of Charleston Gardens
on Jul 16, 2010 at 1:26 pm

I am sorry for Dr Druker's illness, and applaud his speaking out at this stage in his life. But I was really surprised that he would say that obama's plan is bound to fail. The Republicans (of which he counts himself one) had 8 years to fix the rising cost of health care in this country. GDP spending is the highest in the OECD, millions have no decent health care including preventative care, and even the insured are denied care when it suits the insurance companies. And what did they do during that time? Nothing! Obama has the right idea, the right plan - and it could have been even better (universal care, including for undocumented people) save for the jealous, unconstructive obstructions from the other side of the aisle


Posted by donnie, a resident of Meadow Park
on Jul 16, 2010 at 3:34 pm

Sorry, but PAMF has provided me terrible care. The bare minimum with co-pays attached to everything.


Posted by Louis, a resident of Midtown
on Jul 16, 2010 at 5:53 pm

Oh, yeah!
It doesn't matter if he's a Republican and I'm a Democrat. He's still a damned fine human being!


Posted by neighbor, a resident of Greenmeadow
on Jul 16, 2010 at 11:20 pm

I guess it is inevitable that some have had negative experiences at PAMC. I've had one really bad one (years ago), but have otherwise found people to be kind, attentive, and invested in quality care. A family member is currently being treated by a surgeon at the Mountain View center and he and his staff have been phenomenal. He takes lots of time to explain what's going on, what the options are, expected outcomes, etc. Couldn't ask for a better person and medical team.


Posted by Anne, a resident of Another Palo Alto neighborhood
on Jul 18, 2010 at 12:49 am

I second the above. You can have bad experiences everywhere. I can personally think of a few PAMF doctors who shouldn't be practicing medicine, but many, many more who are fantastic doctors.

PAMF is really breaking ground by cutting through a lot of the non-care-related barriers to getting healthcare. Their urgent care centers allow you to be evaluated for urgent problems in that no-man's-land between the doctor's office and the emergency room.

The billing system has become so streamlined and humane compared to other providers, I will often choose a PAMF physician or bloodwork because I know I won't have to deal with the horrible paperwork from some other provider.

It is so incredibly helpful, too, that all doctors have access to your medical record and tests digitally, and you don't have a full-time job just getting an x-ray from one place to another. Again, another reason to choose PAMF, all other things equal.

I'm not sure what to think of the merger with Sutter or what the other poster thought of it above. I have had terrible experiences with Sutter in the past that echo the above poster's opinion. But given the developments with PAMF of late, am wondering if things haven't changed.

No human being is perfect, and no leadership will result in perfect outcomes. But Dr. Druker has definitely done great things for our community. Thank you, sir. Wishing you miracles of body, and if that fails, miracles of spirit.


Posted by Nan, a resident of Community Center
on Jul 24, 2010 at 3:37 pm

Dr. Druker was also my physician when I was young, and I am heartbroken for his family at his passing. He truly was one of the warmest, most caring doctors I have ever met. His patients were not just his patients, but people that he truly cared about. He always wanted to know how our lives were going and he always had a kind or encouraging word and a smile or a hug. His was a life well-lived.


Posted by Great and wise man, listen to him, a resident of Leland Manor/Garland Drive
on Jul 27, 2010 at 7:33 am

What a man of courage. Knowing he was going to be competely dissed for his comments ( with which I agree), he said them anyway.

He spent his entire life in medicine, watching an ever growing disaster come from government intervention in "mandated" aspects of health insurance, and government run Medicare and Medicaid.

But, you know, all you socialized medicine leftists who have never had a business, let alone practiced in medicine for the last 50 years in our system, know so much more than he does and can feel free to dismiss his concerns because he was one of those "Republicans". For goodness' sake, don't actually open your minds and listen to a dying man's opinions from a lifetime of medical work!

Those "34 million uninsured" numbers have been completely debunked as valid, by the way, and of those 12 million or so left who ARE validly inappropriately uninsured, there was an easy fix for them..but the Democrats simply wanted more control over 1/7th of the economy, our bodies and our lives, so they didn't care about real solutions.

The Repubs didn't fix the system either..they lost their spine when every time they floated a real solution balloon, the leftists in the Repub party, every Democrat and all the media denounced them. They knew what not to waste energy on doing.


Posted by One Parent, a resident of South of Midtown
on Jul 27, 2010 at 1:16 pm

We've had wonderful care at PAMF for many years. Our only problem was with Pediatrics, where all doctors are programmed to imagine you've brought your child with the sole aim of nabbing a prescription for antibiotics. Any parent with a cursory acquaintance with good health care knows they are to be avoided unless necessary - not only will they NOT WORK if they aren't needed, but they become LESS EFFECTIVE when misused. After years of trying to convince sundry Pediatricians that I wanted them to diagnose the cause of my children's endless congestion we switched to Family Practice. They immediately sent us to an allergy specialist, who solved the problem. I'm sorry to hear of Dr. Druker's illness and his unfortunate political views. He's just the sort of man who, when he gets behind an idea, it has a far better chance of success.


Posted by Great and wise man, listen to him, a resident of Leland Manor/Garland Drive
on Jul 30, 2010 at 7:34 pm

One Parent; "unfortunate" political views? Good grief, what a silly thing to say. How can you say "unfortunate" political views regarding his opinion that we were in the process of dismantling what is great in our medical care with this bill?

I say we are ruled by "unfortunate" political views right now, "unfortunately" because..well, talk to any physician in Canada or France who has also practiced here and so can compare.., and you will get an earful.

Dr. Druker knew what he was talking about. Pity we didn't listen.

But, oh well, here we are. Your children will not thank you for your unfortunate views on politicizing medical practice.


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