The Merger

Mrs. Grunigen interviewed by Dr. Michael Seffinger, DO

in the home of Mrs. Forest Grunigen in Newport Beach, California
June 13, 2006

Dr. Seffinger: Just to begin Mrs. Grunigen, would you please tell us where you came from and how you became involved with the medical profession in general in California and the osteopathic profession after that.
Mrs. Grunigen: As you mentioned my name is Dolores Grunigen. My date of birth is March 6, 1933. I was raised in Modesto, California and educated in Modesto, California. I went to the University of Redlands for my Bachelor of Science in business administration and of course took other courses to qualify for Secretarial Aquiem. I was trained to be a court recorder for which I turned down. I was a secretary to the Executive Secretary of the State Board of Medical Examiners. This was back in 1959. Being a secretary to the Executive Secretary provided me with a lot of insight into the Board’s activities; educated me in a lot of different ways, which would have been - understanding medical education both foreign and domestic. This is how I learned so much about different types of medical schools and medical training. It wasn’t too long before my boss had quit, so I had to determine what I was going to do with the type of education and background I had. It was suggested by one of my fellow professionals that I should establish a category for myself because I had been qualified for all of these different types of evaluation of education. So I proceeded to do that and established the Assistant to the Executive Secretary which provided me with responsibilities for several of the allied health fields that were licensed within the Board. This gave me a nice future. In doing that, I was responsible for promoting legislation for most of these categories which were physical therapists, podiatrists, chiropractors and psychologists. During that time, new legislation was introduced and I was asked to support the new legislation which was regarding Physician Assistants and Nurse Practitioners. So then this committee was placed under my direction and I was asked to get the law passed and regulations established. The legislation was finally passed for the Physicians Assistants after much lobbying. CMA was totally against it, so it was a difficult piece of legislation to pass, with all of the critics trying to stop the legislation.
Dr. Seffinger: And in that job capacity you basically had to help these allied professions improve their education, critics, and also demonstrate to your critics that they were qualified for an increase in scope of practice. And then you had the same thing with former medical graduates.
Mrs. Grunigen: Yes. Anyone who requested licensure had to meet the regulations and law that had been passed.
Dr. Seffinger: So you are well familiar with the process of evaluating licensed professions for their education equivalents, right? And then this event occurred in 1962. What did you remember of that time period?
Mrs. Grunigen: That brought the newly degreed, the ex-DOs, into the Licensing Board through the passage of Initiative 22 and this then became my responsibility to evaluate their credentials and determine the qualifications for licensure.
Dr. Seffinger: And they sent these in to you and then you checked their training by...How would you do that?
Mrs. Grunigen: This was done basically by the medical school and they in turn would send us the reports as to who qualified and who didn’t. So we really didn’t have to do that much for them because the school had already accomplished that by granting them the MD degree. They had to have already determined that they were qualified. So it was just a matter of receiving documentation to verify that fact.
Dr. Seffinger: Once that occurred, did you have any responsibilities to oversee those people at all or anything else?
Mrs. Grunigen: It was just a matter of getting them licensed so that they could receive their license to practice.
Dr. Seffinger: Now, did you have any other involvement with the profession other than that at the time?
Mrs. Grunigen: In some instances it was necessary to represent them in the state legislature before different committees who were asking questions about why they were being licensed under the aegis of the State Board. I did represent the State Board at these different committee hearings, and explained what was happening at the time.
Dr. Seffinger: How did that go for you?
Mrs. Grunigen: It was not an easy task because when people don’t understand what you are licensing. It was a matter of getting them to understand the different laws and interrupt with what the law was really asking them to do. And of course they would throw out these different nuances, ‘well how can they be doctors, if they are cultists.’ This was very difficult to encounter.
Dr. Seffinger: When did you first hear about the osteopathic profession?
Mrs. Grunigen: When it appeared in the State Board.
Dr. Seffinger: So, about 1962
Mrs. Grunigen: 1962, yes.
Dr. Seffinger: And when you first heard about it, what was your impression?
Mrs. Grunigen: I had no idea who these people were and after evaluating their education qualifications I understood that this group was really quite qualified to practice medicine in the State of California.
Dr. Seffinger: And so then you took that to legislators and tried to tell this, what your evaluation was, but they weren’t so easily...
Mrs. Grunigen: Convinced. So I had to bring in the heavy guns, which was Forest Grunigen. He appeared with me several times before the committee to verify this, because as an initiative passed the legislature didn’t have that much to do with it. So they weren’t really aware of the contents of that initiative. They really had to be indoctrinated as to what this all meant. They didn’t have a clue.
Dr. Seffinger: That was something you didn’t expect, I would think.
Mrs. Grunigen: No, they really gave me a problem with it.
Dr. Seffinger: Did you ever come to understand their point of view?
Mrs. Grunigen: Oh yes. Well, once you evaluated their credentials you could see that they were more qualified than a lot of foreigners that came here, and I could prepare and determine that fact.
Dr. Seffinger: And your opposition of legislators that didn’t know...
Mrs. Grunigen: They just didn’t understand what this group was all about. They didn’t know what a DO was, but once you talked to them and gave them some background, it was easily understood. It was just a matter of time. There wasn’t much time needed especially with Steven Teal in the legislature as Senator. He did a lot of preaching and they knew he was a DO. So with him and Forest Grunigen, I had very few problems.
Dr. Seffinger: It’s kind of like they had to explain a couple of things. One is what a DO was and why a DO wanted to be an MD and so they had to explain both scenarios. There was a lot of education going on there. And the legislators eventually went along with whatever.
Mrs. Grunigen: Well, they really had to go along because the initiative was law. They really didn’t have a choice, but they didn’t understand, so it was really necessary to educate them.
Dr. Seffinger: Do you remember what it was like with the people that felt it was a cult, a cultist label or the people who used that term and concept? Did you see them change over the years or did they maintain that in spite of education?
Mrs. Grunigen: It’s like anyone else. You have a mixture of people who will accept it and those that will not. There were people who would still call them cultists. I mean its human nature to revert. Most of them though understood it, so... We didn’t have a problem in other words.
Dr. Seffinger: Then move up a couple of years to’64, ’65. As you moved into the ‘60s later on, did that cultist label drop out of the...?
Mrs. Grunigen: We didn’t hear it as much. It was acceptable at that point. Once they received their MD degree, how could they possibly, you know, call them cultists?
Dr. Seffinger: Right.
Mrs. Grunigen: It was a non-issue.
Dr. Seffinger: What happened to the DOs that did not become MDs? Were they still called cultists because they did not change?
Mrs. Grunigen: I don’t know because I did not affiliate with them. It was under a different board. So they had their own problems and I’m sure that they were still dealing with this same issue.
Dr. Seffinger: You mentioned you had to bring in Forest Grunigen. Steven Teale was a DO and a State Senator who also had the challenge of using these arguments to get the legislators to understand what the new group of DOs now called MDs, the 41st Society, was about and what their needs were. Can you tell us a little bit about these people? Who was Steven Teale in your mind, his character and what he was like; and also Forest Grunigen, what he was like when you met them and your impressions?
Mrs. Grunigen: These were people who could assist you in passing certain legislation, especially health care legislation, so I did confer with them on many issues with my allied health committees. It was a big assistance to have Forest Grunigen understand what a lot of the allied health field really needed, and that they needed upgrading as far as education and they needed wider range of practice. The physical therapists had a particular cause, they wanted to use ultrasound in their practice and many many of the MDs refused to allow that so it was a long time before they finally got ultrasound as part of their practice. I mean that was just one instance. But these were the types of things that were happening at the time. They were trying to expand their range of practice.
Dr. Seffinger: And Forest Grunigen when he came into talk, did they listen to him pretty well.
Mrs. Grunigen: He was a credible person and he could, once he understood the issue, relate that at a higher tone. I utilized that fact with many of my committees and also the legislature.
Dr. Seffinger: I understand he and Steven Teale worked together to create a lot of legislation or policy they were working on together.
Mrs. Grunigen: In the health field they worked together often. We also had another legislator, who was very, very helpful. There were several who were very, very helpful, but Assemblyman Duffy was one who helped us pass many of the legislation because he was a doctor, an ophthalmologist. He was very, very helpful in assisting us in getting a lot of the legislation passed with the health care. After legislation is passed, you know, there are regulations to be drawn up and that was very critical. Each step was monitored very closely by CMA (California Medical Association). We had a lot of interaction with them when we were determining regulations.
Dr. Seffinger: And you also met Dorothy Marsh at that time?
Mrs. Grunigen: No, no.
Dr. Seffinger: Not until later. And so in the 1960s you continued working there until what year?
Mrs. Grunigen: 1976
Dr. Seffinger: Oh this was ’70 – ’76.
Mrs. Grunigen: This was when the Physicians Assistants law was passed in 1972. So that’s what I was doing during that time.
Dr. Seffinger: And you had met Forest Grunigen during the legislative committee meetings?
Mrs. Grunigen: No, when he was president of the Board.
Dr. Seffinger: Then he became President of the Board...
Mrs. Grunigen: That’s when I first...
Dr. Seffinger: Okay, do you want to talk about that time period? What that was like; that was about 1968?
Mrs. Grunigen: 1968, yes and when he was elected President of the Medical Licensing Board there was quite a discussion as to whether they should elect an ex-DO to the Board. We did have one other ex-DO on the Board, Dr. Oddo. I think between those two they managed to convince the rest of the Board - because the rest of the board were all MDs, just those two.
Dr. Seffinger: There were no allied professionals on the Board?
Mrs. Grunigen: No, they were all MDs on the medical board itself.
Dr. Seffinger: Okay. And they decided to go with him.
Mrs. Grunigen: And they decided, yes, that this man was able to carry any legislation that they might promote. That’s the President’s job.
Dr. Seffinger: Right
Mrs. Grunigen: So it established a precedent that was unheard of until at that time. I guess one other ex-DO was President, but during this time it was unheard of.
Dr. Seffinger: You mean the Dain Tasker era? Yes, he was a DO at the time, but that was in 1910. That was 70 years ago. It was a different era.
Mrs. Grunigen: Yes.
Dr. Seffinger: I don’t think there has been anyone since him.
Mrs. Grunigen: No, not that I know of.
Dr. Seffinger: Is that a one year office?
Mrs. Grunigen: Yes it is.
Dr. Seffinger: And do you remember Dr. Grunigen’s perception of that event in terms that he recognized the uniqueness?
Mrs. Grunigen: Oh yes, oh yes. He worked harder at it, at what he had to do. He made sure that he stayed on the committees at CMA to be of value to this Board. That was very important and of course worked with Steven Teale to assist in different legislation. He became a valuable asset to the Board. They created quite a few changes in the State Board as to qualifications for licensure; even reduced the fees for licensure during his tenure - which was unheard of. Well, they had enough money. Any money the State Board raised through the fees was strictly used by the State Board. It was not included in the overall State budget. So it was a different era. He created a lot of changes. I can’t recall many specifics, and I wish I could because I remember some of the different changes that were made - especially in investigations. As President of the Board, he would, if a doctor was charged, look at the file and determine whether this man should be investigated or not. If he felt this man was being unjustly charged he would actually visit him and see what the situation was. In some instances the charges could be dropped because it wasn’t of value. So he established different criteria for investigation of MDs and this really made a big difference in the practice of medicine.
Dr. Seffinger: Interesting, okay. He then, once he stepped down as President, he still had other responsibilities or he was on the Board still?
Mrs. Grunigen: He was still on the Board because the Board was appointed. It was an appointee position by the governor. As long as the governor appointed you, you remained on the Board.
Dr. Seffinger: And he remained on the Board...?
Mrs. Grunigen: I believe through Governor Jerry Brown.
Dr. Seffinger: Mid-70s?
Mrs. Grunigen: Mid-70s.
Dr. Seffinger: Now in 1974 the Osteopathic Licensing Board regained its ability to license new DOs. Do you remember what the impression was from the CMA side of it, not the CMA, you weren’t part of the CMA, but the Licensing Board? You had the MD Licensing Board people around you all the time. Do you remember what they were talking...Did they ever talk about it? Was there a reaction to that that you recall?
Mrs. Grunigen: I don’t recall any specifics, but the overall impression was that they should have their own Licensing Board especially with their degree, but otherwise, it was...
Dr. Seffinger: I thought the Medical Licensing Board didn’t want to oversee the DOs. They wanted to keep it only MD at that time. And then you at some point decided to marry Forest Grunigen.
Mrs. Grunigen: 1976, yes.
Dr. Seffinger: 1976, right, and you began a whole new life and you stopped working.
Mrs. Grunigen: I stopped working and moved to Newport Beach.
Dr. Seffinger: Big move!
Mrs. Grunigen: It was because Sacramento was my home.
Dr. Seffinger: And at that time period...
Mrs. Grunigen: I was still acting as a consultant to the Board, so I would still travel back and forth and so was Forest. He was still involved. During the 70’s after his Presidency and finishing his term of office on the Board, he established a separate investigation department for doctors for MDs because he felt that an MD should be evaluating the charges against other MDs. So he established this separate investigative department for them. It had all been under one big, you know, department.
Dr. Seffinger: Like a department of Consumer Affairs type thing?
Mrs. Grunigen: Yes.
Dr. Seffinger: How is it now? Do you have any idea?
Mrs. Grunigen: It is separate now for each Licensing Board. They decided that that was a good idea. And he established the title of Medical Investigator for the Board. So that was one of his changes.
Dr. Seffinger: Then you were with Forest for the remaining part of his life. He lived another quarter of a century.
Mrs. Grunigen: Well, 23 years...
Dr. Seffinger: And did other things that he accomplished during that time period that you think people should remember and know about?
Mrs. Grunigen: Well, he was very active in trying to establish a hospital on campus, because this was one of his dreams.
Dr. Seffinger: On the UC Irvine campus?
Mrs. Grunigen: On the UC Irvine campus. The medical school had been set-up of course with the California Medical School which came from Los Angeles. It should have established a hospital as well. Well, there was a big fight here in Orange County because of Hogue Hospital. They didn’t want another hospital for competition. They said we had the County Hospital which should function just as well, and that was the big fight and we didn’t win. But he was very active in that, and really promoted that.
Dr. Seffinger: And after Forest passed, you decided that you had to do a couple of things. Do you want to talk about those things?
Mrs. Grunigen: After that, Dean Cesario is the one who really wanted to do something for him and came to me and said would you be amendable to establishing a library for him? I said yes. I think we need to do something for all the work that he’s dome for this school. So we received the charter money for it. We donated also to the library and established a science library at the medical center and named it after Forest Grunigen.
Dr. Seffinger: What year was that?
Mrs. Grunigen: That was in 1999.
Dr. Seffinger: And then you also set out to write a book about him.
Mrs. Grunigen: And the only reason I really, well, I’ve always wanted to write his history. I thought I’d better get busy and do it because as students came into this library and saw this man’s name they wouldn’t know who this man was. So that was my rationale to write a book, and tell them what this man was all about. That was the reason for it. And it got me ‘off the dime’ so to speak.
Dr. Seffinger: Good. Okay and then you met a lot of people and interviewed a lot of people in that time period.
Mrs. Grunigen: Yes, I had interviewed people throughout our married life and I have a lot of background on tape. This was especially...there was this one - a Dr. Carroll who was very active in politics with Forest. He lived in Laguna. I interviewed him and he gave me a lot of insight as how they worked in Chicago when they were osteopaths.
Dr. Seffinger: They were on the Board of Trustees of the AOA in the 1940s.
Mrs. Grunigen: So they were already ingrained in politics. They knew exactly how to get things done. Dr. Carol was very accommodating.
Dr. Seffinger: Is he still with us?
Mrs. Grunigen: No. He’s gone.
Dr. Seffinger: You also had the chance to talk and meet with Dorothy Marsh.
Mrs. Grunigen: Dorothy Marsh was another who was in the midst of the merger to merge the DOs and MDs. She had a lot of insight into why she wanted to be a DO. It was very difficult for her to make the choice as to give up her DO degree to become an MD and being President of the California Osteopathic Association she did have to make a decision. So it took a lot of inner strength to make that decision. She had a hard time doing it. I know she did.
Dr. Seffinger: She had to promote that whole concept as well. She had to travel around the country.
Mrs. Grunigen: She had to be convinced it was the right thing to do, that’s for sure.
Dr. Seffinger: And how did she do later on in her life? She became, I think, a distinguished Chair which was named after her in her name at UC – Irvine in Obstetrics and Gynecology.
Mrs. Grunigen: Which is on-going.
Dr. Seffinger: What else do you know about her?
Mrs. Grunigen: She was acknowledged by the City of Los Angeles as one of the most prolific obstetricians in the City. She delivered, I don’t know how many, thousands of babies. She was acknowledged for that. She practiced in Glendale most of her career. She had a lot of accolades given to her because of her long standing and her length of practice. She practiced for I don’t know 40 or 50 years. She had a wonderful quality about her. I think all of these people, Teale, Grunigen, Dorothy Marsh, had the quality that ran through this whole era which was, ‘If they said they were going to do something, they’d do it.’ They spoke truth. You knew if they said, “This is truth,” it was. You never doubted it. You never questioned it because it was. These people had this quality and I suppose this is why the success was there for them because credibility is really how you accomplish anything.
Dr. Seffinger: Well that’s a tremendous bit of history that you’ve lived. Some incredible things have changed. Looking back in the 1950 era culture compared to current day culture, I mean there is quite a difference in the last 50 years, don’t you think?
Mrs. Grunigen: Yes. Yes, because truth was more visible then. And then you recognized when the truth wasn’t there. It was so obvious. This is the difference. These are the differences that you can visibly see and you could...As for me, I could talk to a legislator and know that he would support me when I needed the vote. When I talked to him and explained to him the issues, I know that vote would be there. I wouldn’t have to worry about it. It was a different way of life. It was simpler and less complicated I think. I suppose that’s why I was successful because they knew my background and recognized that when I presented something it was for a good reason, and not trying to create additional problems or anything.
Dr. Seffinger: I haven’t heard about or met too many women in the position that you were in. Were there many at the time?
Mrs. Grunigen: No, I was the first and then shortly after that once the position was established it was established through the department office of employment and then it was available to anybody, anybody who could qualify.
Dr. Seffinger: Has there been anybody since?
Mrs. Grunigen: Yes. Yes there are several now. Oh yes, it’s quite a...it’s a real sought after position now.
Dr. Seffinger: Is it sort of like the legislative advocate position or a secretary...
Mrs. Grunigen: It’s a legislative advocate position, because you are dealing with laws and regulations. You really have to know what you are representing, because if you don’t, then it’s obvious.
Dr. Seffinger: That’s tremendous. You made your niche in the history of health care in California.
Mrs. Grunigen: Well, we tried, let’s put it that way; and have succeeded in many instances.
Dr. Seffinger: Have you mentored other women coming up?
Mrs. Grunigen: Never had time. Never had time, I was working 14 hour days and I worked awfully hard at that. It was a real full-time position that you had to really work at it in order to accomplish anything, and I’m sure that even today its much more difficult. I was so recognized in the health field that I was placed on the Department of Health Committee to establish regulations for the Emergency Medical Technicians that they had legislation passed at that time. So I had some input as to what they could and couldn’t do with the Department of Health.
Dr. Seffinger: Have you ever thought about writing a book about that experience of what its like to be a legislative advocate or lobby for all this at all as a female in that process?
Mrs. Grunigen: Its one of those things that you put in the back of your mind and think one day. This is how it was done then, this is how it is done today.
Dr. Seffinger: Well is there anything else that you think people should know about this time period or about yourself or Dr. Grunigen?
Mrs. Grunigen: As far as the licensing of osteopaths, it really was hard to understand the situation because you didn’t know what you were working with. It created a lot of doubts in a lot of people’s minds.
Dr. Seffinger: You mean once they became MDs, who were these people?
Mrs. Grunigen: Who were they? Who was this group? And it was difficult getting that message across. I think that was the most difficult part of that - getting the message across, ‘who these people were?’ You couldn’t deny them because they were MDs. The DO is gone, now they are MDs. Create this in your mind and understand it.
Dr. Seffinger: Okay, so it seems like we covered pretty much what we like to at this point and I would like to thank you for spending the time here sharing with us your history and your perspective on the events that occurred over the latter part of the 20th century, very, very enlightening. Thank you very much.