The Merger


Dr. Richard Ryder, MD, interviewed by Dr. Michael Seffinger, DO

at his home in Long Beach
October 11, 2005

  • Dr. Seffinger:   Dr. Ryder would you like to begin with telling us who you are; where you were born; and how you got involved with the osteopathic profession.
  • Dr. Ryder:   My name is Richard Charles Ryder. I was born at the Monte Sano Sanitarium and Hospital in Los Angeles on July 12, 1931. It was located above Riverside Drive near the intersection of Glendale Blvd. At the time I understand it was one of few if not the only Osteopathic Hospitals in Los Angeles outside of Los Angeles County General Hospital Unit 2. It has since been torn down. Milton Kranz, DO attended my birth. My family went to Osteopathic Doctors connected with the LA Clinical Group, an early group practice. My mother said it was a very hot summer day, but the sanitarium was located above Riverside Drive next to the Los Angeles River where it got a cool afternoon breeze. Remember this was before air-conditioning. I was raised in Southwest Los Angeles and attended the Los Angeles City School System. I graduated from Manual Arts High School in 1949. I attended the University of California at Los Angeles from 1949 to 1953 when I was drafted into the army. I returned to UCLA in 1955 to graduate in 1956 with a BS in Public Health. In September 1956 I matriculated into the College of Osteopathic Physicians and Surgeons and graduated in 1960 with a DO Degree. I was raised as a Christian Scientist and attended Christian Scientist church and Sunday school until the age of 15. This fact limited my exposure to the medical profession. My family liked Osteopathic Doctors and we visited them primarily. This may have had something to do with our faith. It was during this period of time in my life that I developed some serious health problems that neither my faith nor our doctors could cure. This was 60 years ago and by today’s the practice of medicine was in it infancy. By a stroke of luck I grew up on Southwest Los Angeles and lived near Gladys Lindberg. She was one of the pioneers in the health food and health food supplement industry. I went to school and played with her children and had watched them bloom into healthy youngsters. My mother was impressed and we visited her one night to learn what she had accomplished with her three children. Little did I realize that that night in her home was the turning point in my life. I began to take her supplements and follow her nutritional advice. Her daughter and family still own and operate health food stores here in Southern California. Following this simple routine within a year my health problems resolved and I grew into a very healthy vigorous young man. She became a mentor and stimulated my interest in biochemistry, physics, mathematics, physiology and medicine. Three years later I entered UCLA with a premed major. I still remember my orientation class for pre-med. The speaker said, “Look to the right and look to the left because only one of you will be left next year.” I remember the doubts that crossed my mind and I felt very insecure in my choice of a major. Fortunately, I survived four years until 1953 when I was drafted into the army. At the time it was a disaster because it interrupted my career path. In retrospect it turned into an opportunity. My life has been a series of serendipitous events. I am a very lucky person to so many times be at the right place, at the right time, and make the right choice. This was just another example. I was discharged from the army in September 1955. Between the first week of September, 1955 and October 15th I had to take the MCAT test, get all my records together to make application to medical school. I only had time to make application to three schools. I was missing one required course and this was enough to stop my application process. I was devastated because I was 24 and on the GI bill. My sister and I were talking about my situation and she suggested I call Ernie Basher, DO He delivered three of my cousins and my two nieces. In fact, they were all delivered at Monte Sano Hospital. Fortunately, I was able to talk with him on the phone a short time later. He asked me, “Why do you want to be an MD? Be a good doctor and study osteopathy. Call up Grace Bell at the Osteopathic College and make an appointment to see her.” This was the first time I realized that there were two separate healing professions, Osteopathic and Allopathic. I made an appointment with Dr. Bell for an interview. One of the first things she said to me was, “Richard, you have to realize this is a limited profession. You are limited as to where you can practice and where you can go. You will have a full physicians and surgeon’s license, but there are limitations” This was all new to me, because if you were a doctor, you were a doctor. Like most people doctor and physician were synonymous. I entered the College of Osteopathic Physicians and Surgeons in September, 1956 with the condition that I take the required course in summer school. As you know a medical education is expensive, but as a veteran I had the GI Bill. I had financial assistance and this was very important because I didn’t have to work. I could devote full time to my studies. Being drafted and spending two years in the army was an experience I didn’t like but allowed me time to grow up and paid for my medical education. My cousin attended UCLA medical school at the same time. We compared aspects of our training. I think some of my basic science courses were far better than his because mine was pointed directly at training a physician who was going to practice medicine or osteopathy. The large medical schools are research orientated. They were training specialists and sub-specialists and they were not interested in generalist. Now, you can say, “What is the difference between a specialist, sub-specialist and a physician.” Well, there is a lot of difference. It sounds trite but still true, Osteopathic physicians are trained to care for whole person and not limited to one system or disease. The clinical years at the County Hospital were wonderful and I’ve really enjoyed my medical school. I married at end of my 3rd year and moved to Torrance. My wife taught school nearby. I interned at the Long Beach Osteopathic Hospital from 1960-61. The name changed after the merger to the Pacific Hospital of Long Beach and today is an Osteopathic training institution. Here again luck was with me. At Pacific I met my mentor, partner for many years and good friend, Willis E. Tunnell or Bill Tunnell. Bill grew up in the Midwest. His father was a DO country doctor. Hospitals were few or non-existent, so Bill grew up watching his father treat patients in his home or the patient’s home. He did home deliveries and house calls routinely. He was a true country doctor and practiced osteopathic medicine. Bill came to California for surgical training and for several years he owned and operated the Compton Physicians and Surgeons Hospital. In 1959 he bought an office building in Lakewood. It was built in the 1930’s when the Montana Land Company began to develop what is now Lakewood Village. It had been the Lakewood City Hall and the office for the Lakewood water Company. It was a gorgeous old Spanish stucco building typical of Southern California Architecture. It had a large green lawn with Eucalyptus trees out in front for shade. Our waiting room was 45’ long with a 15’ beamed ceiling. My office suite had three enormous examining rooms. They all were about 20’ x 20’ with 9’ ceilings. It was a very attractive spacious office. As you know medical office space is very expensive so they are usually small and compact. We practiced as partners, but we had no formal partnership. From him I learned the practical aspects of practicing medicine. In 1975 he moved to Big Bear and gave his practice to a mutual friend. Besides teaching me the nuts and bolts of medical practice, he gave me the opportunity to invest in some real estate which became to foundation of my retirement. I have given some personal information about my education and early practice to give some background of the effect of the merger of the DO and MD professions in California on my professional career. Going back to the DO/MD controversy, while I was interning at Long Beach Osteopathic, the California Osteopathic profession had their convention in Long Beach. Dorothy March was president that year of the California Osteopathic Association. I can remember her talking at that meeting about the possible amalgamation of the Osteopathic profession with the Medical Profession. I’ll paraphrase what I remember her saying. “Well boys, we are either going to get this amalgamation proceedings under way or we are going to have to forget about it altogether.” At the time everyone in the profession felt that socialized or state medicine was coming and feared the Osteopathic profession would not be included in the new state scheme or would be marginalized and our practice would be limited. As I said earlier after my discharge from the army in 1955 I returned to UCLA to the school of public health earning a degree in public health. One of my instructors was either the Health Officer or Assistant Health Officer for the County of Los Angeles. When I told him I going to attend the College of Osteopathic Physicians and Surgeons and become and Osteopathic Physician, his comment was, “Well, what do you want to be a DO for?” He continued saying, “Oh well, you will be an MD anyway.” I didn’t fully understand his comment, but he elaborated, “There’s going to be an amalgamation of the two professions.” Now this was 1955; that was the first time I was aware of the possibility of a merger. He continued “There’s no reason to have two separate professions.” His comments were directed toward me that it was Ok to go to Osteopathic School, but that the profession was going to be absorbed by the medical Profession. One of my other instructors, who was also an MD, said, “What do you want to do that for? That’s a waste of time. You won’t be able to practice medicine. They just think their doctors.” Here I had two people in positions of authority giving me advice. One was very derogatory and prejudiced against the DO profession and the other very open-minded and supportive. I matriculated into the College of Osteopathic Physicians and Surgeons in September 1956. For the next four years I don’t remember hearing much about the amalgamation. It was at the 1960 COA meeting that I remember Dorothy Marsh giving the primary reason for joining with the medical profession. To paraphrase here, “We really have to do this because we don’t have the funds to support COP&S because medical education is becoming more and more expensive.” I think in 1951 or 52 the California Osteopathic Association increased their dues $400.00 a year to help support the college. It seems like a small fee, but $400.00 was a lot of money in 1951 dollars. I compared my medical education with my cousin at UCLA. The two years are basic sciences taught by academic people and the second two years are clinical taught by practicing physicians. We were taught by doctors who are actually out there treating patients. My cousin at UCLA was taught by academic, and research professionals. I may sound a bit prejudiced, but we were taught by practicing physicians and treating patients in real clinical situations. I was even more fortunate to work with Bill Tunnell from 1961 to 1976. We used the Pacific Hospital and the only rumblings that I remember during that time was a couple of the sub-specialists were a little uneasy because they knew they were going to lose their sub-specialty training and they thought that the MDs were going to come in and take over their hospital and their little referral system and slowly over the years some of the sub-specialist lost their referrals. From 1961 to 1965 my practice and referral patterns remained the same. Pacific has a good staff of surgical and medical specialists. Stanley Golanty and Fred Seligman came on staff. Both were excellent well trained internist and like myself were graduate of DO Schools, and received their specialty training at LA County General during the merger. Pacific also had two surgeons that like me were graduates of DO schools, but went on to take sub-surgical training. In 1956 Long Beach passed a bond issue to build Long Beach Memorial. This bond issue also provided money to enlarge Pacific and two other hospitals. Long Beach overnight had a surplus of hospital beds. This didn’t last long because soon private insurance plans increased their coverage and Medicare-Medical filled up our offices and hospitals. Medical Technology was making rapid advances in surgical and medical care. Prior to 1960 diagnostic radiology in the community consisted mostly of simple contrast studies. Laboratory studies were also simple and preformed by a lab technician. During my last year of school I worked nights in a Hospital Lab and there were no Coulter Counters or auto analyzers or even PH meters. There were no intensive care units or neonatology units. There were no heart catheters or the other sophisticated diagnostic techniques. Myocardial Infarctions were diagnosed and followed with an electrocardiogram. I saw my first EKG monitor in 1962 which was and EKG wired into and oscilloscope. Briefly, the merger took place just as the explosive change in medical technology occurred. I entered the profession the end of one era and the beginning of another. The merger affected my practice but the revolution in medical care affected me more. By 1965 I concluded that my career was going to evolve and I needed more training especially some type of specialty status. I needed some type of board certification or eligibility. I had spent four years in an Osteopathic School and had a one year rotating internship, passed all the exams to obtain a license to practice Osteopathic Medicine. As I said earlier I joined Bill Tunnell in a general practice for one year as an Osteopathic Physician before the merger. After the merger my practice didn’t change except for my degree for about 12 years. People came to me for general medical care. I developed a large general practice and delivered a wide range of services within the scope of my skills. I admitted patients to the hospital for general medical problems. I delivered babies and assisted at surgery. Pacific had a full compliment of specialties so I could always rely of obtaining good consultation for my difficult cases. Everyone knew everyone else and there was always assistance in case of difficulties. In 1963 I suffered multiple injuries in an auto accident and the staff helped me through this difficult period. I was out of work about eight weeks. Between Bill Tunnell and some of my friends at Pacific they kept my practice open during my recovery period. I was also blessed to have an orthopedist and neurosurgeon both DO’s take excellent care of me At the time I had a pregnant wife, a mortgage and lots of bills and no disability insurance. It was a tough time. When you practiced in the Long Beach Osteopathic or after the merger called Pacific Hospital as it today you were held to a high standard of practice. I was really very fortunate use Pacific as my primary hospital. I felt very comfortable there and my patients received excellent care. I had developed a huge general practice during this time and also several new hospitals were built. During this era the general practitioner or what is now called the primary practitioner determined what hospital the patient was admitted to and the specialist consultant they were referred to. After the merger I was more or less courted by several institutions. A few years before they wouldn’t let me in their hospital let alone any of my patients so I always felt a little uncomfortable using another hospital. Pacific was my hospital and I felt comfortable there and my patients liked it. In 1968 the American Board of Family Practice was organized as a medical specialty. I was a Family Physician and there were no more Osteopathic organizations left in California, I felt I must join and try for board certification. I was 35 years-old and had many years of practice ahead. The practice climate was changing very rapidly with third party payers beginning to require Board certification for payment and post-graduate education for licensure. I joined the American Academy of Family Physician and proceeded to prepare for the Family Practice boards. Despite the time out from a busy practice to take the requirements for the Family Practice boards, I accomplished that goal in 1973 and passed the board exam. This gave me a little status in the medical community as I was now board certified in recognized medical specialty. I later became president of the local Academy chapter was involved in some of the politics. In 1973 Pacific closed their OB unit. I was still delivering babies and didn’t want to quit, because I felt that was an essential part of practicing as a family or general practitioner despite the fact the liability rates were escalating. I felt deserted by Pacific because they recommended I give up my obstetrical practice. In the meantime I got acquainted with a local obstetrician to refer my patients to. He invited me to St. Mary’s Hospital where he helped me with my deliveries until I earned my privileges. Unknown to me at the time St Mary’s OB service had shrunk form 500 deliveries a month to less than 50. Abortion was legalized and most of their OB staff took their deliveries to Long Beach Memorial where sterilization procedures were allowed also. The sisters welcomed me with my small obstetrical practice with open arms. Thus began my move to St Mary’s in 1973 and eventually my whole practice. The fact I had passed my boards in family practice really open doors for me and was no longer associated with the Osteopathic profession or as an Osteopath. Over the years patients would discover that I was Osteopathic trained and were pleased that they finally found a DO. I still did structural exams and manual manipulation as indicated. Besides Pacific and St Mary’s I joined the medical staff of Long Beach Memorial, Doctor’s Hospital of Lakewood, Woodruff Community, and Los Alamitos General. With my boards in Family practice I was welcomed anywhere. In 1973 Bill Tunnell decided to move to Big Bear to practice. Bill Baughman, a mutual physician friend took over Bill Tunnell’s practice. We covered each other but he used another hospital much of the time and I went to too many hospitals. It took all morning to do my rounds. In 1976 Dr Baughman had an MI and was forced to retire in 1979 and Bill Tunnell returned. By this time my practice patterns had changed and I was using St Mary’s most of the time. I had a new referral pattern and was involved in the family practice section at St. Mary’s. I had a new home. Medicare came in 1965 so during the 1960’s and 1970’s now referred as the golden age of medicine we treated the patients and Medicare and the insurance companies paid most of the medical bills. The explosion in costly new medical technology coupled with the inflation of the 1970,s caused the cost of medical care to explode. In this period of time CT scans and all kinds of special procedures in radiology became available. New surgical procedures became common place such as chest, open heart, and all types of vascular surgery. Medical procedure made the same rapid advances. There was a proliferation of new drugs and the PDR went from the size of a reader’s digest to telephone book dimensions. I was thankful that I joined the Academy of Family Practice, because post graduate education was essential to keep your skills current. The problem was the cost of this new era of medicine was very expensive, and the insurance, government subsidy method of reimbursement was couldn’t pay for all the medical care we provided. In 1980 I moved from my spacious, beautiful office in Lakewood to an office adjacent to the Woodruff Hospital. It was a small 50 bed hospital that was owned by a medical group and the politics were different. I tried using it, but by this time I had become accustomed to a large general hospital. In 1982 the California legislature passed the Medi-cal contracting law. This was all done without public hearing in closed sessions and the law included the insurance companies. I was involved in some litigation at the time over real estate investment totally unrelated to medicine. The attorney I hired to represent me was on the board of directors of a large hospital. He told me how the legislature by passing the medi-cal contracting law had taken our patients away from us and we in private practice would soon be out of business. Briefly the law allowed the state and insurance companies to contract for medical services with groups of hospitals and physicians bypassing the private physician. Before this law only the patient could contract with the physician for medical care and was responsible for payment. I asked my assemblyman how he could do this and he told me that the cost of the medi-cal program was bankrupting the state and this act was passed to take control of the reimbursement mechanism and the insurance companies had the political muscle to be included. Health net, Maxicare, FHP, and others grew overnight to become major providers of medical care. In 1983 FHP suddenly signed up 20,000 Medicare beneficiaries by a marketing scheme that many of the patients didn’t know they had signed up for that plan until I tried to bill Medicare for services. As I remember there were patients that were in the hospital and didn’t realize that I couldn’t care for them and also the hospital didn’t get paid. Bill Tunnell decided to retire so I bought his practice hoping to find another doctor to come in and assume some of the overhead. We had this new office on woodruff and assumed that the practice would support the overhead. I couldn’t entice anyone to take his office and within a few months I realized that I was working harder longer hours, earning less. Again I had a serendipitous meeting. I was Chairman of the Family Practice Section at St Mary’s. At a Christmas dinner I sat next to Dick Rytting, the medical director for the Harriman-Jones medical Clinic. The Harriman-Jones Clinic had been in Long Beach for years and enjoyed a good reputation. Over the past year I had sent them the medical records for many of my patients. I was a little hostile at the beginning because I accused them of unfairly stealing many of my patients. Dick explained me how the change in the law was going to change the practice of medicine. Fortunately, I had been in practice for over 23 years and had the good fortune to make some sound financial investments. After I recovered from the injuries suffered in the 1963 motor vehicle accident, I was very careful with my money because I had been through a near financial catastrophe at that time. I was financially not that insecure, but my practice was shrinking. The Harriman-Jones was growing rapidly and they had just absorbed another clinic. They were expanding and they needed more family doctors. In the next month I met with Dick Rytting and Jim Hillman, the business manager for the Harriman-Jones Clinic. They saw my large office and needed me and my location as part of their planned expansion the clinic had contracts with several insurance companies and HMO’s and they needed more office space and more doctors. I remembered my conversation with my real estate attorney and immediately realized that here was an answer to my problems. I could already see my practice dwindling a little bit; my malpractice premiums were increasing because I was still trying to deliver babies because I thought that was the way to have a full-time family practice. The clinic wanted me and my location and after some lengthy negotiations I joined the clinic which included a full partnership with full rights and privileges like the rest of the partners. The only downside was my nurse and secretary who had been with me for years, but hated the new arrangement and quit within the first year after our merger. Going from a solo family practice to group practice was a real education, but soon I was not working as hard and making more money. I officially joined the clinic on October 1, 1984. The clinic brought in another doctor in the other office where Bill Tunnell had been and we had a full time family type practice. It was a wonderful time because I didn’t have to worry about the business side of a medical practice. Part of my problem as a solo practitioner was getting patients to pay for my services. I realize now that because I practiced during a time when the insurance reimbursements were very generous and most people paid their bills. The clinic ran like a business and I had practiced as a family physician first and a business second. I had to change in my practice patterns in the beginning. I had to use Long Beach Memorial Hospital and then Long Beach Community. I had to go on courtesy staff at St Mary’s and Pacific. I had to change my referral pattern; because of the clinic contracts I suddenly had a deluge of new patients. I worked hard but I liked the doctors in clinic and I felt the patients were getting excellent care. In September 1991 I suffered an acute myocardial infarction, had bypass surgery and I thought it was going to end my career. I could no longer work the long hours take call, and make hospital rounds. The clinic had an urgent care center and I was given a position there. With my back ground and experience it was a perfect job for me. The hours were regular and for the first time since I entered practice thirty years before the phone didn’t ring day and night and I had a life other that medicine. From 1992 until I retired completely in 2002 I did primarily urgent care and for several years I worked in a back clinic. As an Osteopathic Physician I was specifically trained for back problems. Most medical doctors have no training the structural dysfunction of the back and the pain and disability that results. With my own back injury I was given a lot of insight. Most MD trained physicians called the back - the black box that produces pain and could only prescribe medication, surgery or physical therapy. Our HMO patients wanted chiropractic treatments included in they medical care. Harriman-Jones hired a chiropractor and an Osteopath to treat this problem. I can’t remember the year, but the California Supreme Court overturned the statute that result in the Merger between the DO’s and MD’s and that is the subject of this paper. I worked with a chiropractor, an osteopath, a neurosurgeon and an orthopedist. At that time I joined the American Back Society. One of the leaders of the Society was Dr. Greenman from University of Michigan, school of Osteopathy. I read his book and have studied his tapes. He was a great teacher and from my attending the Society conventions I learned a great deal more about Osteopathic Theory and treatment.
  • Dr. Seffinger:   Do you know who started the Back Society?
  • Dr. Ryder:   Dr. Greenman. Do you know Greenman?
  • Dr. Seffinger:   Phil Greenman?
  • Dr. Ryder:   Yes. I have his tapes. I have his books, oh yes. He is one of the people who I really admire because he was wonderful teacher. I joined the Back Society in 1994 or 95. I have attended several of their conventions. I was most impressed because it was an open forum and speakers and attendees represented the entire spectrum of practitioners of the healing arts. Anyone interested in spinal or structural problems was invited and all therapies were discussed. I came away convinced that conservative treatment had the best long term result.
  • Dr. Seffinger:   And that was started by Aubry Swartz who was a graduate of COP&S.
  • Dr. Ryder:   I have met Aubry but didn’t know we graduated from the same school. I was active in the back clinic from 1994 until 1999. In 1999 I had my second open heart surgery and shortly thereafter the back clinic was closed. There were changes in administration of the Harriman-Jones clinic and many services were contracted out or abandoned due to increasing pressures to cut costs. This practice period was one of the high lights of my career. I saw patients afterwards and they all told me how we helped them with their back ailments. I continued to practice part-time until 2002 when I finally retired. Sometime in 2002 my friend and colleague Stan Golanty, approached me about teaching or mentoring students at Pacific Hospital. He had remained active at Pacific Hospital over the years and brought a medical education program to the hospital to train Osteopathic physicians from the new Osteopathic College in Pomona. He asked me if I was interested in teaching the Osteopathic students in the hospital out-patient clinic. The program needed experienced physicians to assist the students. With my background and training in Osteopathic Medicine he thought I could do the job. Since 2002 I have spent one day a month to one or two days a week as a volunteer teaching in the Family Practice clinic. I many times think that I am learning more than the students. The students are bright, talented and full of enthusiasm. After 45 years of practice I still like treating patients and taking histories and getting acquainted with people. I have had a wonderful career and wish I could relive my life again. I have kept my license and my family practice boards current. Since 1973 I have taken and passed the family practice board examination every six years to maintain my specialist status.
  • Dr. Seffinger:   Is that the same advice you give to the osteopathic physician
  • Dr. Ryder:   I give this advice to any physician. Take time to talk with your patient. Take time to do a physical exam. The osteopathic structural exam is excellent. By performing of structural exam of your patient you can obtain a lot of information about their health concerns and problems it really helps the patient feel comfortable and it communicates to them that you care. When they say, “I don’t have time.” I tell them, “Well make time, because you are not going to succeed if you don’t.” Today one of the most frequent complaints I hear is that the doctor came in the room and asked me a few questions and left and the nurse came in with a prescription and I was sent to the laboratory and x-ray department and I have heard of seen him since and must wait two or three weeks to see him again. The lack of communication is one source of hostility that many people feel toward physicians. As you know hostile patients are impossible to treat. I think many students retreat into subspecialties such as pathology, anesthesiology, and radiology to escape this one-to-one contact, but this one –on-one contact is part of your role as a healer. Medicine is costly and the result is a bureaucratic overlay that is more interested in the cost of medicine not the quality.
  • Dr. Seffinger:   Can you help me understand how you have an osteopathic education, an osteopathic philosophy of care of patient and at the time in 1962 there was a movement to merge professions and to change degrees and how did that affect your philosophy of practice and training if at all and then leaving the American Osteopathic Association and then coming back and training DOs who were then going to become part of the osteopathic association. How does all that make sense to you for people that come in generations thereafter?
  • Dr. Ryder:   The main reason for the merger was the fear that government or socialized medical would take control of medical care. The fear was that Osteopaths would not be included. They would lose their patients because they could not be paid. There were other reasons given, but I feel this was the underlying motivation for the merger. There were a large number of osteopathic school graduates that really wanted to be considered MDs. I have always practiced as an Osteopath and as I said before many patients sought me out because of my training. I have read and studied Dr. Greenman’s books and tapes so I feel comfortable teaching in an Osteopathic training program.
  • Dr. Seffinger:   Also then, you thought it was a good deal to join the MD profession.
  • Dr. Ryder:   Well, the MD was kind of fostered on us. Our leaders here in California told us that this merger was necessary for us to continue to practice. I had 30 or more years of my career ahead of me so I felt I had no choice.
  • Dr. Seffinger:   So then in 1974 when the DO profession began to resume itself in the state of California, what did you think about that? And you watched it grow for the next 25 years.
  • Dr. Ryder:   I knew about it, but by this time my career path had changed. By this time I had become boarded in family practice and become part of the medical community. To switch back at this time would have just disrupted my career and I had a wife and family with children to raise and educate and a very large and busy practice. Before the merger the Osteopathic Physician couldn’t get admitting privileges in most non-Osteopathic hospitals after that opportunity for hospital privileges and post graduate education opened up. Several of my classmates went on and took training is some very prestigious training institutions.
  • Dr. Seffinger:   That was in 1960, right?
  • Dr. Ryder:   This occurred after 1962 because COP&S became CCM and awarded all graduates MD degrees and so were all of us who chose to merge. Prior to 1962 if a patient wanted to go to as MD hospital or a particular MD, I called the MD and referred him over there and rarely saw the patient again. Rarely would I receive a phone call acknowledging the referral and sometimes even a consultation report. My feelings were hurt and it just wasn’t right. In the end the merger didn’t destroy the Osteopathic Profession, but made is stronger and was a factor in the integration of the two professions. The Osteopathic Profession didn’t lose their identity, but I believe led to full recognition as a healing profession. We now have full recognition and full privileges. And the doctors coming out of school with a DO degree now have unlimited professional opportunities. They don’t have the limitations that I had to contend with. From working with DO residents I find them to be as well trained as any MD school graduates.
  • Dr. Seffinger:   I find it ironic that the merger concept was to dissolve...
  • Dr. Ryder:   Destroy...
  • Dr. Seffinger:   destruction, yet we’ve managed to be stronger and actually got (? 49:11) first place. (I don’t think this comment of Dr. Seffinger make sense with my answer.)
  • Dr. Ryder:   Just exactly what I always wanted. So it’s kind of like a u-turn or end-play. I guess you would say it was an end-play. I guess I’ve covered everything I really wanted.
  • Dr. Seffinger:   Do you have any documents or know of any documents that we could use as reference to corroborate facts you mentioned.
  • Dr. Ryder:   No, I don’t have any documents that I can think of. All of my comments are from memory. This spans 50 years of my life and at my age of 74 there are bound to be omissions and distortions. I formally retired from medical practice in 2002 and have either lost of discarded most documents except if you are referring to my Diplomas, medical licenses, diplomate certificates from the family practice board. I have all of them in my office at home. My son-in-law calls it my “Brag Wall”.
  • Dr. Seffinger:   Did you send your DO degree back to the AOA?
  • Dr. Ryder:   Oh no. My DO degree hangs on the wall of my office at home now but I always displayed it when I was in practice. I earned that along with all my other degrees and certificates. I have two MD degrees, a DO degree, several certificates of board certification, BS degree, and a couple state licenses. As part of the merger we were awarded an MD degree from California College of Medicine. As I remember it came in the mail all permaplaqued, but was small and very plain. My DO degree from the College of Osteopathic Physicians and Surgeon was much larger and more impressive. If my memory is correct as terms of the merger we were not to display our DO degree. In 1962 the College of Osteopathic Physicians and Surgeons became the California College of Medicine or CCM. Later on it merged with University of California – Irvine and became what is now called CCM-UCI. I think there were others, but Vic Passy is only one I can think of now that ended up teaching in the University of California Irvine Medical School. Stan Golanty has always been active in medical education. He can give a more accurate history of this part of the effects of the merger. About 1975 UCI decided to form an alumni association of the UCI-CCM graduates. If we joined the alumni association, the school would award a Doctor of Medicine degree from the University of California of Irvine. The problem with the certificate is that it was signed by the then Governor of California, George Dukemejian. Most people knew I had practiced longer than 1975. I always said the piece of paper didn’t change anything. I am still the same person. I joined the Alumni Association and have attended a couple reunions, but nothing further. For the past three or four years I have been mentoring the student at the Pacific Hospital family practice clinic. This community has been real good to me and this is kind of like payback time. Everyone has a community and the community thrives on volunteer organizations. My wife is active in the Long Beach Assistance League; we are supporters of the Long Beach Symphony and my local church. Alexis de Tocqueville was French attorney and nobleman who visited the United States in the 1830’s. He wrote a book about Democracy in America and he wrote about the fact that one of the strengths of our democracy was the volunteer organizations.
  • Dr. Seffinger:   Alexis De Tocqueville.
  • Dr. Ryder:   Alexis de Tocqueville is now all of a sudden a buzz word. He was impressed by the fact that these volunteers preformed services and didn’t expect to be paid and usually received no payment for services. The volunteers are motivated by the desire to make our communities a better place to live. My wife belongs to a volunteer organization where she spends two or three days a week working on various projects. to...And it is totally a volunteer organization and she really involved with the...what we call the Sexual Assault Victims. She provides support for that, but of course that is one of their charities. But I think when you get to a certain age after you have raised your family and you’ve got a little time on your hands. I see these old folks on these cruises, you know, I mean they are self-indulging, but they have lost their purpose in life. And this is what I think that a person who does volunteer work has it all over everybody else because they still have a purpose. The people she is associated with in the Assistance League are mostly retired, but many have had wonderful careers. They have had wonderful educations and they are very interesting people. They are still interesting because their interested in bettering their community. I enjoy working with the students for many reasons. I have forty years of experience to share with them and they in turn teach me. It wasn’t so long ago that I was a student and newly graduated physician. I thought I was well trained, but looking back I had a lot to learn and still continue to learn. I try to impress on the students that medicine is a dynamic profession and changes rapidly. Besides what is taught in school and residency to remain a competent physician for the duration of your career post graduation education is essential. I don’t have any feedback from the students as to what I teach them or how useful the information I try and give them, but as long as they will have me and I am healthy I’m going to continue. I’ve got this little hump to get through this next week. (I had a right carotid enarterectomy perform the next week with a full recovery). I hope that everything turns out all right and continue, but as you get old things wear out and parts have to be rimmed out or replaced once in awhile. When you think about it, my father lived to be 90, my mother lived to be 91, but their parents died much younger. When Bismarck inaugurated pension systems in the 1870’s, he chose the age of 65 for retirement and the age of eligibility for and old pension. This has all changed in the last century really in the last 50 years and we have this large over 65 population that is growing faster that the rest of the population in the developed world. We in the developed world live with an adequate safe food supply, clean safe water and a safer environment and of course good medical care. A couple of years ago I read a book called, “The Horse and Buggy Doctor”. It was written by a physician who practiced in the American Mid-west in the late 1800’s and early 1900’s. Typhoid fevers, malaria, tuberculosis, whooping cough, measles, small pox, bacterial infections, were the diseases that affected us and killed many of our ancestors. Now it is diabetes, arteriosclerosis, heart disease, hypertension, and accidents that are the killers. What is interesting is that our role as healers hasn’t changed much just the diseases have changed.
  • Dr. Seffinger:   Wonderful. Do you have anybody that you can think of that we should contact that was instrumental in the development of osteopathic history in the state of California?
  • Dr. Ryder:   Well, you know Stan Golanty?
  • Dr. Seffinger:   Yes, he’s already interviewed with us.
  • Dr. Ryder:   And I think you know Vic Passy.
  • Dr. Seffinger:   He’s interviewed with us.
  • Dr. Ryder:   Those are the two that probably would have had the most...Do you remember Bob Steadman?
  • Dr. Seffinger:   Yes, I interviewed him too.
  • Dr. Ryder:   Oh you did get Bob. We go back to junior high school.
  • Dr. Seffinger:   Oh really.
  • Dr. Ryder:   Yes, Bob Steadman. He’s actually a couple of years younger than I am and Jack Mosler, we all went to grade school and high school together. Vic Passy was also, he was a year ahead of me and in fact Vic Passy and I went from, oh, junior high, high school, and university - all the way through medical school. Stan I thought I knew him at UCLA, but I’m not really sure now. It’s been a while. The same thing with Bob Steadman and I were on the Art Linkletter show. You remember when they interviewed kids; we were on the same program. This is a small world. Of course Jack Mosler’s sister was a sorority sister of my wife. You see, this is a small town because we grew up in the same era, went to the same schools. And of course this town got so big and so cosmopolitan, it’s hard to remember the way it was. I’m trying to think of anybody else. Larry Biladeau? You remember Larry?
  • Dr. Seffinger:   A little bit.
  • Dr. Ryder:   Larry’s father was a DO and practiced in Pontiac Michigan and was involved with the Pontiac Osteopathic Hospital. He became a radiologist and did special procedures.
  • Dr. Seffinger:   Okay. If anybody comes to mind let me know and if anything else you’d like to add to this you are welcome to do that at any time.
  • Dr. Ryder:   No, I think I’ve talked long enough.
  • Dr. Seffinger:   Ha, ha, ha, okay. Thank you very much. It’s been a pleasure in talking and hearing about your life and your accomplishments and your contribution to the historical development of osteopathy in California.
  • Dr. Ryder:   Well, thanks for inviting me.