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As the new medical director of Kaiser Permanente Medical Center in Los Angeles, Dr. Thomas F. Godfrey has the task of working to reverse two years of big losses at the nation's largest health maintenance organization.

In 1997, Kaiser posted its first-ever loss, totaling $266 million, as it failed to keep premiums in line with rising medical costs. The non-profit HMO is likely to report a similar loss for 1998, though a 9.5 percent average increase in premiums is projected to turn things around this year.

Godfrey said the rising cost of health care poses big challenges for Kaiser Permanente and other HMOs.

"It is more of a challenge to make good medicine affordable," he says. "The pressure is driving the costs of medicine, and the job keeps getting more difficult."

In his new post, Godfrey will oversee medical services and the three teaching centers at one of Kaiser Permanente's largest facilities. Located in Hollywood, the medical center serves about 237,000 HMO members in the L.A. area with a primary care center, teaching institute, and specialized care services for members referred from as far away as Bakersfield and San Diego.

"I think our success has been making high-quality medicine affordable for working Americans," Godfrey says. "We've been a strong advocate for doing what's right for people, and we maintain that against fierce opposition."

During his 25 years at Kaiser Permanente, Godfrey developed a program to improve communications between doctors and patients that is now used throughout the organization. He feels so strongly about patient-doctor relations that he is writing a resource book on the subject.

"Understanding patients' fears and concerns, it doesn't matter if you're an HMO or whatever in medicine, it's in danger of becoming a lost art," Godfrey says. "Doctors need to be able to interact successfully, given the suspicion and pressures, and relate detailed and highly technological information to patients."

For the past three years, Godfrey has been assistant to the Kaiser Permanente regional medical director in Bakersfield. Before that, he was chief of urgent care and coordinator of emergency services in Los Angeles.

Godfrey still manages to find time to write mystery stories and edit anthologies. Although the stories are not necessarily set in hospitals, he says the skills needed to practice medicine come in handy when plotting a good mystery, "Both are demanding and complex," he says.

Jolie Gorchov

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