Dr. Jimmy Hara's dedication to community medicine was forged in the late 1960s idealism of San Francisco's counterculture movement, where he volunteered at the Haight Ashbury Free Clinic when not protesting the Vietnam War or studying medicine at the University of California, San Francisco. A longtime member of Physicians for Social Responsibility, Hara is passing on his passion in his current job at Kaiser Permanente's Los Angeles Medical Center, where since 1984 he's served as family practice residency director. While many hospitals have trouble attracting medical students and residents to family practice, Hara's program is always full, with many UCLA and USC medical school graduates opting to forego lucrative medical specialties for careers as primary care providers. Hara has his students volunteer at the Venice Family Clinic, Los Angeles Free Clinic and various Salvation Army homeless shelters. He is also a widely sought-after expert in the current debates about how to reform the state's health care system and deal with the growing shortage of health professionals as the state's population grows. In addition to his other professional involvements, next year he'll be launching the Southern California branch of the renowned Albert Schweitzer Fellowship Program, which gives young doctors the opportunity to work with underserved populations in Africa and the United States.

Question: You were born in a Japanese internment camp during World War II. To what extent might the experience have affected you?

Answer: It's really hard to say. My parents really didn't talk a lot about the internment camp experience and I was too young to remember much about the camp in Arizona. Like a lot of their generation, my parents basically suppressed and repressed any traumatic memories and moved on.

Q: Did you always want to become a doctor?

A: Not really. As an undergrad at UCLA, I thought I was destined to become a paleontologist. But the professor who I would go out on digs with during the summer told me one time that, you know, there really are only a half dozen jobs in the country in our particular type of paleontology, so maybe you might want to do something else. He was the one who actually suggested medicine.

Q: Why medicine?

A: I seemed to care about people. He saw that in me.

Q: What drew you to community medicine?

A: It was the late 1960s, and I was in San Francisco, so of course I was drawn to Haight Ashbury and the Haight Ashbury Free Clinic, which was one of the first free clinics at the time. I volunteered there as a medical student. In 1967, the Vietnam War protests really picked up, and there was the civil rights movement with Martin Luther King, so during medical school all that activity really molded my thinking about what's really important.

Q: You were a war protester and still went into the Navy?

A: Yes, but I had a deferment for my medical training and almost missed out having to go over to Vietnam. In fact, I was pretty much the last naval medical officer to be sent over to Vietnam. After graduating from UCSF, I came back to L.A. to do my residency at the V.A. hospital and Harbor General Hospital in Torrance. But war was still on, so I eventually had to put in two years in the Navy as soon I finished my training.

Q: Did your views on the war color your military experience?

A: It did make it harder for me to get a security clearance, but they certainly put me in a lot of interesting assignments once they got me over there. After the war ended, I was transferred to Manila to work with the POW release. From there, I went to Hanoi Harbor on a ship that was the de-mining the harbor. After that, I was sent to Long Beach Naval Hospital, where I was delivering babies, treating children and doing minor surgery. I realized I enjoyed that. That's how I came into family practice.

Q: How did you end up working for Kaiser?

A: Toward the end of my time in the Navy in 1974, I was moonlighting at Kaiser's Inglewood facility while still at the naval hospital. I figured I would only do it for a year after I got out of the service until I figured out what I wanted to do. But Kaiser was starting a brand new hospital in West L.A. and they asked me to become the head of the old La Cienega clinic that was part of it. I basically never left the Kaiser system. I was at West L.A. until I was recruited to run the family practice residency program at Los Angeles Medical Center in 1984.

Q: Were you working with residents at the West L.A. clinic even back then and taking them out to the free clinics to volunteer?

A: Of course. I had UCLA medical students working for me, and I used to take them with me to the Venice Family Clinic, which was founded by a friend from my UCLA days. All of my students spend time at places like the Venice clinic, Salvation Army shelter and other clinics or health fairs in Latino and African American neighborhoods.

Q: How big is your program for residents and medical students these days?

A: I get medical students from both UCLA and USC about 14 total right now, plus my 27 residents and around four doctors on fellowships. Over the course of a year, I'll see 125 to 150 medical students.

Q: What attracted you to the free clinic work?

A: I know it sounds corny, but I'm part of that old generation in the 60s who wanted to get into medicine to help my fellow man and help improve the health of the community. I guess that motivated me to stay with Kaiser too. Back in the early days, we were sort of looked at being the closest thing to socialized medicine in this country.

Q: In addition to community clinic volunteering, what is your other community work?

A: I have been involved with Physicians for Social Responsibility since the early 1980s. I'm a past president of the L.A. chapter, and still on the executive committee. We started as an organization against nuclear war, but in recent years we have embraced a broader environmental stewardship. Being of Japanese heritage, I still have eight A-bomb survivors from Hiroshima and Nagasaki among my patients at Kaiser.

Q: Are other members of your family involved in community service?

A: My wife is a nurse who works in utilization management for another health system. Neither of our sons went into medicine one is an investment broker in the Valley and the other is a starving artist in Northern California. But both of them volunteer the broker is very involved in Habitat for Humanity. We raised them to contribute. Back in 1985, for example, my wife took our sons to participate in the March for Peace across the U.S.

Q: Were you ever interested in going into private practice?

A: The reason a lot of us were attracted to Kaiser in the early days was that we just wanted to treat patients not deal with the business and with the billing hassles and all of that. Of course, these days every doctor has to be concerned with the business end of medicine, even here.

Q: Your residency program is healthy, but so many other family practice programs have a hard time attracting applicants. What is the problem?

A: This current generation, the millennial generation, are attracted to volunteering and community service, but I think money is a big reason why so many people who go into medicine end up becoming a specialist. A medical student these days graduates with at least a couple hundred thousand dollars of loan payments to make. Unfortunately, family medicine doesn't tend to be one of the higher-paying fields, though I think I live pretty comfortably.

Q: Why do you believe your program has been as successful as it has been in attracting residents to family medicine and having them actually stay with it?

A: There are a lot of programs that have trouble recruiting, but we have built up a reputation that attracts a certain type of doctor. They know what our program stands for and they know if they train in my program, we're going to expect them to do a lot of community service. Fortunately there are enough doctors out there still interested in doing that kind of work.

Q: If you were an undergraduate today, would you think twice about going into medical school because of the high cost?

A: I would really question it. Today, many medical schools charge as much as $40,000 to $50,000 a year. I remember back in 1966, when we medical school students staged a three-day boycott after the UC system raised incidental fees from $68 to $72. So I guess cost is relative. But today it's really gotten out of hand where this country chooses to invest. We have our priorities and values all screwed up. When you think about the billions of dollars being spent in Iraq and what that same amount of money could do to train doctors, pay nurses more money and improve access to health care in this country.

Q: Throughout this year, the California Legislature and the governor have been haggling over how the state can expand health care access to more Californians. Where do you stand?

A: I'm part of a circle of people who have been advising the Department of Health Services and the people who were putting together the governor's health plan. Universal care is a good idea, but I don't think you have to get rid of the private sector and insurance companies to do it. And I believe in the model of employer-based health care, supplemented by (government) programs for those who are not employed.

Q: Is there any social responsibility for employers to help their workers with their health care?

A: I believe that and that there's also a practical reason employers should be involved. Why would you want your workers getting sick and not being able to get good care? That affects your business. A program that would be affordable to employers should appeal to their self-interest in maintaining a healthy workforce. I have all this experience in working in a system, Kaiser, which provides a good, cost-effective model of providing health care via the workplace.

Q: You sound so busy. How do you relax?

A: My father was a wonderful bonsai gardener and I used to do it too, but all my trees died after we moved from Santa Monica to the Valley. Woodland Hills gets extremes of hot and cold oddly, they survived a very hot summer, but when we had two days of very cold weather, they all died. But we still have our garden and koi. My wife has her Victory garden, and I have my koi pond, both of which we were able to make larger when we moved to a half-acre home.

Dr. Jimmy Hara

Title: Family Practice Residency Program Director
Organization: Los Angeles Medical Center, Kaiser Permanente Southern California
Born: 1945; Camp Gila, Ariz.
Education: B.A., zoology, UCLA; M.D., University of California, San Francisco
Career Turning Point: When the paleontology professor with whom he was interning suggested he would have an easier time getting a job if he switched to medicine
Most Influential People: Lachlan Forrow, president of the Albert Schweitzer Fellowship; Physicians for Social Responsibility leaders such as Dr. Christine Cassel; Dr. Bernard Lown, a cardiologist and Nobel Prize winner who worked to bring Soviet physicians into the anti-nuclear movement
Personal: Lives in Woodland Hills with wife Diane and has two grown sons
Hobbies: Volunteers medical services at free clinics, has a leadership role with Physicians for Social Responsibility and raises koi fish

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