M.D.s and D.O.s in Early California

Dr. Seymour Ulansey, MD, interviewed by Dr. Michael Seffinger, DO

at his home in Malibu, California
August 2, 2006

Dr. Seffinger: Dr. Ulansey, thank you for offering to tell us your story about your history in relation to osteopathy in California. I'd like you to start with just telling us your name; where you grew up; where you trained; your education and background; and how you first came into contact with the osteopathic profession?
Dr. Ulansey: My name is Sey Ulansey (I go by the name of Sey). I was born and raised in Philadelphia, German-town to be exact, Pennsylvania. My father was an allopathic physician.
Dr. Seffinger: Is that your father in the back ground there?
Dr. Ulansey: That is my father behind my head. There was never anything else I wanted to be, but to follow in my father's footsteps; as did my brother who was about five years my senior. My first exposure to the osteopathic profession was through my brother who had enrolled and was graduating at the Philadelphia College of Osteopathy. At his instigation I applied to PCO on the basis of my undergraduate work at La Salle College in Philadelphia. I did do it. At that time we were on an accelerated program at La Salle and I had accomplished three years of work in a two calendar year period. That was war time I believe. Fortunately for me I was accepted on that application with the two years of schooling and three years credit. I started off at PCO. This was my entrée into the medical field. I completed three years at PCO. Having heard of the greater opportunities afforded the students in California, both students and graduates in Los Angeles, California, that I said, "That's for me, that's where I want to go." So with that knowledge and background I did apply and was accepted for transfer and received credits from my undergraduate work in Philadelphia toward graduation at COP&S, that's California Osteopathic Physicians and Surgeons.
Dr. Seffinger: So you transferred in your senior year?
Dr. Ulansey: I was just entering the senior year.
Dr. Seffinger: So you completed your senior year in California?
Dr. Ulansey: Yes. I served a clerkship or externship and some class work in Los Angeles. I was most impressed by my experience in California at the County General Hospital which was a marvelous institution. It was such a revelation to me as compared to the clerkship that I served in my junior year in Philadelphia. We were relegated to giving patients [osteopathic treatment] OT, as it was known then, which really only consisted of rib raising rather than actual manipulative therapy. We were taught manipulative therapy, but only used it in the clinic. It was sort of taught with tongue in cheek at that school. I found the school had excellent academic basic science courses. It was my opinion at the time that the clinical exposure was extremely limited and one didn't get very much of an opportunity at that institution. The revelation at Los Angeles was that I found myself as a clerk extern doing work that the residents at PCO did. An instance that was made so much of in Philadelphia was minimal everyday bread and butter sort of thing at the L. A. County General Hospital.
Dr. Seffinger: Why do you think there was such a discrepancy in training in Philadelphia versus Los Angeles?
Dr. Ulansey: I think it was a tightly held noncompetitive situation. Those who were in power only allowed or fostered their relatives or 'pets' to gain entry to the sought after higher training and experience, as found in the specialties. There was a severe lack of clinical patients and exposure to this important part of medical training, "working hands on with live patients," but with five allopathic schools in Philadelphia, the contrast for learning was disparate.
Dr. Seffinger: The Philadelphia Medical Society was a tightly controlled society, do you think?
Dr. Ulansey: Overall both the medical society and the osteopathic society were both tightly controlled, but I was concerned more with my osteopathic experience than the other one. The other was only hearsay. I was exposed only to osteopathic training and this part was so limited. To learn medicine the student must be exposed to and work with the patients directly in order to see and handle disease.
Dr. Seffinger: So you were not allowed to train in county hospitals in Philadelphia in the 1940s?
Dr. Ulansey: Not at all, not at all! I remember going down to Jefferson Medical College and sneaking in to the amphitheater to observe grand rounds. We had to sort of sneak in backwards. No, we were not freely admitted.
Dr. Seffinger: And you didn't have any big major hospitals for training?
Dr. Ulansey: Not at all. We only had the 48th and Spruee Streets Hospitals, which were owned and operated by the college and private individuals.
Dr. Seffinger: Okay, so you had better training opportunities in Los Angeles and you went and took advantage of that. What year did you graduate?
Dr. Ulansey: I graduated in 1945.
Dr. Seffinger: Okay and what were the DOs in California like at that time? What was your first impression as a newly graduated DO in 1945?
Dr. Ulansey: They were a more progressive and friendly group, a numerically larger group in the county of Los Angeles as well as spread largely throughout the state of California. They were much more willing to impart some of the knowledge and experience that they had gained through their exposure primarily at the county hospital and through allopathic friends.. It was such a marvelous experience; I'll never forget it the rest of my days. The faculty and the attending physician's staff were willing to impart what experiences and knowledge that they had gained to us the students, the young aspiring physicians coming up. It was a revelation. It really was something that as I said for the rest of my life I will never forget the experiences I had at the L.A. County General Hospital.
Dr. Seffinger: Did you find that you could train at other hospitals as well?
Dr. Ulansey: The osteopathic profession in the Los Angeles area consisted of, hospital wise, about…Well, I can name them: Doctor's Hospital, Monte Santo's Hospital, the Wilshire Hospital (which was the pride and joy of the city), the Burbank Hospital; there were a number of these smaller institutions which were typical of California at that time. But they were DO hospitals of varying in size from 30 to 75 beds while the allopathic hospitals also were growing; they were 100, 150 bed hospitals. We didn't have too many of the larger institutions so typical of the well established east coast large cities or eastern United States. The L.A. County Hospital had 4,000 beds, 500 of which were osteopathic.
Dr. Seffinger: Okay and you didn't train at these hospitals particularly, you trained mostly at the County.
Dr. Ulansey: No, there were internships and residencies at most all of these smaller, DO hospitals as well. I refer constantly to L.A. County because in my opinion, it was the best. I took my clerkship there. I did my internship there. I did my residency there and subsequently did a fellowship as well. I lived and breathed county hospital.
Dr. Seffinger: What was your residency in?
Dr. Ulansey: Anesthesiology.
Dr. Seffinger: Okay.
Dr. Seffinger: Quite a happenstance, I was interested in becoming an ophthalmologist. I used to go around at night and examine the eye grounds (fundus) of the very elderly placement patients, which was a good opportunity to learn.
Dr. Seffinger: What is a placement patient?
Dr. Ulansey: These are older people who had no homes to go to and they were put out for placement. Los Angeles had El Rancho which was the senior citizens home run by the County for the poor and indigent.
Dr. Seffinger: Did you know T. J. Ruddy, D.O., who I believe was an ophthalmologist or ears, nose and throat faculty at COP&S?
Dr. Ulansey: Dr. T. J. Ruddy was one of my professors in ears, nose and throat. A little story goes with him. T. J. Ruddy developed a procedure which we called the Ruddy finger treatment. This consisted of putting the operator's finger into the fossa of Rosenmuller through the mouth and manipulating that fossa. Actually what we did I think was to stretch and tear adhesions that existed there. It had a very profound affect. It seemed to help hearing. It helped a number of headache syndromes, head and neck problems, perhaps even more general than that, body problems. It was a very interesting experience learning from him who loved to teach, imparting his knowledge and experiences.
Dr. Seffinger: Did you have any experience with his eye techniques that he called "resistive duction"?
Dr. Ulansey: No, never did.
Dr. Seffinger: Balanced the eye muscles.
Dr. Ulansey: Knew of it, heard of it, but never had any exposure to it that I can recall.
Dr. Seffinger: Okay, so you decided that instead of ophthalmology to go into anesthesiology.
Dr. Ulansey: Because there was a shortage of residents at that time at L. A. County during the post World War II years, 1945-1950. We residents were covering two duties at once. For example, when you did your rotation, you did medicine and something else, surgery and something else, and so forth. It was my fortune to have a number of rotations on anesthesia for which I suddenly developed a taste. It led to my desiring to change my whole plan of professional activity and to become an anesthesiologist, which in fact I did. I did my internship, my residency, a fellowship, and then I became a voluntary assistant in anesthesia for a couple of years. And from there I became a junior attending physician. I've remained on the staff, the teaching staff at the County Hospital, and at COP&S, teaching students as they came up, interns, and new residents. I was in that department for something like 25 years, and gave up one day a week to go to the County. I say gave up, it was a two way street, I learned from it; and I gave something in return for learning. We did everything. We saw everything; things that you didn't see in private hospitals. It was just a marvelous exposure. The beautiful part about L. A. County was patient care; directed by either interns or residents. We were the doctors. Yes, we were overseen by residents more senior to us and they in turn were overseen by attending staff. It was a ladder effect. It was a good exposure.
Dr. Seffinger: You had a lot of responsibilities that you couldn't get in other hospitals probably.
Dr. Ulansey: Absolutely not! Not available! Only in a county type institution!
Dr. Seffinger: Was it common to have anesthesiology residencies at that time?
Dr. Ulansey: No. I think…well there had been some ten or fifteen years before there was one senior physician in town that I knew had a residency in anesthesia. Then it was stopped for reasons I didn't know. Then I was the first one to resurrect that position. I served as I said, gaining marvelous exposure to varying experiences.
Dr. Seffinger: Do you recall who your mentors were?
Dr. Ulansey: Very clearly! Dr. John Stratton and Dr. Amanda Marshall were the senior attending physicians; both of whom I am forever indebted to for the training and direction that they gave me.
Dr. Seffinger: And some people that you then trained; do you remember some of those people?
Dr. Ulansey: Well, I remember one very vividly; that was Dr. Afton Taylor who was one of my interns/residents. Later when I had the need and desire to take on an associate, I asked her if she would join me, and she did. It was a marvelous association for many years. There were also Dr. T. Siu and Dr. Philip Collange.
Dr. Seffinger: Do you recall people like Dr. Steadman, Dr. Passy, who were surgeons later on and trained at the end of the 1950s or so?
Dr. Ulansey: They followed me sequentially. They were younger than I and later graduates. Yes, I knew them as interns and residents in their fields, working with them.
Dr. Seffinger: Did your impression of the osteopathic profession change through the 1950s and 1960s? What did you observe at that time? There was a bit of a change in the winds so to speak in the profession during the 1950s. Do you remember that time period?
Dr. Ulansey: The younger generation always wanted to learn more. They wanted to do more; to see more; to hear more; and they were eager to be better doctors. The opportunities were there, but we couldn't take advantage of them because of the friction between the allopathic and the osteopathic professions. The allopaths had an unwritten rule - a code that they should not mingle with 'we who were less pure.' Some of them were very friendly, very cooperative and helped us immensely. They would lecture to us in small gatherings. They would work with us in some hospitals, not the major hospitals, but in some of the smaller hospitals; some of the hospitals which were operated as osteopathic hospitals.
Dr. Seffinger: But at L. A. County Hospital the MDs and the DOs did not interact or exchange patients or consult on patients together?
Dr. Ulansey: The County Hospital operated so as to separate them; the two professions rarely intermingled. So, fundamentally, no. In a few instances we had contact. I remember contacting the senior resident over at County Unit #1, Dr. John Dillon, not knowing that he was the accomplished and prestigious man that he was. However, he was most generous with his time and pearly words. There was also in anesthesia, Dr. Leffingwell of the White Memorial Hospital. There was always friction between the allopaths and the DOs. The White Memorial Hospital was a little more friendly than most of the allopathic hospitals, and so their people were friendly. I formed a group of anesthesiologists known as the Los Angeles Society of Anesthesiologists. The doctors that I mentioned would come and lecture to us; give us some good tidbits from what they had learned through their experiences. They were friendly and helpful, but that was not the prevalent situation across the county - meaning the Los Angeles County. We couldn't get into USC. University of California at Los Angeles didn't exist then as a medical school. In the larger medical hospitals, we were not admitted to their staff and therefore could not attend their meetings or their educational programs. That was a bone of contention causing friction between the two professions. And another thing that was very bad at that time, there was a rise in malpractice. We found that the allopaths would testify against the osteopaths and the osteopaths would testify against the allopaths, but they wouldn't testify against their own kind. So that was a major friction and had a strong influence in the future of the two professions. I also would mention that these were the war years. The allopaths were drafted into the medical service. The DOs through the generosity and knowledge of General Hershey, the United States General in charge of selective service, were not drafted. He decided that since the DOs did not get a commission (they were not eligible for commissions in the military service, none of the services), he said, "Well then, it is essential for them to stay home and take care of the public health," which was a real boon to the osteopathic profession in California. We represented about 1/20th of the medical professions in California; that is both professions combined.
Dr. Seffinger: Well, you took care of a large population.
Dr. Ulansey: Yes, we had the privilege of staying home and building practices that the medical men, the allopath, had to leave to go serve their country. So we were serving the country in a different manner. We built large, very successful practices and built a name for ourselves.
Dr. Seffinger: And when the MDs came back from the war?
Dr. Ulansey: Very unhappy!
Dr. Seffinger: Did you give them back their patients?
Dr. Ulansey: Ha, ha, not likely! The patients had now become accustomed to a different approach to medical practice. The osteopaths considered themselves as the underdog. They paid more attention to the patients. They listened more attentively to the patients. They spent more time with the patients. This was very good PR [public relations] for them. It paid off. They built their practices. They didn't lose them when the allopaths returned, which made a lot of allopaths very, very unhappy. This fomented further friction between the two groups.
Dr. Seffinger: What would happen if you tried to admit a patient to a hospital that did not have DOs or did not take or allow DOs to be on staff?
Dr. Ulansey: Ha, ha, didn't happen! You couldn't!
Dr. Seffinger: Okay and if you tried to apply for hospital privileges, what would happen?
Dr. Ulansey: You'd be turned down.
Dr. Seffinger: And you couldn't do anything about it?
Dr. Ulansey: Not at all.
Dr. Seffinger: Okay. So you had to have your own hospitals. Is that one of the reasons why you eventually developed your own hospital?
Dr. Ulansey: Yes. I was working at a smaller hospital, about 30-35 bed hospital. There was a mixed staff, DOs and MDs, which did occur in smaller hospitals. It never occurred in large institutions; the Catholic institutions, Protestants institutions, or Jewish institutions…
Dr. Seffinger: Or County Hospital?
Dr. Ulansey: Well, the County Hospital…We had two distinct hospitals…
Dr. Seffinger: Segregated.
Dr. Ulansey: Each segregated; every 20th patient who did not specify was assigned to the osteopathic unit. If they requested or preferred they could take their choice of either one of the two units. The allopathic hospital was approximately, I believe, something like 4000 beds. The osteopathic hospital unit was 350 or 500 beds or so; quite a difference.
Dr. Seffinger: That was before it was rebuilt and expanded.
Dr. Ulansey: Oh yes, that was before; that was in the 1920s and 1930s, I believe.
Dr. Seffinger: In 1928 it started with a little unit; 1932 they had a bigger unit and that stayed until 1956, and 1959 was, I think, when they completed the new osteopathic hospital.
Dr. Ulansey: In 1956 or so the County of Los Angeles built us a new hospital which was state of the art, not quite. We didn't have the major expenditures in equipment such as the 300 milliamp, X-RAY machine, which at that time was the big to do. We didn't have certain other things, but by and large, we were a first class hospital with equipment, nurses, everything first caliber; we relished it of course.
Dr. Seffinger: And that happened after you became involved with your hospital, the smaller hospital or before.
Dr. Ulansey: Well, the County Hospital is for the indigent.
Dr. Seffinger: Oh I see, so you had your own practice….
Dr. Ulansey: The private hospitals and those were varying as I mentioned before the different sizes. I, being the new kid on the block, got into the small osteopathic hospitals. As I said, it was only 32 or 35 beds. Some of our osteopathic hospitals were as much as 75 beds. I worked there for a number of years doing anesthesia for surgeons whether they be DO or MD because we got along very well in that small institution.
Dr. Seffinger: What was the name of that institution?
Dr. Ulansey: That was the Hollywood Leland Hospital. Quite by chance I became very friendly with the owner of that hospital; it was privately owned. He was getting along in years and he presented me with a proposition, "Why don't you buy my hospital?" I was newly out of school, that was in 1950s (middle 1950s), and in practice a couple of years. "Buy a hospital, are you kidding?" Well, he showed me how I could accomplish it. He showed me the financial structures. Taught me a lot about financing of hospitals, and it was far different cry than the hospitals today. At any rate, I did put together a group of doctors, both DOs and MDs. We put up, which was for me, a lot of money. We did purchase that hospital with 16 of us. We operated it very, very successfully, very ethically. We tried to be better and less arrogant than some of our allopathic brethren. We had a very successful operation for many years. We operated that hospital and expanded it to 125 beds. A six story structure came out of a one story structure. It was something to be proud of. We were very proud of it. The advent of Medicare and Medical (the state cares) changed the financial structure considerably to a point where after several years it became untenable financially and we converted it into a nonprofit structure. We saved that tax money, and that gave us operations for another couple of years. Then with the growth of the Medicare and the Medical, particularly the Medical situation, it was no longer feasible to operate the hospital. We had to sell it.
Dr. Seffinger: Now this was about 1980 or so. So you did okay. That hospital stayed private until the end of the 50s, early 60s, into the 70s, you did okay and then by the end of the 1970s…
Dr. Ulansey: It was no longer profitable.
Dr. Seffinger: Okay so then you went to nonprofit and then you eventually sold it.
Dr. Ulansey: To a private corporation, and they changed their tactics. They could do things that we couldn't do. The hospital still exists. Its changed hands twice I believe since.
Dr. Seffinger: Where is it located?
Dr. Ulansey: It is right in the heart of Hollywood; one block off of Sunset and Vine. It is still there. It is doing well as a private corporate operation with a different set of rules to meet the new business techniques they have introduced in the current type of operations by mergers into large corporations with buying power and different type merchandising.
Dr. Seffinger: At the time you were thinking about selling the hospital or make it nonprofit, the osteopathic college in Pomona, the College of Osteopathic Medicine of the Pacific had just opened its doors around 1978. You were aware of that school and you had some relation with the president, Philip Pumerantz. .
Dr. Ulansey: I met the president, Philip Pumerantz who was a very dynamic person, extremely dynamic to say the very least. Because of our financial position, we weren't sinking yet, but the handwriting was on the wall. The small private hospital couldn't exist financially. I came up with the idea that for a tax consequence, which would have been very favorable, we could have donated it to the college which had been established in Pomona. I tried to promote that, but it sort of fell on deaf ears from my partners and associates in my hospital. Also, I don't think that the Pomona College was quite ready to move, since they had just really started to get on their feet in Pomona, which they were doing well. I mean they were starting to graduate students. As a matter of fact, I instituted a program for the students at Pomona to come over and do clerkships at our hospital. Then eventually this led to internships as well as residencies. So we had a few years of internship, clerkship and residency on a smaller scale than the surrounding allopathic facilities. The merger in 1962 came about because of the fact that the DOs wanted to have entry to further education. It was very, very difficult to get into these allopathic facilities. So there were talks going on, some of which I knew about, some of which I didn't know about. A merger took form - took shape. When the merger was just in the talking stage, our AOA, our esteemed association, became incensed by the idea that we would dare to discuss any of the problems that we had locally, which were malpractice, the testifying of the two groups against each other; and the problems with Medicare/Medical. These were of essential importance to us and the AOA. In a dictatorial fashion, after the AOA heard of our discussions, and there were only discussions at that time, between the two professions, they said, "Cease and desist." Well that was a red flag, the flag went up with the DOs overwhelmingly; I believe it was some 2,000, overwhelmingly rebelled. I say rebelled against the dictatorial statement and threat which the AOA did enact. They took away all of our certifications. We were Board certified, a great number of us. They took it away from us! Just absolutely took it away! The DOs were incensed. Now this cost the AOA eventually 2,000 members who left them with bitterness; bitterness not because of the merger itself, but, it was because they were ordered to cease and desist.
Dr. Seffinger: To talk…
Dr. Ulansey: To talk! Just to talk! We had members of the COA were on the board of Trustees of the AOA. They were told, "You're off! Goodbye! Cease and desist!" As I say, that incensed the membership at large. In the meantime, it became more known that there were discussions going on. They were at full force at this point because of the high handed manner which the AOA was acting. The AMA and the CMA seemed to honor and want us, to be friends, and to heal the wounds - the differences between the two professions to the extent that an amalgamation or merger (it was called by several names) did take place. And I will attest to the fact that the CMA and AMA did fulfill all their pledges that they had in discussion to honor the merger agreement that we had engaged in. This also did mean the change of the college, COP&S, which was in my opinion, one of the better colleges of the six that existed at that time. They changed the name of it, I believe. It became an AMA approved and accredited medical college in the United States, called the California College of Medicine. Eventually, we were all granted, en mass, an MD degree. The college became a subsidiary of the University of California system, moved to its Irvine campus and is known today as the University of California, Irvine School of Medicine. We were all granted both an MD degree as well as a license by the medical board and new diplomas showing that we were now graduates of the California College of Medicine, which was later updated to state that we graduated from the University of California (CCM), California College of Medicine Division. So we felt we were very fairly treated by the medical profession. The merger took place, not without certain diehards, which were on both sides. Not every last DO became an MD. There were a relatively smaller number that didn't chose to merge. Some did to choose to hold both degrees. That became a little sticky. I don't know how that worked out, but all-and-all the merger was one of major cooperation between the two groups.
Dr. Seffinger: What did the DOs, as a profession, have to give up in order to receive that kind of acknowledgment?
Dr. Ulansey: Well, we didn't give up anything. The only thing we gave up was…Well our board certification had been taken away because the AOA, unlike the AMA, held within its fist the certification program. Those who had been certified, and California had a large number of certified DOs in proportion to the DOs of the other states, lost their certification. Now the California Medical Association in order to fulfill some of their agreements set up a new committee of certification. All of us who had been certified or who were engaged in a proper program towards certification were granted their certifications. We're very appreciative that they did do that; that is, to attest to our certification and accreditation by examination and peer recognition.
Dr. Seffinger: So you had to give up your DO degree?
Dr. Ulansey: Yes!
Dr. Seffinger: And the college…
Dr. Ulansey: Yes!
Dr. Seffinger: And that means no further DOs would be trained.
Dr. Ulansey: That was part of the agreement.
Dr. Seffinger: Right. Did that work out okay?
Dr. Ulansey: As far as we were concerned, yes, until there was some activity by a group out toward Pomona who wanted to resurrect and re-establish the DO licensure and a college. Through the efforts of Dr. Pumerantz, who I said was a real dynamo, he did get cooperation from a lot of the roots, the DOs, the MDs who had been DOs, but the main thrust came from a handful of DOs who had chosen to remain so. Now, they have a fine college. Western University has a pharmacy school, veterinary school, nursing and physical therapy schools. They've built quite an institution out there and I understand they are heading towards a dental school.
Dr. Seffinger: Who helped Dr. Pumerantz to finance the college in the beginning?
Dr. Ulansey: Well, I don't know the full intricacies of it. I know that a lot of us who had been DOs made contributions, voluntary contributions, donations.
Dr. Seffinger: Can you explain your thoughts at that time, why you would want to support the startup of a new DO college after voting the previous decade to give up the DO College? Did something happen? Did something change in the culture of the state? Were the DOs accepted more? Was their less tension between the two professions? I know various things changed.
Dr. Ulansey: Many things changed, but there was less need for a separate college, a separate profession. There didn't seem to be the justification for it. But nevertheless, despite all that since this group was starting to work on it in Pomona, a lot of us, me included, felt a certain loyalty. The professional offshoot is what gave me the opportunity to become a physician against social odds prevalent at the time. I felt a certain loyalty.
Dr. Seffinger: So you could also support the College of Medicine at UC Irvine at the same time that you supported the college in Pomona?
Dr. Ulansey: We had a duo loyalty, a duo loyalty.
Dr. Seffinger: That's very unique.
Dr. Ulansey: Yes it was, but I felt that and a lot of my colleagues felt the same way and we did exactly that. We contributed to the Irvine California College of Medicine as well as making, perhaps in some instances more, in some instances lesser, contributions to the newly formed college.
Dr. Seffinger: Did you participate in training MD students as well as DO students?
Dr. Ulansey: Yes, I did. When I finished my residency and started the fellowship in anesthesia at the osteopathic college at the L.A. County Hospital, I was also on the teaching staff, an Assistant Professor of Anesthesia at the College the Osteopathic Physicians and Surgeons; and then when the merger/amalgamation took place I was transferred to the staff of the California College of Medicine, and I had the same status teaching even after the college affiliated with the University of California and moved to Irvine. However, when they moved the institution to that new geographic location, it became a hardship to travel back and forth from Beverly Hills area where I lived to Irvine, which I forget, I don't remember the mileage, but traffic was increasing day by day. I gave up. I resigned from my status on the staff. I have an Emeritus status, though.
Dr. Seffinger: Did students come to your office or hospital to train at all from Irvine in the 1970s.
Dr. Ulansey: No, no, we no longer had the intern program. We lost that when we separated from the…We were cut off from the DOs. They no longer…Our hospital was no longer an approved osteopathic hospital.
Dr. Seffinger: Right. And you were not yet an approved MD training hospital.
Dr. Ulansey: No, no we were not.
Dr. Seffinger: So Unit Two merged with Unit One at that time in1962, 3, 4 around there?
Dr. Ulansey: I do believe so.
Dr. Seffinger: And the MDs…
Dr. Ulansey: Oh yes, Unit II became the Women's Hospital division of L.A. County General Hospital.
Dr. Seffinger: Okay, Women's Hospital Los Angeles and pediatrics also?
Dr. Ulansey: I believe you are right.
Dr. Seffinger: Yes. So they trained MDs there after.
Dr. Ulansey: Exactly.
Dr. Seffinger: And then later on in the1970s and early 80s were you training new DO students from Pomona.
Dr. Ulansey: Yes. I think we gained back…I can't remember the details of it, but we did have students, interns, externs and residents from Pomona at our hospital; it became the Hollywood Community Hospital. The name changed when we rebuilt. We had those students and interns until the amalgamation took place, until the AOA cut us off, then they would no longer…
Dr. Seffinger: They didn't come for the 1960s and 1970s that's for sure. Then when the Pomona College began in 1978 they had their first students came out to clerkships around 1981, 1982 era.
Dr. Ulansey: We did institute the program then. We did have students as well as…We had good affiliation
Dr. Seffinger: Into the 1980s?
Dr. Ulansey: Yes.
Dr. Seffinger: Okay. So you had somewhat of a residency program for family medicine or something?
Dr. Ulansey: Yes. I think we had surgery. We had a resident in surgery and one in family medicine.
Dr. Seffinger: Do you remember how long that lasted?
Dr. Ulansey: I'm a little vague on that; probably until the 1980s.
Dr. Seffinger: When did you sell the hospital?
Dr. Ulansey: Around 1983 or '84.
Dr. Seffinger: Okay. So, it was only a few years.
Dr. Ulansey: Yes.
Dr. Seffinger: And then when you sold the hospital, it was no longer a training site.
Dr. Ulansey: Correct.
Dr. Seffinger: Okay. We touched on most of the issues that I think that are pertinent. One issue you wanted to discuss a little bit was the acceptance into the DO profession of a variety of people from various ethnic backgrounds. Did you notice in the 1940s, 1950s, there was a lot of social tension in America and across the globe at that time? Was it different in the osteopathic profession or was it the same as it was in every other profession? Did you feel there was an ability to excel within this profession that you could not excel in other professions?
Dr. Ulansey: At that time that I enrolled in the college in Philadelphia, there was a definite underground, unwritten prejudicial situation as far as admission to medical school. The PCO, Philadelphia College of Osteopathy, was a private institution and they did admit those who could pay the tuition. A large percentage of the college was Jewish students. In my class, I'd say 50% were Jewish, both from Philadelphia and surrounding states. When we skipped out to California, my class had a much smaller percentage of Jewish students. I believe there were only six or eight, but at PCO in one class I think there were 80 or 90. The war (WWII) changed a lot of situations as far as the expression of prejudices, prejudice against Jews, anti-Semitism, against Negro, against Asian. My class in COP&S had several Asian students, all of whom were top grade. We had one in my class. We had one black American and I think only six or eight were Jewish. There were not the prejudices against the Irish and the Italian that had been historic in my younger years that I saw in the Philadelphia area where I grew up. World War II changed a whole lot of prejudice because Americans were fighting side by side with Americans whether they were black or white or Catholic, or Protestant, or Jewish or what have you. This was a major change in our United States.
Dr. Seffinger: How did that affect the osteopathic profession? How you saw within in the osteopathic profession your interest in becoming better than…You were already put down in one ethnic group, and so a lot of the ethnic people want to be… it's frustrating to deal with double prejudice, you know. This is what you find with women and blacks. So you have one prejudice going already and you become a DO which is a second class profession you figure here is another, you know….
Dr. Ulansey: Off the record we used to have a saying, "What is the lowest station in life you could be?"
Dr. Seffinger: It was either a black or a woman. In Japan it was a woman.
Dr. Ulansey: It was a Jewish black female and one more thing - osteopath. That was the epitome of low life.
Dr. Seffinger: So, what I would like to discuss, if we can finish up, is the issue of why excel or the need to excel? And did that played a big roll in taking on this challenge of merging? Why it was so important?
Dr. Ulansey: I'm not sure I get you.
Dr. Seffinger: Did you see that you were being held back from excelling?
Dr. Ulansey: Yes.
Dr. Seffinger: When you began, the DO profession was great; it was grand. You were glad that they accepted you, they accepted Jews; but you were held back from excelling to your potential.
Dr. Ulansey: You mean by the country?
Dr. Seffinger: Yes, by the prejudice against DOs.
Dr. Ulansey: Yes! Absolutely!
Dr. Seffinger: So the issue is how you scrape this brand off your body.
Dr. Ulansey: This was the merger.
Dr. Seffinger: Yes. That's why Forest worked so hard because he hated being second class when he had the skills of the first class.
Dr. Ulansey: Oh, he was a fine surgeon, among many other of his accomplishments. He was an urologist; highly esteemed.
Dr. Seffinger: Well, he had trained in various places around the world.
Dr. Ulansey: We all did at some roads; we sneaked in here and sneaked in there. I told you I used to carry my father's membership card in the AMA and I would flash that when I went to a meeting.
Dr. Seffinger: So if we could just touch upon how that worked into your decisions. How your decisions in life were influenced by either oppression or control, wanting free will, wanting to be a doctor, too, but some of these decisions for instance, against the AOA when they enacted that attitude thing. This other one was when you were held back from education, from position in society, freedom of choice…
Dr. Ulansey: You mean what did the amalgamation do for all those things?
Dr. Seffinger: Yes that is, why would you want to push for all that so much? It is that here you have seen various things broken down in terms of prejudice yet it didn't reach as far as the DOs. Your profession was still dealing with prejudicial treatment; even though you have this great big county hospital, you were still segregated. At that time Martin Luther King started marching around the south. This is when there was a big movement of the blacks from the south into L.A.
Dr. Ulansey: You see, after the merger went on and was accomplished, segregation largely diminished.
Dr. Seffinger: Right, that issue.
Dr. Ulansey: Yes. I mean we were now admitted on the staff of major hospitals.
Dr. Seffinger: Segment two, where we were talking about the affect of World War II on prejudice in America, which had opened up quite a bit of opportunities for a variety of ethnic groups, Jewish, black American, various people, yet in the 1950s you still see the DOs in California unable to obtain the education that they wanted, the hospital privileges they wanted, they were not able to move freely within their medical profession, which led to talks about merging with the MD profession. I just wanted to remember that, that change in opportunity that came with the merger.
Dr. Ulansey: Well, when the merger took place, opportunity should have changed immediately. But it didn't change immediately. It occurred slowly, but you could see it. It took place! We had appointments to allopathic hospital positions. One of my friends, an anesthesiologist, is head of anesthesia at the St. Vincent's Hospital, a very prestigious hospital. One is currently right now Chief of Anesthesia at Cedars Sinai Hospital, another prestigious hospital. This merger brought about a lot of that. It was definitely, clearly a change. There were also social issues. I mean people started to have respect for an osteopathic physician, "Oh, yes I go to an osteopathic physician."
Dr. Seffinger: You mean you were able to still use that term 'osteopathic physician" after the merger!
Dr. Ulansey: No. No, no, I'm talking about now.
Dr. Seffinger: Oh, currently.
Dr. Ulansey: Yes. Currently the new DOs have profited professionally, they have been accepted into the military as commissioned officers, and at more prestigious institutions, and generally are more socially acceptable with the public.
Dr. Seffinger: Okay, could you talk about that, in other words the affect of the merger helped to increase the prestige of the osteopathic profession in general.
Dr. Ulansey: Without a doubt! Without a doubt because the public was no longer fed by the MDs as to the prejudices of the MD as the DO being less trained, or less educated, if they were now good enough to be admitted to work, and held appointments, in their hospitals.
Dr. Seffinger: Could you walk us through that, tell us how that occurred?
Dr. Ulansey: After the merger took place there was then a physical contact between the two professions. They were working in similar hospitals, same hospitals. They were interchanging ideas. They were even consulting with each other. Most of the consultation went toward the allopathic end because they still had the edge on the educational facilities. When UCLA built a tremendous expansion, we were allowed to come into it. USC - University of Southern California built a big expansion. They took over the county hospital where we were, but we were admitted to them. Socially, it became a better situation. You didn't have to explain what a DO was. I think that the merger had an unbelievable effect on the United States, on the situation for the DOs in the United States of America. When I went to school in the 1940s there were six osteopathic colleges. And there had been such for many years. But it was after the merger that there are now twenty-two I believe, some of which are part of state universities. They are financial subsidiaries to these state universities, medical schools. This was an unheard of thought before the merger. I think that the osteopathic profession owes California an immeasurable debt for the progress they made. However, there is no question that they have improved their schools; they have raised the school standards; and they have earned some of this respect themselves. The AOA has lost some of its power, some of its dictatorial power. It has become more democratic. This also has raised the estimation of the public for the merits of the osteopathic physician. He has become a more valuable asset to the public.
Dr. Seffinger: Very interesting perspective.
Dr. Ulansey: That's my personal belief. I believe I share that with a number of other people. I've talked with friends about it. They seem to share that same opinion.
Dr. Seffinger: Yes, I think, there is no doubt that boom in this profession, the growth would not have occurred had the California group not merged with the CMA or seceded from the AOA at the time or the AOA pushed them out, so to speak, pushed to the brink of wanting to leave.
Dr. Ulansey: I think it is very apparent to any one who has his eyes open! Some of the old diehards probably don't agree, but I think it's clearly evident.
Dr. Seffinger: Yes. As an MD do you find that people still mark you as an ex-DO at all?
Dr. Ulansey: Some do. Some MDs do. For the most part I think there has been a general acceptance of us. They know what we were. They know who we are. I think since they know who we are today, the DO in its resurgence has faired better here in California too because they think, "Well, these are osteopaths, you were osteopaths, you are our surgeons today, you are our specialists today. They are specialists today. They must be pretty good." Also, today the DOs are being accepted for internships, residencies, clerkships, fellowships, in many, many, many hospitals around California as well as the Untied States.
Dr. Seffinger: I'm going to take you back to a phrase, you said something about at the time in the 1970s there was no need for a new school, yet a new school developed because the people who were DOs wanted a new school for themselves. Once the school began then you felt some feelings of loyalty, you helped support it. Do you feel at this point that there needs to be or should be two separate professions and where do you stand on that kind of situation? You are kind of straddling the two and you are supporting both professions as do many doctors. I'm in both the AAFP (American Academy of Family Physicians) and its California affiliate, the California Academy of Family Physicians, as well as the AOA. We have the OPSC now, not the COA, but we have the Osteopathic Physicians and Surgeons of California, and I'm part of that. I'm in a mixture of groups that accept DOs and MDs both, so in this day and age there is a lot of people who question, is there a need for two separate professions?
Dr. Ulansey: (Deep sigh) that is a quandary that I find myself in, when I think on it. I do believe there is one major… Now heretofore, I didn't think there was. I couldn't see the differentiation between the two schools of thought. I think now there is more research being done to properly evaluate the effectiveness and value of the theory of osteopathy, whatever that is. That's opened to a lot of discussion and so forth. The other thought that comes to my mind is, there is still, or not still, newly developed, perhaps, prejudicial situation for applicants to the field of medicine. The discrimination against Jews in particular, is not nearly as great as it was, against women much better than it was, against blacks, black America, they still have a problem. It is still there whether we like it or not, it's still there. Other ethnic groups, other racial groups, there is some evidence of a persistence or resurgence of prejudice. I must say from my contacts with the school in Pomona, that's the only one I have any contact with, that from the enrollment that I look at, and I do look at their enrollment every opportunity I have, they are so diversified as to color, ethnicity, religion, they seemed to be so open. This, in my mind, makes for a major justification for the continued existence, co-existence, of the two schools of thought. Also, I'm very interested recently hearing about some of the research work that's being done, real research, not lip service, true research to separate the wheat from the chaff, the real efficacy of manipulative therapy, the real value of it. I'm very enthused about hearing about some of it which you have brought to my mind. Also, another thing I want to touch on. In my day I did touch on the fact that the DO had no opportunity for commissioning in the military service. If they went into the service they went as a buck private, or seaman 3rd class.
Dr. Seffinger: In the 1940s and '50s.
Dr. Ulansey: 50s, 60s…
Dr. Seffinger: Until 1967 I think.
Dr. Ulansey: Then, and now, I have met men who deserved what they have achieved. I've seen and met several admirals of the navy. I believe there is a general in the army. I know they are active in the Coast Guard, commissioned officers which was unheard of in my day and I'm proud to see that these men have achieved the knowledge, position and status of what they now hold and deserve. That is a personal pride item for me.
Dr. Seffinger: Yes, many advances have been made in social stature of the osteopathic physician, especially after the 1960s and into the '70s and continue to grow.
Dr. Ulansey: No question.
Dr. Seffinger: Let us say you had an osteopathic student in front of you, what advice would you give them at this stage given your 60 some odd years of experience in this profession?
Dr. Ulansey: Well, since they didn't know what medicine was; and they were only going to live with what is going to be; go ahead and make the most of it. It is never going to be what it was for me. I don't know what I could have done that I would have given me greater self-satisfaction out of in my years of practice. It's been good to me. It has been good financially. It's been good socially. It's been good for my peace of mind. I've enjoyed being a physician.
Dr. Seffinger: Do you have anything in particularly to say to an MD student in training.
Dr. Ulansey: Go to the county hospital. That's where to go. That's where you will get the best training. You are going to pay more for it, in your health, in your life, your work, your endeavor. But, you will be repaid many times over. You will be a better physician for it.
Dr. Seffinger: You mean they are going to be tired?
Dr. Ulansey: They are going to be tired. We were tired. We didn't get paid. Now they get paid for it. The difference in the salary is major - that is during the training period, interns and residencies. The earning capacity of the profession whether it be MD/DO or PDQ, it is a new world. It is not going to be what everybody thinks the physician makes. There are a few handfuls that will always excel and succeed to be far and above the run of the mill. You won't be one of those, few of you will be, but it will give you satisfaction of having been a doctor and a warmth inside that I cannot begin to describe. I loved it.
Dr. Seffinger: Do you have other people that we should contact in your mind for this history project.
Dr. Ulansey: Yes, there are a number of people I can name; a close friend of mine, 91 year-of-age and still has all his faculties; Dr. Gazin; Dr. Paul Alloy – surgeon; Dr. Steve Brody - family practitioner/pediatrician; and Dr. Henry Brenner – generalist (he may be retired now). I would carry on with what you are doing. I think it is marvelous. You've educated me, re-educated me in some of the things I hadn't heard about in the profession in the achievements.
Dr. Seffinger: You will be able to read all this on the internet pretty soon. By the end of the year we should have it all up on our website.
Dr. Ulansey: I will look forward to it because it really will give me a great deal of pleasure.
Dr. Seffinger: Do you have any documents you want to submit for this project to be put into archives or things that support some of the things you have discussed?
Dr. Ulansey: Well, I can forward some pictures of the hospital that I put together. I'm not sure.
Dr. Seffinger: If something comes up…
Dr. Ulansey: Oh, I will absolutely forward it to you.
Dr. Seffinger: Okay. Is there anything else you want to discuss with us? It doesn't have to be right now; it can be in the future, but if you have anything on your mind now, I'd like to hear it. Otherwise we can setup any other time that you want or you can just type in ideas.
Dr. Ulansey: I'd like to keep in touch because I am interested in the historical value of this thing that I am a small part of. I still know my roots. If you've seen the picture "Roots," you know of what I speak and its just great.
Dr. Seffinger: Well, I think you want to also show us some of your wife's art work.
Dr. Ulansey: Yes. Let me say a little bit about my family. I was married when I was 39, like Jack Benny. My wife was 21 when I met her. She was a most unusual person, most talented, not because she was my wife, but just because she was talented. She was a sculptor. She worked in pottery, clay and stone. She was a gourmet cook. She could go into a restaurant, have a meal and duplicate it at home. In fact make improvements on it. She used to knit. She was prolific in stonework. She used to read one or two books every week. She was a very avid, voracious reader. She could cook, sew, knit; I don't know all these terms, but knitting, pearling, needle point work. You see evidence of it around my house. She was a mother to end all mothers. She went to every little league game there was. She was a member of the PTA, just a very active lady. She was my wife.
Dr. Seffinger: You were married for how many years?
Dr. Ulansey: I was married for 35 years until she died of Hodgkin's Lymphoma.
Dr. Seffinger: When was that?
Dr. Ulansey: That was 1994. She was a horsewoman. She rode our American saddle bred horse beautifully. She used to show it. There is so much more to tell. I can't remember. But, above all, she was my wife.
Dr. Seffinger: Well, let's take a look at some of her artwork.