About the Department
The Department of Pediatrics has a proud history of providing specialized care to infants and children, educating future pediatric care givers and conducting innovative research leading to new strategies to promote health and treat disease. Its history is inextricably intertwined with the history of the Stanford School of Medicine and related health care institutions.
Stanford University School of Medicine (SSoM)
In 1858, a young surgeon, Elias Samuel Cooper, newly arrived in San Francisco, established at the University of the Pacific the Medical Department bearing his name. Unfortunately, Cooper, said to be a somewhat contentious and controversial figure, died of nephritis only four years later. Around that time, Dr. H. H. Toland established a competing medical school in his name and affiliated it with the University of California and, in doing so, established the roots of UCSF. As part of this process, he tried to recruit the faculty of Cooper to Toland—setting the stage for the first failed merger between UCSF and what later became Stanford Medical School.
In 1870, Levi Cooper Lane, nephew of the then-deceased Elias Cooper, revived the medical school and a new hospital and education facilities were constructed on Webster and Sacramento Street. Lane appointed Dr. William Ophuls as a full-time salaried professor in 1898, and discussions about the possible association of Cooper Medical College with Stanford began in 1901—ten years after Stanford had been established as a university -- and paved the way to the founding in 1908 of the Stanford University School of Medicine.
David Starr Jordan, Stanford's first President, agreed that the Cooper Medical College would become the Stanford University School of Medicine. He had two conditions. First, that it be a school for medical research (which was debated hotly by the clinical faculty of the day) and second, that it could not cost the university more than $25,000 per year to operate.
The first 50 years of the SSoM were marked by significant growth in the clinical programs. Students spent their first year on the Palo Alto campus and then moved north for their remaining education. In 1951, plans were put forth to consider the move of the SSoM to the Stanford campus in Palo Alto, in part based on the report of the Faber Committee (Harold Faber was the Chair of Pediatrics at the time). This plan was embraced by President Wallace Sterling, and in 1958, the SSoM united geographically with its parent university in Palo Alto and a new medical school and hospital opened a year later at a cost of $21 million. This move changed the trajectory of the medical school, and it must be attributed to the vision of President Sterling (an historian), Provost Fred Terman (an electrical engineer), and Dean Robert Alway (a pediatrician) who recognized the opportunity to leverage federal funding for research and create a research-intensive school of medicine. The move from San Francisco disenfranchised a number of the clinical faculty who elected to remain in the city. At the same time, Sterling, Terman and Alway recognized that recruiting the most talented individuals they could find would help place Stanford on a new level. In 1959, Arthur Kornberg and Paul Berg were recruited from Washington University to found Stanford's new Department of Biochemistry, and Dr. Josh Lederberg was recruited from Wisconsin to found a new Department of Genetics. With newly minted Nobel Prizes and intellects and energy that spanned many domains, they set a new trajectory for Stanford Medicine. This continuing and enduring excellence in basic discovery research has been the distinguishing feature of the Stanford School of Medicine. It has always been visionary and opened new paths in discovery and innovation—frequently crossing traditional disciplinary boundaries and thus taking advantage of Stanford's excellence in engineering and the physical sciences. As of 2015, the School of Medicine’s faculty has received eight Nobel prizes and still has seven Nobel laureates actively participating in campus life. The faculty and an environment that allows for the formation of contiguous connections between the disciplines have made Stanford a special place. This has been enhanced further by the connection of the medical school to its two major affiliated hospitals and of the medical center to the university and its community -- including the intellectual vitality of Silicon Valley and the concentration of biotechnology and device companies -- a number of which had their origins at Stanford.
In response to the recent and profound changes in health care and health care delivery systems, the SSoM has worked closely with the adult hospital, Stanford Health Care (SHC), and the Lucile Packard Children's Hospital Stanford. Both hospitals are building new facilities on campus and have created primary care networks (University Health Alliance and Packard Children’s Alliance) to compete in this new environment. The combined revenues of the SSoM, SHC and LPCHS are now more than 60 percent of the combined total revenue of the seven Schools at Stanford University.
Health Care Facilities for Children
Lucile Packard Children’s Hospital Stanford (LPCHS) traces its roots to the Stanford Home for Convalescent Children, which was established in 1919 to care for children with long-term illnesses such as polio, tuberculosis and rheumatic fever. As described in the history of the SSoM, in 1959 Stanford University Medical Center opened a 420-bed facility in Palo Alto and incorporated an in-patient pediatric ward (SHC’s current Bing dining room was part of the facility).
This strengthened the teaching and research ties to the University and allowed for the care of more seriously ill children. In 1969, a new 60-bed Children’s Hospital at Stanford replaced the Stanford Home for Convalescent Children and further expanded its roles in teaching and research. In 1986, David and Lucile Packard generously donated $40 million to construct a new children's hospital devoted to the care of children and expectant mothers on the Stanford University campus. The hospital opened in 1991 and was named in memory of LPCHS’ visionary, Lucile Salter Packard, who had died in 1987.
In the hope of weathering the financial pressures of managed care in the late 1990s, the medical centers at Stanford and UC-San Francisco merged in November 1997. By pooling resources and increasing bargaining power, UCSF Stanford Health Care was projected to save $256 million by 2000. However, this bold experiment failed, with the company losing $86 million in its last fiscal year. The de-merger was even more complicated and costly.
The lack of success stemmed from a lack of common culture; cutbacks by managed care companies and reduced reimbursements from the state and federal governments; and unexpected costs of the merger. For example, integrating computer systems cost $126 million, five times what was expected. Also 1,000 new employees had to be brought on board, rather than the projected 200.
Although Stanford's medical services lost $20 million in the last year of the merger, a bright future lay ahead for both the adult and pediatric hospitals.
In the wake of the merger, the LPCHS and the SSoM joined with the Silicon Valley philanthropic community to transform what had essentially been a community children’s hospital into a nationally-recognized children’s hospital.
The “Children’s Health Initiative” (CHI), 2001-2005, was carefully planned, and was launched with a $300 million donation from the David and Lucile Packard Foundation and $226 million raised by the Lucile Packard Children’s Foundation for Children’s Health (LPFCH, http://lpfch.org/. Leading physicians and surgeons were recruited to newly created six Centers of Excellence at the LPCHS. Success came at such a rapid pace that by midway through the first decade of the 21st century, it was recognized that LPCHS needed to expand.
The first step of this expansion was termed “Phase I” and involved the construction of LPCHS operating rooms and a cardiovascular ICU, along with the updating of the Bass Center for Childhood Cancer and Blood diseases (including them addition of new stem cell transplantation beds). In 2012, LPCHS began Phase II of its expansion, adding two new wings at a cost of $1.2 billion. The incremental 521,000 square feet, doubling the current space, is adjacent to the existing LPCHS and will include advanced technologies, more private patient hospital rooms and expanded clinics, and will be surrounded by healing gardens and green space. These additional facilities will expand services and bring the most advanced patient-centered care to children and their families. A significant portion of the $548 million raised during the “Breaking New Ground” campaign (2007 – 2012) was allocated to this expansion, with the remainder being used to support hospital programs and the SSoM’s academic programs related to maternal and child health. Patient occupancy is expected in mid-2017.
Changes in health care, including the Affordable Care Act, led the LPCHS and the SSoM to jointly create the Packard Children’s Health Alliance (PCHA, http://www.pcha.org/), a network of world-leading pediatric and obstetric physicians in partnership with the LPCHS. Since its inception, PCHA has grown quickly and now includes community-based physician practices (approximately 110 physicians), providing multiple access points for patients and families in the South Bay, East Bay, San Francisco and beyond. Together the LPCHS and PCHA form what is now known as Stanford Children’s Health (www.stanfordchildrens.org).