John R. De Palma, MD

Santa Monica, Calif - John R. De Palma, MD It is with great sadness to announce the death of John Richard De Palma, MD, FACP on March 24th in Santa Monica, CA. Dr. De Palma was born July 14, 1934 in Syracuse, New York. In 1959 he graduated from State University of New York (SUNY) College of Medicine at Syracuse, Syracuse, New York. In the years 1962-64 he served in the US Army Medical Corps as a US Army Captain in Nurnberg, Germany. Following as a US Medical officer he completed his post-graduate medical education in Internal Medicine and Nephrology at the University of Washington Medical Center in Seattle, Washington in 1966. His mentors were Robert G Petersdorf, Chief of Medicine and Belding H Scribner, Chief of Nephrology.

He came to Los Angeles in 1966; being selected by UCLA faculty at Cedars-Sinai Medical Center to start a new Federal Health & Human Services Agency (HHS) Clinical Research Grant in home hemodialysis. Shortly thereafter, he also became the Director of Hemodialysis Programs at Cedars-Sinai Medical Center, the site of the home hemodialysis research grant. He carried the academic rank of Assistant Professor of Medicine at UCLA. In 1968 on his own initiative, he met with California Medi-Cal providers in Sacramento, and provided them with detailed cost data about home hemodialysis costs versus the much more expensive hospital out-patient costs. With that single meeting and within a month's time, the State of California passed regulations and provided financial support for home hemodialysis. This was a first in this field.

By 1970 he had achieved a successful, community based home hemodialysis program. He had the largest such program in California. That same year, he was awarded a second major HHS grant in self care dialysis at Olive View Medical Center in Southern California. He was the principal investigator of that grant.

Dr. De Palma left academic medicine in 1973 and went into private practice. He cared for many patients with acute renal failure. It became apparent that he was caring for a number of patients who developed their acute renal failure as a result of surgery and/or the use of drugs which impaired kidney function. He discovered that the costs for care of these patients with acute kidney failure was over $100,000 per patient while resulting in a 50 to 90% mortality. His chart analysis discovered that some to many of these cases were due to the use of antibiotics or drugs used during X-rays of blood vessels. He wrote letters to the various chiefs of the medical staffs which were politely ignored except at Glendale Adventist Medical Center where he was believed. His idea that kidney function had to be studied before surgery and antibiotics were administered was put into medical policy. These changes resulted in a dramatic reduction in incidence of acute renal failure first in Glendale, then in other San Fernando Valley hospitals, and finally wound its way to the major medical centers of UCLA and USC.

A Federal law which provided Medicare benefits of Americans with End Stage Renal Disease (ESRD) was passed in 1973. By then Doctor De Palma had demonstrated the success of self-care dialysis. Despite a burgeoning dialysis industry, there was no formal training for hemodialysis personnel. He began an evening lecture series for Registered Nurses interested in learning about this new field. That lecture series was an immediate success, attracting over 100 nurses within the first year.

But... there continued to be a shortage of trained direct care hemodialysis personnel. Because of his success in teaching and using Nurses Aids to teach and do self-care dialysis, he wrote a white paper proposing to the State of California that they acknowledge these individuals and allow a credential and training process for these direct care dialysis personnel. He coined the name Patient Care Technicians (PCTs) to distinguish these individuals from Machinery Technicians (MTs); the latter usually lacking in either interest or knowledge of direct patient care. Out of one of his patient's gratitude, a special state funded project for this type of training was begun at Glendale Community College (GCC) in 1975. With community inspired support, he organized, gave the lectures and the didactic portion of this first college level one-semester course for hemodialysis Patient Care Technicians. This program immediately attracted Registered Nurses seeking formal training. The course schedule spanned 20 weeks, 30 hours per week for a total of 600 hours. Each week consisted of 9 hours of formal lectures and 21 hours of clinical practice in a dialysis clinic. Class was in session 6 hours each day, 5 days per week. It was the oldest and most well regarded college-level RN and PCT program of didactic and practicum dialysis teaching in the United States. The dialysis training program closed in 2006 due to GCC budget cuts. As a result he started the American Dialysis College in Hemodialysis, Inc. to continue formal training of hemodialysis healthcare workers.

In 1978 he founded the California Corporation Hemodialysis, Inc (Hi) in Glendale, California to fill the growing void of quality hemodialysis care. He was chief executive officer (CEO) of that corporation. The dialysis facilities included Holy Cross Renal Center in Mission Hills, CA. and Huntington Dialysis Clinic in Pasadena, CA. These dialysis facilities were well respected for the exceptional delivery of dialysis care to patients.

With a love of machinery and dialysis in conjunction with others who are entranced with the man-machinery interface, Doctor De Palma developed machinery and laboratory tests. He is a US patent holder of dialysis related devices. Almost all of these have been assumed by commercial companies and are still in use. All dialysis reuse machines in the United States pay homage (but no money) to his and Barry Mason's original patents. His test for residual Formalin is a commercial product. His dialysis chair "The Ma-De Chair," developed because there was no special chair for dialysis patients.

In the 1982 he founded the non-profit (501-C6) California Corporation, The California Dialysis Council (CDC) because of lack of communication between the various factions of the dialysis industry with their dealings with the legislators in Sacramento. The California Dialysis Council consists of members of dialysis units from all sectors: university, private, non-profit, for-profit, large dialysis chains and small. From its inception, the CDC has grown in status, to discuss and address ESRD issues. The CDC is considered a formal resource by the California Department of Health and Human Services; they recognize the CDC as a fair, expert and industry oriented group. The CDC is one of Doctor De Palma's proudest achievements; it also is unique in the dialysis industry.

He also has been a founder, initial member of the board of directors, and/or originator of a variety of other health care entities. Some of these companies and organizations are: Dialysis Operations, Inc; The Western Dialysis & Transplant Society; Community Dialysis Services (known as Vivra); Dialysis & Transplant Magazine; Emergency Medicine Magazine; Renal Physicians Association; Ma-De, Inc; Renal Lab; and already mentioned GCC Hemodialysis Training Program; and the CDC.

In the past, he has had published over fifty densely researched editorials on unresolved, unsolved, and difficult problems of the healthcare industry. His editorials are scientific and satirical. He attempts to make these serious meta-analyses of dialysis issues humorous, easy to read and understandable by all. His editorials are written in a manner to attract rebuttal and debate. His satires have been responsible -in part- for positive healthcare legislation and/or regulations both in California and in Washington, DC. Health Care Financing Administration (HCFA), was established in 1977 by the federal government as part of the Department of Health, Education, and Welfare (HEW). HCFA's purpose was to oversee the Medicare program, the federal portion of Medicaid, and related quality assurance activities. In July 2001, HCFA was renamed the Centers for Medicare & Medicaid Services (CMS). Dr. De Palma's editorials have led to modification of Federal ESRD regulations and investigation of questionable medical practices by public companies.

In 2000, Dr. De Palma developed an educational online website: Hemodialysis-Inc.com for staff that provide care to patients with End Stage Renal Disease (ESRD). A series of monographs on specific aspects of hemodialysis therapy, offering thirty contact hours per monograph for license renewal for Registered Nurses, Licensed Vocational nurses and Certified Hemodialysis Patient Care Technicians. Published articles by Dr. De Palma are available to download. For entertainment and fun - Seven (7) crossword puzzles were added on dialysis re�lated topics with answers included. These home study courses remain extremely popular throughout the USA.

Dr. De Palma had a private interment at Woodlawn Cemetery, Eternal Meadows in Santa Monica, CA. accompanied by close loved ones. A celebration of life will be held at a later date. He will be remembered by his staff and everyone as a champion of the delivery of a safe and efficacious dialysis therapy. John has been described as a renaissance man, a man that liked to intimidate in playful ways and a kind soul.