Caldwell B. Esselstyn papers

The Caldwell B. Esselstyn Papers, part of the Contemporary Medical Care and Health Policy Collection, are made up of thirty-nine linear feet of correspondence, professional papers, organization files, writings, and print material. More than half the papers date from Esselstyn's career as director of the Rip Van Winkle Clinic (1946-1964). The later papers (1964-1975) are less complete but include extensive correspondence files.

The Esselstyn Papers provide Interesting coverage of the origins and development of prepaid group practice from the mid 1940s through the mid 1970s and of the organization and delivery of health care in rural areas. They also include valuable information on efforts to implement a national health insurance program for the elderly (Medicare) as well as on a variety of other medical care and health policy programs and issues during the period.

The papers are organized in five series: CORRESPONDENCE, PRINCIPAL PROFESSIONAL ACTIVITIES, OTHER PROFESSIONAL ACTIVITIES, WRITINGS, and REFERENCE.

Series I, GENERAL CORRESPONDENCE, is organized in three sections: Correspondence, 1945-1964, Correspondence & Subject Files, 1964-1975, and Personal Correspondence. The Correspondence, 1945-1964section is made up of Esselstyn's professional correspondence while he was director of the Rip Van Winkle Clinic (through July 1964). The section includes exchanges with directors and other officials of the Rip Van Winkle Foundation, associates in a variety of medical and health services fields, friends, local and state community leaders, professional societies and organizations, and others. The section provides information on Esselstyn's activities and interests, his developing national influence in group practice and medical care, and his opinions on a variety of health and social issues.

Most of the significant correspondence concerning the Rip Van Winkle Foundation in Correspondence, 1945-1964 is listed and cross referenced in the Rip Van Winkle Foundation section (see Series II, PRINCIPAL PROFESSIONAL ACTIVITIES). The correspondence with Allan A. Ryan, foundation chairman, and exchanges with Laurence J. Ackerman regarding prepayment (1955 Jun 2) and with Edwin F. Blair concerning clinic finances (1959 Jan 28) are of special note. The papers as a whole contain little information on Esselstyn's patients, but this section does include a few letters from patients or their relatives.

Correspondence with leaders in health and social policy develops in the early 1950s and becomes increasingly more voluminous over time. Individuals represented in the section include George Baehr, David P. Barr, Morris Brand, Lester Breslow, Agnes Brewster, James Brindle, Wilbur J. Cohen, George Crile, Jr., Nelson H. Cruikshank, Michael M. Davis, Isidore S. Falk, Leslie A. Falk, Franz Goldman, Lorin E. Kerr, Margaret C. Klem, Isidor Melamed, M. Allen Pond, C. Rufus Rorem, Cecil G. Sheps, Milton Terris, and Ray E. Trussell.

Both the first and second sections of Series I contain correspondence with Benjamin Spock, a friend and former classmate, which covers personal and professional concerns. Other correspondence of special interest in the section includes exchanges with Norton Sager Brown, a former associate and private practitioner, regarding prepaid group practice and a letter to Aims C. McGuiness (1959 Jun 19) concerning the American Medical Association.

The Correspondence & Subject Files, 1964-1975 section represents the continuation of Esselstyn's professional correspondence and dates from August 1964 through 1975. The section consists primarily of correspondence but also includes reports, printed matter and other material.

The section reflects Esselstyn's succession of professional appointments during the period, but in general the correspondents and subjects covered are the same or similar to those in the first section. There are a number of letters to friends and associates informing them of the closing of the Rip Van Winkle Clinic, and a letter to Milton C. Rose (1965 Dec 12) includes a description of the clinic's financial problems. An exchange with Rolf Scholdager (1968 Apr) explains why he resigned from the Community Health Association is of special interest.

The first two sections of the CORRESPONDENCE series contain cross references to most of the significant correspondence in Series II, PRINCIPAL PROFESSIONAL ACTIVITIES, and Series III, OTHER PROFESSIONAL ACTIVITIES. However, there are no cross references between the two sections. The names in both sections must be reviewed to find all of the correspondents in the papers.

The third section in Series I, Personal Correspondence, contains exchanges with Esselstyn's family and correspondence regarding a variety of personal activities, including alumni associations, expense accounts and honoraria. More interesting are the 1964 inquiries regarding employment (folder 488).

Series II, PRINCIPAL PROFESSIONAL ACTIVITIES, contains Esselstyn's files from his professional appointments for the years 1946 to 1974. The series is organized in five sections: Rip Van Winkle Foundation, Community Health Association, New York Metropolitan Regional Medical Program, New York State Department of Health, Bureau of Emergency Services, and United States Department of Health, Education, and Welfare, Health Maintenance Organization Service.

The Rip Van Winkle Foundation section makes up more than half of the series and is organized in five subsections: General Papers, Business Records, Programs and Projects, Publications and Photographs, and Reference Material. The papers, which primarily cover the period 1946 to 1964 but include a few items through 1968, are not complete, but they provide information on the organization of the foundation, the functioning of the clinic, fund raising and a number of medical programs and projects. The General Papers subsection contains a few administrative papers (e.g., board and committee minutes, annual reports) and correspondence and subject files. The latter include correspondence with clinic staff, the Columbia County Medical Society, the Health Insurance Plan of Greater New York, Inc., and other individuals and organizations; the files also contain cross references to relevant correspondence in Series I. The Business Records sub-section contains financial records (including fund raising correspondence) and material regarding personnel recruitment. The Programs and Projects subsection covers seven topics and includes extensive subject correspondence. The Publications and Photographs subsection includes an almost complete run of the clinic Proceedings from 1949 to 1962, and Reference Material contains clippings from local newspapers which cover foundation activities from 1946 to 1964.

In addition to the material in the Rip Van Winkle Foundation section, Series V, REFERENCE, contains Esselstyn's desk calendars for the period and dictaphone recordings of a conference held to commemorate the tenth anniversary of the foundation. Tape recordings of the conference have been transferred to Historical Sound Recordings, Sterling Memorial Library.

The Community Health Association section is made up of a small number of personal office files which Esselstyn retained after his resignation from C.H.A.; nearly all of the papers date from 1964 to 1967. Although the section is small in volume, the Correspondence and the Administrative and Program Papers subsections provide a good deal of information on C.H.A.'s program and on Esselstyn's involvement with local and national health care issues. The correspondence with Melvin Glasser, Emil Mazey, and other United Auto Worker's officials, which also includes transcripts of telephone conversations, contains frank discussions of policy differences between Esselstyn and the union.

The last three sections in the series New York Metropolitan Regional Medical Program, New York State Health Department, Bureau of Emergency Services, and the Department of Health, Education, and Welfare, Health Maintenance Organization Service provide limited information on both the organizations' functions and on Esselstyn's activities. They typically include routine correspondence, occasional minutes and administrative files, and a variety of photocopied, mimeographed and printed materials. However, the files of the Committee on Health Careers for the Disadvantaged in the N.Y.M.R.M.P. section are an exception. Esselstyn chaired the committee, and the files document its activities.

Series III, OTHER PROFESSIONAL ACTIVITIES, is made up of Esselstyn's files from his participation in professional societies and other volunteer activities. The papers date from 1952 to 1973 and are organized in seven sections: American Public Health Association, Group Health Association of America, Health Insurance Plan of Greater New York, Inc., New York State Public Health Council, Physicians Committee for Health Care for the Aged through Social Security, and Public Affairs Committee, Inc.

The American Public Health Association section is made up primarily of papers of the A.P.H.A. Medical Care Section, of which Esselstyn was elected chairman in 1960. The Medical Care files include correspondence with Isidor Melamed, George Baehr, E. Richard Weinerman, Frederick Mott, Leslie Falk and other leaders in the field as well as minutes, memoranda and related material. The section also includes a few general papers and files of the Subcommittee on Medical Care of the Committee on Administrative Practice.

The Group Health Association of America section is the largest in the series and is organized in five subsections: Background Papers, Correspondence and Subject Files, Subdivisions, Programs and Institutes, and Reference. The papers date from 1953 to 1974 and provide extensive information on Esselstyn's role in the association and on the association's organization and activities.

Esselstyn was elected president of the G.H.A.A. in 1960, and the Correspondence and Subject Files subsection contains nine folders of his correspondence as president (arranged chronologically) as well as individual folders (arranged alphabetically) for Appalachian Regional Hospitals, James Brindle, W. Palmer Dearing, fund raising, Horace R. Hansen, Lorin E. Kerr, legislation, Frederick D. Mott, Saskatchewan group practice development, and other subjects and individuals for the years 1950 to 1974. The Background Papers subsection contains material on the founding of the G.H.A.A in 1958 and on its predecessor organizations. The Subdivisions subsection includes correspondence, minutes, and related material on the association's board of directors, committes, and divisions.

The Health Insurance Benefits Advisory Council section covers the years 1965 to 1970, the period of Esselstyn's membership, and consists primarily of agenda books, reports, procedural manuals, circulars, and technical correspondence which document the implementation and early operation of the Medicare section of the Social Security Amendments of 1965.

The bulk of the Health Insurance Plan of Greater New York, Inc. section is made up of minutes, memoranda and reports extending from 1962, when Esselstyn was appointed to the board of directors, through 1974. Esselstyn's involvement with H.I.P. began much earlier, however, and other series in the papers contain additional material on the plan (see especially Series I, folder 273, and Series II, folders 36-46).

The New York State Public Health Council section is divided into two subsections, General Papers and Meeting Files, and documents the last five years of Esselstyn's term (1955-1963) on the council. The correspondence supporting and opposing Esselstyn's reappointment to the council (March-August 1961) is of special interest. The correspondence with Health Commissioner Herman E. Hilleboe and others covers a variety of health topics.

The Physicians Committee for Health Care for the Aged through Social Security section provides broad coverage of both the committee's origins and operation, and of the issue of federal health insurance for the aged. The Background Material subsection traces the development of the issue from the introduction of the Forand bill in 1957 through 1960. The correspondence and other material in General Papers documents the organization of the committee, plans for and reaction to the meeting with President Kennedy in March 1962, and promotional and other activities through 1965. The transcript of a 1966 oral history interview (folder 364) contains Esselstyn's account of the committee's development and operation. (NB: The transcript is copyrighted and may not be photocopied.)

Series IV, WRITINGS, is arranged chronologically. The series extends from 1949 to 1974, although the bulk of the material dates from 1960 forward. About one third of the series is made up of correspondence concerning speaking engagements, publications, and requests for reprints. The remainder consists of speech texts and notes, reprints, and drafts of articles and other writings. Some of the writings prior to 1960 deal with medical and surgical topics; after 1960 the series concerns the organization and delivery of health services.

Series V, REFERENCE, includes print material on medical care for the aged, the Saskatchewan doctors' dispute, and labor and health care. The series also contains Esselstyn's desk diaries and calendars and dictaphone belt recordings of a panel discussion presented by the Rip Van Winkle Foundation in 1956.

The Esselstyn Papers were donated to Yale University Library by Mrs. Caldwell B. Esselstyn in 1980.