The larger Palo Alto Medical Foundation now employs the non-physician staff members who provide administrative, operational and clinical assistance to the Clinic physician partnership. But before the Foundation's existence, the Clinic itself hired and managed its staff. Generally, the physicians' social and professional links with each other did not extend to non-physician employees. "The doctors were pretty much the doctors, and the nurses and staff were separate. The old-fashioned way of doing things was that there wasn't a lot of the team thing going on," said Rosemary Maresca, R.N., a nurse who joined the Clinic in 1964.
But the doctors could not have operated the Clinic without the help of their nurses, business managers, file clerks, laboratory technicians, receptionists and many other employees – and they knew it. In 1980, Dr. Russel Lee told the Palo Alto Weekly that the Clinic had lasted 50 years in part "because of a frugal business manager at the outset, a man who, when paint in the hallway chipped, hired a painter to dab at the spot without doing the whole wall." For Dr. Maurice Fox, "the greatest gift the Clinic gave me was Dr. William Clark's receptionist, Susanne Nishimura. Anybody who called up with whatever kind of complaint, when Susanne answered the telephone, they were completely at ease. People just knew her and trusted her. Nobody ever came to my office mad after talking to Susanne."
Like the physicians, many staff members spend their entire careers at the Clinic, building relationships and making an impact. Maresca, who still works at the Palo Alto Medical Foundation, has assisted surgeon Walter Cannon for 27 of her 40 years with the group.
"He's very respectful of what I bring to the practice, and he's been very supportive of the things I want to do," such as her idea in 1990 to create a care management program for breast cancer patients that remains successful today. "My husband will say, ‘When are you going to retire?' And I say, ‘When Walter retires, I'll retire.' His wife says to him, ‘Walter, when are you going to retire?' And he says, ‘When Rosemary retires, I'll retire.' We haven't figured it out yet."