The Palo Alto Medical Foundation for Health Care, Research and Education (PAMF) is a not-for-profit health care organization with medical offices in more than 15 cities in the Bay Area. It has more than 900 physicians and had over 2 million patient visits in 2008. It is rated as one of California’s top medical groups. The history of the group dates back to 1930, when Dr. Russel Van Arsdale Lee founded the Palo Alto Medical Clinic (PAMC). Within a few years, several physicians joined Dr. Lee, including Edward F. Roth, Blake C. Wilbur, Herbert Niebel, Milton Saier and Esther Clark, one of the first female physicians in the country. In 1946 — before health plans were standard business — PAMC agreed to provide medical care to nearby Stanford University students in exchange for a flat fee. In 1950, it became one of the first facilities in the nation to offer radiation therapy for cancer patients in an outpatient setting. In 1981, the for-profit physician group PAMC created the not-for-profit PAMF to control its operations and assets, and in 1993, PAMF became an affiliate of Sutter Health, a not-for-profit organization with hospitals and medical groups in Northern California. In 1999, it was a very early adopter of an electronic health record system. In 2008, PAMF’s three medical groups — Camino Medical Group, Palo Alto Medical Clinic, and Santa Cruz Medical Clinic — merged to form a single medical group.