In a pioneering study, Dr. Sheldon Greenfield found that elderly patients with breast and pancreatic cancer receive degraded treatment and better care for patients who burn doctors during consultations, died February 26th at their home in Newport Beach, California. He was 86 years old.
The cause was colon cancer, his daughter, Lauren Greenfield, said.
Dr. Greenfield is the founder and director of the Center for Health Policy Research at the University of California Irvine University and a leader in medical outcomes research, with over 22,000 patients and 500 physicians involved.
Harvard University President Alan M. Gerber praised Dr. Greenfield as “a towering figure in healthcare research.”
“His impact has expanded more widely than he knew through research into medical outcomes and many other studies,” Dr. Gerber said in an email.
In 1991, collaborators, including Dr. Greenfield and his wife, Dr. Shelley Kaplan, discovered that too many conversations about care were dominated by doctors. They recommended a protocol that includes a 20-minute coaching session for the patients before consulting with the doctor.
“When doctors dominate medical interviews, they don't, just like when patients exert more control,” Dr. Greenfield told the New York Times that year.
According to a 1995 study, diabetic patients who asked questions about their intake during their appointment and volunteered for other symptoms during their medical examinations recorded a 15% reduction in blood glucose levels two months later. Similar results were seen in studies of patients with ulcers and hypertension.
As the main author of that study, Dr. Greenfield explained that the researchers focused on adult diabetes. This is because it is popular so that appropriate treatment can prevent complications that become one of the most expensive chronic diseases to treat.
Four years ago, a research team led by Greenfield Reid concluded that 96% of women aged 50-69 with breast cancer received appropriate minimum levels of acceptable care. (This study defined either the removal of the whole breast and removal of surrounding tissue or removal of lumps and either the nearest lymph nodes, followed by radiation treatment.)
“The lives of these patients can be reduced unnecessarily,” said Dr. Greenfield.
In 1989, a group led by Dr. Greenfield discovered that older men with prostate cancer were less likely than younger men to receive the best available treatment.
He also expressed concern about the lack of appropriate follow-up care for cancer patients. He attributed this in part to the fact that in many cases insurance companies, health plans, and Medicare didn't cover the tests and exams they needed.
“The success of cancer treatment is not over once the patient has completed his initial treatment, when the patient leaves the door,” Dr. Greenfield told The Times.
Harold C. Sox, professor emeritus at Geisel School of Medicine at Dartmouth University, said he and Kaplan “addressed the impact of physician-patient relationships on chronic illness outcomes.” “They showed that better physician-patient partnerships paid off with better patient outcomes.”
“We've heard a lot about the shortage of primary care physicians,” Dr. Sox added. “Dr. Greenfield's work has shown that good primary care is extremely important.”
In another study conducted in 1995, Dr. Greenfield found that treatment by health maintenance organizations and traditional medical practice physicians could produce similar outcomes despite the significantly lower cost of HMOs.
Additionally, in a report commissioned by the Food and Drug Administration after recalls of several well-known devices that have injured thousands of patients, Dr. Greenfield proposed a more stringent approval process that was employed in a wider range of medical devices, including hip implants and external cardiac defibrillators.
Sheldon Greenfield was born in Cincinnati on April 22, 1938. His father, Robert, owned a clothing store. His mother, Faye (Block) Greenfield, taught Sunday School.
When she decided to pursue a medical career, Dr. Kaplan said her husband was “very kind and he was heavily influenced by his pediatrician, who treated his child with respect and care.”
After graduating from Harvard University with a bachelor's degree in biochemistry in 1960, he received his medical degree from the University of Cincinnati in 1964. From 1966 to 1968, he was a deputy commander in the Navy, dealing with physiological intelligence at the National Centers for Communication and Disease (now the Centers for Disease Control and Prevention).
He was an intern at Boston Israel Hospital (now Beth Israel DeConnes Medical Center) from 1971 to 1972 and at Beth Israel Hospital (now Beth Israel DeConnes Medical Center) in Boston.
In 1972 he moved to the University of California, Los Angeles University, met Dr. Kaplan, coached by Dr. Charles E. Lewis and joined Dr. Lewis' team. This applied an algorithm to medical conditions to measure the quality of care.
He and Dr. Kaplan continued their research into medical outcomes research at Tufts University School of Medicine, where they founded the Primary Care Outcomes Institute.
He taught at UCLA, Tufts and Harvard School of Public Health before moving from Boston to Southern California in 2003. So he and Dr. Kaplan founded the Institute for Health Policy in Irvine.
In addition to her daughter Lauren from her marriage to Dr. Kaplan, who married in 1983, and her divorced Patricia Marks, Dr. Greenfield also survived the marriage, her son Matthew Greenfield. Two children, Rob Greenfield and Wendy Morner, have been with Dr. Kaplan from his marriage. Eight grandchildren. sister Joan Zapin;
In the 1970s and 1980s, Dr. Greenfield volunteered at the Venice Family Clinic in Venice, California, where he lived. He was keenly aware of the lack of affordable local health care when his family babysitter got sick.
“It made an indelible impression on me,” Dr. Greenfield said in an interview on the clinic's website:
