Dr. Sheldon Greenfield, whose pioneering study found that elderly patients with breast and pancreas cancer received hypothesis and that patients who bake their doctors during consultations received better care, died on February 26 at his home.
The cause was colon cancer, said his daughter Lauren Greenfield.
Dr. Greenfield was the founder and director of the Health Policy Research Center at the University of California, Irvine and the leader of the study of medical results, which involved more than 22,000 patients and 500 doctors, which determined in 1986 that doctors often ordered an outrageous to offer equally good.
Alan M. Garber, the president of the Harvard University, praised Dr. Greenfield as “a tall figure in health care research”.
“His influence was widely extended than he could even know, through studying medical results and so much more,” Dr. Garber told an email.
In 1991, Dr. Greenfield and her associates, including his wife, Dr. Sherrie Kaplan, they found that too many talks about care are dominated by doctors. They recommended a protocol that included a 20 -minute meeting for patients before consulting their doctors.
“When doctors dominate the medical interview, patients do not do as much as the patient has more control,” Dr. Greenfield told the New York Times that year.
Patients with diabetes who raised questions about the dosage and voluntarily offered other symptoms during tests, according to a study in 1995, reported a 15 % reduction in blood sugar after two months. Similar results were found in studies of patients with ulcers and hypertension.
As the main author of the study, Dr. Greenfield explained that the researchers focused on adult diabetes because they are widespread and because proper treatment can prevent complications that make it one of the most expensive chronic diseases for treatment.
Four years earlier, a research team led by Dr. Greenfield concluded that while 96 % of women aged 50 to 69 with breast cancer received the appropriate minimum level of acceptable care, only 83 percent of different healthy women 70 years old. (The study defined “appropriate” either as the removal of the entire breast and some surrounding tissue or removal of hollow and closest lymph nodes, followed by radiation treatment.)
“The lives of these patients can be reduced unnecessarily,” Dr. Greenfield said.
In 1989, a team led by Dr. Greenfield found that older men who develop prostate cancer are less likely than younger men to receive the best available treatment.
He also expressed his concern about the lack of proper monitoring for cancer patients. It partially attributed it to the fact that, in many cases, insurance companies, health plans and Medicare do not cover the necessary tests and exams.
“Successful cancer care does not end when patients get out of the door after completing their initial treatments,” Dr. Greenfield told the Times.
The work he and Dr. Kaplan “have faced the impact of the doctor-patient relationship on the results of chronic illness,” said Dr. Harold C. Sox, a professor at the Geisel Medical School at Dartmouth College. “They showed that the best doctor-patient collaborations were attributed to better patient results.”
“We hear a lot about the lack of primary care doctors,” Dr. Sox added. “Dr. Greenfield’s work has shown that good primary care is of great importance. ”
In another study, conducted in 1995, Dr. Greenfield found that treatment by health maintenance organizations and doctors in traditional medical practices produced similar results, although HMOS costs significantly less.
And in a report commissioned by the Food and Drug Administration after several well -published recruitment of equipment that injured thousands of patients, Dr. Greenfield proposed a tougher approval procedure, partly adopted for a wide range of medical devices, including implants.
Sheldon Greenfield was born on April 22, 1938 in Cincinnati. His father, Robert, held a clothing store. His mother, Faye (Bloch) Greenfield, taught the Sunday School.
To decide to pursue a career in medicine, Dr. Kaplan said, her husband “was strongly influenced by his own pediatrician, who was extremely kind and healed children with respect and care”.
After graduating from Harvard College with a degree in Biochemistry in 1960, he obtained a medical degree from the University of Cincinnati in 1964.
He was a practitioner at Boston Hospital and resident from 1971 to 1972 at Beth Israel Hospital (now Beth Israel Deaconess Medical Center), also in Boston.
In 1972, he moved to the University of California, Los Angeles, where he met with Dr. Kaplan, was guided by Dr. Charles E. Lewis and joined the team of Dr. Lewis, who applied algorithms to medical conditions to measure the quality of care.
He and Dr. Kaplan continued their work on the study of medical results at the University of Tufts Medical School, where they founded the Institute of Research on Primary Care Research.
He taught at UCLA, Tufts and Harvard School of Public Health before moving from Boston in 2003 to southern California, where Dr. Kaplan founded the Irvine Research Institute.
In addition to Dr. Kaplan, whom he married in 1983, and his daughter Lauren, from his marriage to Patricia Marks, who ended with divorce, Dr. Greenfield survives a son, Matthew Greenfield, also from this marriage. Two children, Rob Greenfield and Wendi Morner, from his marriage to Dr. Kaplan. Eight grandchildren. And a sister, Joanne Zappin.
In the 1970s and 80s, Dr. Greenfield volunteered at the Venice Family Clinic in Venice, California, where he lived. He had strongly experienced the lack of local and affordable medical care when his family’s babysitter became ill and had to lead her to the nearest public hospital, to Torrance, about 40 miles away.
“It made an indelible impression of me,” Dr. Greenfield said in an interview on the clinic website, “about how difficult it was, not abstract but as a practical issue, for people to get medical care when they needed it.”
