Dr. Sheldon Greenfield, who revealed gaps in healthcare, dies at 86

Dr. Sheldon Greenfield, whose pioneering studies have shown that older patients with breast and pancreatic cancer received impoverished treatment and that patients who grill their doctors during consultation, receive better care, died on February 26 at his home at Newport Beach in Kalifornia. He was 86 years elderly.

The reason was colorectal cancer, said his daughter Lauren Greenfield.

Dr. Greenfield was the founder and director of the Center for Health Policy Research at the University of California, Irvine and a leader in the study of medical results, which included over 22,000 patients and 500 doctors, which in 1986 determined that doctors often ordered exorbian and unnecessary tests and directed patients to a specialist, nurser Nurses could provide care as well.

Alan M. Garber, president of Harvard University, praised Dr. Greenfield for “a high number of healthcare tests”.

“His influence expanded more than even he could know, by studying medical results and many others,” said Dr. Garber We -mail.

In 1991, Dr. Greenfield and colleagues, including his wife, Dr. Sherrie Kaplan, said that too many conversations about care are dominated by doctors. They recommended a protocol that included a 20-minute coaching session for patients before they consulted with doctors.

“When doctors dominate in a medical interview, patients do not cope as well as when the patient makes more control,” said Dr. Greenfield at the Novel York Times this year.

According to research from 1995, patients with diabetes who asked questions about dosage and volunteered to other symptoms during the inspection, recorded a 15 -percentage drop in blood sugar after two months. Similar results were found in patients with ulcers and hypertension.

As the main author of this study, Dr. Greenfield explained that scientists have focused on adult diabetes because it is common and because proper treatment can prevent complications that make it one of the most costly chronic diseases for treatment.

Four years earlier, the research team, which was led by Dr. Greenfield, came to the conclusion that while 96 percent of women aged 50 to 69 with breast cancer received an appropriate minimum level of acceptable care, only 83 percent of well 70 and older women. (The test was defined “appropriate” as removing the entire breast, and some surrounding the tissue or removal of the nodule and the nearest lymph node, followed by radiation.)

“The lives of these patients may be unnecessarily shortened,” said Dr. Greenfield.

In 1989, the group led by Dr. Greenfield said that older men who develop prostate cancer are less exposed to younger men who will receive the best available treatment.

He also expressed concern about the lack of proper observation of cancer patients. He partly attributed to the fact that in many cases insurance companies, health plans and Medicare do not include the necessary tests and exams.

“Successful caring for cancer does not end when patients go out the door after the initial method of treatment,” said Dr. Greenfield The Times.

The work he and Dr. Kaplan “dealt with the influence of the doctor-patient relationship on the results of a chronic disease,” said Dr. Harold C. Sox, a retired professor at Geisel School of Medicine at Dartmouth College. “They showed that better doctor-patient partnerships paid off in better patients’ 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 has many things. “

In another study, conducted in 1995, Dr. Greenfield stated that treatment by organizations for maintaining health and doctors in conventional medical practices brought similar results, although HMO costs much less.

And in a report ordered by food and second administration, after several well -publicized withdrawal of equipment, which hurt thousands of patients, Dr. Greenfield offered a more arduous approval process, which was partly accepted for a wide range of medical devices, including hip implants and external defibrization hearts.

Sheldon Greenfield was born on April 22, 1938 in Cincinnati. His father, Robert, was the owner of a clothing store. His mother, Faye (Bloch) Greenfield, taught Sunday school.

When deciding to continue his career in medicine, Dr. Kaplan said that her husband “was under the mighty influence of his own pediatrician, who was extremely nice and treated with children with respect and care.”

After graduating from Harvard College with a bachelor’s degree in the field of biochemistry in 1960, he obtained a medical degree at the University of Cincinnati in 1964. In 1966–1968 he served in the war navy as a lieutenant commander, dealing with the intelligence of the epidemic at the National Center for Communal Disease (now Centers for Disease Control and prevention).

He was an intern at Boston City Hospital and the main resident in 1971–1972 in Beth Israel Hospital (now Beth Israel Deaconess Medical Center), also in Boston.

In 1972 he moved at the University of California in Los Angeles, where he met Dr. Kaplan, he was mentated by Dr. Charles E. Lewis and joined the team of Dr. Lewis, who used algorithms in medical conditions to measure the quality of care.

He and Dr. Kaplan continued to work on the study of medical results at the Tufts University School of Medicine, where they founded the Research EXTORCOM Research Institute.

He taught in Ucla, Tufts and Harvard School of Public Health before he moved from Boston in South California in 2003, where he and Dr. Kaplan founded the Institute of Health Policy Research in Irvine.

In addition to Dr. Kaplan, whom he married in 1983, and his daughter Lauren, from marriage with Patricia Marx, who ended in divorce, Dr. Greenfield survived his son Matthew Greenfield, also from this marriage; Two children, Rob Greenfield and Wendi Morner, from marriage with Dr. Kaplan; eight grandchildren; And sister Joanne Zappin.

In the 70s and 80s, Dr. Greenfield volunteered to Venice Family Clinic in Venice in California, where he lived. He realized the lack of local and inexpensive medical care when the guardian of his family got infirmed and had to go to the nearest public hospital, in Torrance, almost 40 miles.

“I was impressive on me,” Dr. Greenfield he said In an interview on the clinic’s website “On how arduous it was, not in abstraction, but as a practical case, so that people could get medical care when they need it.”