Obituary of Sheldon Greenfield

Sheldon Greenfield, MD, passed away on Feb. 26, 2025, after a remarkable career spanning over 50 years in primary care and clinical/health policy research. He is survived by his wife and colleague of 50 years, Sherrie Kaplan, PhD, MPH, four children, and eight grandchildren. Dr. Greenfield earned his medical degree in 1964, graduating Alpha Omega Alpha from the University of Cincinnati, and completed his internship and residency at Boston City Hospital and Beth Israel Hospital of Boston, where he served as Chief Resident from 1971-1972. He was an Epidemic Intelligence Surveillance Officer with the Centers for Disease Control from 1966 to 1968, conducting early research on infectious disease understanding and prevention, including an influential article on the detection and management of meningococcal meningitis published in the New England Journal of Medicine. He moved from Boston to UCLA in 1972, where he met and was mentored by Charles E. Lewis, MD, ScD. There, he joined a team studying the effectiveness of training nurse practitioners to manage common, low-risk illnesses, such as acute upper respiratory disease, using algorithms. In 1973, he became part of Dr. Lewis’ EMCRO* team, which focused on developing methods to evaluate the quality of care provided by physicians, where he also met Dr. Kaplan. Together, they applied the principle of algorithms to various diseases and conditions, creating a novel, branching, logic-driven approach to quality-of-care assessment. He and Dr. Kaplan became pioneers in shared decision-making, using the algorithm approach to improve patients' understanding and involvement in their care. Their series of randomized controlled trials demonstrated the effectiveness of incorporating patients in healthcare decisions on doctor-patient communication and health outcomes, which is now widely accepted as an international policy that includes both adults and children in their healthcare. (Greenfield volunteered at the Venice Family Clinic in the 70s and 80s: https://venicefamilyclinic.org/news/stories/greenfield-familys-volunteerism-spans-generations/) In 1986, alongside colleagues from the RAND Corporation, he co-led the Medical Outcomes Study, a landmark observational study involving over 22,000 patients and 500 physicians, designed to examine the effects of different healthcare delivery systems on patients’ interpersonal care, as well as clinical and quality of life outcomes. He and Dr. Kaplan, along with other investigators, continued their work on the Medical Outcomes Study at Tufts University School of Medicine, where they founded the Primary Care Outcomes Research Institute. In 2003, he and Dr. Kaplan moved from Boston to UC Irvine, establishing the Health Policy Research Institute (HPRI), a replication of the Primary Care Outcomes Research Institute at Tufts. Focused on understanding and reducing disparities in health and healthcare, HPRI also served as the foundation for their clinical research training program, leading to the establishment of the Master’s degree in Biomedical and Translational Science in the UCI School of Medicine. Dr. Greenfield, along with Dr. Kaplan, played a crucial role in promoting interdisciplinary research, generating cross-disciplinary clinical research and research training programs on both coasts. Dr. Greenfield studied various international healthcare delivery systems to inform efforts to reform and improve the US healthcare system. In 1971, he was a Fellow of the World Health Organization, studying healthcare delivery in England and Sweden. In 1974, he was part of the first public health delegation to Cuba, focusing on the use of community healthcare workers to enhance population health. Dr. Greenfield’s substantial contributions to science were recognized by his election to the (then) Institute of Medicine in 1996 (now the National Academy of Medicine), where he chaired or co-chaired numerous committees that generated reports addressing timely and critical health policy and clinical research issues, such as quality of care, comparative effectiveness research, and the expansion of cancer care beyond the acute phase across a patient’s entire lifetime. He received multiple lifetime achievement awards, including the Robert J. Glaser Award from the Society for General Internal Medicine (of which he was a past president), the Pew Foundation Healthcare Professions Award, the 2006 Founders Award of the American College of Medical Quality, the Distinguished Alumni Award from the University of Cincinnati School of Medicine, and most recently, in 2023, a lifetime achievement award from the UC Irvine School of Medicine. His research, spanning over five decades, has been widely cited and has significantly influenced the delivery and evaluation of high-quality healthcare. He was a true pioneer in the advancement of excellence and effectiveness in clinical and health policy research and maintained his interests in the emerging fields of precision medicine and the intersection of artificial intelligence and clinical medicine through his retirement in 2023. His intellectual agility, scientific curiosity, spirit of social equity, and deep commitment to caring for all of his patients and students highlight his unique stature in the healthcare community. He will be dearly missed.