Dr. Arnold Relman, Former NEJM Editor-in-Chief, Dies at 91 — Physician’s First Watch

Medical News |
June 18, 2014

Dr. Arnold Relman, Former NEJM Editor-in-Chief, Dies at 91

By Joe Elia

Edited by David G. Fairchild, MD, MPH

Arnold S. Relman, MD, who edited the New England Journal of Medicine from 1977 to 1990, has died at age 91.

Dr. Relman, an expert in acid-base balance, became fascinated with public policy during his editorship and wrote a clarion call warning of the advent of "The New Medical-Industrial Complex" in 1980. The then-emerging network of private corporations, he wrote, "may be more efficient than its nonprofit competition, but it creates the problems of overuse and fragmentation of services, overemphasis on technology, and 'cream-skimming,' and it may also exercise undue influence on national health policy."

In a 2012 interview with the Clinical Conversations podcast, "Bud" was still at it, railing — but in his typically reasoned way — against the influence of private health insurance.

In the New York Review of Books, Relman wrote about his care and recovery from a 2013 fall at home that caused a broken neck.

Reader Comments (2)

Matthew Anderson, MD, MSc Physician, Family Medicine/General Practice, Bronx, NY

It is unfortunate that Dr. Fairchild's obituary perpetuates the idea that Dr. Relman, a truly admirable man and physician, was the originator of the "Medical Industrial Complex" formulation. In fact, the concept of the Medical-Industrial Complex had been developed by the Health Policy Advisory Center (Health-PAC), a remarkable New York City think tank that was created in the late 1960's and produced an impressive body of scholarship. (See, for example, Barbara and John Ehrenreich's 1970 book: The American Health Empire: Power, Profits, and Politics.).

In reading Relman's 1980 article he makes no mention of this prior work. I sense that Dr. Fairchild's obituary continues this marginalization of progressive viewpoints within the halls of academic medicine.

For interested readers, the HealthPAC archives are available at: http://www.healthpacbulletin.org/.

Joe Elia Other Healthcare Professional

My brief obituary doesn't credit Dr. Relman as the originator of the "medical-industrial complex" formulation, nor did Relman ever claim to have done so, but his position as editor-in-chief of a widely read journal certainly lent prominence to the metaphor.

As to the Ehrenreichs' book, I reviewed it for the Journal in 1971 (http://www.nejm.org/doi/full/10.1056/NEJM197111042851929). You'll note, I hope, that there's no hint of "marginalization of progressive viewpoints" therein.

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