Arnold S. Relman

{{short description|American internist, professor and journal editor (1923–2014)}}

{{Infobox scientist | honorific_prefix = | name = Arnold S. Relman | image = Arnold Relman 2.16.12 (6918405677).jpg | image_size = | alt = | caption = | birth_date = {{birth date |1923|06|17}} | birth_place = Queens, New York, US | death_date = {{death date and age |2014|06|17 |1923|06|17}} | death_place = Cambridge, Massachusetts, US | resting_place = | resting_place_coordinates =  | other_names = | residence = | fields = Internal medicine, social medicine, education | workplaces = ''The New England Journal of Medicine'' | education = Cornell University | alma_mater = College of Physicians and Surgeons at Columbia University | thesis_title =  | thesis_url =  | thesis_year =  | doctoral_advisor =  | academic_advisors = | doctoral_students = | notable_students = | known_for = Editor of ''The New England Journal of Medicine.'' Contributions to medical education. | influences = | influenced = | awards = | signature_alt = | website =  | footnotes = }}

'''Arnold Seymour Relman''' (June 17, 1923 – June 17, 2014) — known as '''Bud Relman''' to intimates — was an American internist and professor of medicine and social medicine.<ref>{{Cite web|url=https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/46373|title=Arnold Relman, MD: Physician, Educator, and Editor|date=2014-06-18|website=www.medpagetoday.com|language=en|access-date=2020-02-25}}</ref><ref>{{Cite web|url=https://bostoncremation.org/obituary/dr-arnold-relman|title=Dr. Arnold Relman|website=Boston Cremation|language=en-US|access-date=2020-02-25}}</ref><ref>{{Cite news|last=Martin|first=Douglas|url=https://www.nytimes.com/2014/06/22/us/dr-arnold-relman-outspoken-medical-editor-dies-at-91.html|title=Dr. Arnold Relman, 91, Journal Editor and Health System Critic, Dies|date=2014-06-21|work=The New York Times|access-date=2020-02-25|language=en-US|issn=0362-4331}}</ref> He was editor of ''The New England Journal of Medicine'' (''NEJM'') from 1977 to 1991, where he instituted two important policies: one asking the popular press not to report on articles before publication and another requiring authors to disclose conflicts of interest.<ref name= "NYT obit"/> He wrote extensively on medical publishing and reform of the U.S. health care system, advocating non-profit delivery of single-payer health care. Relman ended his career as professor emeritus at Harvard Medical School in Boston, Massachusetts.<ref name=Harvard_profile>{{cite web |url= http://connects.catalyst.harvard.edu/profiles/profile/person/78290 |title= Harvard Catalyst Profiles: Arnold Seymour Relman, M.D. |website= catalyst.harvard.edu |author= Harvard Catalyst: The Harvard Clinical and Translational Science Center |publisher= The President and Fellows of Harvard College |access-date= 2014-06-23 |archive-url= https://web.archive.org/web/20110719210149/http://connects.catalyst.harvard.edu/profiles/profile/person/78290 |archive-date= 2011-07-19 |url-status= dead }}</ref>

==Biography== Relman was born in Queens, New York, in 1923.

He was educated at Cornell University and the College of Physicians and Surgeons at Columbia University. After Medical school, he contracted tuberculosis. Although an antibiotic called streptomycin had finally been developed by that time, Relman eschewed the opportunity to use it as he feared its side effects which were most toxic. The years of rest without streptomycin delayed his career and during this time he read Thomas Mann's novel "Magic Mountain" about the experience of patients in a tuberculosis sanitarium. The work affected him greatly and he never failed to recommend the work to medical students on his service. He was first professor at Boston University School of Medicine, then Frank Wister Thomas professor of medicine and chair of the department of medicine at the University of Pennsylvania School of Medicine (now the Perelman School of Medicine), and finally a professor at Harvard Medical School.

Relman was editor of the ''Journal of Clinical Investigation'' from 1962 to 1967.<ref name="InselKornfeld2004">{{cite journal |last1= Insel |first1= Paul A. |last2= Kornfeld |first2= Stuart |last3= Majerus |first3= Philip W. |last4= Marks |first4= Andrew R. |last5= Marks |first5= Paul A. |last6= Relman |first6= Arnold S. |last7= Scharschmidt |first7= Bruce F. |last8= Stossel |first8= Thomas P. |last9= Varki |first9= Ajit P. |last10= Weiss |first10= Stephen J. |last11= Wilson |first11= Jean D. |display-authors= 4 |title= Blasts from the past |journal= Journal of Clinical Investigation |volume= 114 |issue= 8 |year= 2004 |pages=1017–33|pmid= 15489944 |pmc= 522273 |doi= 10.1172/JCI23321}}</ref> He was editor of ''The New England Journal of Medicine'' (''NEJM'') from 1977 to 1991.<ref>{{Cite news|last=Langer|first=Emily|url=https://www.washingtonpost.com/national/health-science/arnold-s-relman-new-england-journal-of-medicine-editor-dies-at-91/2014/06/24/610e3812-fbab-11e3-932c-0a55b81f48ce_story.html|title=Arnold S. Relman, New England Journal of Medicine editor, dies at 91|date=2014-06-24|work=Washington Post|access-date=2020-02-25|language=en-US|issn=0190-8286}}</ref>

Relman was the only person to have been president of the American Federation for Clinical Research, the American Society for Clinical Investigation and the Association of American Physicians.<ref name= "NYT obit"/> In 1988 he was awarded ''Honorary Fellowship'' by the New York University School of Medicine.<ref name=Honorary>{{cite journal |pmc= 1629363 |title= Conferring of Honorary Fellowship upon Arnold S. Relman, M.D. | pmid=3072042 |volume= 64 |issue= 8 |date= November 1988 |last= Farber |first= Saul J. |journal= Bulletin of the New York Academy of Medicine |pages= 887–90 }}</ref>

Relman died in Cambridge, Massachusetts of melanoma in 2014 at the age of 91.<ref name= "NYT obit">{{cite news |last= Martin |first= Douglas |date= June 21, 2014 |title= Dr. Relman, medical editor and health system critic, dies at 91 |newspaper= The New York Times |url= https://www.nytimes.com/2014/06/22/us/dr-arnold-relman-outspoken-medical-editor-dies-at-91.html |access-date= 2014-06-23}}</ref> He was married to Harriet Vitkin for 40 years, and together they had three children, David Relman, John Relman, and Margaret Relman Batten. His second wife Marcia Angell also served as editor of ''NEJM'' and was the first woman to do so.<ref name="obit">{{cite news|last1=Marquard|first1=Bryan|title=Dr. Arnold Relman, 91; ex-N.E. Journal of Medicine editor|url=https://www.bostonglobe.com/metro/2014/06/17/arnold-relman-former-new-england-journal-medicine-editor-was-forceful-voice-health-care-debate/k4Flrz8z2xgWyilyMB555I/story.html|access-date=24 August 2016|work=Boston Globe|date=17 June 2014}}</ref>

==Views==

===On for-profit health care=== Relman was an uncompromising critic of the American health care system as a profit-driven industry. He once said, "The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful."<ref>Relman A, Angell M. America's other drug problem. New Republic 2002. December 16: 27.</ref> He coined the term "medical–industrial complex." He deplored the increasing treatment of health care in the US as a "market commodity" distributed according to a patient's ability to pay, not medical need. He believed that the solution would come only by two fundamental structural reforms: implementation of a single-payer financing system like Medicare without investor-owned private insurance companies and provision of a non-profit delivery system, with multi-specialty groups of physicians paid by salary within a preset budget.<ref>Angell, Marcia (2014), "On Arnold Relman (1923-2014)", ''New York Review of Books'', (14 Aug issue).</ref>

In 1999, Relman participated in a Harvard Medical School debate on the subject of unionization of physicians and for-profit health care. His stance was described: : "Although he believes that managed care is here to stay, the current 'marketplace' state of health care is not viable. In order for the system to work, it is going to have to be 'not-for-profit, community-based, and run by doctors and local health care institutions with the support of community groups.' Keeping the big picture in mind, Relman said, 'Unions are unnecessary in a not-for-profit sector.'"<ref name=Focus_debate>{{cite news |last= Chu |first= Catherine |url= http://archives.focus.hms.harvard.edu/1999/Dec3_1999/medical_practice.html |title= Panelists debate if doctors should unionize |magazine= Focus |date= December 3, 1999 |publisher= Harvard Medical School}}</ref>

===On alternative medicine=== Relman was a decided skeptic regarding the alternative, complementary and integrative medicine movement. In 1998 he wrote:

<blockquote>There are not two kinds of medicine, one conventional and the other unconventional, that can be practiced jointly in a new kind of "integrative medicine." Nor...are there two kinds of thinking, or two ways to find out which treatments work and which do not. In the best kind of medical practice, all proposed treatments must be tested objectively. In the end, there will only be treatments that pass that test and those that do not, those that are proven worthwhile and those that are not. Can there be any reasonable "alternative"?<ref>*{{cite news |last= Relman |first= Arnold S. |author-mask= 0 |url= http://www.quackwatch.com/11Ind/weil.html |title= A trip to Stonesville: Some notes on Andrew Weil |magazine= The New Republic |date= December 14, 1998 |volume= 219 |issue= 24 |page= 28}}</ref></blockquote>

==Works== *{{cite book |editor1-last= Ingelfinger |editor1-first= Franz Josef |editor2-first= Arnold S. |editor2-last= Relman |editor3-first= Maxwell |editor3-last= Finland |title= Controversy in Internal Medicine |publisher= W.B. Saunders |year= 1966 |oclc= 500690355 |editor2-mask=1 |location= Philadelphia |volume= 1}} *{{cite book |editor1-last= Ingelfinger |editor1-first= Franz Josef |editor2-first= Arnold S. |editor2-last= Relman |editor3-first= Maxwell |editor3-last= Finland |title= Controversy in Internal Medicine |publisher= W.B. Saunders |year= 1974 |isbn= 9780721650265 |editor2-mask= 1 |location= Philadelphia |volume= 2 |url-access= registration |url= https://archive.org/details/controversyinint00inge }} *Relman, Arnold S. "The New Medical-Industrial Complex". N Engl J Med 303(17):963-70, 1980. doi: 10.1056/NEJM198010233031703 *{{cite book |last= Relman |first= Arnold S. |author-mask= 0 |title= The Future of Medical Practice |year= 1982 |series= Merrimon Lecture Series |location= Chapel Hill, NC |publisher= University of North Carolina; School of Medicine |oclc= 10027873}} *{{cite journal |last= Relman |first= Arnold S. |author-mask= 0 |title= Publishing Biomedical Research: Roles and responsibilities |journal= Hastings Center Report |date= May–June 1990 |volume= 20 |issue= 3 |pages= 23–7 |pmid= 2376495 |doi= 10.2307/3563157|jstor= 3563157 }} *{{cite book |last= Relman |first= Arnold S. |author-mask= 0 |title= 10 Shattuck Street: Selected Editorials |year= 1991 |location= Waltham, MA |publisher= Massachusetts Medical Society |isbn= 9780910133340}} *{{cite book |last= Relman |first= Arnold S. |author-mask= 0 |title= The Choices for Healthcare Reform |year= 1992 |location= Camp Hill, PA |publisher= Pennsylvania Blue Shield Institute |oclc= 27164594}} *{{cite book |last= Relman |first= Arnold S. |author-mask= 0 |title= When More is Less: The Paradox of American Health Care and How to Resolve It |year= 1997 |location= New York |publisher= W.W. Norton |isbn= 9780393035797}} *{{cite news |last= Relman |first= Arnold S. |author-mask= 0 |url= http://www.quackwatch.com/11Ind/weil.html |title= A trip to Stonesville: Some notes on Andrew Weil |magazine= The New Republic |date= December 14, 1998 |volume= 219 |issue= 24 |page= 28}} *{{cite journal |last1= Angell |first1= Marcia |first2= Arnold S. |last2= Relman |author-mask2= 1 |title= Patents, profits & American medicine: Conflicts of interest in the testing & marketing of new drugs |journal= Daedalus |date= Spring 2002 |volume= 131 |issue= 2 |pages= 102–11 |jstor= 20027764 |url= http://www.amacad.org/publications/spring2002/angell.pdf}} *{{cite news |first1= Arnold S. |last1= Relman |first2= Marcia |last2= Angell |author-mask1= 1 |date= December 16, 2002 |title= America's other drug problem: How the drug industry distorts medicine and politics |url= http://www.commercialalert.org/relmanangell.pdf |magazine= The New Republic |volume= 227 |issue= 25 |pages= 27–41 |pmid= 12561803 |access-date= June 24, 2014 |archive-url= https://web.archive.org/web/20150217023403/http://www.commercialalert.org/relmanangell.pdf |archive-date= February 17, 2015 |url-status= dead }} *{{cite journal |last= Relman |first= Arnold S. |author-mask= 0 |title= Restructuring the U.S. health care system |journal= Issues in Science and Technology |date= September 2003 |volume= 19 |issue= 4 |url= http://issues.org/19-4/relman/}} *{{cite book |last= Relman |first= Arnold S. |author-mask= 0 |title= A Second Opinion: Rescuing America's Health Care |year= 2007 |location= New York |publisher= PublicAffairs |series= Century Foundation Books |isbn= 9781586484811 |url-access= registration |url= https://archive.org/details/secondopinionres00relm }} *{{cite news |last= Relman |first= Arnold |title= On Breaking One's Neck |url= http://www.nybooks.com/articles/archives/2014/feb/06/on-breaking-ones-neck/ |date= February 6, 2014 |magazine= The New York Review of Books}} *{{cite journal |last= Relman |first= Arnold S. |author-mask= 0 |date= June 2, 2014 |title= Physicians and politics |journal= JAMA Internal Medicine |issue= 8|pmid= 24887238 |doi= 10.1001/jamainternmed.2014.509 |department= Invited Commentary |volume=174 |pages=1318–9}}

== References == {{reflist}}

== Further reading == *{{cite web |last= Peck |first= Peggy |date= June 19, 2014 |title= Arnold Relman, MD: Physician, educator and editor |url= http://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/46373 |work= MedPage Today |department= Public Health Policy |location= Little Falls, NJ}} *{{cite news |last= Lowes |first= Robert |date= June 19, 2014 |title= Arnold Relman, medicine's long-time conscience, dies at 91 |url= http://www.medscape.com/viewarticle/827038 |work= Medscape Medical News |publisher= Medscape}} *{{cite web |last= Sabin |first= James |date= June 18, 2014 |title= Arnold Relman: 1923-2014 |url= http://www.over65.thehastingscenter.org/arnold-relman-1923-2014/ |work= Over 65 |type= blog}} *{{cite news |last= Marquard |first= Bryan |date= June 17, 2014 |title= Dr. Arnold Relman, 91; ex ''N.E. Journal of Medicine'' editor |url= https://www.bostonglobe.com/metro/2014/06/17/arnold-relman-former-new-england-journal-medicine-editor-was-forceful-voice-health-care-debate/k4Flrz8z2xgWyilyMB555I/story.html |newspaper= The Boston Globe |type= Obituary}} *{{cite news |last= Conaboy |first= Chelsea |date= January 28, 2014 |title= Dr. Arnold Relman on becoming the patient |url= https://www.bostonglobe.com/lifestyle/health-wellness/2014/01/28/arnold-relman-becoming-patient/4YIRIEDPhNiPIhXQSl1HgP/story.html |newspaper= The Boston Globe}} *{{cite news |last= Zuger |first= Abigail |date= March 19, 2012 |title= A drumbeat on profit takers |url= https://www.nytimes.com/2012/03/20/science/a-drumbeat-on-profit-takers.html |newspaper= The New York Times |series= Profiles in Science: Arnold Relman and Marcia Angell}} *{{cite journal |title= Arnold Relman — the last angry doctor |department= At Large: with Dennis L. Breo |journal= JAMA |volume= 265 |issue= 21 |pages= 2864–9 |pmid= 2033748 |doi= 10.1001/jama.1991.03460210110042 |date= June 5, 1991|last1= Relman |first1= A. }}

== External links == {{Commons category-inline}} * [https://id.lib.harvard.edu/ead/med00188/catalog Arnold S. Relman papers, 1953-2011 (inclusive), 1974-2011 (bulk). H MS c353. Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass.] {{Authority control}}

{{DEFAULTSORT:Relman, Arnold S.}} Category:1923 births Category:2014 deaths Category:Medical doctors from Massachusetts Category:Cornell University alumni Category:Harvard Medical School faculty Category:The New England Journal of Medicine people Category:American critics of alternative medicine Category:Columbia University Vagelos College of Physicians and Surgeons alumni Category:Medical journal editors Category:Journal of Clinical Investigation editors Category:Members of the National Academy of Medicine