Dr. Sheldon Greenfield in 1992. The author of numerous studies, he urged patients to question their physicians
and expressed concern about cancer treatment for older adults. (Photo by Lauren Greenfield)
Dr. Sheldon Greenfield, whose pioneering research found that older patients with breast and pancreatic cancer got subpar treatment and that patients who grill their doctors during consultations receive better care, died on February 26, 2025 at his home in Newport Beach, CA. He was 86. The cause was colon cancer, his daughter Lauren Greenfield said.
Dr. Greenfield was a founder and director of the Center for Health Policy Research at the University of California, Irvine, and a leader of the Medical Outcomes Study, involving more than 22,000 patients and 500 physicians. It determined in 1986 that doctors often ordered exorbitant and unnecessary tests and referred patients to a specialist when a primary care doctor or a nurse practitioner could have delivered equally good care.
Alan M. Garber, the president of Harvard University, praised Dr. Greenfield as “a towering figure in health care research.” “His influence extended more widely than even he could have known, through the Medical Outcomes Study and so much else,” Dr. Garber said in an email.
In 1991, Dr. Greenfield and collaborators including his wife, Dr. Sherrie Kaplan, found 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 their physicians. “When doctors dominate the medical interview, patients don’t do as well as when the patient exerts more control,” Dr. Greenfield told The New York Times that year.
Diabetes patients who asked questions about dosage and volunteered other symptoms during checkups recorded a 15 percent drop in blood sugar after two months, according to a study in 1995. Similar results were found in studies of patients with ulcers and hypertension. As that study’s principal author, Dr. Greenfield explained that the researchers focused on adult diabetes because of its prevalence and because the proper treatment can prevent complications that make it one of the most expensive chronic diseases to treat.
Four years earlier, a research team that Dr. Greenfield led had concluded that while 96 percent of women ages 50 to 69 with breast cancer received the appropriate minimal level of acceptable care, only 83 percent of otherwise healthy women 70 and older did. (The study defined “appropriate” as either removal of the entire breast and some surrounding tissue or removal of the lump and the nearest lymph node, followed by radiation treatment.) “The lives of these patients may be needlessly shortened,” Dr. Greenfield said.
In 1989, a group led by Dr. Greenfield found that older men who develop cancer of the prostate are less likely than younger men to receive the best available treatment.
He also expressed concern about the lack of appropriate follow-up care for cancer patients. He attributed this in part to the fact that, in many cases, insurance companies, health plans and Medicare don’t cover the necessary tests and examinations.
“Successful cancer care doesn’t end when patients walk out the door after completion of their initial treatments,” Dr. Greenfield told The Times.
Dr. Greenfield in 2009 on the campus of the University of California, Irvine, where he and his wife and frequent collaborator, Dr. Sherrie Kaplan, established the Health Policy Research Institute. (Photo by University of California, Irvine)
The work that he and Dr. Kaplan did “addressed the effects of the doctor-patient relationship on the outcomes of chronic illness,” Dr. Harold C. Sox, an emeritus professor at the Geisel School of Medicine at Dartmouth College, said in an email. “They showed that better doctor-patient partnerships paid off in better patient outcomes.”
“We hear a lot about the shortage of primary-care physicians,” Dr. Sox added. “Dr. Greenfield’s work showed that good primary care matters a lot.”
In another study, conducted in 1995, Dr. Greenfield found that treatment by health maintenance organizations and by doctors in traditional medical practices produced similar results, even though the H.M.O.s cost substantially less.
And in a report commissioned by the Food and Drug Administration after several well-publicized recalls of equipment that injured thousands of patients, Dr. Greenfield proposed a tougher approval process. It was adopted, in part, for a wide range of medical devices, including hip implants and external heart defibrillators.
Sheldon Greenfield was born on April 22, 1938, in Cincinnati. His father, Robert, owned a clothing store. His mother, Faye (Bloch) Greenfield, taught Sunday school.
In deciding to pursue a career in medicine, Dr. Kaplan said, her husband “was heavily influenced by his own pediatrician, who was extremely kind and treated children with respect and care.”
After graduating from Harvard College, where he was a member of Leverett House and the Class of 1960, with an A.B. degree in biochemistry in 1960, he earned a medical degree from the University of Cincinnati in 1964. From 1966 to 1968, he served in the Navy as a lieutenant commander, dealing with epidemic intelligence at the National Communicable Disease Center (now the Centers for Disease Control and Prevention).
He was an intern at Boston City Hospital and chief resident from 1971 to 1972 at Beth Israel Hospital (now Beth Israel Deaconess Medical Center), also in Boston.
Dr. Greenfield in an undated photo. Dr. Kaplan said that in deciding to pursue a
career in medicine, he “was heavily influenced by his own pediatrician.” (Photo from the Greenfield family)
In 1972, he moved to the University of California, Los Angeles, where he met Dr. Kaplan, was mentored by Dr. Charles E. Lewis and joined Dr. Lewis’s team, which applied algorithms to medical conditions to measure the quality of care.
He and Dr. Kaplan continued their work on the Medical Outcomes Study at Tufts University School of Medicine, where they founded the Primary Care Outcomes Research Institute.
Dr. Greenfield taught at U.C.L.A., Tufts and the Harvard School of Public Health before moving in 2003 from Boston to Southern California, where he and Dr. Kaplan established the Health Policy Research Institute at Irvine.
In addition to Dr. Kaplan, whom he married in 1983, and his daughter Lauren and his son Matthew, from his marriage to Patricia Marks, which ended in divorce, Dr. Greenfield is survived by 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, CA, where he lived. He had become acutely aware of the lack of local and affordable medical care when his family’s babysitter became ill and he had to drive her to the closest public hospital, in Torrance, about 20 miles away. “It made an indelible impression on me,” Dr. Greenfield said in an interview on the clinic’s website, “about how difficult it was, not in the abstract but as a practical matter, for people to get medical care when they needed it.”
Modified slightly from what was published by The New York Times on March 14, 2025 (Updated March 19, 2025).
Sam Roberts is an obituaries reporter for The Times, writing mini-biographies about the lives of remarkable people.
With a heavy heart, the University of California at Irvine School of Medicine shares the news that Sheldon Greenfield, MD, Donald Bren Professor of medicine and co-executive director of UC Irvine's Health Policy Research Institute, passed away on Wednesday, February 26, 2025. He was born on April 22, 1938, in Cincinnati. His father, Robert, owned a clothing store. His mother, Faye (Bloch) Greenfield, taught Sunday school.
With a career spanning more than 50 years, Greenfield made significant contributions to primary care, as well as clinical and health policy research. After preparing at Walnut Hills High School in Cincinnati, OH, Sheldon earned his A.B. degree, concentrating in biochemistry, from Harvard College in 1960 as a member of the Class of 1960 and a resident of Leverett House. Sheldon received his M.D. from the University of Cincinnati in 1964. He completed his residency at Boston City Hospital and Beth Israel Hospital of Boston.
Greenfield served as an Epidemic Intelligence Surveillance officer with the Center for Disease Control (CDC), publishing an influential article on the detection and management of meningococcal meningitis in The New England Journal of Medicine. He also co-led the landmark “Medical Outcomes Study” with colleagues from the RAND Corp., examining healthcare delivery systems’ effects on patient interpersonal care, clinical and quality of life outcomes.
He served as a prominent faculty member at UCLA, Tufts University School of Medicine and the Harvard School of Public Health before coming to UC Irvine in 2003 with his wife and colleague, Sherrie Kaplan, PhD, MPH. Together, they established the Health Policy Research Institute within the School of Medicine, focusing on disparities in health and healthcare.
Greenfield was recognized as a fellow of the World Health Organization and participated in the first public health delegation to Cuba in 1974. He was elected to the Institute of Medicine (now the National Academy of Medicine) in 1996 and received several lifetime achievement awards, including one from UC Irvine School of Medicine in 2023.
He is survived by his wife, four children and eight grandchildren.
