Obituary: Arnold Relman and the medical industrial complex

 

4 Dr. Arnold Relman, 91, died on June 17, 2014.

Perhaps best known as the editor of The New England Journal of Medicine from 1977 to 2000, Arnold Relman was also an editor for the Journal of Clinical Investigation, a researcher on kidney function, a professor at Boston University, The University of Pennsylvania, Oxford, and Harvard. He contributed frequently to the New York Review of Books.

Relman was outspoken early in his position as editor at The New England Journal of Medicine. On October 23, 1980, he wrote an essay in the Journal in which he targeted profit-driven hospitals and other medical  industries. He was very clear that the desire for profit was adversely affecting patient treatment, and that investor-run companies could never have a primary goal other than profit. It was not a popular stance, and he had many critics who dismissed him as a conspiracy theorist or naive medical Don Quixote.

Aalg relman quote

Relman continued urging a reform of the American health care system, and suggested that a single-taxpayer-supported insurance system replace the private insurance companies. He considered the 2010 USA health care law to be only a partial reform, and said so.

The New England Journal  of Medicine, under Relman’s direction, was the first journal that required authors to disclose any financial arrangements that might affect their judgement of their research and publication. Many journals would follow this disclosure of conflicts of interest, and though there are those who still protest that the source of funding is irrelevant and that trying for such integrity was unrealistic, Relman’s stance was crucial in moving the medical and research culture to the expectation of accountability. (In 2002, under editor-in-chief Dr. Jefrey Drazen, The New England Journal of Medicine reversed the rule for authors for financial disclosure as so few authors had no industry financial ties.)

Relman was fortunate in having a work- and later, life-partner who agreed politically and philosophically with him, Dr. Marcia Angell. They worked together at The New England Journal of Medicine, lived together since 1994, and married in 2009. Together they won the George Polk Award for a 2002 article in The New Republic that documented how drug companies invested much more in advertising and lobbying than in research and development. Angell is now investigating the the influence of drug company money on the prescribing habits of physicians.

The New York Times obituary for Dr. Relman  and a New York Times 2012 interview with Relman and his wife, Dr. Marcia Zuger  are the source of the information of this short posting.

 

 

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