Remembering Dr. Arnold Relman

Accomplished physician, professor, and scholar Arnold “Bud” Relman, MD, passed away on June 17, his 91st birthday. A longtime skeptic of for-profit health care, Dr. Relman is best known for having led The New England Journal of Medicine (NEJM) for more than 13 years, serving as editor from 1977 to 1990. Throughout his career, Dr. Relman served as an influential voice in medicine and research, encouraging Americans to be cognizant of rising health care costs and the need for a more standardized system of health insurance.

Dr. Relman, who was originally from Queens, NY, received an undergraduate degree from Cornell University and a medical degree from the Columbia University College of Physicians and Surgeons. He spent much of his career, however, in Boston. From 1951 to 1968, Dr. Relman served as professor of medicine at the Boston University School of Medicine and years later, after a term at the University of Pennsylvania School of Medicine, returned to Boston to serve as editor of NEJM.

Dr. Relman’s enduring legacy in the research world can be seen through his work at NEJM. Not only did the journal benefit from both increased profits and circulation during his tenure, but it also became “the first medical journal to require authors to disclose potential conflicts of interest if they owned stock in biomedical companies when they published research that might benefit those firms (The Boston Globe).”

His interest in conflicts of interest extended into his research as well. In his scholarly pursuits, Dr. Relman addressed the difficult issue of finding a balance between self-interest and ethical standards. His work was driven by a desire to resolve this conflict and he urged medical, law, and education professionals to reconsider their previously held ideals about profit-driven industries—to focus instead on providing services ethically.

Dr. Relman’s wife, Marcia Angell, MD, a former member of PRIM&R’s Board of Directors, recently told The Boston Globe: “He believed in medicine as primarily a profession where doctors and patients make their decisions without any financial incentives other than to do what was best medically for the patients, a bold philosophy.”

In October 1990, Dr. Relman participated on a panel at PRIM&R’s conference titled “Conflicts of Interest in Biomedical and Biotechnology Research.” During the meeting, he spoke about the importance of minimizing conflicts in research and medicine: “As a practical matter we all know that in medicine, particularly in clinical medicine, there may be many years of background noise, ambiguity, and uncertainty during which society may bear a heavy burden if we do not do everything we can to make sure that our clinical science is as honest and impartial as it can be.”

Dr. Relman remained committed to his work until his death. Just a few months ago, he gained widespread recognition for an article he had published in The New York Review of Books titled “On Breaking One’s Neck.” In the piece, Dr. Relman chronicled his experiences as a patient in the US health care system after sustaining life-threatening injuries from a fall down the stairs. Dr. Relman’s experience as a patient brought several injustices and inefficiencies within the system to the fore, and his article was widely admired for its honesty.

Dr. Relman’s intellectual prowess, passionate leadership, and steadfast commitment to improving the US health care system served to shape the current landscape of reform. His legacy undoubtedly offers inspiration to many who continue to work toward ensuring ethical and affordable health care access for all.