The phrase, “larger than life,” is often used to describe people who seem to live their life a notch above the rest of us. It could certainly be applied to John Eisenberg in terms of his many achievements and the profound impact he has had on the U.S. health care system. But, “larger than life” does not accurately describe the way that John lived his life, because he made himself so much a part of everyone else's lives. A conversation with John Eisenberg was rarely a “conversation” and was rarely about himself. Instead, it was usually an intense discussion about what needed to be done to advance the field of health services research and the health system at large and what you could do and must do to achieve these goals. Some of us came to call these “John's pep talks.”
John was one of those rare people who could do so many things well. He was an outstanding clinician, teacher, researcher, and administrator. As a clinician, he was an astute diagnostician and empathetic communicator with his patients. He was a teacher/mentor par excellence both in his formal role as a professor and chair of medicine and in his interactions with colleagues around the country. One of the early alums of the Robert Wood Johnson Foundation Clinical Scholars Program, he was an early role model for many clinicians who tried to straddle the worlds of academic medicine and health policy. As the first recipient of the Academy for Health Services Research and Health Policy's President's Award, he was presented with many glowing letters from individuals whom he had mentored over the years.
John also made significant contributions to the field of health services research most notably reflected in his groundbreaking 1986 book on Doctors’ Decisions and the Cost of Medical Care. Drawing from many streams of research including the clinical decision sciences, innovation theory, and adult learning, this book has had a pervasive impact on health services researchers and clinical practitioners alike. It provided the field with the first systematic assessment about why physicians practice as they do and what could be done to affect those practices. It laid the foundation for much of the current work on implementation of evidence-based medicine in clinical practice in order to improve quality and outcomes of care.
As an administrator, John, taking full advantage of his MBA degree, knew how to position an organization for success. He was the architect behind the turnaround of the Agency for Health Research and Quality (AHRQ) formerly the Agency for Health Services Research and Health Policy. His many talents were a perfect fit for the challenge of leading the Agency. He had the ability to identify “two-for-one” solutions. For example, selecting a research agenda that would draw on both the interests and resources of the field and the interests of politicians and Congress. He was equally comfortable talking with a researcher interested in risk adjustment as he was with an HMO executive wanting to know how risk adjustment methods could be used most effectively in health plan enrollment decisions. In similar fashion, he was adept at working both sides of the aisles of Congress in explaining the importance, for example, of a National Health Care Quality Report Card.
Above all, the collective memory that we have of John Eisenberg is that of a leader on a mission. He was interested in maximizing the impact of health services research on policy and practice and in continuous improvement. Acouple of years ago, John asked one of us how well we thought the Agency was doing. What could it do better? He said, “You know, all I ever hear around here is how well things are going. I never hear any criticism, and I need that if we are going to be better.” The nonplussed respondent felt compelled to offer some “criticism” or suggestions for improvement. John wrote them down on a notepad and responded, “You know, you are right. We can do a better job on that front.” John pushed himself as hard as he pushed others for “continuous improvement.”
Those of us associated with HSR believe that John and the Agency had a special relationship with the Journal, which went back to John's tenure as President of the then Association for Health Services Research. The Agency made many grants to the Journal for special issues; and, more recently, printing the AHRQ updates on various topics of interest to the field in the Journal. We realize, of course, that other Journals can make similar claims because John had a way of making everyone and their associated entities feel that they had a special relationship with him. The bottom line is that he will be sorely missed by all of us. John was well aware of his prognosis and chose to lead the last year of his life as head of AHRQ , continuing to carry the torch with energy, enthusiasm, and commitment. It is now time for the rest of us, in our own ways, to pick up the torch and carry it on. It is the best way for us to honor John and the inspiration that he provided to all of us.
