The Institute of Medicine today presented the 2013 Gustav O. Lienhard Award to Steven A. Schroeder, whose pioneering efforts to control tobacco use have helped save millions from premature, smoking-related deaths. The award also recognizes Schroeder's leadership in general medicine as well as his work to improve end-of-life care.
"It is my great privilege to present this award to a dedicated champion of health for Americans and citizens around the world," said IOM President Harvey V. Fineberg. "Dr. Schroeder's perseverance in funding tobacco research and creating breakthrough strategies to help smokers quit facilitated a shift in public attitudes toward smoking and shaped policies to prevent smoking."
As president of the Robert Wood Johnson Foundation (RWJF) from 1990 to 2002, Schroeder established and led programs to reduce smoking, enhance end-of-life care, expand health insurance for children, and encourage physical activity. His most influential initiative at RWJF focused on leveraging research, policy, advocacy, and education to reduce tobacco use and drive systemwide changes that created higher tobacco taxes, smoke-free indoor air laws, and better access to addiction treatment. RWJF tobacco research was cited in the formulation of and advocacy for such policy adoption. The impact of anti-smoking campaigns by RWJF and its partners was profound. Smoking rates among adults declined from 25.5 percent in 1993 to 18 percent in 2011, meaning that 5.3 million fewer people were smoking and more than 60,000 smoking-related deaths had been avoided by 2010.
At RWJF, Schroeder also funded the Dartmouth Atlas of Health Care, which was influential in documenting large regional variations in medical services that do not correlate to desired health care outcomes. In addition, he initiated a national program to enroll eligible children for health insurance following the passage of State Children's Health Insurance Program legislation. The program has been credited as an important reason why the number of uninsured children reached a modern low from 2000 to 2005. Furthermore, after negative results from a controlled trial to improve care for seriously ill hospital patients, known as the SUPPORT study, Schroeder instituted a series of national programs to improve such care at hospitals. Bringing together physicians, nurses, palliative care experts, clergy, and patients, the initiative attempted to minimize legal barriers to prescribing pain medications at the end of life, expand hospice and hospital-based palliative care, energize patient groups, and work with hospital chaplains. As a result, more than 500 hospitals have received training in palliative care and many have instituted their own programs.
Upon leaving RWJF and returning in 2003 to the University of California, San Francisco -- he was originally on the faculty from 1976 to 1990 -- Schroeder continued his dedication to curbing tobacco use by founding the Smoking Cessation Leadership Center. Under his direction, the center aims to increase the cessation rate of smokers and the number of clinicians who help smokers quit by creating partnerships to develop and implement action plans. By working with leaders at more than 80 health organizations nationwide, the center has expanded the types of groups that support smokers' attempts to quit, such as dental hygienists, pharmacists, emergency physicians, and nurses; created new ways to market toll-free telephone quit lines; and engaged the mental health community in treating tobacco addiction.
Schroeder has also been devoted to all aspects of health care delivery, including the training of health professionals, the equitable distribution of care, economics, and legislative barriers. He was one of the first physicians to describe variability in the physicians' use of costly medical services to demonstrate the pro-technology biases associated with fee-for-service medical payment and to illustrate the failure of voluntary approaches to containing the costs of hospital care. At UCSF, he founded the division of general internal medicine and conducted research and training programs of national significance, and at George Washington University, he was the founding medical director of a university-sponsored HMO.