Acting as a conscience on behalf of the youngest and poorest, Dr. Joel J. Alpert told the American Academy of Pediatrics in 1999 that the lack of health care for the country’s most vulnerable citizens was nothing short of an embarrassment.
“I find it unconscionable that we are the only nation in the developed world that fails to provide health insurance for all of its children,” he said at an organization meeting when he was the outgoing president.
Inspired to become a pediatrician by a stint as a summer camp counselor for deaf children, and guided by his mother’s work helping the underprivileged, he spent his career promoting the expansion of health care coverage, and he also coauthored a key monograph in the early 1970s that set forth enduring criteria for primary care physicians.
“I think it defined four or five important characteristics of primary care,” said Dr. Howard Bauchner, editor in chief of the Journal of the American Medical Association. “That definition has stood the test of time for 40 years and has become one of the centerpieces of health care reform.”
Dr. Alpert, chairman emeritus of pediatrics at the Boston University School of Medicine and a former assistant dean of student affairs, died of leukemia at sundown New Year’s Eve in hospice care not far from his Palm Beach Gardens, Fla., home. He was 83 and also had residences in Wayland and in East Parsonsfield, Maine.
“Joel was a tireless advocate for our nation’s children. He believed deeply in providing children with health insurance,” said Dr. Robert J. Vinci, the Joel and Barbara Alpert professor of pediatrics at the BU School of Medicine. “It was an important priority in his career and in many ways he preceded what we’re now doing with health insurance nationally.”
Dr. James Perrin, former director of the division of general pediatrics at Massachusetts General Hospital, said that Dr. Alpert “was a remarkable leader in many areas,” having been a leader of several medical organizations.
“Within the academy he’s always been one of the most forceful and effective spokespersons for making sure we have every child in this country insured,” said Perrin, the current president of the American Academy of Pediatrics.
In an oral history interview conducted in November by Dr. Ed Keenan, Dr. Alpert said he thought that “one of the things about pediatricians is the overwhelming majority of us who went into pediatrics are first of all nice.”
Dr. Alpert was not averse to being somewhat less than nice, however, when it came to policies and behavior that affected the health of children or the public in general.
As director of the pediatric service at what was then Boston City Hospital, “he campaigned aggressively around issues of lead poisoning, and he campaigned aggressively against smoking in and around the hospital,” said Bauchner, who considered Dr. Alpert a key mentor. “It was not a pleasant encounter if he found you smoking. He really felt doctors should lead the way and not smoke.”
In the oral history, Dr. Alpert also called standard childhood immunizations “the great triumph” of the 20th century, and he criticized celebrities who try to dissuade parents from letting their children get them: “Isn’t it tragic that today seemingly well informed but really ignorant people critique immunization when they have no idea of the horrible specter of polio or measles?”
Born in New Haven, the older of two children, Dr. Alpert went to public schools and called editing the Hillhouse Sentinel, his nationally recognized high school student newspaper, “my crowning achievement.”
His father, who was born in Russia, had a solo accounting practice. His mother was “an activist,” he said in the oral history. “A lot of my political views and social values came from my mother, who dedicated herself to helping the underprivileged.”
In a 1998 interview with the American Academy of Pediatrics news magazine, he called his parents “philanthropists of time. We were not a wealthy family, but my parents gave generously of their time.”
Dr. Alpert went to Yale University, where he took a minimum number of science courses and concentrated instead on American literature, economics, and sociology.
He graduated from Yale in 1952 and from Harvard Medical School in 1956. The following year, he married Barbara Wasserstrom, whom he met on a blind date. In the academy news magazine interview, he said his wife was “called “Saint Barbara” in the BU pediatrics department, and added that his career success would not have been possible without her support.
In 1958, after a residency at Boston Children’s Hospital, Dr. Alpert and his wife moved to London, where he was an exchange registrar.
“The value system was totally different,” he recalled in November. “The value system appeared to be the importance of listening to the patient, of a careful physical exam.” He added that experience made him realize he needed to pursue “a patient-oriented career.”
After two years as an Army physician in Kansas, he returned to Boston as a physician and teacher, first at Harvard Medical School, and then at BU.
As he weighed leaving Harvard for leadership positions at Boston City Hospital and BU’s School of Medicine, he listened to advice from a mentor, Dr. Charles Janeway. In the American Academy of Pediatrics interview, he recalled Janeway’s advice: “At Harvard, you will teach the people who teach. At Boston University, you will teach the people who do.”
In 1978, Dr. Alpert was elected to the Institute of Medicine. Twenty years later, the Pew Foundation honored his coauthorship, with Dr. Evan Charney, of “The Education of Physicians for Primary Care.” An advocate of gun control, he was so pleased to be placed on the National Rifle Association’s enemies list that he noted his inclusion as the most recent final dated entry on his curriculum vitae.
“I think that one of the things that has helped me cope, succeed through all these years at whatever, is the ability to laugh, to have a sense of humor. Even in the most trying of circumstances,” he said in the oral history interview.
In addition to his wife, Dr. Alpert leaves two sons, Norm of Purchase, N.Y., and Mark of Canton; a daughter, Deb Alpert Levin of Wellesley; a sister, Edith Alpert Slossberg of Hamden, Conn.; and eight grandchildren.
A memorial service will be held at 10 a.m. Monday in Temple Isaiah in Lexington. Burial will follow in Westview Cemetery in Lexington.
Dr. Alpert initially was diagnosed with myelodysplastic syndrome, which in October converted to acute myeloid leukemia.
“He was very realistic and clinical about his prognosis and often commented to me about a recent article in the New York Times entitled ‘How Doctors Die,’ ” his son Norm wrote in notes for a eulogy. “No question this was another teachable moment for all of us, as well as a very easy way for him to make his wishes clear.”
Rather than opt for the most aggressive treatment that would lower his quality of life, Dr. Alpert chose a middle-of-the-road course, and in the oral history, he spoke with distaste of how end-of-life planning is “characterized by certain people on the far right as death panels.”
Instead, drawn by the healing power of optimism, he even bought nonrefundable plane tickets to London — for September.
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