As a health care administrator on Cape Cod, Dr. George Rowland developed programs to manage congestive heart failure and depression, and helped create a clinic that made it easier for Brazilian immigrants to get medical treatment.
“He was someone who was honestly and deeply committed to health equity, and everything he did as a public health professional was for the purpose of making sure everyone had equal access to health services,” said Lissette Blondet, who had worked with Dr. Rowland, who was known as Robin, at Cape Cod Healthcare.
Although some initiatives they launched weren’t big money-makers, they “were the right thing to do,” said Blondet, who is now executive director of the Massachusetts Association of Community Health Workers. Projects such as the clinic, she added, were “very visionary of Robin.”
Dr. Rowland, who was 79 when he died Jan. 2 in his Escondido, Calif., home of idiopathic pulmonary fibrosis, applied to his work on the Cape the lessons he had learned at the outset of his career in a place that was strikingly distant geographically and culturally.
After growing up in Greater Boston and attending the Yale School of Medicine, he was drafted in the mid-1960s and opted for the US Public Health Service, rather than head to Vietnam, where he would have been required to focus on combat surgery.
Instead, he served as an officer in Chinle, Ariz., assigned to the Indian Health Service on the Navajo reservation. The experience shaped his approach to medicine ever after.
“While in Chinle, I became fascinated with the challenge of taking care of more folks for less money,” he once wrote.
On the reservation, patients arrived “on wagons and horseback and trucks and all sorts of stuff,” he said in an interview not long ago with his son Christopher Rowland, an assistant managing editor at the Globe and the paper’s Washington bureau chief.
“To get people through the waiting room, we trained our Navajo nurse how to wander the waiting room and identify people who had relatively minor illnesses,” Dr. Rowland recalled, “and she would do a quick assessment, and we would treat them under protocol, and it meant we would see a lot more patients.”
Long before managed care was a dominant theme, Dr. Rowland taught himself and his colleagues to make the best of scant resources while managing the care of people who wouldn’t have access to physicians and nurses otherwise — usually seeing about 70 patients daily.
An innovative physician, Dr. Rowland used punch cards to monitor chronic diseases.
“Holes would be punched out for everybody who had thyroid disease, for instance, and was due for a follow-up of some kind, and we would send community health workers out to find them,” he said, adding that his patient referral relationships included a couple of Navajo medicine men. “It was eye-opening. I got into cross-cultural medicine out there.”
By contrast, his upbringing had been decidedly New England. George Briggs Rowland grew up on the Pine Lodge estate in Methuen, until his family sold it in 1957 to the Sisters of the Presentation of Mary. Dr. Rowland’s grandmother was a cousin and heir to interior decorator and architect Edward Francis Searles, who had transformed his childhood home into the estate in the late 1800s.
The middle of five children, Dr. Rowland was a son of Benjamin Allen Rowland, who revitalized old mill buildings in Lawrence, and Sara Briggs Bolton.
“He had a really big heart. He was very kind and gentle,” said Dr. Rowland’s sister, M.A. Swedlund of Deerfield. “Growing up, he taught me how to ride horses, and he taught me how to shoot .22s. There’s not a lot of brothers who are seven years older who take good care of you, teaching you stuff.”
Dr. Rowland graduated from the Brooks School in North Andover, Yale University, and the Yale School of Medicine. His public health experience on the Navajo reservation was career-changing, leading him away from clinical care and toward serving as a health care consultant and administrator as he worked to eliminate inefficiencies.
“I never saw it as forsaking anything,” he later said of setting aside private practice. “I figured as a physician I wasn’t going to starve.”
Leaving the Indian Health Service, he was based in Arizona, working for the US Centers for Disease Control and during that time, received a master’s in public health in epidemiology from Yale. He later was a health care administrator in Maricopa County, Ariz., and San Luis Obispo County, Calif., before starting a consulting firm and relocating to Cape Cod. From 1999 to 2006, Dr. Rowland worked for Cape Cod Healthcare as director of community health, quality, and practice management. Since 2007, he ran the firm Rowland Associates and returned to California several years ago.
“He really liked to rethink stale thinking,” his son Chris said. “When he found hidebound thinking or people stuck in the rut of doing things the old way, he relished mixing things up and showing people how they could be more efficient. He was always looking for efficiency and simplicity.”
Dr. Rowland’s marriage to Susan Scott Rowland, with whom he had two children, ended in divorce, as did his marriage to Elaine Cantrell Petrosino, with whom he also had two children.
In 1987, he married Marie Cassidy Noel, a health care professional.
A musician since childhood, Dr. Rowland sang in choirs and a cappella groups, and was fond of folk music duets with his brother Dan of Lexington, Ky., with whom he recorded a CD a couple of years ago.
“We sang together from when I was 6 years old and he was 9,” Dan recalled. “We started when neither of our voices had changed and did it until Robin said we couldn’t do it anymore.”
An avid sailor, Dr. Rowland competed in Newport-to-Bermuda races and in 2002 joined a four-man crew his Cape Cod colleague Dr. David Penfield put together to sail from South Africa to the Caribbean — which took 28 days, seven hours, and 41 minutes, Penfield said.
“He was gregarious, well-accepted, and soft-spoken — just a real genteel, appropriate guy,” said Penfield, who added that Dr. Rowland “was a community-oriented physician ahead of his time.”
A service has been held for Dr. Rowland, who in addition to his wife, son, sister, and brother leaves a daughter, Alix of Durango, Colo.; two other sons, Ryan of Phoenix and Sean of Oceanside, Calif.; two other brothers, Edward of Hamilton and Benjamin of Marblehead; a half-brother, Rodney of New Castle, N.H.; and five granddaughters.
Knowing his illness was terminal, Dr. Rowland analyzed his own health care prospects, medically and emotionally.
“He dealt with it in a very determined way,” his brother Dan said. “He prepared us all.”
With his family and with medical students who, as part of their training, visited him while he was in hospice care, Dr. Rowland shared his detailed plans for when his life would end. Last month, he wrote: “A good death is a death well-planned, with wishes of the dying fulfilled, without too many surprises, with healing of past wounds, and with family and friends surrounding one with love at the time of death.”Bryan Marquard can be reached at firstname.lastname@example.org.