Alvin Tarlov, ‘visionary leader’ in academic general medicine, 1929-2023

Alvin R. Tarlov, MD, who played a key role in the evolution of academic medicine by establishing one of the first sections of general internal medicine, died May 27 in White Plains, New York. He was 93.

A longtime chair of the University of Chicago’s Department of Medicine, Tarlov helped spearhead a shift in thinking that would reverberate across the United States. In the late 1960s, he advanced the idea that patients needed to be viewed as whole individuals, not merely the parts of the body that weren’t working correctly.

During that time, most U.S. physicians had been focused on subspecialization — fields such as cardiology or pulmonology. While subspecialization meant doctors developed expert knowledge in specific areas, Tarlov realized many patients arrived at their doctor’s office with multiple illnesses and that patients receiving sophisticated specialty care developed health problems unrelated to their original illness.

Tarlov believed establishment of a section of general internal medicine would strengthen subspecialties, giving trainees the breadth and depth needed to provide care involving multiple symptoms and conditions. Under his leadership, in 1973, UChicago established one of the first such academic sections in the country.

During an interview last year from his winter home in Tucson, Arizona, he recalled the need that many patients felt to connect with their doctors, and the critical importance listening to them played.

“Patients would talk to us about life and what bothered them about their living circumstances," said Tarlov. "They wanted to talk to you.”

Tarlov was born July 11, 1929, in Norwalk, Connecticut. At 7 years old, he began working in his father's restaurant, peeling vegetables. His uncle, neurosurgeon Isadore Tarlov, greatly influenced Alvin with his time spent helping migrant workers in Coney Island, New York.

He attended New York Medical College and the University of Chicago School of Medicine for medical school and completed his internal medicine residency at Philadelphia General Hospital. As a young doctor, he studied rehabilitation and recidivism after being assigned in the 1960 doctor’s draft to help with a malaria drug trial at an Illinois prison.

Impact at UChicago

In 1962, Tarlov was hired as an assistant professor of medicine at the University of Chicago. He was appointed chair of the Department of Medicine in 1969 and served in the position until 1981.

In 1969, a committee created by Tarlov to study medical training recommended residents receive “intensive, comprehensive training in general medicine as an optimal basis for advanced training, whether in a subspecialty or general internal medicine.” Four years later, UChicago established a Section of General Internal Medicine that included services for inpatients, outpatients and consultations.

“I had the opportunity to meet Al a couple times, and he was always very kind, supportive and proud of the continuity of the academic general medicine unit and the things we've accomplished,” said Deborah Burnet, MD, Professor of Medicine and Chief of the Section of General Internal Medicine. “He was a big champion for general medicine.”

At UChicago, Tarlov hired a team of up-and-coming physicians, including Mark Siegler, MD. Now the Lindy Bergman Distinguished Service Professor of Medicine and Surgery, Siegler is also the founding director of the MacLean Center for Clinical Medical Ethics and the executive director of the Bucksbaum Institute for Clinical Excellence.

Siegler recounted the day in 1972 when Tarlov called him in to assign several responsibilities. Some were expected, such as supervising new inpatient and outpatient services, while others were a little surprising.

“He said, ‘Break down some of the walls in the individual patient rooms and set up a medical intensive care unit; I’ll count on you to attend 12 months of the year,'" recalled Siegler. "I said, ‘What’s an intensive care unit?’”

Soon, other institutions were bolstering their general internal medicine programs as well.

Thanks in part to Tarlov's vision, UChicago Medicine’s Section of General Internal Medicine is home to nationally recognized physicians in ethics, medical education, clinical care and healthcare disparities and outcomes research, as well as several multidisciplinary academic programs.

'A Visionary Leader'

“Alvin Tarlov was a visionary leader who realized the importance of general medicine in an academic setting," said Everett Vokes, MD, Chair of the Department of Medicine. "Through his significant leadership of over a decade as chair of the Department of Medicine, he transformed general medicine and the care and treatment of our patients. His innovative thinking influenced institutions across the country and continues shaping the future generation of physicians.”

Tarlov was also a faculty member of the University of Chicago’s Committee on Social Thought and enjoyed spending time with the interdisciplinary PhD-granting program's distinguished scholars and writers.

Dr. Tarlov later went on to become chair of the Department of Health and Human Services’ Graduate Medical Education National Advisory Committee, president of the Henry J. Kaiser Family Foundation, and then executive director of The Health Institute at the New England Medical Center (now Tufts Medical Center). He also served as a professor at the Harvard School of Public Health and Tufts University School of Medicine, as well as senior fellow in health policy at the Baker Institute for Public Policy.

"Dr. Tarlov was among the most influential physician-scholars in U.S. health care and health policy in the 20th and 21st centuries," said Dana Gelb Safran, who succeeded Tarlov as executive director of The Health Institute and is now president and CEO of the National Quality Forum.

He is survived by his wife Janet Belkin, children Richard Tarlov (Janet), Elizabeth Tarlov (George Ofman) and Jane Bowers (Jonathan), stepchildren Lisa Belkin, Gary Belkin and Kira Belkin, and numerous grandchildren, step-grandchildren and one step-great-grandchild. He is predeceased by his daughter Suzanne Tarlov and son David Tarlov.

His body was laid to rest on May 30 in the Independent Hebrew Cemetery in Norwalk. Gifts in his memory can be sent to the Medical Consortium on Climate and Health.