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Stead, Medical Visionary, Dead at 96

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Duke Health News 919-660-1306

DURHAM, N.C. -- Eugene Anson Stead, Jr., M.D., hailed as a
visionary for his innovations in cardiology, medical education
and health care delivery, died on June 12, 2005, in Bullock,
N.C., at the age of 96. Stead served as the chairman of the
Department of Medicine at Duke University Medical Center from
1947 to 1967.

According to his Duke colleagues, no single individual had
more impact on how medicine was taught and practiced in the
mid-20th century America than Stead. His pioneering studies in
the 1940s with cardiac catheterization formed the basis for
much of what is now used in the treatment of heart failure. At
Emory University Medical Center and at Duke, his research teams
described the physiologic basis of shock and congestive heart
failure.

Stead's most celebrated accomplishment was the creation of
the Physician Assistant profession, established at Duke in 1967
to supplement the shortage of physicians and nurses and to
provide returning Vietnam medical corpsmen with a venue for
their newly acquired paramedical skills. Today there are more
than 38,000 physician assistants whose skills, notably in
primary care, provide invaluable support to physicians across
the nation.

Throughout his endeavors, Stead earned national acclaim for
what colleagues termed his remarkable intuition and
common-sense approach to all aspects of health care, from
administering departments to teaching students to the improving
the doctor-patient relationship.

"His ability to get to the heart of the matter and to do it
unerringly; his ability to get us, his underlings, to do more
than we thought capable; his excitement and curiosity about the
world of the patient; his great loyalty to those who were
willing to join him in the venture made him one of a kind,"
said Francis Neelon, M.D., associate professor emeritus of
general internal medicine at Duke.

Dozens of former students and colleagues have written essays
or book chapters interspersed with anecdotes describing his
remarkable talents for inspiring students and caregivers and
for devising novel solutions to persistent problems. A former
Duke chairman of medicine, Barton F. Haynes, M.D., described
Stead as an extraordinary visionary whose ideas changed the
face of medicine.

"It is remarkable how many trends, events, and medical
advances Gene Stead has anticipated and predicted over the
years: computer databases in medicine, evidence-based medicine,
modern medical school curricula, the effects of managed care on
academic health center research and teaching, the nursing
shortage, the success of the physician assistant's program, and
the importance of genetics and genetic screening in preventive
medicine," said Haynes.

Stead translated his vision into action by putting into
practice a wide range of his ideas, said Haynes. He was one of
the first to see the potential for computers to change the
practice of medicine. Toward that end, he coached the team that
developed the Duke Cardiovascular Disease Research Databank, a
successful experiment using the computer to tie clinical
outcomes of individual patients to their initial findings and
use this process to determine the best treatments for new
patients.

Today, its outgrowth -- Duke Clinical Research Institute
(DCRI) -- is among the largest academic clinical research
organizations in the world, containing clinical data on more
than 250,000 patients. Studies generated by this repository of
information have changed the way cardiovascular medicine is
practiced today, said Robert Califf, M.D., a Stead protégé. The
DCRI is now led by Califf and has grown into an international
force in cardiology as well as minority health, neurobiology
and other disciplines.

In addition to his innovations as a clinician and
researcher, Stead was widely recognized as an outstanding
medical educator. He attracted students from many other
universities who then went on to leading posts in other
schools. Thirty-three Stead trainees became chairs of
departments of medicine.

Secondly, he changed the structure of medical education
itself by spearheading the 1966 revision of the Duke Medical
School curriculum that cut in half the required basic sciences
and thereby provided room for a full year of research without
extending the overall duration of time spent as a student. This
change reflected his belief that most facts need not be
memorized because they are quickly forgotten. Instead he argued
that students need to learn how to learn what they need when
they need it.

Indeed, his belief in the average citizen prompted him to
conceptualize the physician assistant profession. Stead was not
particularly concerned with formal education, nor about what
type of certificate would be conferred at graduation, according
to Justine Strand, current chief of the Physician Assistant
Division at Duke. In an article about the physician assistant
profession and its history, Strand quoted Stead as saying he
believed "…a person with a high school education, a reasonable
rate of learning, and a tolerance of the unavoidably irrational
demands often made by sick people can learn to do well those
things a doctor does each day."

The PA profession itself is a reflection of Stead's belief
that it is possible to meet many patient needs without all the
time and cost overhead of a traditional medical education.

Stead was born in Atlanta in 1908 as one of six children to
Eugene Anson and Emily White Stead. He received his B.S. and
M.D. degrees from Emory University and completed internship and
residencies in internal medicine and surgery at the Peter Bent
Brigham Hospital in Boston, Cincinnati General Hospital and
Boston City Hospital.

After serving on the faculty of Harvard University under the
tutelage of Soma Weiss, he returned to Emory as chairman of the
Department of Medicine (1942-46) and dean of the School of
Medicine (1945-46). In 1947 he came to Duke as chairman of
medicine. He served in that capacity until 1967, when he
stepped down to spend the next 24 years helping younger faculty
start innovative programs. Thereafter, faculty and medical
students often went to Kerr Lake to visit him and seek his
wisdom on matters medical and non-medical.

Stead served as president of the American Society for
Clinical Investigation and the Association of American
Physicians. He was a founding member of the Institute of
Medicine of the National Academies. He was editor-in-chief of
Medical Times, Circulation, and the North Carolina Medical
Journal. He received many awards including the American College
of Physicians Distinguished Teacher Award, The Association of
American Medical Colleges' Abraham Flexner Award for
Distinguished Service to Medical Education, the Kober Medal
from the Association of American Physicians, Durham North
Carolinas' City of Medicine Award and the William G Anlyan,
M.D. Lifetime Achievement Award from Duke.

Stead and his late wife Evelyn raised three children. He
protected time for the family from his busy professional life.
He turned building the house at Kerr Lake into a family project
that took 25 years of weekends and summer vacations. He is
survived by son and daughter-in-law, William Wallace and Janet
Stead, daughters and sons-in-laws, Nancy and Alan Atwood, and
Lucy and Curt Barnhill; three grandchildren, Elizabeth Stead,
Christina Auch and family, and Patrick LaVarre and family.

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