John C. Beck: 1924-2016
an extraordinary man beloved of many, died in Perth, Australia on September 29, 2016 at the age of 92.
John C. Beck: An Extraordinary Life
Dr. John C. Beck, an Emeritus Professor of Medicine at the David Geffen School of Medicine, University of California, Los Angeles, died in Perth, Australia on September 29, 2016. The cause was a pulmonary embolism. Dr. Beck is survived by the wife he adored, Arlene Fink; a son, Philip Beck; a sister, Ellen McLean; and his beloved golden retriever, Ingvard.
Dr. Beck was a distinguished academic who contributed enormously to the development of medical institutions in Canada, the USA, Israel, and countries in Africa and Southeast Asia. The international reputation of the Royal Victoria Hospital and McGill University in Montreal, Canada; University of California, Los Angeles, School of Medicine, USA; and Ben-Gurion University of the Negev, Israel, are in part a reflection of his vision and leadership.
Dr. Beck's contributions have affected many aspects of medicine. In fact, independent observers of his professional activities have concluded that he has had five interconnected yet distinct careers. This followed from his conviction of establishing a clear vision of his objectives and evaluating these at five-year intervals. He believed strongly that if these objectives were not met in two five-year periods, it was time to move on. He also continually sought the excitement of new intellectual challenges.
Born in Audubon, Iowa in 1924, Dr. Beck received his BSc. MSc., Diploma in Medicine, and M.D.C.M. degrees at McGill University in Montreal, Canada, winning the coveted Holmes Gold Medal for the most outstanding performance in his class upon graduating from the Faculty of Medicine. He served in the Canadian armed forces during World War II, rising from a private to a commissioned officer and company commander during this time.
Following graduation, he pursued clinical and research training at the Royal Victoria Hospital in Montreal, the Cleveland Clinic, Tufts New England Medical Center in Boston, Rilgshospatalet (University Hospital) and the Carlsberg Institute in Copenhagen, and University College Hospital Medical School in London, where he received his first academic appointment as a lecturer in pharmacology. This background led to his pioneering work in basic and clinical endocrine research on the pituitary and adrenal glands, the hormonal changes in pregnancy, the gastrointestinal hormones influencing pancreatic endocrine function, and the hormonal control of adipose tissue metabolism.
Dr. Beck's first career began in the 1950s when he became Director of the Division of Endocrinology and Metabolism at the Royal Victoria Hospital. In addition to his own productive group of close collaborators, including Drs. Eleanor Venning, Inge Dyrenfurth, David Rubenstein, and Eleanor McGarry, he attracted to the Royal Victoria Hospital and McGill University outstanding physician scientists, such as Henry Friesen, J. Maxwell McKenzie, John Dossetor, John Dirks, John Dupreé, Keith Dawson, and Barry Posner, with whom he also collaborated and mentored, and each of whom went on to outstanding careers of their own. It was a golden age for endocrinology at the Royal Victoria Hospital and McGill.
This phase of his career was enhanced by his selection as an awardee of the prestigious Markle Scholars in Medical Sciences award, one of two Canadians so honored by the Foundation of New York. It permitted five years of personal and research support to enable the development of academic leadership in North American medical schools.
Medical schools nominated candidates who were subsequently evaluated by a selection committee in a residential environment lasting three to four days. Medical schools, for their part, were required to support the young faculty member over the longer term and provide annual reports to the foundation. An annual meeting of all scholars took place which resulted in the establishment of lifelong intellectual and social connections well beyond the candidates' own special interests. This eventual group of 500 scholars played an important part in what has been termed the golden era in academic medicine. Their contributions included some of the earliest descriptions of the physiological, biochemical, and clinical effects of the newly discovered ACTH and cortisone in the human, including descriptions of its beneficial effects in beryllium granulomatosis and acute phosphorus poisoning; the isolation and bioassay methodology for the sodium retaining hormone of the adrenal gland (subsequently identified as Aldosterone); ascertaining the role of Aldosterone in hypertension and the regulatory mechanisms for Aldosterone in the human. In addition, in conjunction with Maurice Raben from the Tufts New England Medical Center and Dr. Ernst Knobil of the University of Pittsburgh, he wrote the first report of the metabolic effects of human and monkey growth hormone in man (Science, 1957), thus elucidating the species specificity of growth hormone in the human, and setting the stage for the development of a treatment for growth hormone deficient short stature (pituitary dwarfism) in children, as well as the development of assay methods for the measurement of growth hormone in biological fluids.
This research could not have been accomplished without several enabling factors that Dr. Beck pioneered. The first was the creation of a special inpatient facility to perform research in humans (named the Endocrine Metabolic Unit at the Royal Victoria Hospital). Its counterpart in the USA was Ward 44 at the Massachusetts General Hospital, pioneered by Dr. Fuller Albright. These two facilities became the template for the Clinical Research Centers founded by the National Institutes of Health and found in most Academic Medical Centers today. The second enabling factor was the creation of a Canadian National Pituitary Agency, followed quickly by the U.S. National Pituitary Agency for the collection of post-mortem human pituitaries and their subsequent extraction for the isolation and purification of human pituitary hormones to be used for research and clinical purposes. This remained the only source of growth hormone for the treatment of short stature due to growth hormone deficiency until the development of the biotechnology industry.
Dr. Beck's second career began in 1964, when he was appointed Physician-in-chief at the Royal Victoria Hospital and Chairman of the Department of Medicine at McGill University. Much of his energy at this time turned to undergraduate medical education, residency and fellowship training and advanced training for physicians, primarily destined for academic and leadership roles in Canada, the USA, and Commonwealth countries, particularly Australia, Kenya, and Singapore. He was instrumental in bringing about major changes at all levels of the educational curriculum through his membership on the council of the Royal College of Physicians and Surgeons of Canada; the American Board of Internal Medicine, where he served as Chairman from 1971-73; the American Board of Medical Specialties, where he was a member of the executive committee, Vice President and President, the latter from 1976-78 (the first internist to play this role); the Liaison Committee on Specialty Boards; and the Coordinating Council on Medical Education. It was during this time that fragmentation of the internal medicine sub-specialties was avoided, the family practice community was granted specialty recognition by the ABMS, and the Liaison Committees for Graduate Medical Education and Continuing Medical Education were established. These latter groups were organized in part to become the accreditation agencies for graduate and continuing medical education in the USA. He strongly supported the efforts by the newly established Specialty Board of Family Medicine to establish the concept of recertification, now accepted as an important element of Continual Professional Development (CPD).
As Physician-in-chief, Dr. Beck assumed the role of a generalist rather than a sub-specialist endocrinologist. It was during this time that he and four other departmental chairmen at Johns Hopkins, Duke, Case Western Reserve, and Stanford Universities became cognizant that many outstanding medical students and house officers no longer wished to pursue traditional biomedical research and expressed interest in health policy, health systems, quality of care, and social and economic determinants of health, a field now best known as Health Services Research. These departmental chairmen conceived of an advanced training program for physicians to develop doctoral level skills in the social and behavioral sciences, which became known as the Clinical Scholars Program. The pilot program was funded jointly by the Carnegie Corporation of New York and the Commonwealth Fund. Most observers of the day doubted the feasibility and need for the program, and only when its first graduates took leadership roles in medicine did this expansion of post-residency training become acceptable in academic circles and in the halls of government and industry.
In addition, Dr. Beck's international ties were strengthened through his advisory role to former British colonies as they became independent and wished to develop their own Academic Medical Centers (Jamaica, Malaysia, Singapore, Uganda, and Kenya). In Kenya, the McGill Department of Medicine played a major role in the formation of the University of Nairobi's Faculty of Medicine, and the McGill departments involved in this effort had many faculties in Nairobi on leave from their home departments for one- to two-year tours of duty.
Dr. Beck, together with four other international endocrinologists (from the U.K. and Europe), was instrumental in organizing the first International Congress of Endocrinology in Copenhagen in 1960. At that time, it became apparent that supportive aid to the development of endocrinology internationally was a major challenge for the field of endocrinology and metabolism. This was particularly true for former iron curtain countries. This emerging need led to the formation of the International Society of Endocrinology in 1964, with Dr. Beck elected as Secretary-General, a role he played until 1976. During that time, he was responsible for the organization of four international congresses of endocrinology, the development of a sister organization, the International Society of Neuroendocrinology, and the training of innumerable graduate students in the field, primarily in U.K. and North American laboratories. During these years a number of important achievements occurred: incorporation of the ISE by the government of Canada as an international organization; major support for the issuing of visas by the U.K., Canada and the U.S.A. to endocrinologists, particularly from Eastern Europe and Asia, fostering better communications across national boundaries; the establishment of a Trust Fund which forward funded international congresses; formal recognition of the ISE by the WHO as an NGO; ISE statements (1) facilitating the use of radioisotopes by endocrinologists in their basic and clinical research, (2) encouraging the creation of international measurement standards in endocrinology, (3) concerning persecution of endocrinologists in some nations and (4) establishing ISE sponsored Awards. The ISE Secretariat also facilitated the incorporation of meetings of national endocrine societies into the ISE sponsored congresses. During this period Dr. Beck also served on the board of the Laurentian Hormone Conference (similar to the Gordon Research Conferences), which sponsored the annual week-long Laurentian Hormone Conference and published the annual Recent Progress in Hormone Research, the most influential publication in the field of endocrinology at that time.
During this decade, Dr. Beck was able to maintain his laboratory group, and its major interests and contributions to the field of endocrinology and metabolism were in four areas:
1) The role of intestinal hormonal factors (secretagogues) and amino acids in the regulation of insulin and glucagon secretion;
2) In-vitro studies of the hormonal effects on the metabolism of lipids and amino acids in adipose tissue, muscle, and lung;
3) Radioimmunoassay methods of pituitary hormones, particularly growth hormone in animals and humans; and
4) Localization of the secretion, storage, and release of pituitary hormones using fluorescent labeled antibody techniques mainly pioneered by the group.
In these two career roles, 1954-1974, Dr. Beck and his laboratory colleagues were responsible for the research training of 70 graduate students, primarily physicians, with a substantial number of PhDs, many of whom subsequently took leadership roles in Academic Medical Centers (AMCs) in Canada, Australia and the U.S.A.
Dr. Beck's third career began its formulation during his tenure as departmental chairman at McGill and his role as Physician-in-chief in the Department of Medicine at the Royal Victoria Hospital in Montreal. At this time, he became concerned about the fragmentation of medicine, the social responsibility of the various professional organizations, the role of primary care in the delivery of health services, health and social care of the elderly, physician and other health professional workforce issues and the training of non-bench physician scientists. In view of his leadership in the pilot Clinical Scholars Program sponsored by the Carnegie Corporation and the Commonwealth Fund of New York, an opportunity presented itself when the emerging Robert Wood Johnson Foundation decided to support an ongoing national Clinical Scholars Program. Dr. Beck was appointed the first national director of this program and served as a senior consultant to the Robert Wood Johnson Foundation during its transition from a local foundation to a national one. This leadership role (1974-79) also gave him the opportunity of experiencing the foundation world. During this time, Dr. Beck was appointed as professor of medicine at the University of California, San Francisco and to the attending staff of the Department of Medicine at the Moffett Hospital in San Francisco.
The Clinical Scholars Program became one of the Foundation's flagship programs and is one of the most prestigious fellowships awarded to physicians in the USA. Clinical Scholars continue to conduct innovative research under supervision of faculty from a selected group of Academic Medical Centers. The research involves practitioners, professional organizations, communities, and policy makers often leading to changes in the health care system. The alumni scholars, as of 2011, numbered over 1,100 and include leaders at academic, state, and national levels, including a former Surgeon General, the recent head of the Agency for Healthcare Research and Quality (AHRQ), an assistant secretary in the Department of Health and Human Services, the head of RAND-Health, and the president of the Robert Wood Johnson Foundation.
This role also gave him the opportunity to pursue many of the concerns that he had identified as a Department of Medicine chairman. Dr. Beck played a major role in the slowing of the fragmentation which was taking place within internal medicine and the other medical specialties through his Board membership and eventual chairmanship of the American Board of Internal Medicine and his service as a Board member of the American Board of Medical Specialties, eventually becoming the first internist to become president of that organization. The creation of areas of Special Competence within these emerging areas under the umbrella of the already established specialty boards persists. Dr. Beck was the major proponent and supporter of the creation of the American Board of Family Practice and used its decision to mandate a recertification process as a template for the discussion and eventual development of Maintenance of Certification programs by the other specialty boards.
Dr. Beck's strong conviction that professional organizations had a major societal responsibility in ensuring high quality of post-graduate training, continuing medical education, and certification contributed to the development of the Liaison Committee for Graduate Medical Education (now, the Accreditation Council on Graduate Medical Education), the Liaison Committee on Continuing Medical Education (now, the Accreditation Council on Continuing Medical Education), and the Coordinating Council on Medical Education. These organizations initiated studies on workforce issues in the health professions, primarily physicians, physician's assistants, and nurse practitioners.
Dr. Beck's interest and support for primary care were put to a practical test when he was asked to join in the creation of a new medical school in Israel by Professor Moshe Prywes, President of the newly founded Ben-Gurion University of Negev. This new Faculty of Health Sciences' major objective was to provide a new kind of generalist physician in an environment which integrated the university, hospitals, and community care systems into an integrated whole.
Dr. Beck's leadership role in the National Robert Wood Johnson Clinical Scholars Program compelled him to acquire knowledge and skills in Health Services Research and Health Policy through coursework at the University of California, Berkeley, as a founding faculty member of the University of California–San Francisco, Center for Health Policy (now, the Phillip H. Lee Center for Health Policy) and through a sabbatical leave at the RAND Corporation in Santa Monica, California. During this time, he co-edited a book with Phillip Lee, L. Leroy, J. Stalcup: Primary Care in a Specialized World. During this period, he also served as Vice President (1974-76), President (1976-78), and Past President (1978-1980) of the American Board of Medical Specialties, the Liaison Committee of Specialty Boards (1974-78), and the LCGME and LCCME (1974-78). He became a member of the Board of the Governors of Ben-Gurion University of the Negev in Israel in 1975, and Chairman of the Committee on Academic Programs in the university in 1976. In that year, he was made Chairman of the Visiting Faculty for the newly formed Faculty of Health Sciences, which brought distinguished faculty from the Western world (primarily the USA) to Beer Sheva to supplement the fledgling faculty onsite. In 1985-86, he co-chaired the first total review and evaluation of all academic units and their faculty at Ben-Gurion University, which was also the first to be done in Israel of Israeli universities. It resulted in a major reorganization within the university system.
Dr. Beck's fourth career encompasses the years 1979-1993. During that period, Dr. Beck relocated to Los Angeles because of his loving partnership with Arlene Fink, a Professor of Medicine and Public Health at UCLA. He and Arlene built an extraordinary life of work, charity and travel. Their home in Pacific Palisades, which overlooks the Pacific Ocean and the Santa Monica Mountains, was a sanctuary for both.
While in Los Angeles, Dr. Beck and his colleagues (D.H. Solomon, R.L. Kane, T. Makinodan, A. Cherkin) built one of the earliest and strongest programs in geriatric medicine in the nation. In a recent brief history of geriatrics in the USA, Morley refers to it as the West Coast school of geriatrics and rightly identifies that one of its major strengths was its integration with two Geriatric Research and Education Centers (GRECCs) at V.A. Medical Center, Sepulveda, California, and Wadsworth Medical Center (now West Los Angeles Medical Center) in the greater Los Angeles area. As of 2005, it produced the directors of geriatric programs at the University of Washington, Seattle (Abrass), Emory University, Atlanta (Ouslander), Mount Sinai, New York (Siu), Cleveland Clinic (Palmer), St. Louis University (Morley), Rush University in Chicago (Gorbien), UCLA (Reuben), and Northwestern University, Chicago (Sier). The annual UCLA Intensive Course in Geriatric Medicine was successful in spreading geriatrics education widely throughout the USA and replicated itself over the years in many USA medical centers.
In preparation for entering the emerging field of Geriatrics and Gerontology, the Robert Wood Johnson Foundation agreed to sponsor a one year sabbatical at the RAND Corporation in Santa Monica, California (1978-79), during which time responsibility for the highly successful Clinical Scholar Program would be transferred from San Francisco back to the foundation headquarters in Princeton, New Jersey. Dr. Beck was joined in the geriatrics/gerontology endeavor by David Solomon (also on sabbatical), Robert Kane, and Emmet Keeler. This working group, during the year, produced the first projections for the workforce needs (physicians, nurses, and social workers) for the USA in anticipation of the greying of America. The physician data was reported in the New England Journal of Medicine in 1980 (The Future Need of Geriatric Manpower in the United States). It was during this sabbatical leave that Dr. Beck was able to establish a close working relationship with Sidney Katz at Case-Western University, which led to another New England Journal of Medicine paper introducing the concept of Active Life Expectancy (NEJM, 1983). This has also come to be known as functional life expectancy or disability free life expectancy. During his sabbatical leave at RAND and at UCLA, he was made a Visiting Professor of Medicine and in 1979, invited to take on the task of creating a division of geriatric medicine by Dr. David H. Solomon, then the chairman of the department of medicine at UCLA. This division was to have a clinical care, education, and research mission.
This task was a gargantuan one for several reasons, the first being the perception that aging services in an Academic Medical Center were unnecessary and superfluous. The second was related to the overall mission, which necessitated the creation of a system of care ranging from the acute care hospital, ambulatory facilities, daycare centers, residential care facilities, nursing homes and home care as novel clinical care sites, teaching facilities, and new laboratories for research in geriatrics and gerontology. The third task was the need to develop new funding streams to accomplish the mission since it became evident early on that the University's contributions to the endeavor would be limited.
The solution of the first problem area would not have been accomplished without the strong and enduring support of David Solomon, then departmental chairman, who later agreed to join Dr. Beck as Associate Director of the Division of Geriatric Medicine. The mission would have been impossible in the absence of strong support from the Veterans' Administration, both locally and centrally, particularly the two GRECCs (Sepulveda and West Los Angeles) which were in the early phases of their establishment.
The creation of a system of care ranging from the acute care hospital to the older person's home led to the development of new institutional affiliations which had never previously been done by the university. The most important of these were the Jewish Homes for the Aged of Greater Los Angeles, a residential and nursing home site; the Freda Mohr Multipurpose Center at the Jewish Family Service as an ambulatory care site, later to be known as the Olshan Health Center and eventually the Eichinbaum Health Center; and Senior Health and Peer Counseling Center of Santa Monica, later the Center for Healthy Aging, emphasizing preventive activities. Because many institutions were involved in the clinical care, education, and research effort in geriatrics and gerontology, the over-arching title of the evolving academic unit was the Multicampus Program in Geriatric Medicine and Gerontology.
External funding required working with federal and state legislatures in the creation of funding streams through new legislative efforts supporting the new division and the field of aging. Concrete examples of this were support for the Geriatric and Gero-psychiatry Fellowship training (a source of new faculty), the Older Americans' Independent Centers (Pepper Centers) for research activities and the Long-Term Care Gerontology Centers.
At the state level, funding was developed for the creation of the Academic Geriatric Resource Centers supporting the development of Geriatric/Gerontological educational activities in the health professional schools of the UC system. The latter would not have been possible without the help of Dr. Phillip Weiler at the UC Davis campus and the resolute support of Charles Young, the chancellor of UCLA at that time.
During this period (1979-1993), Dr. Beck's appointments included Professor of Medicine at UCLA and Director of the Multicampus Program in Geriatric Medicine and Gerontology (MPGMG), attending physician, UCLA Medical Center and the Jewish Homes for the Aged of Greater Los Angeles, physician consultant, Department of Veterans' Affairs Medical Centers, Sepulveda and West Los Angeles, member of the Advisory Committee of the two GRECCs, and Senior Natural Scientist at the RAND Corporation.
During this time, the faculty of the MPGMG succeeded in making substantial, but far from ideal, inroads into the undergraduate curriculum, the core training in general internal medicine residency training, and establishing what was recognized as the most outstanding Geriatric Medicine Fellowship Program nationally. This program led to the development of many outstanding young faculty and clinician leaders who can be found throughout the nation aiding in solving the major shortage of faculty in the field of geriatric medicine. Dr. Beck and colleagues succeeded in developing a Mid-Career Program in Geriatric Medicine. In this program, established faculty in the nation's Academic Medical Centers spent up to a one-year period in a process which led to their becoming geriatric medicine faculty in their home institutions.
Care of older persons is a multidisciplinary task. Thus, the educational efforts of the MPGMG were also directed at nursing, social work, public health, dentistry, pharmacy, and personnel in the long-term care sector, principally through the efforts of the Long-Term Care Centers and the Geriatric Education Centers, both funded by the federal government.
In spite of substantial administrative, clinical, and teaching responsibilities, Dr. Beck was able to maintain his scholarly research interests. This was greatly facilitated when he was able to convince Dr. David H. Solomon to join him as Associate Director of the MPGMG after he stepped down as the UCLA Department of Medicine chairman.
During this time, Dr. Beck's and colleagues' research interests and subsequent publications addressed the following topics:
- Work force needs for the oncoming graying of America, particularly generalist physicians, geriatricians, geropsychiatrists, social workers and gerontological nurse practitioners. These included baseline surveys and subsequent updates of the number of geriatricians, gero-psychiatrists, gerontological nurse practitioners, social workers, public health faculty, pharmacists, and physician medical directors of nursing homes;
- Producing the first published educational objectives and competencies in geriatric medicine and gerontology for students at the undergraduate level and physicians at the residency and fellowship level. This activity was fostered and strongly supported by the Department of Veterans' Affairs Central Office;
- The use and effectiveness of Comprehensive Geriatric Assessment (multi-dimensional assessment) in the acute hospital, ambulatory, and home setting;
- Inappropriate medication use in nursing homes and community settings;
- Early quality of care indicators relating to the care of older persons; and
- Risk assessment as a better indicator than age as a criterion for mandating retirement of airline pilots.
These research efforts led to over 50 publications in the refereed world literature. They were accomplished with the help of faculty colleagues, geriatric fellowship trainees, and mid-career faculty trainees.
Community service is an integral role for faculty in the University of California system and Dr. Beck's contribution to this arena was extensive. The most important of these included:
- • Member of the Board of Governors, Ben-Gurion University of the Negev, in Israel; the American Associates, Ben-Gurion University of the Negev; Chairman of the Overseas Faculty, Faculty of Health Sciences, Ben-Gurion University of the Negev; Co-Chairman of the Academic Review Committee, Ben-Gurion University of the Negev which carried out the first university-wide review of an Israeli university and which led to major organizational changes in the university;
- Member of the Board of Directors for the Senior Health and Peer Counseling Center (later the Center for Healthy Aging) in the City of Santa Monica, California, whose major mission was the prevention of disability;
- Member of the Senior Services Committee, Jewish Family Service of Los Angeles, during which time UCLA established the first integrated social service-medical care program for older adults, initially named the Freda Mohr Multipurpose Center;
- Chairman of the UC system's Academic Resource Center Program, which facilitated the introduction of aging content into the curricula of the health professional schools, including social work in the UC system;
- Member and often Chairperson of Committees of the Institute of Medicine, American College of Physicians, Gerontological Society of America, and the American Geriatrics Society;
- Member of the Board, RAND-UCLA Center for Health Policy;
- Member of the Advisory Board, the CIBA Foundation, London;
- Member of the Advisory Board, American Federation for Aging Research;
- Board Member of the Jules Stein Eye Institute, UCLA;
- Member of the Advisory Policy and Research Committees of the UCLA Robert Wood Johnson's Clinical Scholar Programs;
- Member of the Board, University of California, San Francisco, Aging Health Policy Center;
- Member of the National Board of Medical Examiners;
- Member of the Technical Committees of Health Services and Long Term Care, and Chairman of the (1981) White House Conference on Aging; and
- Member of the Health Services Committee, 1986 White House Conference on Aging.
In addition, Dr. Beck served on many Editorial Boards of journals in the field of aging.
Dr. Beck's fifth career began in the 1992-93 academic year, with what has become a recurring event in the University of California system – budget cuts due to California's cyclical economy and other factors. Drs. Beck and Solomon had agreed that Dr. Beck should waive his "ten-year rule" (1979-89) since the MPGMG, although one of the strongest in the nation remained somewhat fragile from the point of view of its financial stability. One of the accomplishments in the 1989-1993 period was a much stronger financial underpinning for the MPGMG's activities. The UC system, in dealing with faculty and staff related to California's budget cutbacks, adopted "early retirement" as one of its strategies for dealing with the problem. Drs. Beck and Solomon jointly accepted this strategy with the understanding that a special case should be made that release of their salaries would be directed at assuring that promising young faculty who had been recruited to geriatric medicine and had not obtained tenure track funding could be retained.
Dr. Beck became Emeritus Professor of Medicine in 1993, and decided that his future activities would be directed at two major areas – ongoing and new research activities and a major commitment to mentoring two junior faculty at the University of Bern and the University of Lausanne. Drs. Andreas Stuck (Bern) and Dr. Christophe Bula (Lausanne) had previously obtained extensive clinical and research training in the MPGMG and had returned to Switzerland to begin careers in geriatric medicine. They were faced with similar, but probably even more difficult problems, than Dr. Beck had encountered when he joined the UCLA faculty.
Dr. Beck's research interests during his Emeritus status have focused on the prevention of disability in elders. A randomized control trial (RCT) of the effectiveness of the system in the UK, Germany, and Switzerland, was initiated in the first half of 2001, in part funded by the European Union. This trial evaluated the impact of the HRA on health related behaviors, medical care utilization, and function. Primary outcomes were health behaviors and use of preventive services based on self-report and chart abstraction in the Swiss arm of study the later at year two. The results of this study were published in the Public Library of Science in 2015.
Dr. Beck was also a co-principal investigator of a series of studies which have developed and extensively tested an instrument for screening of community-dwelling elderly for alcohol-related problems, a major emerging public health concern.
During this period (1993-2014) Dr. Beck was an author of over 100 papers published in peer-reviewed journals. His community service focused on two areas, one in Los Angeles, the other in Israel. In the former, he committed substantial time and effort as a Board and Executive Committee member to the Center for Healthy Aging. He chaired its long-range planning committee whose activities eventually led to its merger with the Wise Community Agency in Santa Monica. The new agency has come to be known as the Wise and Healthy Aging Center.
In Israel, Dr. Beck, together with a core group of health policy and health services researchers, conceived of the creation of a National Institute fashioned, but culturally adapted, on the U.S. Agency for Health Care Research and Quality (AHRQ). With initial substantial support from the Koret Foundation of San Francisco, an organization was created: the Israel National Institute for Health Policy Research, established by Israel's Health Council which was created as part of the National Health Insurance Law (1995). Its major mission is support of health services research in Israeli institutions by granting awards on a competitive basis, the funds coming from the Israeli government as part of the Israel National Health Service. It also acts as a forum and meeting place for professional and public discussions about the organization, management and health policy in Israel. It encourages interdisciplinary scientific cooperation on the national level among all participants, academic and managerial, with an interest in the promotion of the Israeli health system, and it monitors the influence of the National Health Insurance Law on health services in Israel, their quality, effectiveness and cost. Dr. Beck served as Chairman of the International Advisory Board of the Institute until 2008. He and his colleagues played a major role in organizing the first four Jerusalem Conferences on Health Policy which remains an ongoing international conference series.
John Beck received multiple honors during his career. Among them, he was awarded a Ph.D. (honoris causa) for his contributions to the establishment of the new university in Israel (Ben-Gurion University of the Negev). In addition, he was awarded a Mastership from the American College of Physicians in 1987, the Milo F. Leavitt Memorial Award from the American Geriatric Society in 1988, the Bruce Hall Memorial Lecture Award and the Allen T. Bailey Memorial Lecture Award in 1989, the Duncan Graham Award of the Royal College of Physicians and Surgeons, Canada) and the Joseph T. Freeman Award in 1990, and the Irving S. Wright Award from the American Federation on Aging Research in 1991. He was elected to the Institute of Medicine in 1980, and is a fellow of the Royal Society of Canada. In 1993, he was made a Fellow of the American Association for the Advancement of Science, and in 1994, he received a D.Sc. (honoris causa) from McGill University. In 2001, he received the Donald Kent Award from the Gerontological Society of America. The American College of Physicians-American Society of Internal Medicine conferred the Philip's Award, a lifetime award for Clinical Excellence, on him in 2003. In 2004 he delivered the Chaikin Oration, entitled "Living Longer – Living Better," to the National Academy of Technological Sciences and Engineering of Australia. These are just a few examples of the many ways his colleagues have chosen to recognize his substantial influence on the world of medicine.
Dr. Beck led an extraordinary life and was passionate about everything he did. He was a master at building networks of people and institutions, left an incredible legacy, was proud to still be working and making contributions until he died unexpectedly at 92 of pulmonary embolism while on yearly vacation in Australia for the 30th consecutive time. Dr. Beck was recognized globally as an icon, a powerhouse of ideas and a person who towered over all of us with loving grace.