Robert Dorwart was an academic of the highest rank and a physician committed to understanding and improving the lives of those who could not access quality health care.
As a psychiatrist, Dr. Dorwart was a pioneer in health services research at a time when the value of such research was little understood. Dr. Dorwart was among the first generation of psychiatrists whose studies generated insights into the organization, financing and quality of mental health care. An advocate and practitioner of collaboration across clinical, quantitative and qualitative disciplines, Dr. Dorwart worked closely with Mark Schlesinger, PhD, now at Yale. His work contributed to the empirical foundation for healthcare reform, a primary interest which no doubt would have continued today. His contributions are enduring.
Less known about Dr. Dorwart were his clinical skills. He never flaunted his acumen. Whether it was stepping in to cover an emergency room shift, consulting on an inpatient unit or guiding a complex state hospital he exercised tremendous caring along with the same superb judgment he demonstrated as a researcher and administrator. His clinical experience enriched his understanding of health services research and undoubtedly contributed to his concerns about access to and quality of care.
Robert Dorwart cannot be fully remembered without identifying what may be his proudest accomplishment. He was a premier baseball pitcher for Harvard College. Good enough to be recruited by professional teams, he chose instead to pursue medical education. However, he never lost his love for baseball and his cherished moments as a college player. He would just as easily cite baseball statistics as the economic arguments for mental health care coverage. In his home his most cherished mementos were not his diplomas or awards, but pictures and other memorabilia from his baseball years. What he learned from baseball guided every aspect of his life. When the expression “Baseball is life” became popular, Robert (aka “Bob” to many) used to say “I always knew that.”
A cum laude graduate of Harvard College, Dr. Dorwart went to Tulane Medical School where he obtained both an MD and MPH. His interest in community psychiatry and citizen participation in mental health began during his undergraduate years. His more formal commitment to public sector psychiatry emerged from his experiences at Tulane. He completed a residency in psychiatry at Cambridge Hospital. From 1981 to 1983 he was Kellogg Foundation Fellow in Health Policy and Management at the Harvard School of Public Health which resulted in an MSc. Beginning in 1983 and continuing for the rest of his career was Dr. Dorwart’s intense involvement in substantial health services research and parallel activities in academic teaching and clinical administration. Few individuals have the capacity or intellect to be so substantively involved in these dual pursuits.
In 1985, Dr. Dorwart was the Director of the Working Group on Mental Health Policy. His leadership of the Working Group on Mental Health Policy was symbolic of what he really loved to do which was galvanize a group of people to take on challenging questions that went deeper than the standard run of health services research. At this early point in his career he was taking on research, clinical and administrative responsibilities simultaneously. Dr. Dorwart was always inclined to question prevailing assumptions that represented conventional wisdom in mental health policy. When citizen participation was being championed, he wrote elegantly and incisively about the realistic limitations of that participation. When corporate control was held up as a way to rationalize the delivery of medical services (including psychiatric care), Bob wanted to do more than just applaud or scold — he wanted to figure out how much it really mattered, for good or ill. This deeper probing is one of his truest legacies reflected in his writings and in the work of those he mentored.
Grants and scholarly papers continued to flow while he assumed both major clinical and administrative responsibility at the Cambridge Hospital Department of Psychiatry as Associate Chairman until 1995. Central to Dr. Dorwart’s administrative style was to seek consultation from those he considered to be his mentors or, in his research, colleague who shared his interests. Always discreet, Dr. Dorwart most often preferred to work behind the scenes providing information, strategy or guidance to others to advocate or implement services for those most in need.
Dr. Dorwart’s successes led to his being named Professor of Psychiatry 1994 and Chief and Chairman of the Department of Psychiatry at Cambridge Hospital in 1995. In addition, he held appointments as Professor of Health Policy and Management, Harvard School of Public Health, Professor in the Malcolm Wiener Center for Social Policy at the John F. Kennedy School of Government, and Professor of Social Medicine at HMS.
As a teacher and mentor, Dr. Dorwart reached Erikson’s stage of generativity unusually early in his career. He taught a lively course on mental health policy at Harvard’s Kennedy School of Government and always made time for students, psychiatry residents and trainees from other fields. Indeed, he was well known as the “go to” person for young doctors, psychologists and others who had interests in policy or services research. He routinely scheduled meetings to help them clarify their interests and explore the opportunities ahead. “There’s about one future researcher in ten of these get-acquainted meetings,” he once said. But he generously made himself available to all comers, reaching for his ubiquitous yellow-lined paper to sketch out a model illustrating a point. For those trainees seeking to pursue a research career — and over the years there were many — Dr. Dorwart generously offered opportunities to discuss new ideas and analyze data, first-author papers or chapters. Under his guidance, several progressed through fellowships, career-development awards, and obtained independent funding. Today he even has academic grandchildren— that is, his K-award mentees are now mentors of a new generation of researchers. Robert Dorwart’s wisdom and spirit live on. He served as a model for those wishing to pursue an academic career in the context of the “real world.” As his academic appointments attest Dr. Dorwart generously mentored students throughout the University and truly took pleasure in their accomplishments.
There is little doubt that for reasons that are not clear he was driven to make a mark, but this never seemed self-serving. Rather it called attention to the needs of marginalized populations. As Susan Grosdov, his longtime assistant stated, “Bob was always strategic and a master at the art of persuasion. In his too short life, he was able to accomplish what would have been a lifetime of accomplishment for most.” Dr. Dorwart published widely in the most prestigious peer reviewed journals and published two books, “Citizen Participation in Mental Health: Research and Social Policy” and “Privatization of Mental Health Care: A Fragile Balance.” Dr. Dorwart was a consultant to many State and Federal agencies and professional groups.
When Robert Dorwart had a goal in sight he was never deterred by the usual roadblocks in the public sector. He was a patient negotiator who had the facts at hand, and his arguments were compelling. Dr. Dorwart saw the development of services as an active, creative process and had a desire to understand and work with process. He never appeared frustrated and did not speak out of turn.
Robert Dorwart is survived by his wife Nancy Langman, daughter Kirsten, son Stefan, his brother Donald an attorney in St. Louis, and an extended family of nieces and a nephew.
Joseph T. Coyle
Edward A. Layne
Joseph P. Newhouse
John G. O’Brien
Mark J. Schlesinger
Ronald J. Steingard
Myron L. Belfer, Chair