Dr Greenburg is currently Professor ofSurgery Brown Medical School and Surgeon-in-Chief, The Miriam Hospital Providence Rhode Island. Theseappointments allow full and active involvement in the triad of academic surgical endeavor: clinicalcare, teaching and research. An added element is, of course, administrative responsibility. Educatedat the University of Chicago (SB '59, MD '63) with surgical residency to follow at the University ofChicago, Michael Reese Hospital and University of Illinois he also spent a number of years inresearch. At Northwestern University he earned a PhD in Industrial Engineering/Management Sciences in1972 fulfilling a long time goal of becoming "an engineer". In his dissertation he explored the roleof physician ordering in driving the complex hospital function and its relationship to physiciandecision-making, a concept that has just recently been instituted at The Miriam Hospital in the formof a functional system. The IE/MS program presented a unique opportunity to integrate acrossdisciplines-an early form of translational research or interdisciplinary activity if you will-toeffect a better patient outcome.

Over a period of 30 years Dr Greenburg has applied the tools ofIE/MS to problems in medicine, especially the concept of "systems design and evaluation" and computerapplications generally. Explorations of multiphasic screening systems and intensive care units werecarried out using an approach that integrated analytical tools and simulation modeling techniques. Hehas been involved in and instrumental in developing a methodology to assess nursing time involvementin patient care creating and evaluating predictor models. These models demonstrated that there weretimes in a busy ICU that the demand for functions exceeded the resources available at the time. Fromthese models, adjusted to reflect patient's state of health, alternative modes of nursing practice inthe ICU were needed. Alternatives were generated, exercised on the simulators and eventually put intopractice once all of the variables were identified.

Working with a very talented medical studentat UDSD Dr Greenburg helped to design and build a computer program to diagnose neurologic illness.Based on the structure-function model of the neurologic system, it was possible to include a dynamicappraisal of lesion regression and progression so there was a major educational element in the systemas well. In the course of this effort the need to deal with more complex lesions or multiple lesionsnot easily addressed by the classic structure-function model became obvious. Using "fuzzy logic" and"chaos theory" to address some of these problems yielded surprising results and opened a new vantagefor other areas of diagnostic complexity. This foray into expert systems again demonstrated theadvantage of an interdisciplinary approach to problem solving within the confines of elements of thehealth care system.

Dr Greenburg continues to apply the tools and concepts of IE/MS in dailyadministrative tasks, especially those that require quantitative analysis of complex data or scalingof qualitative information. Building schedules for resource use in an operating room suite or analysisof data for utilization so that surgeon time can be more efficiently assigned or new rooms soughtrelies heavily on these basic techniques. Most recently a model designed to predict the operating roomload one and seven days in advance has been constructed (with the help of friends from graduateschool) and exercised. The model is remarkably stable and appears accurate within 5% on any given day.The variations are being explored but the data to date has been useful in reallocation of operatingtime and staffing issues.

The concept of physician's ordering driving the medical informationsystem proposed over 30 years ago has surfaced as new project for the hospital. Leading a team of ISpersonnel, physicians, ancillary support personnel and nurses Dr Greenburg has launched a fullyintegrated operational Physician Order Management System within two busy units of the hospital. Basedfully in classic systems concepts, physicians enter orders, which are then checked for a variety ofinteractions and dose ranges, allergies and other elements before being accepted for action. Improvedrecord keeping, avoidance of errors and more consistent accuracy are the end products, all desirableend points in the modern era where patient safety is of concern.

In addition to applying thesystems concepts to administrative tasks Dr Greenburg has actively pursued the development of "oxygentherapeutics", a class of agents designed to deliver oxygen to under-perfused tissue associated withtrauma, blood loss, surgery or disease. From the design and evaluation of the chemical modificationof hemoglobin to full scale clinical testing of this unique solution the concepts of systems has beena constant in the effort. In general the product appears safe and effective when measured againstspecific outcome measures. Additionally, the mechanisms of action and biomechanical aspects of thephysiologic effects of the solution have been explored in a variety of model settings.

Researchinto outcomes of surgery in the elderly and after ambulatory surgery are ongoing. Dr Greenburg hasco-edited the new 5th Edition of Nyhus and Condon's Hernia published in 2002.With an obvious interestin surgical education, teaching awards from the residents at two universities, UCSD and Brown, havebeen received. Dr Greenburg spent 16 years working with the National Board of Medical Examiners inmany roles and as chair of major committees. For the immediate past president he undertook anexploration of the relationship between basic sciences and the clinical practice of medicine, a mostcomplex and challenging topic. The nature of the relationship, one at the very heart of modern medicaleducation, is not easily defined and a clear answer to the question is not readily apparent.

Amember of all the prestigious surgical societies having held office in many and author or over 230manuscripts, peer reviewed articles and book chapters, Dr Greenburg continues an active involvement inacademic surgery. Full time surgeon and educator, part time philosopher and translational researcherhe enjoys the ability to contribute to many aspects of modern medical science. With his wife, Reva, heenjoys all forms of music, bicycling in foreign lands, attending surgical meetings world wide andvisiting with his three accomplished daughters and two grandchildren-generally accepting thechallenges of daily life always seeking solutions to problems.