Steven A. Schroeder, MD

Inspiration and Timeline

My original decision to become physician stemmed from the desire to make a difference in society. How and what that would entail varied over time. Initially, I planned to be a psychiatrist, but my clinical rotations steered me into internal medicine. During my fourth year at medical school, I did a three-month fellowship in tropical medicine in Salvador, Brazil, where I learned about parasitic infections and underprivileged communities. My training in internal medicine was interrupted by a two-year stint at the Epidemic Intelligence Service of the CDC, where I became an expert on the epidemiology of salmonella infections.  After completing my medical residency, I did a two-year fellowship in community medicine, which was sort of a precursor to the Clinical Scholar Program. At that time, my intent was to learn how the health care system operated and then take a federal policy job. Accordingly, I accepted a position at the George Washington University Medical Center where, in addition to clinical work as a general internist, I was medical director of the clinics and of an emerging university-sponsored health maintenance organization. In that capacity, I observed great variability in the use and costs of medical services and published a number of papers documenting those findings. In 1976, I was recruited back to the San Francisco Bay Area, my original home. I joined the Health Policy Program (now Institute for Health Policy Studies) at UCSF and pursued the issue of medical costs in greater depth. I also became involved in the epidemiology of medical technology use and in the medical workforce, especially primary care. In 1980, I was asked to develop a division of general internal medicine (DGIM) at UCSF. Our unit emphasized holistic and preventive medicine and cost-effective care and did scholarly work on a variety of topics relevant to health and quality of care. I was also involved in a number of national organizations and activities on these subjects. Our DGIM faculty members were superb, and we became a leading unit locally and nationally.

In 1990, I was asked to become the third president of The Robert Wood Johnson Foundation (RWJF). In my job interview, I volunteered that the foundation was not living up to its mission of “Improving Health and Health Care for the American People,” because it was only focusing on health care. Between July 1990 and December 2002 it was my privilege to lead RWJF as we funded a variety of efforts to improve health, including reducing harm from substance abuse including tobacco, alcohol, and illicit drugs and promoting exercise. We also continued RWJF’s tradition of improving health care: expanding health insurance coverage for youth; improving care at the end of life; increasing the number of health professionals of color; promoting primary care; and trying to improve quality of care.

When it came time for me to return to UCSF, I elected to form the Smoking Cessation Leadership Center, which for the past 17 years has focused on helping smokers quit by influencing clinical, governmental, and advocacy organizations to do better in this regard. Over the past 60 years, the epidemiology of smoking has changed from it being something most people did to now being mainly a problem with disadvantaged and marginalized populations. Thus, smoking has become a social justice issue. Looking back, this seems like a rambling and unplanned journey. What has been constant has been my quest to make a difference at the population level, to integrate clinical medicine and public health, and to use evidence as a way to make social change. It has been a gratifying and interesting journey.



  • Prioritizing public health interventions. In 1999, while serving as Director of RWJF, I led the effort to re-organize the foundation into two overlapping groups, one dedicated to health (behavioral and social causes of poor health), the other to health care (hospital-based care), each headed by a senior vice-president. This opened up resources for behavioral scientists, and facilitated shifting the national conversation around health to a more social perspective.
  • Improving the care of dying patients. Under my directorship at RWJF, we looked at hospital care of the dying at five academic medical centers. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) showed that those targeted to receive better care did no better than the control group. People were dying in pain hooked up to machines, and were without a Do Not Resuscitate order until the last moment, suggesting minimal advance planning. We concluded that the system could be improved, and developed a three-part grant-making strategy that involves professional education, institutional change, and public engagement. This opened the door to an explosion of knowledge about care at the end of life in standard medical journals and textbooks. The number of health care professionals who have been trained to do things better has positioned the nation to provide more appropriate care at the end of life.


  • Publish in professional journals: To create actionable evidence, which may be used in policy designing. I have co-authored over 240 publications in peer-reviewed journals.
  • Serve on grant making bodies and panels: To ensure robust evidence is being collected and analyzed.
  • Join Committees, Boards, Panels, and Professional Organizations: To develop consensus and keep conversations centered on evidence and health impacts.
    • 2014: Interagency Committee on Smoking and Health
      This committee coordinates Department of Health and Human Services’ research, educational programs, and other smoking and health efforts with similar activities of other federal, state, local, and private agencies.

      In the intervening years, the committee has monitored the following:
      • Smoke-Free and Tobacco-Free Policies in Colleges and Universities-US and Territories, 2017
      • State Laws Regarding Indoor Public Use, Retail Sales, and Prices of Electronic Cigarettes 2017
      • Smoke-Free Policies in the World's 50 Busiest Airports-August 2017
      • Smoking, Access, and Purchases Among Students Aged 13-15 Years - 45 Countries 2016
      • State and Local Smoke-Free Laws for Worksites, Restaurants, and Bars-United States, 2015
      • Approaches for Controlling Illicit Tobacco Trade-Nine Countries and the European Union
      • Use of Tobacco Tax Stamps to Prevent and Reduce Illicit Tobacco Trade-United States, 201Ω
    • 2004: Board of the James Irvine Foundation 
    • 2004-2015: Chair, American Legacy Fund re-named Schroeder Inst for Tobacco Research & Policy Studies 
    • 2003 Director Smoking Cessation Leadership Center
      Funded by the Robert Wood Johnson Foundation and the Truth Initiative, the Center works with leaders of more than 80 American health professional organizations and institutions to increase the cessation rate for smokers.  
      • Expanded the types of clinician groups that support cessation. 
      • Developed an alternative cessation message (Ask, Advise, Refer).
      • Created new ways to market toll-free telephone quit lines.
      • Engaged the mental health and addictions treatment community for the first time. The Center is focused on how to reduce the huge health burden from smoking that falls upon those with mental illnesses and/or substance abuse disorders.  
      • Works with SAMHSA, HRSA, the CDC, and multiple health professional groups to provide technical assistance to help strengthen smoking cessation capabilities.  
      • Facilitates summit meetings involving 18 states, enabling them to achieve targeted reductions in smoking rates among behavioral health populations. 
      • Designated by SAMHSA as the National Center for Excellence in Tobacco-Free Recovery.
    • 1994-2013: Editorial board of the New England Journal of Medicine
    • 1990-2003: President and CEO of the Robert Wood Johnson: The Foundation made grant expenditures of almost $4 billion toward improving the health and health care of all Americans. It developed new programs in substance abuse prevention and treatment, care at the end of life, and health insurance expansion for children, among others.
    • 1976: Joined the Health Policy Program, precursor to Philip R. Lee Institute for Health Policy Studies
  • Work with government entities: To ensure evidence is accessible and understandable. Much of my life’s work has been focused on engaging government bodies and institutions in effective, evidence-based decisions around healthcare. From my time as an Epidemic Intelligence Officer for the CDC (1966-1968) all the way to my current work with the Smoking Cessation Leadership Center, I have collaborated with government entities, either synthesizing and clarifying information, or serving on grant- awarding bodies, to elucidate new aspects of scientific enquiry.
  • Serve as an expert witness: For legislative bodies. 
    • 1990: Congress charged the Institute of Medicine with designing a strategic plan for assessing and assuring the quality of medical care for the elderly. 
      • Chaired the Study Committee to Design a Strategy for Quality Review and Assurance in Medicare. I testified at the Hearing before the Subcommittee on Medicare and Long-Term Care of the Committee on Finance, United States Senate. 
    • 1986-1988: Congress created Prospective Payment Assessment Commission, (ProPAC). In 1986 to participate in setting and updating the DRG rates. Comprised of 17 experts in health care delivery, finance, and research, appointed by the Director of the Congressional Office of Technology. I served as Chair of the Data Development and Research subcommittee, and a member of the Diagnostic and Therapeutic Practices subcommittee
  • Contribute to public discourse:
    • I have been a public health expert. I have been interviewed by news and specialty outlets multiple times in my professional life.
    • 1993 I served as the moderator at national field hearings in Florida, Iowa, Michigan, and Washington DC on National Health Care Reform known as the Clinton health care plan.
    • 1974-75 member of the Advisors and Task Force of "Feeling Good," a series of 26 hour-long programs by the Children's Television Workshop, which aired on 250 Public Broadcasting Service TV stations.
    • Mentor the next generation of scientists, educators and researchers