Prof. Philip H. N. Wood

Philip Wood died in June 2008. He leaves legacies that provided the foundation for increased awareness and resources relating to rheumatic diseases, and a sea-change in how we can understand the consequences of health conditions, particularly those associated with disablement. Philip was born in Cardiff in 1928 and raised in Sheffield, but with strong family ties to Cornwall, to where he retired in 1989. After a brief spell at Sheffield University during which he dabbled in the theatre, he did his national service (1946–47) in the R.A.M.C. ending up as Chief Clerk at the Military Hospital York, acquiring organizational skills that he brought to his later work. He received his medical training at St Bartholomew's Hospital, University of London, qualifying in 1955. During his post-graduate training he gravitated towards research and to rheumatology. His time with Prof. E. G. L. Bywaters and Dr A. St J. Dixon as a research registrar at the Hammersmith Hospital and the Postgraduate Medical School of London (1960–63) was a formative period. This was followed by 2 years as Research Assistant Professor of Medicine, State University of New York at Buffalo School of Medicine, where he had the opportunity to participate in ongoing epidemiological studies. On his return to the UK he consolidated his commitment to research as an Arthritis and Rheumatism Council (ARC) Senior Research Fellow in Epidemiology, Rheumatism Research Centre, University of Manchester. He succeeded John Lawrence as Director, ARC Epidemiology Research Unit, University of Manchester in 1968, a post which he held for the next 20 years. His work at the ARC unit started with conventional epidemiological surveys investigating a possible cluster of gout in the Cotswolds and collaborating with the Epidemiology Unit in Cardiff under the leadership of Archie Cochrane on surveys in the Rhondda Fach. He continued to collaborate with clinical colleagues on research throughout his career. Indeed one of his most cited scientific papers concerns diagnostic criteria for polymyalgia rheumatica. However, arguably his greatest achievements are in the realm of service. His public health perspective made him well aware of the crucial role of public and political awareness of rheumatic diseases in improving care for those affected. He master-minded reports (released to the media by the ARC) drawing attention to the large burden of rheumatic diseases on both the health care system and on society at large, which laid the foundation for the ongoing recognition of arthritis as a leading chronic disease. Philip was a guiding hand for the establishment of rheumatology and rehabilitation as separate specialties, writing the constitution for what later became the British Society for Rheumatology. He was instrumental in getting rheumatologists into most communities in the UK, also, in part, by publishing reports to the media on variations in availability of rheumatology services at the district level. The UK rheumatology workforce register (as it is now known) which he established in 1971 remains an important tool for promoting rheumatology services at the local level. Documenting the importance of rheumatic diseases drew attention to two major gaps affecting availability of data, and led to innovations, which although somewhat esoteric, have had major implications particularly in the light of the universal shift to computerized databases. Philip's role in these is generally unrecognized as both were published under the name of the World Health Organization (WHO), hiding Philip's ground-breaking and seminal contributions. The first innovation related to the way data on rheumatic diseases were captured. For example, in the 1970's version of the WHO International Classification of Diseases (ICD-8), it was not possible to distinguish between back pain and OA. To remedy this, Philip joined the British delegation revising the ICD and rewrote the chapter on Diseases of the Musculoskeletal System and Connective Tissue for ICD-9, making clear separations between major groupings of rheumatic disorders and innovations in the way multi-system diseases could be coded. These continue to be the international standard in ICD-10. The second major innovation, a most remarkable accomplishment, was a classification and conceptual framework for systematic collection of data on disability. Taking advantage of his connections with the WHO, he largely single-handedly wrote the International Classification of Impairments, Disabilities and Handicaps (ICIDH), an undertaking that would be usually done by a committee of experts. The original draft was accepted by the WHO revision conference in 1975 and was an extraordinary document given the strongly biomedical focus of WHO at that time. In particular, the classification of handicap extended the medical model of disease into the psychosocial and societal arenas. The final version of the ICIDH was published in 1980, and served the worldwide community well for 20 years. It has now undergone its first revision and has been renamed the International Classification of Functioning, Disability and Health (ICF). The ICF is recognized as the international framework for data relating to disability, and provides a conceptual framework for medicine and rehabilitation, particularly for the development of outcome measures. In this format, the circle of what Philip started for arthritis is being closed, as the ICF is becoming established in rheumatology as a basis for the systematic collection of clinical and outcome data. In summary, Philip Wood was a scholar and a man of many parts: a rheumatology researcher, an epidemiologist, a health services researcher, a social scientist, a philosopher and an innovator. He is survived by his wife, Cherry, to whom he was married for over 50 years, four daughters, and eight grandchildren. Disclosure statement: The author has declared no conflicts of interest.

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