Remembering UpToDate creator Burton (Bud) Rose, the ‘Steve Jobs of medicine’

Ask any doctor, nurse, or other clinician about UpToDate and you’ll get some version of this answer: I use it all the time to stay current, and often pull it up when I’m talking with patients. For clinicians around the world, UpToDate is essentially Google for medicine, but smarter and based on evidence.

The creator of this invaluable and now-omnipresent resource, Dr. Burton “Bud” Rose, a brilliant kidney specialist, entrepreneur, and our friend and colleague, died on Friday from complications of Covid-19 at age 77.

Nearly 30 years ago, Bud wanted to find a way to more rapidly update his first textbook, “Clinical Physiology of Acid-Base and Electrolyte Disorders,” which had become the nephrology bible for medical students, practicing clinicians, and faculty members in the United States and beyond. When his publisher declined to put the book into a format that was accessible by computer, Bud did it himself, and UpToDate was born.

He first focused on kidney disease, then gradually opened the lens to include virtually all of medicine. With his wife, Gloria, as his partner, Bud turned a basement business into the most widely used and universally respected educational resource for clinicians around the world.

UpToDate helps health care workers with access to a computer or a smartphone know the right thing to do for their patients, and know it immediately.

When Wolters Kluwer bought UpToDate in 2008, more than 3,000 physicians were reviewing and updating its content and creating recommendations for how to diagnose and treat thousands of conditions. Today, clinicians use this resource about one million times every day, and often change their clinical decisions based on what they read.

As one of us (M.Z.) said at a party celebrating Bud’s retirement from Beth Israel Deaconess Medical Center, he was truly the Steve Jobs of medicine.

Dr. John P. Forman, who Bud trusted to take over the nephrology section at UpToDate, said that Bud’s idea, and its execution, represent “the most important medical invention in the past 30 years, possibly longer. I’ve argued more than once that he should have won the Nobel Prize for medicine.”

Bud Rose defined what it means to be a superb clinician educator. From his training through his faculty positions at the University of Massachusetts Medical School in Worcester, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, and Harvard Medical School, he was a clinician and educator without peer. He had the gift of delivering clear, concise, and precise presentations on any topic, especially his chosen field of nephrology. Bud’s writing sparkled, with crisp, logical thinking presented in a straightforward style that all could understand.

Even as his work at UpToDate demanded more and more of his time, Bud continued to see patients at Beth Israel Deaconess and continued to teach. He met every week with our nephrology fellows to hear cases and teach them the ins and out of kidney disease and its management. Fellows — and faculty members — benefited from the magic of his teaching. Bud also developed and directed an annual review course in nephrology that each year attracted an all-star cast of guest lecturers who came to Boston to teach because of their respect for Bud and his work.

Recognition as a teacher supreme who established what education should be at every level came with his promotion to clinical professor of medicine at Harvard Medical School. National acknowledgement for his work in educating kidney specialists came when he was honored with the Robert G. Narins Award by the American Society of Nephrology, the highest award given by the discipline for education in nephrology.

Clinicians around the world — UpToDate is available in nine languages — and their patients owe an enormous debt of gratitude to Bud, who exemplified excellence in clinical care and teaching. Those of us who had the privilege to know him and work with him will remember him with affection and reverence for years to come. For millions of others, Bud’s legacy quietly contributes to a goal he passionately worked toward throughout his life: providing better care for patients.

Martin Pollak, M.D., is professor of medicine at Harvard Medical School and chief of the Division of Nephrology at Beth Israel Deaconess Medical Center. Mark Zeidel, M.D., is professor of medicine at Harvard Medical School and physician in chief and chair of the Department of Medicine at Beth Israel Deaconess Medical Center. Theodore Steinman, M.D., is professor of medicine at Harvard Medical School and senior physician at Beth Israel Deaconess Medical Center.