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Thomas O. Pyle, at 67; built an HMO into industry giant


Three years after a showdown with physicians in 1991 forced him to resign as chief executive of Harvard Community Health Plan, Thomas O. Pyle noted wryly to the Globe, "I'm not a very popular guy among the doctors."

By applying business strategies to the practice of medicine, he built the health maintenance organization into an industry trail blazer. Membership increased more than sixfold during his tenure, which was hailed as innovative by many -- except the scores of rank-and-file salaried doctors who bristled at having their performance measured.

"Like many brilliant people, he had that tough side, but the thing that always interested me about Tom was that he was a romantic idealist," said Dr. Gordon Moore, a Harvard Medical School professor who served under Mr. Pyle as the organization's medical director. "He loved doctors, he put them up on a pedestal. They were on the top rung, next to God. . . . But when they crossed him, it made him very, very angry."

Mr. Pyle, whose leadership of Harvard Community Health Plan for two decades helped transform the healthcare field and introduced concepts that are commonplace today, died of complications from pancreatic cancer June 18 in his house in Duxbury. He was 67 and also kept a home in Boston.

His pursuits away from work might have surprised doctors who viewed Mr. Pyle as a bean counter unable to grasp that the pas de deux between physician and patient should not be timed and graded for productivity. He was fond of romantic music and so devoted to theater that sometimes he would take his wife to New York City and sit through six plays in a single weekend.

And in the months before he was ousted from his healthcare organization, Mr. Pyle took a sabbatical to attend Wadham College in Oxford, England, where he read philosophy and politics.

"He loved that kind of yearning and longing for things," said his wife, Regina. "Not so much that the glass is half empty, but just knowing and having the sense that there is something more out there, and going after it."

At the chief executive's desk, that meant expanding Harvard Community Health Plan from two centers to nearly four dozen locations, giving nurse practitioners a greater role, embracing computerized medical records in their nascent days, and -- to the chagrin of many doctors -- finding ways to measure the quality of care.

"That was a visionary thing -- he fostered innovation," said Dr. Donald Berwick, whom Mr. Pyle recruited to help the HMO use techniques from other industries to measure quality at a time when economics called for cost-cutting. "He had confidence that you could measure the quality of care. He regarded it a matter of stewardship to make sure healthcare was great."

The son of a house painter and a schoolteacher, Mr. Pyle grew up on Fishers Island, a sliver of land off the coast of Connecticut where the permanent population of fewer than 300 swells in warmer months when the wealthy return to their summer homes.

"He began his life as an outcast," his wife said. "He didn't fit with the summer people and didn't fit with the local people. He was very smart."

At 16, he graduated from high school and went on scholarship to the Massachusetts Institute of Technology. By the next summer he had dropped out.

"I wasn't ready for MIT," he told the Globe in 1991. "It was a pretty miserable year for me."

"Every time I go across the Mass. Ave. bridge, I think of him as a 16-year-old from a town of 300, walking to MIT from a fraternity in the Fenway, freezing to death," his wife said.

He went to New York City, where an acquaintance from Fishers Island helped him land a job as a page for "Ted Mack and the Original Amateur Hour." Then Mr. Pyle became an account executive with the Young & Rubicam advertising agency and met Regina Schlank, the sister of a colleague. They married in 1962.

From New York, Mr. Pyle went back to Boston and back to college, as one of the few students allowed to enter Harvard Business School without an undergraduate degree. He graduated in 1967 and worked in other industries before entering the healthcare field.

"Tom was a phenomenon in Harvard Business School," Moore said. "He could have done anything. He could have been a captain of industry and made millions and millions of dollars, so it's interesting that he picked healthcare. He had a real need to do good -- healthcare, in a way, was the patch that he wanted to till in his life."

Mr. Pyle joined Harvard Community Health Plan in 1972. Membership was 18,000 that year, 80,000 when he became chief executive officer in 1978, and 525,000 when he was forced to resign in 1991.

Just before becoming CEO, he was founding chairman of the Controlled Risk Insurance Co. and The Risk Management Foundation of the Harvard Medical Institution. The malpractice insurance programs covered hospitals affiliated with Harvard and thousands of physicians and trimmed costs considerably.

He also founded the Harvard Community Health Plan Foundation to fund research and projects in the community.

After resigning as CEO, he became an executive with MetLife Insurance Co., and was among those tapped by the Clinton administration in 1993 to work on its proposal for a national healthcare system.

For nearly 20 years, he also served on the boards of corporations private and not for profit, including PolyMedica Corp. and the Medical Education for South African Blacks, a charitable group that is closing after years of working to improve healthcare for disadvantaged residents of that country.

"He had an incredible humanity about him," said Dr. Saul Levin, the organization's former chief executive officer. "No matter who you were, he was always able to listen and give you his good attention."

Years ago in New York City, before Mr. Pyle married, he was in a relationship that ended, even though his fiancee was pregnant, his wife said. For decades, he wondered if he had a child somewhere, only to learn he did when his son contacted him four years ago. Scott Laughlin, who now lives in Natick, had grown up in Newton about five blocks from where Mr. Pyle and his wife lived at the time.

"People asked, 'Are you going to get a DNA test?' and there was no need," she said. "He's just the spitting image."

Diagnosed with cancer 15 months ago, Mr. Pyle and his wife flew to Greece and sailed a boat from Santorini through the Greek islands to Athens. About six weeks ago, by then quite ill, he rallied for a trip to his house in the south of France, inviting friends for a final celebration.

"He just astounded us all," his wife said. "He willed himself to do these things, and he did them."

"He truly knew how to celebrate life and how to enjoy the wonderful things around him, that's what I loved about him," Levin said. "I'm incredibly heartsore at his loss."

In addition to his wife and son, Mr. Pyle leaves a grandson and a granddaughter.

At his request, there will be no service.