Psychiatrist, activist, and author Ralph Shelton Crawshaw was an internationally recognized pioneer in health reform and physician education. He designed the Oregon Health Plan with John Kitzhaber and founded nonprofit organizations that advanced health policy in the public interest.
Crawshaw was born in Brooklyn in 1921. Though his English immigrant parents struggled financially, they took him to museums, read the works of Charles Dickens to him, and expected him to pursue a profession. As a child, he was drawn to medicine by the 1931 film Arrowsmith, as well as a sister’s death from diphtheria. After graduating high school at the age of fifteen, Crawshaw attended free city college programs before transferring to Middlebury College. He graduated from New York University’s Medical School in 1947 and completed an internship at Lenox Hill Hospital.
During World War II, Crawshaw volunteered for the 10th Mountain Division ski troops, where he later recalled “dragging stuff up and down mountainsides, including movie cameras, so Errol Flynn’s picture could be taken.” During the Korean War, he served as U.S. Navy physician to the Marine Corps.
Crawshaw became interested in the field of psychiatry through its balance of science and humanism. He conducted a residency at the Menninger School of Psychiatry in Topeka, Kansas, an international leader in the field. But ever since a childhood viewing of a newsreel image of Mount Hood, Crawshaw had longed to live in Oregon. His dream coincided with practical realities: he was recently married, and his wife Carol was pregnant (the Crawshaws would have two children). The Oregon State Hospital offered an attractive recruitment package to residents, ensuring he could support his young family while completing his training.
Crawshaw established a private practice in Portland in 1960. With the support of Tektronix cofounder Jack Murdock, he founded the Tualatin Valley Guidance Clinic in 1961, which brought counseling services to children and families in Washington County. Now known as Lifeworks Northwest, the clinic offers affordable mental health and addiction counseling in the Portland metropolitan area.
In 1982, Crawshaw founded the nonprofit Oregon Health Decisions. The group held a series of town hall meetings that sought to give the public a voice in health policy. John Kitzhaber, then a state senator and emergency room doctor, was one of many who were inspired by Crawshaw’s advocacy. Kitzhaber and Crawshaw crafted the Oregon Health Plan, which sought to make health care accessible to low-income individuals, while prioritizing services to control costs. Under Kitzhaber’s political leadership, the plan entered into law in 1993.
Crawshaw’s enduring interest in physician well-being, particularly suicide prevention and compassionate approaches to the doctor-patient relationship, led to the establishment of the Foundation for Medical Excellence in 1984. The nonprofit provides educational programs and consulting for physicians and facilitates collaboration on regional health policy. In 1999, Crawshaw helped establish the Collegium for the Study of the Spirit of Medicine, a discussion group within TFME that addressed humanistic aspects of medicine.
In 1984, in an article in the Journal of the American Medical Association, Crawshaw called on his colleagues to establish an international exchange program for medical education. The result was Health Volunteers Overseas, a nonprofit based in Washington, D.C., to provide physician education and professional development in resource-scarce countries.
In the 1990s, Crawshaw engaged in environmental activism. Focusing on the protection of the Bull Run watershed, he worked with environmentalists to protect the wilderness area and to maintain safe drinking water for the City of Portland. He was the author of The General Practice of Community Psychiatry (1969); Compassion’s Way: A Doctor’s Quest into the Soul of Medicine (2002); and Encounters of a Medical Imagination (2007). From 1971 to 1990, his film review column “The Physician at the Movies,” ran in The Pharos, published by the Alpha Omega Alpha honor society.
Crawshaw was appointed to the Institute of Medicine of the National Academy of Sciences and Great Britain’s Royal Society of Medicine. In 1978, the Oregon Medical Association named him Oregon Doctor Citizen of the Year. He was also president of the Medical Society of Metropolitan Portland and Senior Scholar at OHSU’s Center for Ethics in Health Care. Crawshaw died in 2014.