Newborn care advocate Alistair Philip dies at 86

Alistair Philip, MD, a professor emeritus of pediatrics who made significant advances in understanding and treating infections in newborns, died Jan. 21 at 86.

“Dr. Philip was a pioneering figure in neonatology, revolutionizing the way we treat newborns,” said Lloyd Minor, MD, dean of the School of Medicine and vice president for medical affairs at Stanford University. “His dedication to the field was seen in his generous teaching nature and his warm bedside manner. His legacy will live on in his science, his colleagues, his trainees, and in the thousands of children he cared for so deeply.”

His discovery of the application of C-reactive proteins, an indicator of infection, changed the way most physicians practice newborn care by providing proper infection diagnosis and avoiding unnecessary antibiotic use, said David Stevenson, MD, the Harold K. Faber Professor in Pediatrics, who recruited Philip to Stanford Medicine in 1993.

Innovative newborn care

Philip was born in England to Scottish parents on July 28, 1937. He earned his medical degree from the University of Edinburgh in 1961.  

In 1962, Philip became a resident at the American Hospital of Paris in France, then a pediatric resident at the Kauikeolani Children’s Hospital in Honolulu, Hawaii.

In 1970, after stints in Boston, Scotland and Paris, he became an assistant professor of pediatrics at the University of Hawaii and the first neonatologist in Hawaii at the Kapiolani Maternity and Gynecological Hospital in Honolulu. He held academic and clinical appointments at the University of Vermont, Northwestern University and Maine Medical Center, where he was also a director of the neonatology division until 1993.

While at the University of Vermont, his landmark 1979 paper describing the evaluation of neonatal sepsis using C-reactive proteins was published in the journal Acta Paediatrica. Hospitals around the U.S. have since adopted the test, reducing antibiotic use. Overuse of antibiotics in newborns stunts the development of healthy bacteria, failing to prime babies for fighting off future infections.

Philip published extensively, including a detailed review book in 1977 called Neonatology: A Practical Guide which remains a reference for many practicing neonatologists (now in its fourth edition).

Philip’s specialty underwent vast changes during his career. In a 2005 paper titled “The evolution of neonatology,” Philip noted that a one-kilogram (2.2-pound) preterm baby born in 1960 had a mortality risk of 95% but by 2000 had a 95% survival probability.

In 1993, Philip became the medical director of nurseries at El Camino Health, where he helped the hospital provide more advanced critical care for newborns and trained others to provide that care. In 2002, he became the director of Lucile Packard Children’s Hospital Stanford’s intermediate care nursery.

“Alistair had a lot of clinical credibility, which elevated the hospitals where he worked,” said William Benitz, MD, an emeritus professor in neonatology. “He had experience and leadership skills and was a consummate diplomat. And those skills were exactly what we needed to help get El Camino’s critical care nursery program started nearly from scratch.”

Philip standardized care and conducted routine data collection and analysis in a systematic way at the hospitals where he worked. Now called “quality improvement,” the process is routine in hospitals, where clinicians follow protocols to deliver the best care. Philip was doing quality improvement before it found its way into neonatology in general, Benitz said.

A gentleman, scholar and mentor

His bedside manner as a clinician, in addition to his administrative duties, made Philip stand out, Benitz said.

“Alistair was a genuinely honest, nice man,” Benitz said. “That was recognized quickly by the parents whose babies he cared for. They trusted him straight out of the blocks, and he remained a role model to the other clinicians.”

Philip had an outsized impact in the field to this day in part due to his training approach and demeanor.

“Alistair was a thoughtful and considerate teacher,” Stevenson said. “He was generous when people made mistakes, and he made it easy for people to learn because he didn’t make people feel uneasy or embarrassed.”

“He was always thinking about how to share his knowledge while letting other clinicians practice their autonomy and critical decision making,” Stevenson added. “He had faith in his fellow clinicians’ best judgment.”

“He’s influenced many people, in many different places, and that’s one of his biggest legacies.”

A joyful life

Philip retired as an emeritus professor in 2005 and moved to Sebastopol, California, with his wife, Louise Holcomb. He continued in his editorial role at NeoReviews and remained a member of national organizations such as the American Pediatric Society, the Society for Pediatric Research and the Western Society for Pediatric Research. He wrote nearly 100 papers, close to 15 book chapters and five books.

Philip and Holcomb spent many happy years on their country property where they enjoyed gardening, hiking and traveling abroad.

In addition to being an avid golfer, Philip played multiple instruments, including piano and classical guitar and was an accomplished Scottish country dancer.

Philip was preceded in death by his first wife, Elin Philip; his elder daughter, Tania Philip; and his brother, Duncan Philip. Besides Holcomb, he is survived by his daughter, Katrina Philip; a sister in Scotland, Elizabeth Kemp; and two granddaughters.