Still associated with MTM, Paltrow served as executive producer of the acclaimed drama "St. Elsewhere", which followed the staff of a decrepit Boston-area hospital. Again, he was associated with a series that critics loved, which could make money by appealing to an upscale demographic, but which was no winner in overall ratings. "St. Elsewhere" was a perennial nominee at the Emmy Awards and that cachet helped it eke out a six-year run. of a decrepit Boston hospital. After numerous years on the West Coast, Paltrow shifted his base to NYC in the mid-1980s. In 1988, he was creator and executive producer of the Manhattan-based "Tattinger's" (NBC), a series set in and around a chic eatery that mixed somber stories with more witty fare and featured a heavyweight cast including Stephen Collins, Mary Beth Hurt, Jerry Stiller and Paltrow's wife Blythe Danner. When the show fell to poor ratings, he attempted to retool the material as a sitcom ("Nick & Hillary" which also sputtered.
Disillusioned with the demands of network TV, Paltrow took a hiatus before returning to the grind as co-creator and co-executive producer of the comedy series "Home Fires" (NBC, 1992), which began each episode with family therapy. Two years later, he served as executive producer and director of the pilot for "The Road Home" (CBS), in which Karen Allen and family move back to rural North Carolina.
Although his first big screen outing as writer-producer-director was the pallid comedy "A Little Sex" (1982), Paltrow announced a return to moviemaking in 1997 at the helm of the comedy-drama "Duets", set in the world of karaoke. At its initial disclosure, the film was to be a vehicle for Paltrow's daughter Gwyneth and her then-fiance Brad Pitt. Shortly before production, the couple had a very public break-up, although they planned to fulfill their commitment to the project. Columbia Pictures put the film into turnaround thus sparing the estranged couple from having to work together. Paltrow and his partners were able to place the material with Seven Arts and Gwyneth Paltrow stepped before the cameras with her dad in the director's chair in late 1998 and was released to mostly negative reviews in 2000. By all accounts Paltrow had a warm and doting relationship with his superstar daughter, and the two were vacationing in Rome together to celebrate Gwyneth's 30th birthday when Paltrow died of complications of pneumonia and a recurrence of throat cancer in October 2002.