Transformed: How Oregon's Public Health University Won Independence and Healed Itself

by William Graves

Overview

Oregon Health & Science University seemed stuck in the backwaters of the nation's academic health centers when Dr. Peter Kohler became its president in 1988. Its hospital hemorrhaged money, served rusty water from its faucets, and sometimes forced women in its cramped maternity ward to deliver babies in hallways. Legislators proposed bills to close it. State support for the university was on the decline as was maintenance on its aging buildings. Roofs leaked, walls cracked, and researchers struggled in dark, ill-equipped labs. So Kohler and his young administrative team came up with a radical plan to help OHSU take control of its fate as a semi-independent public corporation. And they sold the plan to the Legislature and state leaders. Free from constraints of the state and its university system, the health center's creative and entrepreneurial power exploded. Over the next two decades, OHSU more than doubled its research, clinical and classroom space; tripled its employees; quadrupled its research grants; and expanded its operating budget five-fold, reaching the top echelon of the nation's medical research universities. This remarkable story offers a case study and possible model for other public universities and academic health centers now facing the same social and economic forces that drove OHSU to transform.

Product Details

ISBN-13:	9780988482791
Publisher:	Pacific University Press
Publication date:	02/28/2017
Pages:	478
Product dimensions:	6.00(w) x 9.00(h) x 0.96(d)

About the Author

William Graves has worked more than three decades as a daily newspaper journalist, including 23 years at The Oregonian in Portland. He is co-author of a book on education reform, Poisoned Apple, a graduate of the University of Puget Sound and Western Washington State University, and a former Nieman Fellow at Harvard University. He and his wife, Karin, have three adult children and live in Beaverton, Ore.

Editorial Reviews

"I know of no other academic health center or major public research university that ever made a change as radical as OHSU made in 1995: It left the state and the state system of higher education to operate largely on its own as a private corporation with a public mission. The architect of this change was Dr. Peter Kohler along with his leadership team, whose story unfolds in this excellent book, a worthwhile read for anyone with connections to academia or government." - Phil Knight, Chairman Emeritus, Nike Inc.

From the Publisher

2017-10-19
A book chronicles an ailing public academic health center's transformation into an independent corporation. In 1988, Dr. Peter Kohler became the president of Oregon Health & Science University, at the time beleaguered by problems. It was saddled with debt; state funding had all but dried up; its infrastructure was in desperate need of repair; its reputation was less than stellar; and it was divided by internecine disputes. Kohler believed that the way to a brighter future was through a radical reconfiguration of its operating model. This involved liberation from state regulatory manacles, which were prohibitively restrictive as well as nonsensical given the lack of support Oregon provided: "Withering state funding was the chief driver for OHSU to transform, not only because it needed more flexibility to compete in health care, but also because it made no sense to give the state regulatory authority over an institution it was no longer supporting." Graves (co-author of Poisoned Apple, 1995) details the history of this metamorphosis, ultimately achieved in 1995, and all the hurdles—logistical, financial, and legislative—that had to be cleared in advance of it. Once an independent corporation, OHSU was permitted to raise funds from investors, improve and expand its facilities, attract top doctors and researchers, and bid for higher-paying patients, eventually rehabilitating its name. The author also considers the extent to which OHSU can be understood as a model for others to emulate and a bellwether of the future of academic health centers. Graves has covered health care and education as a journalist for more than 20 years, and his experience can be seen in his remarkably thorough investigative research and unfailingly clear, concise prose. More than just an institutional history, this is an intriguing mélange of profiles, especially the sensitive portrayal of Kohler. Furthermore, it would be impossible to adequately relate OHSU's tale without also furnishing a history of Oregon's approach to the financing of health care as well as federal funding, something Graves expertly supplies. But one of the principal virtues of the book—its unremittingly scrupulous attention to microscopic detail—is also its chief vice; there is no factoid so minute that the author considers it unworthy of protracted examination. For example, complex discussions of OHSU's entry into the bond market, the challenges it faced expanding beyond Portland into outlying rural areas via the construction of a tram, and the resistance its mutation faced from its own faculty are all important parts of OHSU's history but are also unlikely to grip readers without a professional interest in the subject. Nonetheless, this is an astute peek not just into Oregon's grappling with the question of how to best provide affordable high-quality health care to its citizens, but also the nation's encounter with the same issue at large. Despite the accessible language, this is more an academic than popular treatment of the subject and should serve as a valuable resource for those working in the medical field. A comprehensive and insightful look at the intersection of health care and government.

Kirkus Reviews