OHSU

Retiring OHSU President Dr. Peter Kohler Receives Honorary Degree

06/06/06  Portland, Ore.

Oregon Health & Science University President Peter Kohler, M.D., received an honorary degree from OHSU during his final commencement ceremony on Friday, June 2. The honorary Doctor of Science degree recognized Kohler’s dedication to the improvement of health care delivery systems and patient access. Kohler will retire from his post as president, a position he has held for the past 18 years, at the end of 2006.

In his speech to graduating OHSU students, Kohler spoke of his vision to transform health care access and counteract the forces impeding patients from obtaining the care they want and need. Kohler also spoke of the important intersection of health science, engineering and information technologies and how these expanding fields will continue to merge to serve an important role in improving health care. Kohler’s speech can be read in its entirety at www.ohsu.edu/ohsuedu/landingpages/kohlerspeech06.
 
Kohler is one of the longest standing presidents at an academic medical center in the United States. The many accomplishments that occurred during his tenure include:

  • The expansion of rural health care in Oregon through OHSU’s Area Health Education Centers.
  • The creation of the Center for Women’s Health, offering women throughout the region a level of specialized health care found in few other places in the country.
  • The conversion of OHSU into a public corporation, helping ensure its future healing Oregonians.
  • An expansion in OHSU’s research funding from $40 million to $274 million per year.
  • An increase of annual patient visits from 245,000 to 751,000.
  • Growth in the number of employees from 5,800 to 11,500.
  • The Oregon Opportunity public-private partnership to expand OHSU research. The project benefits
  • Oregonians through access to the latest, promising health care technologies and through economic benefits.
  • An increase in the university’s operating budget from $254 million to $1.2 billion.
  • The physical plant of the university has increased from 3 to 6 million square feet.


In addition, the university is currently completing a series of facilities expansion projects including the university’s new Biomedical Research Building and the Peter O. Kohler Pavilion, which greatly expand research and hospital and clinic capacity on Marquam Hill. The OHSU Center for Health & Healing will open this fall in Portland’s new South Waterfront neighborhood to provide research, clinical and education space. It will be linked to Marquam Hill via the Portland Aerial Tram.

 “It was a great honor to receive this degree and to be invited to address the next generation of OHSU’s medical, nursing, dental and engineering graduates, many of whom will work or practice within the state of Oregon,” said Kohler. “I look forward to watching these students and OHSU as a whole continue to transform the face of health care in the state, region and nation.”

Dr. Peter O. Kohler's 2006 OHSU Commencement Speech

The following speech was delivered by OHSU President Peter Kohler, M.D., on June 2, to OHSU’s 2006 graduating class.  Approximately 967 degrees from the School of Dentistry, School of Medicine, School of Nursing, the OGI School of Science & Engineering and the joint program of OHSU and Oregon State University College of Pharmacy and Allied Health will be given out during the ceremony at the Arlene Schnitzer Concert Hall.

Thank you.  On behalf of OHSU, I want to offer a warm welcome and heartfelt congratulations to the OHSU graduating Class of 2006.  This is a special day and I know that you want to spend it with your friends, families and classmates, so I plan to give one of the shortest commencement addresses on record. 

I would like to begin by asking a rhetorical question: Why did you enter the health and science professions?  As members of a society, I believe that we are all bound together by the social contract as envisioned by Rousseau.  As citizens, we have the responsibility to act in ways that benefit the general welfare, not just purely personal interest.  As health care and high technology professionals, we have an obligation to act in ways that improve the quality of life of our fellow citizens.

And from what I’ve seen, the altruistic motivation so valued by Rousseau is alive and well in the OHSU Class of 2006.  Student-led initiatives such as the International Health Conference give me confidence that the goal of service is firmly entrenched in this generation of professionals.  For those family members here today, this past year the students organized an extremely successful program on worldwide health with internationally renowned speakers.  Registration had to be closed off at 900 for lack of meeting area. The focus was on health issues in undeveloped countries.  I can cite many other examples such as the free clinics the students have started, the help for tsunami victims, and the work in poor neighborhoods here and elsewhere.  I could go on, but I applaud your actions.

Today is a day of change for you, one in which you turn the page from one chapter of your lives to the next.  It seems fitting on a day like this to try to imagine the changes that you are going to see, in your professional lives, over the next 20 or 30 years. You will need to be life-long students who can adapt, and to possibly create change yourselves.

There are significant trends in the field of health care and technology that I think will be paramount:  1) the state of the health care system itself, which is going to be unable to cope with increased need if we do not adapt; 2) the way we will need to deliver care in an era of scarce resources and provider shortages; and 3) the continuing – and accelerated – convergence between health care, engineering and information technology.  Let me take these one at time.

The Health Care System

The first is the method in which we as a country pay for health care – what is often known as the health care system.  So, one might reasonably ask: how did we get the system we have today?

For a long time we had fee for service with indemnity insurance.  In the 1960s the government enacted Medicaid and Medicare to provide coverage for the poor and the elderly.  As a result, today almost all Americans get their coverage through a third-party payer – either the government or an employer.

Because our system is built around categorical eligibility – the elderly, certain poor citizens, and the employed – we find ourselves with a growing gap made up of those Americans who do not fit into a covered category.  Today, 45 million Americans lack insurance coverage.  That figure is unacceptable and will continue to get worse without changes in the system.

The best way to address these gaps is to shift our system to one based on universal coverage.  As former Governor John Kitzhaber has said, we need to change the debate from category of recipient to level of benefit that all citizens will receive.  Everyone deserves health, but the allocation of scarce resources will increase the need for expanded ethics programs in health care.  Consider the problem of the allocation of resources internationally for the malaria and the AIDS pandemics.

So how do we get there?  I think cost will force the issue.  Health care now accounts for 16 percent of the nation’s economy.  The cost of health benefits makes it difficult for American companies to compete in a global marketplace with countries that provide coverage directly rather than require the employers to do so.

With the promise of exciting, revolutionary (and potentially very expensive) new genetic therapies in the near future, the cost of health care will continue to go up and up.  It should ultimately force our leaders to address the issue.  The debate has already begun.

Shifting The Delivery Model

That brings me to the second area, the delivery of health care.  This will affect all of you in your new career.  There are three major forces coalescing right now that I think are going to force us to reconsider how we deliver care.  These are: 1) the growing shortage of practitioners, which will certainly keep all of you in great demand; 2) the aging population; and 3) the growing uninsured population, which will be exacerbated as a result of 1 and 2.

The nursing shortage is fairly well known, but we are also facing gaps in physicians, dentists, pharmacists and technologists – and all to a degree that few people are aware of.  In fact, the World Health Organization recently called for the education and training of 4 million additional health workers over the next 20 years to combat chronic shortages around the globe.  Job security will not be a problem for you.

The aging population will increase demand for health services.  A 65-year-old will use on average three times as much care as a person younger than 50; those older than 85 – the fastest growing segment of the population – use six to seven times as much.  In short, we are going to have more demand for health services and yet a smaller supply of health care workers qualified to provide those services.  This will force us to find new ways to perform the patient encounters.

For decades, we have anticipated health teams made up of different professionals.  In the future, the teams approach should become more the norm than the exception.  Across the system, this would represent a more rational allocation of health care expertise.  And I hope that is an important step in creating a system in which you will want to practice – not because of the financial rewards but because of the human rewards.

On that note, I’d like to echo the comments of Virgil: “Let us improve life through science and art.”  I think that there is an art to health care and it comes into play whenever scientific expertise is backed by compassion and kindness.  I hope you bring this artistic and human touch to our scientific endeavors.

The Convergence of Health Care and High Technology

That brings me to my final trend, the convergence of health care, engineering and information technology.

The implementation and use of decision supporting software is just one example of this.  Another will be the use of advanced computational applications to manipulate and interpret vast reams of human genome data in the search of the genetic basis of diseases like Alzheimer’s, breast cancer and depression.

Perhaps the most immediate point of convergence will be in the development of sophisticated, computationally driven diagnostic tools.  (I had a CAT scan earlier this week that took only 40 seconds.)  In addition to improving accuracy and reliability of diagnoses, such tools will hopefully decrease costs over time.  It would be terrific if we could see in health care the shift to more powerful tools at decreased cost in the same manner that this has occurred in the high-tech industry.

OHSU researchers are already collaborating with the high-tech industry to develop technology to assess how seniors function in their home environment.  They have developed a pill dispenser that sends a signal wirelessly to a computer system when one of the compartments is opened.  The intelligent MedTracker pillbox is designed to help seniors maintain their independence and optimize their health and quality of life by collecting data for intelligent computing systems that can detect changes in health long before they would affect the seniors or their caregivers.

This is a great example of bringing health and science together.

Conclusion

These trends will impact how your career unfolds, but I would encourage you to consider that change itself may in fact be the dominant trend over the coming decades.

I hope you are proud of your achievement as OHSU graduates.  We believe that the university makes its greatest contribution through its graduates.  You are our most important product.

As you leave here today, I encourage each of you to think about how the great necessities of our day can call out the great virtues in each of you.  I know you will use your new knowledge wisely and well.  I hope you find in yourself the commitment to uphold the social contract.  You have already shown that you can put the needs of others ahead of your own.  In this way you can be assured that you will make important contributions to society and the world.

The world certainly needs heroes these days, and health is in many ways our most important possession.  I hope the successors to Albert Schweitzer and Mother Theresa are developing now.  Just think, you can be a local hero.

Again, I congratulate you on your choice of careers and I urge you to continue the altruistic motivation that you have pursued thus far.  You occupy an important role in society. I envy you the journey on which you are about to embark.

To the class of 2006: Thank you, congratulations, and good luck.

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