PRES. HARROZ: Welcome back to Conversations with the President. If you have not subscribed yet, that is on you, do it immediately. We are thrilled you are back. It is that time of year again. It is maybe 105 outside right now. We've just started the new academic year and the excitement is everywhere.
So in a lot of these conversations, we've talked about what are the best indicators that a university is doing well in this big change, new world for higher education. The best indicator that I know that is out there, best early indicator is the size and quality of your freshman class. The last two years we have welcomed record freshman classes and this year is our third year, but it's not just a record year this year, we are actually over last year's record by 11%. We have over 5200 new freshmen coming to campus in our 135 years. We have never been stronger. The credentials are also chart topping. It's a really exciting time to be here but bring a small fan at least for today.
Topics. Today is exciting. The next two episodes actually will be interviews with and conversations with our two provosts. A lot of folks will ask what is a provost. I think the literal definition is a warden, but in fact, it is the chief academic officer.
We all know what deans do, and our deans on each campus report to the provost, who is the chief academic officer. Our first guest today is Dr. Gary Raskob. He is provost of the Health Sciences Center. He is a remarkable individual. We have been friends ‑‑ he is one of the few people who has been at OU longer than I have. What year did you join us, Gary?
DR. RASKOB: 1991.
PRES. HARROZ: Alright. He joined us in 1991. I came in 94. And you might just tell them a bit about your background. Tell folks what all you have done at the University of Oklahoma prior to this job.
DR. RASKOB: Well, thank you. As I said, I joined in 1991. I moved here from Canada, and I came as a faculty with a joint appointment in the College of Public Health and Epidemiology and in the College of Medicine and Internal Medicine. I started as a faculty working as usual primarily with a focus on clinical research and clinical trials and teaching in the epidemiology and public health programs.
And then, in 2002, the provost at that time asked me to take on the role of Dean of the College of Public Health and I did that job for 20 years.
PRES. HARROZ: That is a good round number, 20 years.
DR. RASKOB: Yes, and it was remarkable, incredibly enjoining, enjoyable and rewarding experience, and so now appreciate the opportunity to serve and continue to serve the university that has been so great to me and my career and professional development.
PRES. HARROZ: Yeah, you have been too modest, which is not my strong suit. If I were you, I would have told more about it. Before we get to the job you're doing right now, could you tell folks a bit about the research you do?
DR. RASKOB: My career has been focused on clinical trials and evaluating new approaches for prevention and treatment of a condition called thrombosis, which is blood clots. People may not know that a blood clot is the underlying cause of a heart attack, of most strokes, and of a condition called pulmonary embolism where clots are in the lungs and can cause death. And that underlying condition is ‑‑ thrombosis is responsible for one in four deaths in the world, and I so have worked with partnership with many pharmaceutical companies in developing new drugs and treatments for this condition, which affects many millions of people across the world.
PRES. HARROZ: And you have been an advisor to the CDC, the Centers for Disease Control based out of Atlanta and the National Institute of Health.
DR. RASKOB: Yes.
PRES. HARROZ: I would have lead with that if I were to have those credentials. All right, so you spent 20 years as the dean of the college, the Hudson College of Public Health including being close to the Hudson's and securing that name and gift. Did a stunning job and I got to know you really well during your time when I was a dean and you were a dean as well. We asked you to step in on an interim basis to be provost, and you spent about 10 months doing that and then came in and you have been doing the full‑time job now for more than a year. You have done an incredible job. Why don't you tell the listeners, the deans and the colleges that report to you.
DR. RASKOB: Yeah, no. You know the University of Oklahoma Health Sciences Center is really one of only three across the country that have all seven health professional colleges on the same campus. So medicine, nursing, pharmacy, allied health, dentistry, public health and then a graduate school, and then together with that, we have NCI Designated Comprehensive Cancer Center and a level one trauma center for both adults and children. So this is an incredible environment, and so each of the deans of those colleges, the graduate school, the director of the cancer center and the director of the Hamm Diabetes Center are my direct reports and close colleagues and work together to, you know, really have a coordinated effort at the Health Sciences Center in education and research.
PRES. HARROZ: Yeah, people drive by the campus every day because the primary campus is located in Oklahoma City, and it has the seven colleges that you referenced. People often get confused on what the missions are for the Health Sciences Center. Could you talk about what the three missions are and how they operate?
DR. RASKOB: So the terrific thing and the thing that makes it really enjoyable is that we have three core missions, and they are all equally important, and they are very much integrated into each other. The first and foremost and the foundation is for us to deliver top‑quality cutting edge, clinical care, healthcare delivery for diseases across the spectrum, and for the most complex and sickest patients that, you know, other systems in the state can't deal with, and that is the foundation, and we build on that. That is executed through our partner OU Health, and then that forms the basis by which we can be the flagship entity for educating all various health professionals, medicine, dentistry, nursing, and the ones I mentioned. And our healthcare system provides the great substrate for where those people get excellent training and their professional development. And at the same time, we integrate into that research across the spectrum of basic laboratory studies through to very applied clinical studies in patients to community‑based prevention programs. So you get that tripartite spectrum of work on taking care of patients, educating the next generation of health professionals, and really contributing to discovery and advancement of knowledge.
PRES. HARROZ: Yeah, and to me this is the exciting thing that was not intuitive to me until I got really involved in academic medicine, and in academic health systems, and that is that those three missions, that is being a healthcare provider for the sickest patients in the state that nobody else could care for, and those who can't afford care, that being the one mission that you discussed. The teaching and training of the healthcare workforce for our state in the region and also the research, the fact that these three things work together and without one, each of them would not work and certainly would not work at the level they do when they are together.
DR. RASKOB: Yeah, no that's right. And you can think for example, a patient at the Stephenson Cancer Center is there to get top‑quality care for their cancer, which is a devastating diagnosis, but at the same time, that patient may see a resident or a fellow who is being trained in their discipline of maybe medical oncology or one of the specialties of cancer. And that patient may also then, fortunately have the opportunity to enroll in a clinical trial of cutting-edge therapy that is not yet approved by the FDA and would not be available to other patients if you are not in the clinical trial, and unfortunately, many patients in cancer need those treatments because the standard care does not work for them.
PRES. HARROZ: Yeah, and I think that is something that again is not intuitive to a lot of people. That there are healthcare systems that we have and some very good ones in Oklahoma, but they are community hospitals meaning they don't have the academic and research component that has the subspecialists and those treatments that nobody else can provide outside of an academic health system, and we are the only ‑‑ the states only comprehensive academic health system.
DR. RASKOB: Yes.
PRES. HARROZ: And to me that is a point that can't be lost. Now let's turn to the second of those missions, which is education. We've talked about the seven colleges that are part of this, but I want to tell one story. We were in COVID and ‑‑ across the country and certainly across our state, there were people that could not get enough nurses to provide care. People were literally dying because there were not enough nurses and you were in this position on an interim basis, and this is where you earned your nickname, which I'm going to divulge to our listeners, but we have been told we could not increase materially the number of nursing students that we have, and therefore impact the number of nurses available for Oklahoma.
Now, a lot of folks don't know this, but we provide over 70% of the healthcare workforce for our state. And I asked a question, could we increase the number of nurses that we generate through our program? And nursing is typically two years, but it can be an expedited program of 15 months. You came in and I asked you to come up with a solution and you came back, and you said Joe, we can take every qualified nursing applicant and I said well, Gary, that is ridiculous, there are over 500 that we turn down each year because we don't have enough slots. And you, through your leadership, found a way to get that done. Over the last two years, we have increased by how many the number of nurses that we are producing.
DR. RASKOB: Well, we went in 2020, we entered an entering class of about 300. Just this week or last week we started our entering class a little over 500. So we have increased very significantly. And, you know, thank you for the kind words. I mean what a great team we have at the College of Nursing faculty, staff, the dean. After they stopped hyperventilating, when I said we are going to increase the class, they said okay. We are in, they stepped up, we got a team together and it was simply about looking at resources. We made space available, we hired more faculty and we got more stuff and tutors. Very important to stress, we didn't lower the quality of the requirements to come into the program. We just said let's realign our resources to address the crisis. Oklahoma needs about another 14,000 nurses to come up to the national average of nurses per capita. We as the Academic Health Center, have to be a leader in helping meet these workforce crisis. These are going to play out in some of the other areas, by the way as well, but, you know, the people I think expect us to deliver, and we just said look, let's figure out how we can do this. What can we delay for a while, reallocate resources, make great space available. The students are so excited. They are wonderful, and it is really exciting to see it happening.
PRES. HARROZ: Yea, it really is. I've been over to watch some of the classes and to see how they have leveraged technology to help enhance the teaching and make this possible through advanced simulations and it really is stunning. And you are right, the dean, all of the talent over there stepped up in a magnificent way. So we will go from graduating, you know, 600 or having classes of 600 to about 1000. And that is remarkable. And that earned you a nickname, which is ‑‑ which I'm going to reveal right now, which is the cracken, which if you have not had a chance, Google that and you will see that is who we have as the provost at cracken.
So we know there are not enough nurses, we are working hard on that. We have also taken a look at the other colleges at the Health Sciences Center, and we realized that we don't have enough physicians, there are not enough dentists. Go across the spectrum. So tell us about ‑‑ we worked on a strategic plan, appreciated your leadership ‑‑ a very clear strategic plan for the Health Sciences Center. So talk a little bit about the other academic areas.
DR. RASKOB: So there are ‑‑ we face a physician shortage in the United States. We have to do our part and as the only really medical school in the state, and the key issue there is that we can’t quite do it as quickly as we did with nursing. We have to do a stage approach over several years due to our accrediting bodies, but we are working with them so that we can take again as many as we can. There is no shortage of applicants for medical school. There is way more than we can have taken. We can take more, and we will do that and again this is a matter of just logistics. Then you go to dentistry –
PRES. HARROZ: So hold on. So when talking about physicians, how many more are in this class than the previous class?
DR. RASKOB: 13 more medical students this year. That is about a 7% increase. We will try to do that every year, but I think we will really -- next step is to engage with the accrediting bodies and it's very important all of our healthcare programs are accredited. That means they are reviewed by outside bodies to make sure they are rigorous and adhering to highest possible standards. They just want to be sure that we don't stretch the envelope too much in terms of not providing resources to give a good education. That is their responsibility, but if we make the resources available, we can increase the class significantly.
PRES. HARROZ: Yeah, and that is the exciting part is it has increased 7% this year because that's the maximum you can do it in one year under the current accrediting standards. We are going to make sure we always live up to those, but to the extent we can bring more in we will. And the same issue with dentistry, right.
DR. RASKOB: Yeah, there are counties in Oklahoma that have no dentists. I think somewhere in the range of 8 to 10 counties don’t even have one dentist. Dental care across rural Oklahoma is very challenged. So both through the Doctor of Dentistry program providing more dentists, but also through the dental hygiene program, which at least gets people out to help people prevent, you know, poor consequences of poor oral health.
PRES. HARROZ: Yeah. It is exciting. So what we are going to see is real growth in the number of the healthcare workforce, talent that we are producing. I think it is incredibly exciting. Now let's turn to the third of those tripartite mission that you referenced, which is research. We spent a lot of time talking about where we want to go, but let's first talk about where we are today relative to healthcare research in our state.
DR. RASKOB: So the OU Health Sciences Center has a portfolio of extensive research, as I mentioned, from basic laboratory study through to very applied clinical investigation. We have the largest portfolio of NIH funded research in the state at approximately $60 million a year. For the listeners and watchers, it is important to note that all of those funds are competitively won by our faculty through their proposals, competing against the top-notch institutions across the country and rigorous review. The National Institute of Health, which is the largest government funder of research in the world is putting 60 million a year to us for research across the spectrum of cancer, diabetes, cardiovascular disease, neurosciences, brain aging. All really important areas that are directly linked to the burden of disease in Oklahoma.
PRES. HARROZ: Yeah, it is remarkable. So I have learned these stats from Dr. Mantle who, of course, runs the Stephenson Cancer Center, but you know, it is stunning, right. In Oklahoma one in two men will be diagnosed with cancer. One in three women will be diagnosed with cancer, and 35% of those who get diagnosed with cancer, it will be their cause of death. We know that if you go to an NCI Designated Cancer Center and we are the only one in this state and some states don't have any, that your opportunity to live beyond one year and those rates are improved by 25%. You have been spending a lot of time working on broadening out where people can go to get Stephenson's cancer research and treatment. Tell us where we are in our path to making it available, right now as of a year ago, one in six Oklahomans that receive a cancer diagnosis went to Stephenson, but there was just one location. What are you doing to help broaden that up?
DR. RASKOB: During the last year, we have expanded to have a presence in Norman with an important partnership with Norman Regional Hospital, and so there is a Stephenson Cancer Center, patients can be seen there. I think it is important before I go into more detail to say that when you have cancer, if you can go to a place close to your home, it makes a world of difference. Our mission is to bring NCI Designated Cancer Care statewide in Oklahoma and to have a statewide presence.
PRES. HARROZ: So let’s pause. For those that – you know, no one gets to dodge the cancer journey with their family, but for those that haven’t had to do it yet, the reason that proximity matters so much is that when you go in for your course of treatment, you are there almost every week, and you have to be there for your chemo treatments, right? Or for your radiation treatment or for the surgical component. And so while the fortunate few can fly to MD Anderson or elsewhere, most people you’ve got to maintain a job while you are doing this. You have to maintain the connection to your family. And if it’s too far away, then you simply can’t receive the treatment.
DR. RASKOB: Right.
PRES. HARROZ: And we, as of a year ago, we are suffering from this and Oklahoman’s are suffering from this because we are the only one and we were just located in Oklahoma City. Now we’ve added with Norman Regional, an opportunity in Norman.
DR. RASKOB: Right. And we are well on our way to efforts to expand the Stephenson Cancer Center to Tulsa and Northeast Oklahoma. You know, the critical thing is it's not that there’s not other cancer doctors in some of those communities, but again, if you’re the significant proportion of patients for which the existing treatments do not work, you must have those options to get to clinical trials and other things to save your life. And so we hope that by expanding to the Tulsa area and serving Northeast Oklahoma with, for example, mobile screening and going out in the community with ways to help people in rural Oklahoma, that will change from one in six Oklahomans to really one in three Oklahomans receiving cancer care at Stephenson Cancer Center within the next five years.
PRES. HARROZ: Yeah, it’s really dizzying. When we looked at Northeast Oklahoma, while one in five or one in six Oklahomans that received a cancer diagnosis, were being treated at Stephenson when it was only in Oklahoma City. We realized that for Northeast Oklahoma, that only 3% of those that received that diagnosis from that geographic area were coming to Stephenson. That is they were not getting access to clinical trials, to the protocols that involved specialized tumor boards versus just one doctor looking at this even if they are an oncologist. That has a material difference in outcomes and so that is the reason we are looking so hard at Northeast Oklahoma. And literally, you can do the math on how many lives will be saved, how much suffering can be reduced and how much prevention can take place when we are a part of that entire cycle of care. That is detection, diagnosis and treatment, in some cases the elimination of it, hopefully is the outcome. To me, there is not much in life you can do to be a part of being a superhero, but what takes place at Stephenson is a good example.
Talk a little bit about we have – there are so many other areas from having the only level one trauma center in the state to what we do around pediatric ICU, but talk a little bit about, if you would, what takes place in the Hamm Diabetes Center.
DR. RASKOB: Yeah. The Hamm Diabetes Center is really remarkable. It is, again, it’s going to be very analogous to the Stephenson cancer center and its missions and goals just to set the context for that. About 14% of people in Oklahoma have diabetes. That is right now about 450,000 individuals with diagnosed significant diabetes and diabetes then over years brings serious consequences in terms of cardiovascular disease, risk of heart attack, stroke, kidney failure, blindness, limb loss. Just a litany of devastating consequences for people's life morbidity. So after – and then another million people in Oklahoma have what we call prediabetes. So at the Hamm Diabetes Center we are taking sort of a –
PRES. HARROZ: Wait, say that again. How many?
DR. RASKOB: About another million Oklahomans have prediabetes.
PRES. HARROZ: So to be clear, in our state, we have 4 million people.
DR. RASKOB: Yes.
PRES. HARROZ: So one in four, just to be clear the scale, right, on top of that one fourth of Oklahomans have prediabetes.
DR. RASKOB: Yeah. So prediabetes is basically a situation where your body is not handling glucose properly, but 11% per year of those people will convert to actually full‑blown diabetes and then puts them at all of the risk for all of the bad consequences that you can get after years of diabetes. So we are taking sort of two tacts of research. One is very basic investigation to try and understand the cause. What is causing this? Yes, it is being driven by overweight and obesity, but why do some people get it and not others who are overweight and so on and what is going on at the cellular level? What is going on perhaps in the womb before a baby is born, influencing their genetics or other things that is leading to that. And what is going on in the area of research called the microbiome? That’s the gut bacteria and so on. And how are these things influencing the metabolism and the issues with diabetes. So that's really cutting edge, frontier science that is the lifeblood of what will come in 10 or 15 years in terms of treatment.
At the same time, we realize there’s so many people who can’t wait for that. They have serious diabetes now, and they are going to face bad consequences, so we are looking at programs of prevention and treatment to address the complications and to really reduce the suffering. One of the key areas are individuals, you know, who are facing bad circulation in their legs because of diabetes and limb loss. And having a multidisciplinary team to prevent that and to prevent amputation, to prevent wounds in the feet and so on that diabetics get, also blindness, you know. So looking across the spectrum and to say we need to reduce the suffering from diabetes. There’s a lot we can do right now through some very coordinated multidisciplinary programs. And we want to be the place where a lot of these new drugs are tested and evaluated so that people can get access to those and not have to wait years for FDA approval.
PRES. HARROZ: Yeah, and really the incredible ‑‑ think about what a state can do for the citizens. We talk a lot about where the Health Science Center fits, and when you think about the three things a state can do, it is the health of the population and you have written a book recently over this. It’s the health of the population. It is the education of those and the economic opportunities and prosperity that can arise from that. And really, there is not a great state in the country that lacks a fully integrated comprehensive academic health system, which is a mouthful, but an academic health system at this level that does serious research is absolutely essential to the prosperity of a state and the well‑being of a state.
To me, what is so exciting about this is that when we talk about increasing the number of individuals that can be a part of the healthcare workforce and we talk about the clinical care treatment options that are only available in an academic health system where no other health system can or does provide it, right. As we look at each of these, there is a partnership going on with the state right now that has not existed before and with donors whether it is Charlie Stephenson, or Harold Hamm, right, or the Chickasaw Nation or all of those individuals that invest in what we are doing and at the state capital. We have seen record dollars flowing into this area because they understand that we have to have this to improve our health care outcomes as a state, and it’s starting to have traction.
DR. RASKOB: Yes, no it’s going to make real impact and I think with our plans, with the strategic plan for growth, I think we will begin to finally start to move the needle on some of those metrics where, you know, frankly I’m -- I have been here 30 some odd years now and I'm tired of hearing Oklahoma ranks so bad in heart disease and depicted and we are down in the bottom five of these health indices. Now, if that was the situation for the OU football team, some serious action would happen, wouldn’t it?
PRES. HARROZ: Absolutely.
DR. RASKOB: So it’s good that we are starting to see, you know, the legislature, so appreciative of them appropriating $96 million to OU Health for indigent care, you know, to bring the same level of quality treatment to people who are unfortunate to have that, and that is I think a crucial, critical role of an Academic Health Center as well.
PRES. HARROZ: Yeah, and there are areas, you know, so the 96 million was for just that, it was to pay the actual hard cost of treating individuals that didn’t have healthcare and wouldn’t be treated by anyone else, right as we go through this, but talk about other investments. One of those that is on the near – on the horizon occurring right now is around pediatric behavioral health.
DR. RASKOB: Yes.
PRES. HARROZ: What is happening there?
DR. RASKOB: Yeah, very important area, and through the, again through the legislature, over $40 million was put forward to help really build a strong --strengthen what is an excellent effort already in healthcare, particularly for children, behavioral health for children and adolescents. This is any, you know, any parent who has a child with some of those conditions really understands the impact that it has, and there is a shortage of those professionals, there is a shortage of these treatments because this is not a big revenue generator for most hospitals.
PRES. HARROZ: But it is a critical need for families.
DR. RASKOB: Absolutely crucial.
PRES. HARROZ: When you need pediatrics, inpatient or outpatient behavioral health, the whole world is upside down there, terrible consequences. To me this is exciting, this is a nonpolitical issue and to me it’s fun to see the governor, the governor's wife, it’s great to see involvement in these matters, it's great to see Pro Tem Treat, Speaker McCall, we can't leave out the biggest advocate for this, which is Senator Roger Thompson, folks that are really invested in this.
DR. RASKOB: Right. And this will have a big impact on families, huge impact on families.
PRES. HARROZ: Alright. I know we have limited time in these and I could go on with this forever, but one topic I want to cover though is we had a breakthrough in the research with, I think it’s OK1, which is an ovarian cancer drug. Tell us a little bit about that.
DR. RASKOB: Yeah, so, you know, new drugs go through a series of development. Of course, maybe people don't realize before a drug actually goes into a person, there is a huge amount of front end work, preclinical work, screening for toxicity and so on. And then comes what is called the clinical development plan. And phase one is the first time it is given to people, then it goes through phase two and three, which are a series of clinical studies to do two things. Establish that it actually works for what it is supposed to do or not, and then secondly, make sure that it is safe and that we evaluate the side effects, and we get good data on risk and benefits so doctors can explain this to patients.
We were very fortunate that our team at the Stephenson led the clinical development, the global clinical development of that drug in ovarian cancer. That means they were the academic leaders on the committee that, you know, oversaw the study. Designed the study, oversaw the study, and you know, that is incredible. This was a global study because nowadays, these studies have to be quite large, so any one individual can’t do it all. You have to be in a partnership of many centers, but it's important I think for Oklahomans to know that we are taking an important national leadership role in many of these areas. That we have scientists of the caliber that pharmaceutical companies and the NIH and the NCI and others coming to say we want your person to lead this project, those people are at the University of Oklahoma Health Sciences Center and Society.
PRES. HARROZ: It’s incredibly exciting. Gary, you know, it’s been a joy to watch you lead the College of Public health, the Hudson College of Public health. You did a remarkable job there. When you came in to take over the interim job, we were looking at a national search, and I thought it would be a temporary position for you. You have just done stunning work. You are moving the needle. You are -- the passion that we heard in your voice about making a difference, right. None of us should accept the health care outcomes in our state right now. This is our state. It belongs to us, and we are the ones who are in a position to move the needle. Your leadership is beyond valuable. You do it with a joy and a zeal and a commitment. I just want to say thank you for joining us here. Thank you for all of the work you do and thank you for earning the title and the name the cracken. Thank you for joining us.
DR. RASKOB: Thank you for having me.
PRES. HARROZ: That concludes this episode of Conversations with the President. Certainly thank Dr. Raskob for joining us. You can see why he’s the right leader at the right time. Please join us again. Thank you for tuning in for Conversations with the President.
