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The transformation of Oregon Health & Science University under Dr. Peter Kohler's leadership showcases a remarkable turnaround from financial struggles and poor facilities to a thriving academic health center. By implementing a bold plan for semi-independence, Kohler's administration unlocked creative potential, leading to significant growth in research space, staff, and funding. This inspiring narrative serves as a case study for other public universities facing similar challenges, illustrating how strategic innovation can drive success in the academic health sector.