A Publication of WTVP

Dr. Donald E. Rager is the clinical associate professor of medicine and regional dean, University of Illinois College of Medicine at Peoria.

He was born in Peoria in 1932, attended Kingman Grade School, and graduated from Woodruff High School in 1950.

He worked as a machinist apprentice at Caterpillar Tractor Company from 1950 to 1953, before being drafted, and serving in the U.S. Army, in Korea, from 1953 to 1955.

Dr. Rager then attended Bradley University from 1955 to 1958, and graduated with bachelor’s degree in biology and chemistry in 1960.

He then graduated from the University of Illinois College of Medicine at Chicago in 1962, and completed his residency in Internal Medicine at University of Illinois Hospital, Chicago, in 1966.

Dr. Rager operated a solo practice in general internal medicine in Peoria from 1966 to 1968, before becoming chairman of the Department of Internal Medicine, and Residency Program director at OSF Saint Francis Medical Center. He held that position until 1982, and was named director of Medical Affairs at OSF Saint Francis Medical Center, serving in that position until 1995.

He has served on the faculty at the University of Illinois College of Medicine continuously since 1963.

Retired from 1995 to 1999, he reentered the workforce in 1999 to serve as interim regional dean at the University of Illinois College of Medicine at Peoria.

Dr. Rager has three sons and nine grandchildren.

Tell us about your upbringing, family, schools, academic accomplishments, etc.

I was born in Peoria and lived on Alexander Street in “Old Averyville.” I walked to nearby Kingman Grade School, the same school my mother (now 99 years of age) attended through 8th grade.

My father was supervisor of inventory control at Caterpillar Tractor Company and later suggested I should enroll in their machinist apprentice program, which I did after graduation from Woodruff High School.

My older brother, Charles, and sister, Doris, preceded me through the same schools, and my younger brother, Ken, followed the same path.

Two years into my training I was drafted by the U.S. Army. Fortunately, halfway through my infantry training, an officer in assignments, who was a baseball teammate at Woodruff High School, redirected me to truck mechanic school. Consequently, I was stationed in Pusan, Korea, far from the warfare.

Who or what influenced you to become a physician?

It was in Pusan that I volunteered to assist at nearby Mary Knoll Sisters Hospital—after cleaning the grease from my nails. That was the beginning of my interest in medicine.

Nevertheless, after discharge, I matriculated for a year as a mechanical engineering student, due to the assistance and encouragement of Caterpillar.

Toward the end of that year, engineering lost its appeal; but I concluded I was a good enough student (unlike high school) to succeed in medicine, and made the switch. The rest is history.

Tell us about your career path, beginning with private practice in general internal medicine.

Although I was asked to remain in Chicago for further subspecialty training, my wife, Laura, our three sons, and I were anxious to return home.

I enjoyed the two years of solo private practice in internal medicine in Peoria, but also enjoyed teaching; so I continued my faculty position by returning to Chicago each Tuesday to teach in the University of Illinois outpatient clinics. Meanwhile, I also engaged actively in teaching interns and residents at OSF Saint Francis Medical Center.

In 1968, I was asked to become full-time department chairman and residency program director at OSF Saint Francis Medical Center. I fully enjoyed 13 years in that position; but when offered the position as the first director of medical affairs at OSF Saint Francis Medical Center, I seized the opportunity to be in a position to be more effective in the further development of graduate and undergraduate education in our community. In that new role, I became the principal liaison between OSF Saint Francis and the College of Medicine.

In 1995, I fully retired to enjoy my family, my farm, tennis, handball, woodworking, machine work, tractor restoration, vegetable and flower gardening, and took up the acoustic guitar.

When asked by the University if I would consider serving as interim regional dean, my wife said, “why not?” so I said “why not?” I began as interim dean December 13, 1999, and then became regional dean January 22, 2001.

Not all physicians teach at a medical school. What are the requirements and/or advantages to a physician to also instruct?

The presence of a medical school provides a rich opportunity for a satisfying career for those of us who enjoy teaching and learning, and that activity can multiply any individual contributions possible in the usual physician practice. It does require juggling the competing demands of providing clinical care while meeting teaching obligations and engaging in some scholarly activity—not everyone’s cup of tea.

Tell us about the advantages to a community that has a medical school?

Some of the advantages of having a medical school have already been realized by this community over the past 30 years. The direct addition of 190 physician graduates to the tri-County area, the recruitment of countless specialist and subspecialist physicians attracted by the opportunity to become faculty, and the insertion and growth of biomedical research with its attendant spirit of inquiry, to name just a few.

All of these efforts elevate the quality of medical care and expand the breadth of clinical services. Most of these advances were accomplished in close cooperation with the hospitals, physicians, and community agencies.

Some services, such as the Pediatric Resource Center for child abuse and the Heart of Illinois HIV/AIDS Center, are primarily University developed and supported. Other, perhaps even more significant benefits, are yet to be realized.

Give us a brief overview of the College of Medicine. Number of employees/students?

The University of Illinois College of Medicine at Peoria, along with other regional sites in Rockford and Champaign-Urbana, was created in 1970 as a strategy to retain physicians in Illinois and deploy them in our region.

We matriculate 50 students yearly for three years. There is some attrition, so we might have 120 to 150 in any given year. Currently, we have 134; and with the Class of 2000, we graduated 1,169 physicians.

We employ 130 physicians and 138 staff, but rely heavily upon our 770 volunteer physician staff for their teaching efforts. This heavy reliance upon volunteer faculty is very different from traditional medical schools.

At what point in their education do students come to UIC? What can they expect? How long do they stay? Are any efforts made to keep them in the area after graduation?

Upon graduation from various universities, students apply for medical school and express a preference to spend their first basic science year either in Chicago (175) or Champaign-Urbana (125). Those who are assigned to Chicago remain there for second, third and fourth years of medical school.

Champaign-Urbana students choose Peoria (50), Rockford (50) or to remain in Champaign-Urbana (25).

The University of Illinois is the largest college of medicine in the United States, but our regional component is smaller, more personal and supportive—but no less rigorous.

Students can expect a challenging, primarily classroom transitional year, followed by two clinical years of supervised education in hospitals, clinics, and agencies (with increasing expectation of independence in preparation for the most difficult and demanding residency years).

We make every effort to convince them to continue their five-to-seven years of residency training in one of 10 programs in Peoria.

Currently, we have 167 residents and fellows training in family practice, internal medicine, medicine-pediatrics, pediatrics, emergency medicine, obstetrics-gynecology, surgery, neurosurgery, neurology, and radiology. Upon completion of that education, we encourage and assist them to enter practice in our region.

What areas of research have been conducted at the Peoria campus? What areas would you like to cover that have not been to date?

It is not so much an issue of what kind of research or how much, although those are important; it’s more a matter of blowing on that flickering flame of inquiry to ignite a widespread interest in discovery. That is, after all, what a university should be all about. “University types” like to talk about scholarly activity; I think of it as a kind of nosiness about life, a sort of formalization of natural curiosity.

If I do not list current areas of research, it is intentional so as not to insult any individual or group because I value it all. Having said that, it is nevertheless true that there has been a concentration of effort in the neurosciences, cardiovascular disorders, and an increasing attention to cancer research, which we plan to strengthen.

What is the economic impact of the UIC to the Peoria area? What are the potential economic benefits to the area?

Immeasurable! I say that because it is. It is easy to identify, but hard to put a number to.
Consider for a moment the number of employees, new physicians and their families, students, researchers, and support staff brought to this community in the past, and those yet to come as we grow this enterprise.

There will be new construction for our trade unions in the future. More and more, travelers will come for continuing education and research symposia. Perhaps a new biotechnology business will be attracted or sprout from products of research.

What is the price tag on providing facilitates for medical research? How are most costs covered?

We are currently developing plans for a 30,000 square-foot addition to our laboratories in support of an expanding program in cancer biology research. The cost for that is currently estimated to be $9 to 10 million. The costs for equipping, operating, and maintaining that space must come from research grants and contracts. The most significant sources would be the National Institutes of Health and the National Science Foundation.

You have been presenting Vision 20/20 to business and community leaders. What was the impetus behind creating the vision? Why is the UIC of Peoria the right vehicle to lead this strategic plan? Why/how is it important to central Illinois and the College of Medicine today?

Our Vision 20/20 was developed by the dean’s advisory committee, a group of 20 faculty leaders composed primarily of academic departmental chairs and associate deans. I asked them to create a shared vision to guide us as we develop our future.

We decided our purpose should be to lead collaborations to improve the health of our community and region. In fact, this vision is in fulfillment of our original purpose.

The Campbell Report, Education in the Health Fields for the State of Illinois, 1968, which commissioned this regional site, specifically recommends increased affiliation between private and public sectors to encourage much needed collaboration between the areas of practice and education, leading to fuller exploration of the community as an academic resource. Additionally, some community leaders have asked us to step forward and assume this role as a neutral convener of competitive entities.

Certainly no one can be threatened by us, so we would not be leading from a position of power or control, but as servant leaders on behalf of accomplishing the vision.

Perhaps this is our time, the moment in Peoria’s history when the health care industry comes together to be all that it can be, to more nearly realize its potential; to create some unity that would elevate our status as a regional resource, increase referrals, stabilize escalating health care costs, even stimulate economic development. Surely that would be important to the entire community.

What businesses and organizations in the area are important to the strategic plan and would be necessary in collaboration efforts?

Obviously, our second and third largest city employers, OSF Saint Francis and Methodist Medical Center, are key organizations if we are to succeed; but in fact our strength is to be found in the breadth and depth of our diversity.

We are at once large enough and small enough. Large enough in resource capacity to provide comprehensive services with the highest standards of care, but small enough to create a unified medical community with linked communication.

I do not underestimate the magnitude of complexity or the enormity of the barriers, but I see the vision as compelling. The approach must be inclusive of all stakeholders and share everyone’s mission.

What model, if any, has Vision 20/20 been patterned after? What was responsible for the success of a collaborative initiative in Kansas City?

We have no model and do not seek one. We believe our situation is unique, and we are excited about the opportunity to be creative. There are, of course, elements that we can borrow, such as a research planning process. That is why we traveled with hospital CEO’s and representatives from Bradley University and the Economic Development Council to learn about the Kansas City life sciences strategic plan.

Our need to create a research plan corresponds very well with our intention to identify an initiative suitable for a broad collaboration. There are no competitive issues to contend with as we seek a platform for building relationships. That approach appears to have been effective in Kansas City.

Isn’t the concept similar to corporate business plans when faced with rising costs and mounting competition? How so? How is it different?

In some ways, the joint venture between Caterpillar and Daimler is an example of identifying a scope of collaborative work that makes sense based on the unique strengths of each organization.

However, it takes a mature organization in a mature industry to gracefully and successfully compete and collaborate at the same time. Such maturity is not currently evident in health care organizations, so it is important to proceed slowly since risk is an inherent element in any collaboration. Since we intend to have long-term relationships with our partners, we must allow time for good ideas to emerge. Perhaps we can all mature together.

How is the Peoria area uniquely positioned to become a downstate medical center similar to Mayo Clinic?

We possess most of the raw ingredients for success, such as comprehensive medical services, highest standards of care, and commitment to medical research; but we need funding for medical research, linked communications, and a unified medical community to create a seamless, patient-friendly, efficient system of leading edge care that builds reputation.

What obstacles must be overcome?

Our greatest obstacle will be to confront and work through the substantial issues of difference of culture, tradition, and logistics between the involved institutions and agencies.

Those elements that form the basis for differentiation in the local marketplace must now be merged with shared capacities that will differentiate our community from our competition in the larger state and regional markets. That will require new attitudes as a determinate of new behaviors. We must have great patience as we work to transform our culture.

What can businesses do to support Vision 20/20?

We are venturing into very unfamiliar territory, so we will need advice from those in business who are aware of some of the pitfalls we might avoid and some of the strategies we should adopt. Most importantly, business leaders need to encourage collaboration, especially in those moments when mean-spirited competition rears its ugly head. Businesses and business leaders whom we all respect must exert a calming influence upon all of us.

What has been the community feedback on Vision 20/20? Which of the envisioned outcomes does the community value most?

The community has been very supportive of our Vision 20/20 and helpful to its further development.

New elements, such as attention to a nursing collaboration, have been added along with advice about strategies. The outcome most favored is “a healthier population where the needs of all are addressed within a financially viable system reflecting the best utilization of resources.” IBI