Turning Point

"I am a teacher."

These are the simple words Raymond L. Woosley, M.D., Ph.D., uses when asked about his medical career.

Woosley's modest statement is accurate -- but far from complete.

This distinguished University of Louisville graduate also is a pharmacologist, a physician, an internationally known researcher, a visionary administrator and an advocate for fundamental change in the culture of health care in this country.

In 1988, Woosley moved to Georgetown University School of Medicine, where his research on Seldane, then thought to be the "safest drug in the world," uncovered its potentially lethal characteristics.

The impetus for the research was a patient who had blacked out for no apparent reason. Woosley and others were asked to see her.

"We got together and decided it was her medications," Woosley recalls.

Until his follow-up study, no one had investigated whether Seldane could cause a potentially fatal effect on the heart when taken in combination with other commonly prescribed medications.

Woosley eventually was able to uncover the mechanism by which Seldane caused fatalities, but he didn't stop there.

During a rare quiet moment -- Woosley happened to be back in Kentucky to celebrate Christmas -- very late one night while feeding a bottle to his newborn son, David, it suddenly dawned on him that fexofenadine, a breakdown product of Seldane in the body, would provide the benefits of Seldane without the risk of death.

The result was Allegra, which today is one of the most widely prescribed antihistamines in the world, with annual sales of more than $1.9 billion.

In response, the American Society of Clinical Pharmacology and Therapeutics gave Woosley its prestigious Rawls-Palmer Award in 1990 for his contributions to medicine.

Woosley also worked with David Flockhart, M.D., Ph.D., at Georgetown in pharmacogenomics, the study of how genetic makeup influences drug reactions. Thanks to such on-going research, doctors may one day be able to write highly personalized prescriptions.

Flockhart, who today is a professor of medicine, genetics and pharmacology at the Indiana University School of Medicine, describes Woosley as a "visionary clinical pharmacologist who sees things way before they come over the horizon."

Given Woosley's deep interest in the causes of drug side effects, it's not surprising that he became the earliest proponent of the federal Centers for Education and Research on Therapeutics. Nor is it surprising that he was invited to direct one of the first CERTs.

Now seven in number, each center conducts research on a different type of patient population or drug therapy. The centers' shared mission is to improve medical therapy and reduce adverse drug reactions.

One mechanism already in place is an international online registry for reporting patients who develop arrhythmias because of medications they are given (http://www.QTdrugs.org).

The CERT that Woosley established at Georgetown has relocated to the University of Arizona, where Woosley became vice president of the Health Sciences Center in 2001.

His CERT-based research already has resulted in a better understanding of why women are at greater risk of certain drug-induced arrhythmias: Women are not more sensitive to the drugs in question; rather, men are more resistant.

A recent $3.9 million grant from the U.S. Agency for Healthcare Research and Quality will fund research to identify arrhythmias among methadone users. Woosley believes the research will result in "hundreds of lives saved from preventable drug toxicity."

Despite such a busy research agenda, Woosley has at least one other larger-than-life goal: He wants to change the culture of health care.

"Health care in this country is a disaster," he says. "We burden the system with so much bureaucracy there's no time left to take care of patients. We also reward the wrong behavior by paying the pharmacist, doctor and nurse for the volume of their work instead of the quality of care they give patients."

Woosley thinks he can make a difference at the University of Arizona Health Sciences Center, in part because it is only 35 years old and not steeped in any particular tradition. In fact, he's already brought together the schools of medicine, nursing, pharmacology and public health to develop new ways of teaching and delivering health care with teams of physicians, nurses, pharmacists and public health specialists.

According to a colleague in Arizona, Woosley's seeming inability to focus on a single goal is both his best and worst quality. He's always brimming with ideas and endlessly taking on new projects. He also admits he has a very hard time saying "no" to potential collaborators.

Woosley's interest in working with people in other disciplines can be traced to his first conversations with Huang at UofL.

Similarly, his experience of enjoying not just the study of medicine here, but also of history and humanities, is reflected in Woosley's enthusiasm for learning and understanding new cultures.

Despite outspoken criticism of the drug industry, in 2000 Woosley was asked to become a candidate for commissioner of the U.S. Food and Drug Administration.

Ultimately he declined, doubtful of his ability to win the highly political appointment. Instead, the challenges and opportunities of managing an academic health sciences center drew him to Arizona.

National and international acclaim have not caused Woosley to forget his Kentucky roots. His son was born in the state, and the family listens to bluegrass music nightly in Arizona. And when he called an elderly aunt during basketball season, "all she wanted to talk about was the NCAA and Kentucky's teams," he says.

"My memories of UofL are important," Woosley adds. That word can be applied to Woosley's work as well.

It's work that's extremely important, and a credit to both him and the University of Louisville.