Dr. David Russian is the new CEO of Western Washington Medical Group, a practice of 90 some health care providers based in Everett. (Kevin Clark / The Herald)

Dr. David Russian is the new CEO of Western Washington Medical Group, a practice of 90 some health care providers based in Everett. (Kevin Clark / The Herald)

W. Washington Medical CEO: Times are a changin’ for health care

Dr. David Russian, CEO of Everett-based Western Washington Medical Group, seems younger than his 54 years.

There’s excitement in his voice when he talks about challenges facing his profession and the group of doctors he’s been leading for not quite a year.

He quotes a favorite line from the Bob Dylan song, “My Back Pages,” and it seems to suit him: “I was so much older then, I’m younger than that now.”

Russian became the CEO of the growing medical group earlier this year. He takes over at a time of changing demands for his profession.

Russian grew up on the other side of the country, in Cranston, Rhode Island — a suburb of Providence — but a University of Washington medical fellowship many years ago brought him and wife Mari Vicens, a freelance journalist, to the Northwest.

Given his music penchant, it’s not surprising their son, 20, is named Dylan; they also have a 17-year-old daughter, Adrian.

The beauty of this “special place” captivated them, Russian said, but it’s also a culture thing.

“If you’re talking about medicine — I think this is something that folks don’t appreciate out here — we’re pretty progressive in the Northwest and the West Coast, particularly in the Northwest.”

He’s experienced both mindsets in his medical career.

After getting his medical degree from Washington University School of Medicine in St. Louis, Missouri, Russian did his residency at New York University’s huge Bellevue Hospital Center in Manhattan. That’s where he discovered his passion for pulmonary medicine.

Back then Bellevue Hospital in New York and San Francisco General were “the ground zero hospitals for the AIDS crisis,” Russian said.

A lot of gay men and drug addicts were coming in with what came to be called pneumocystis pneumonia.

“PCP was the term and we were just starting to figure out what that was,” he said. “It was a very unusual, very rare infection that was all of a sudden becoming very common.”

It was cutting-edge medicine, it was exciting, and it led Russian to specialize in pulmonary medicine — anything to do with the lungs, including asthma, occupational and industrial damage, and the effects of lifestyle choices like cigarette smoking.

Named a “top doctor” by peers and patients alike in publications ranging from Seattle Magazine to national health guide Castle Connelly to websites like www.vitals.com/doctors, Russian also specializes in sleep medicine, which he said was unheard of 30 years ago, but has become a hot topic in the past 10 to 15 years.

“Now it’s been a huge growth field and trying to help folks with their sleep is amazingly rewarding,” he said.

Russian moved here permanently in 1998 and joined Western Washington Washington Medical Group, serving as a board member at one point and later, as president of the group for five years.

Selected by the 18-member board last November to replace Jerry Tillinger as CEO, Russian is the group’s fourth CEO and the first doctor named to the position.

Following a six-month trial period, his title became official last May.

Despite his demanding job as CEO of a 95-member-and-growing medical group, he still manages to see patients the equivalent of one day a week.

He said it helps him understand what doctors are up against in a medical world where one of the big challenges is that health care costs too much.

The advent of the Affordable Care Act and a government mandate for electronic medical record-keeping — which Russian said he agrees with in principle — has been difficult for all medical groups because the technology is still rapidly evolving.

“Those products, I think it’s universally understood,” he said, “were not quite ready for Prime Time.”

A second big challenge, he said, is that payment models are changing, moving away from the traditional “piecework” method of charging by the X-ray or by the size of the stitched laceration, to charging by the episode.

So if a patient has a heart attack, he or she might get charged for the whole episode, Russian said, rather than “for every time the doctor saw you or every time the nurse gave you a water pill and every time you had an X-ray done.”

A third and constant challenge is to provide the best possible medical care in the evolving medical landscape, he said.

New data shows independent medical groups better able to manage this because their doctors can choose hospitals that best meet their patients’ medical and insurance needs.

From a business perspective, that’s a winning strategy.

“And the payers know this, by the way, the insurance companies — they get it,” he said. “Which is probably another competitive advantage we have; they understand that independent medical groups are very important in the landscape going forward.”

Western Washington Medical Group is 100-percent doctor-owned, Russian said, which means it’s not beholden to any hospital or corporation.

It is, however, Everett-centered; more than 90 percent of the group’s hospital work is at Providence Everett and 90 percent of its doctors live within a 15-mile radius.

“And we really feel like our model is super important,” he said, “in terms of providing the best care to the citizens, the folks that we’re in the community with.”

The group has doubled in size in the past 5-7 years and will likely continue to grow. By just how much is a question the group’s 18-member board is grappling with at the moment, hoping for an answer by early next year.

“We’re provider-centered, we’re independent, we’re growing,” Russian said. “But we don’t want to ever be just a cookie-cutter, Kaiser kind of a thing.

“We want people, when they come to see us, that they feel they’re getting personalized service. That’s really important to our group.”

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