An all-in­clu­sive leader

For­mer Vir­ginia Ma­son exec ‘pushed the en­ve­lope’

Modern Healthcare - - Health Care Hall of Fame - Ed Finkel

Austin Ross led from the back of the room. For­mer col­leagues at Vir­ginia Ma­son Med­i­cal Cen­ter, where he served as ex­ec­u­tive ad­min­is­tra­tor, say he ex­erted his in­flu­ence sub­tly but un­mis­tak­ably on many fronts, per­haps most notably when coax­ing the birth of the in­te­grated de­liv­ery sys­tem and reach­ing out to both ru­ral and in­nercity providers.

Gary Ka­plan, chair­man and CEO at 289-bed Vir­ginia Ma­son, Seat­tle, re­calls meet­ing Ross for the first time as an in­ter­nal medicine res­i­dent and find­ing him ap­proach­able and hum­ble. “He is very re­spect­ful and very in­clu­sive,” Ka­plan says. “Al­though learned and wise, he saw the unique at­tributes of ev­ery in­di­vid­ual. He made you feel val­ued and ap­pre­ci­ated the ideas that each in­di­vid­ual brought for­ward.”

Ross was named CEO of Vir­ginia Ma­son Hospi­tal in 1968 and held the top job at the med­i­cal cen­ter from 1977 un­til his re­tire­ment in 1991.

Ross, 80, re­calls the 1987 fi­nan­cial merger of not-for-profit Vir­ginia Ma­son Hospi­tal and the for-profit Ma­son Clinic—which had al­ways been joined in a “Si­amese-twin­like” ar­range­ment at the ex­ec­u­tive man­age­ment level—as the most sig­nif­i­cant achieve­ment dur­ing his time there, al­though he’s quick to stress that “it’s not due just to me.”

The for­mer part­ners in the clinic had to vote to give up their eq­uity in­ter­est, which all but one did—and that per­son “told me later he didn’t think doc­tors should ever to­tally agree on any­thing,” Ross re­calls with a chuckle. “I’ve felt for a long time that hos­pi­tals and doc­tors needed to get on the same side of the ledger. The docs had to be the ones that led the de­ci­sion, ul­ti­mately.”

Ross had a deep un­der­stand­ing of the need for doc­tors and ad­min­is­tra­tors to work to­gether out of mu­tual re­spect in the pa­tients’ best in­ter­ests, says Ka­plan, who also val­ues Ross’ lead­er­ship in found­ing a not-for-profit health ser­vices con­sor­tium that linked about 14 small, ru­ral hos­pi­tals with Vir­ginia Ma­son and one an­other.

“He had a vi­sion for in­te­grated care, for what the Vir­ginia Ma­son group prac­tice and Ma­son hospi­tal would be­come, and how he could im­pact the re­gion through his health ser­vices con­sor­tium,” Ka­plan says. “How do we share knowl­edge, share con­tin­u­ing med­i­cal ed­u­ca­tion?”

In that vein, Ross built ties with pri­mary-care com­mu­nity clin­ics in Seat­tle and through­out the re­gion, to which Vir­ginia Ma­son pro­vided “thou­sands upon thou­sands of re­fer­rals, and made a con­tri­bu­tion in re­duc­ing health dis­par­i­ties and im­prov­ing ac­cess for low-in­come peo­ple,” says Mark Secord, for­mer as­sis­tant ad­min­is­tra­tor at Vir­ginia Ma­son. “He pushed the en­ve­lope. That was Austin’s trade­mark.”

Ross cred­its Vir­ginia Ma­son’s board with the fore­sight to ac­quire enough prop­erty to al­low for ex­pan­sion, bloom­ing from 26 doc­tors and about 200 beds when Ross first ar­rived at the or­ga­ni­za­tion in 1955 as an ad­min­is­tra­tive as­sis­tant to 400 doc­tors and 280 beds when he re­tired more than three decades later.

“You couldn’t do that on the old prop­erty,” Ross says. “It’s the out­pa­tient, am­bu­la­tory side that was re­ally grown.”

An­other achieve­ment about which Ross re­mains proud is Vir­ginia Ma­son’s de­ci­sion to step up and save the Bai­ley-Boushay House, es­tab­lished in June 1992 in Seat­tle to pro­vide care for HIV and AIDS pa­tients, when the agency that had planned to run it backed out. The de­ci­sion car­ried fi­nan­cial risks as well as the stigma that AIDS still held two decades ago.

“It was a pretty con­tro­ver­sial thing. Med­i­cal staff peo­ple and oth­ers didn’t want to get too in­volved,” Ross says. “The key to it was get­ting the smart-think­ing physi­cians to take the lead­er­ship in it. … Ev­ery­body looked at AIDS as bad stuff.”

“Vir­ginia Ma­son’s tak­ing over the op­er­a­tions of Bai­ley-Boushay House wouldn’t have hap­pened without him,” Secord says. “What made sense to Austin was sim­ply the com­mu­nity need for some­one to step up and do a com­pe­tent job. There cer­tainly was a con­sid­er­able amount of fear about AIDS and ho­mo­pho­bia within ev­ery or­ga­ni­za­tion, in­clud­ing Vir­ginia Ma­son. … The big­ger is­sue was the fi­nan­cial risk.” Ross en­joyed a sec­ond ca­reer as a pro­fes­sor of pub­lic health af­ter his re­tire­ment from Vir­ginia Ma­son. He says he val­ues the aca­demic chap­ter of his ca­reer greatly, both for the op­por­tu­nity to work with young peo­ple and to pub­lish even more fre­quently than he had done as an ad­min­is­tra­tor. “I loved teach­ing. I feel it’s so im­por­tant to men­tor peo­ple,” says Ross, who re­tired from teach­ing in 1999.

“He helped to both cre­ate and to honor and make vis­i­ble the body of knowl­edge that made one a health­care ex­ec­u­tive,” Ka­plan says. “His text­books are leg­endary. He’s one of the great­est, if not the great­est thinker, among health­care ex­ec­u­tives.”

Of his six books and more than 50 ar­ti­cles, Ross’ most cel­e­brated work is likely a text­book that he co-au­thored, Am­bu­la­tory Care Man­age­ment, first pub­lished in 1984 and most re­cently up­dated in 1998, that’s still used in uni­ver­si­ties across the coun­try.

William Dowl­ing, past chair­man of the Health Ser­vices Depart­ment at the Uni­ver­sity of Wash­ing­ton, ap­pre­ci­ated Ross’ open door to tak­ing in­terns at Vir­ginia Ma­son from UW in ad­di­tion to his alma mater, the Uni­ver­sity of Cal­i­for­nia at Berke­ley. “He said, ‘Fair’s fair. This is the MHA pro­gram in the state of Wash­ing­ton,’ ” Dowl­ing re­calls. “He was al­ways very sup­port­ive in a guest lec­ture role, men­tor­ing our stu­dents, or find­ing field work projects they could do at Vir­ginia Ma­son.”

When Ross joined as a full pro­fes­sor upon leav­ing Vir­ginia Ma­son af­ter sev­eral years on the clin­i­cal fac­ulty, some in the depart­ment sniffed that Ross hadn’t paid his dues on the re­search side, “from the nar­row per­spec­tive, I would say, of academia,” and Dowl­ing an­swered: “Look at his C.V. He has pub­lished more than most of you have, even run­ning an or­ga­ni­za­tion like Vir­ginia Ma­son.”

Ross led the de­sign of a cer­tifi­cate pro­gram in

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