Kaiser Permanente CEO Richard Isaacs Shares His Thoughts on Physician-Led Care

As CEO and executive director of The Permanente Medical Group, Richard Isaacs, MD, is responsible for overseeing an operation that provides care for more than five million people. He is also an otolaryngologist and completed his residency in Manhattan Eye, Ear and Throat, and a fellowship in head-neck oncology and skull base surgery at the University of California, Davis.

Dr. Isaacs recently spoke with ENTtoday physician editor Alexander G. Chiu, MD, about his work, including how his background as an otolaryngologist has prepared him for the role.

Dr. Chiu: Could you tell us a little about yourself, your current role, and what a normal work week looks like for you?

Dr. Isaacs: For the past three years, I have been the CEO and executive director of The Permanente Medical Group (TPMG), which is the largest medical group in the nation, and president and CEO of the Mid-Atlantic Permanente Medical Group (MAPMG). Between these two medical groups, we have approximately 11,000 physicians and more than 40,000 staff who provide care for 5.2 million Kaiser Permanente members in Northern California, Maryland, Virginia, and Washington, D.C.

I’ve been with The Permanente Medical Group for 24 years. I came right out of fellowship in Northern California and joined TPMG. When I was on the East Coast, I didn’t know about Kaiser Permanente. But it’s a great model for care delivery because the medical groups are aligned and in partnership with the health plan and hospital system. And we all work together to provide care and coverage to all Kaiser Permanente members.

When I first joined TPMG, I was a skull base surgeon and a microvascular surgeon at Kaiser Permanente’s South Sacramento Medical Center. For 10 years, I did complex skull base and microvascular surgery, head and neck surgery. I created a center of excellence in South Sacramento and became the physician-in-chief for the medical center, which serves about 300,000 people. During my tenure as physician-in-chief, KP South Sacramento was the alpha site for the successful implementation of Kaiser Permanente’s electronic health record, which was adopted by KP throughout the country.

I’m extremely fortunate to have excellent teams in both Northern California and in the Mid-Atlantic regions, and our physicians and staff are doing tremendous work for their patients.

Dr. Chiu: How does your identity as a head-neck surgeon influence your current role?

Dr. Isaacs: Being a head and neck surgeon has positioned me for every opportunity I’ve had at Kaiser Permanente. Number one, as an otolaryngologist you’re basically involved in every department: You’re taking care of kids, you’re taking care of teenagers, all the way up to geriatric populations, emergencies, the operating room, labor and delivery, the ER.

On a medical level, otolaryngology helped me gain a thorough understanding of hospital operations and how to get things done. In my current role, I still am a practicing head-neck oncologic surgeon. I get called in for cases that need a particular expertise, and I really appreciate the opportunity to still be part of a surgical team that is having such a positive impact on the lives of our patients.

Dr. Chiu: Can you talk about Permanente Medicine?

Dr. Isaacs: Permanente Medicine began during the Great Depression, when our founder Dr. Sidney Garfield went to the Mojave Desert to deliver medical care to California Aqueduct workers at a modest 12-bed hospital, called Contractor’s General Hospital.

Dr. Garfield was a general surgeon who trained in California, but he couldn’t find a job during the Depression so he went to the desert to provide healthcare to the construction workers, and basically went bankrupt the first year. But he borrowed some money and created a new concept in care called pre-payment, where for five cents per employee per day, he took care of all their healthcare needs. And that’s where the focus on prevention was established.

Then, during World War II, Dr. Garfield joined forces with industrialist Henry J. Kaiser in Richmond, Calif., to oversee the medical care and treatment for the Kaiser Shipyard workers building cargo ships, aircraft carriers, and other vessels to support the war effort. And by 1943 Dr. Garfield was leading a team of physicians and staff that provided medical care for more than 90,000 workers. After the war, the Permanente care delivery program was offered to the public.