Reflections on Coordinated Care: Meet Russell Gray, M.D.

February 16, 2018 | by Deborah Stambler

Gray-Russell Russell Gray, M.D.
As with so many other physicians, Russell Gray, M.D., decided to pursue a career in medicine when a science class in high school sparked his curiosity. Since then, he has devoted his career to anesthesiology — and cardiac anesthesiology in particular.
When Gray joined City of Hope in 2005, he already had 17 years’ experience as an anesthesiologist. He has since joined the Patient Safety Committee and now serves as patient safety officer. He is also medical director of the Preanesthetic Assessment and Testing Clinic (PATC).
On the team at City of Hope, Gray serves as part of the coordinated effort to ensure patient safety during surgery and for a quicker recovery afterward. His experience in cardiac anesthesiology serves him well in helping to identify patients with increased perioperative risks and to ensure better outcomes postoperatively. When patients are dealing with co-existing disease states, it’s his job to identify any anesthetic risk factors prior to surgery.
As an anesthesiologist, Gray cares for patients with different diagnoses, at varying stages of illness and with a variety of risk factors. From this perspective, he sees the value in a total care approach that emphasizes strong communication among the team from admission to discharge.
“From the patient’s perspective, what they see is a uniform and organized approach to care,” he said. This includes evaluating for anesthetic needs, pain management, other conditions and psychological considerations. For anyone about to undergo surgery, these concerns and needs can best be addressed by a coordinated effort across departments, according to Gray.
Gray describes the current trend in medicine as stressing greater alignment across departments. This is certainly the perspective at City of Hope and it’s just one of the reasons he’s been part of the team for so long.
In the case of surgery, surgeons, operating room nurses and anesthesiologists work in concert. Prior to surgery, the team makes sure the patient understands the procedure, pre-op instructions around fasting and medication, is adequately informed about the procedure and any stress, anxiety and fears are addressed.
He explained that with major surgery, the effort extends to dealing with more than just potential risks — the team is also working hard to optimize outcomes. This means that postoperative care centers on nursing, pain management and dealing with side effects from anesthesia and procedures. Not only is this approach representative of the overall direction of medicine, it provides an opportunity for patients to participate in their care.
Good pain management during surgery and recovery involves good practices in anesthesiology. For example, Gray described multimodal anesthesia, which “steers patients away from becoming drug dependent.” Medications such as ibuprofen, use of nerve blocks during procedures and a blend of pain modalities are increasingly common in the face of the increase in drug addiction and opioid abuse.
 “We spend a lot of money on health care in the United States,” he said. “A lot of the gross national product is spent on health care, but we need to do better in delivering care in the United States.”
He’s excited about the patient-centric care he sees becoming more popular and better developed across the country and especially at City of Hope.
In anesthesiology, the practice known as ERAS, or enhanced recovery after surgery, has patients up and running sooner. Evidence is showing less invasive procedures and a multidisciplinary approach are resulting in fewer complications, less hospital time and fewer post-op side effects. Anyone who’s dealt with nausea after surgery and anesthesia knows how important this level of comfort can be.
And that’s the whole point, according to Gray — patient safety and comfort. After more than a decade at City of Hope, he describes the compassion, care and level of services at the hospital as a big part of the motivation for his work.

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