By Paul Yost, MD, FASA , ASA Director for CA and Johnathan Pregler, MD, FASA, ASA Alternate Director for CA
The American Society of Anesthesiologists held its first safe successful annual meeting since the outbreak of COVID-19 in San Diego October 9-13! Using many COVID safety precautions including a CLEAR App that tracked vaccination status, testing status, and daily symptom reviews, as well as indoor masking, more than 7,000 live and 2,000 virtual attendees were able to safely experience the world-class educational programs and in-person networking.
California was well represented by our President Ron Pearl, MD, PhD, FASA, CSA leadership, and a full delegation of 32 members! It was absolutely wonderful to experience and actively participate in on-site meetings with personal contact! It has been a long 18 months!
Some advocacy and governance highlights of the meeting are as follows:
- A CSA All-Member Reception attended by over 200 active and resident members that featured California’s newest physician member of the State Assembly, San Diego’s own Dr. Akilah Webber, who spoke eloquently and powerfully about physician involvement in advocacy.
- California received the Alabama Cup, which is awarded to the state that contributes the most money to ASAPAC; our voice in Washington DC! Our delegation photo with the cup was very special. It was a proud moment to be a California Anesthesiologist!
- There was an impactful opening session on leadership in a turbulent time by historian and author, Doris Kearns Goodwin. It was a refreshing and optimistic look at a very unsettling time through the lens of history (more details in next week’s CSAOF).
- ASA President Beverly Philip, MD, FASA, address to the House of Delegates outlining the many challenges anesthesiologists face including Out of Network Billing through the “No Surprises Act” and looming Medicare Cuts. The expansion of nursing practice at the VA during COVID, and damaging title misappropriation, including nurses calling themselves “nurse anesthesiologists”.
- Several California members received significant recognition at the meeting, including:
- Michael Champeau, MD, FASA, ascended to the office of President Elect.
- Dan Cole, MD, FASA, received the ASA’s highest honor, the Distinguished Service Award.
- Paul Yost, MD, FASA, was named the Chair of ASAPAC Board of Directors.
- Linda Hertzberg, MD, FASA, former California Delegate to the ASA was recognized for her many contributions to Diversity, Equity and Inclusion.
- Jonathan Pregler, MD, FASA, was recognized for his work on the Committee on Economics and their work on the Anesthesiology Medicare 33% problem.
Of particular interest to California Anesthesiologists are the actions the ASA is taking on scope of practice and payment issues. The House of Delegates Handbook contained reports from the President, Chief Executive Officer and Administrative Council that addressed all these topics in detail including past activity, progress made to date, and the roles of each of these important issues in the ASA strategic plan.
Medical title misappropriation is being addressed by the ASA on multiple fronts at local and national levels. An example of the local efforts is the successful legal efforts of the ASA and the New Hampshire Society in preserving the use of the term “anesthesiologist” for only individuals licensed to practice medicine. At a national level the ASA has a public and stakeholder education campaign that is underway to maintain the accurate use of medical titles. Foremost in this effort is facing the challenge of the American Association of Nurse Anesthetists “nurse anesthesiologists” campaign and the renaming of their society. The ASA has allotted $500,000 as of March 2021 to this initiative and convened a summit of leaders from multiple medical specialties with the AMA to address the issue.
The ASA continues in its major effort to preserve payment for Anesthesia services through its Payment Progress Initiative. Both Beverly Philip, ASA President and Randy Clark, ASA President Elect addressed this program in their comments to the House of Delegates.
A special educational session took place on Monday afternoon with presentations from Dr. Philip, Jeff Mueller ASA Vice President for Professional Affairs, and from California members Michael Champeau ASA First Vice President, Neal Cohen Chair of the Section on Professional Practice, and Johnathan Pregler, Chair of the 33% Problem Workgroup.
Dr. Mueller addressed how the ASA is dividing the major economic issues which include the 33% Medicare payment problem, possible “Medicare for All” legislation, Surprise Medical Bills, and value-based payment models across the ASA committees.
Dr. Pregler presented the progress on the 33% Medicare problem to date with a review of the three publications that the workgroup has produced over the last year and is available here. He also presented the current strategy of the ASA to develop additional arguments that support increasing the Medicare Anesthesia conversion factor. The ASA is also evaluating possible modifications to the ASA RVG payment system that would support improved valuation or at least containment of the problem. The ASA is currently in the RFP process to obtain outside technical consultant support to perform the analytic work for both of these strategies.
Dr. Cohen presented an in-depth look at the ASA’s initiatives to prepare for any possible Medicare for All legislation and an analysis of all the current legislative proposals. Dr. Champeau concluded the program with an excellent review of the Federal “No Surprises Act”. He reviewed how the current rule making process bypassed the intent of the congressional legislation and put increased importance in the “Qualifying Payment Amount” which unfairly favors the commercial payors in the arbitration process which could ultimately affect commercial contracting.
With all of the challenges we face, there has never been a more critical time for all anesthesiologists to come together and speak as one voice!