Although there’s certainly not the same simple folksy innocence as we might remember from the 1939 Frank Capra film with Jimmy Stewart as pure-of-heart novice Senator, Mr. Jefferson Smith, walking into any US congressional office on Capitol Hill takes one right back to the representative’s or senator’s home district and state. There are always familiar and iconic posters, photos, and other decorations that tell any visitor exactly what geography this particular office cares about. Walking through the halls of the House office buildings also gives a strong sense of our nation’s history, mixed with the brightness and energy of the legions of young men and women who staff those offices and congressional committees. Those of us fortunate enough to attend the annual ASA Legislative Conference, held again this past week in Washington DC, get the opportunity to experience this special place, learn about how our government affects our medical practice, and communicate our perspective about issues related to the practice and business of anesthesiology to our elected representatives with the goal of improving our ability to provide the best possible care to our patients.
Traditionally, the CSA president invites a number of politically active members to be part of our official delegation to the ASA Legislative Conference, although registration is open to any ASA member wishing to come on his or her own. The CSA also encourages our California anesthesiology residency programs to fund one of their residents to benefit from this valuable experience. This year’s conference attendance was over 500 anesthesiologists, including sixteen CSA members and three resident members.
The Monday afternoon opening session featured speakers representing a number of ASA’s state component societies. They related their experiences with ongoing maneuvers by nurse anesthetists to achieve independent, unsupervised practice, and also spoke about successful efforts in a number of states to establish a licensing basis for the practice of anesthesiologist assistants. We heard entertaining and thoughtful stories by anesthesiologists who are both former and current state legislators, about the rewards and frustrations of seeking and holding elected office. Their experiences make clear the inestimable value of having physicians, and especially anesthesiologists, representing us and their constituents, in state and national office.
The next day, in what has become an annual presentation to the conference, Maryland Rep. Andy Harris MD, the only anesthesiologist member of the House of Representatives (this number may increase with anesthesiologists seeking election in two districts in California and Pennsylvania), continued this theme. A dynamic, knowledgeable, and eloquent speaker, Dr. Harris discussed many issues, including the problems surrounding this year’s disappointing failure to abolish the universally deplored Sustainable Growth Rate formula funding mechanism that continues to cripple Medicare payment to physicians, and the need to re-examine and redirect NIH funding for younger researchers at the peak of their productive years of investigation and discovery. Speakers from ASA leadership and the US Congress, and federal agency officials filled out the remainder of Tuesday’s program.
While the conference is an outstanding opportunity to hear and learn from experts in governmental affairs, an equally important aspect of this gathering of anesthesiologists from across the country is to engage in face-to-face meetings with our representatives in Congress. The Washington staff of the ASA sets the agenda of the issues we are asked to discuss, provides informational materials to aid in delivering our messages, and identifies congressional leaders on key committees dealing with those issues. This year, the major focus was directed at curtailing policy changes proposed in relative secrecy by the Nursing Office within the VA Hospital system, which would mandate the independent practice of nurse anesthetists throughout the nation’s VA hospitals.
For weeks and months in advance of this meeting, attendees are expected to contact the Washington offices of their representatives and senators and arrange appointments. This can be a time-consuming and often frustrating duty, but one that is considered vital to the advocacy efforts of OUR ASA on YOUR behalf. We visit with not only our individual congresspersons and our two senators, but as many key representatives as possible, visiting offices in small groups or sometimes just one-on-one.
Often the legislator is able to attend the meeting but, in the majority of cases, we are usually speaking with a legislative staff member. These staffers have the ear of the individual member of Congress and help shape the positions taken on specific issues by the member. What makes all the hard work worthwhile and truly gratifying is this interaction with typically young and remarkably engaged people, eager to understand the practice of anesthesiology and the challenges we face related to federal laws, agencies and regulations. Another equally important way to get issues in front of an individual member of Congress is by setting up similar meetings at the local level when the representative is in his or her home district.
In terms of governmental advocacy, the annual ASA Legislative Conference may not have the high profile and visibility to our membership that the ASAPAC does, but the activities and individual participation by ASA members that take place both at this conference and the local level are what really give value to the money you donate. Please insist that your colleagues join you in maintaining a voice in our government by contributing to the ASAPAC and CSA’s GASPAC.
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