Narendra S. Trivedi, MD, CSA President 2010-11


Address of CSA President-Elect Narendra Trivedi, M.D., to the 2010 House of Delegates

I am honored to serve as your 63rd President of the California Society of Anesthesiologists. With your help and support, I believe we can make this a year of great achievements for the medical specialty of Anesthesiology and for the CSA. We will be faced with many challenges in the upcoming year: Every day California's budget looks worse,the national economy is still unstable and the implications of healthcare reform by President Obama are of increasing concern.

Though federal healthcare reform legislation has been signed, it is becoming evident that we can influence and modify certain aspects of this reform if we stand up for what is right: right for our patients, right for our members, and right for our country. Therefore, we must make advocacy the top priority for the next year. Advocacy will allow us to build relationships with legislators and assist them in modifying the reform bill, to improve the care we provide to our patients, and to address the issues facing our members. Someone has to take the lead in designing revisions to President Obama's healthcare bill: CSA and California anesthesiologists are qualified, positioned and need to do this.

There have been times in the last 20 years when medical specialties faced challenges to their practices. Some of these specialties just ​​'hoped​​' for change led by someone else, rather than working hard to address those challenges. As a result, some of these specialties, like pathology, are no longer major players in modern health care. Another specialty that just hoped for a better tomorrow is Cardiac Surgery. With the invention of angioplasty, stent placement and many new advances in technology, cardiac surgery volumes have significantly declined. Cardiac surgeons did not take the lead to use these new advances to their advantage; they were committed to the status quo.
Now, many cardiac surgeons are struggling, looking for work, and performing general surgical cases to maintain their income. We must learn from these specialties that have suffered because they didn't prepare themselves for new challenges. We must prepare ourselves for the challenges of the future and push for any change that it is within our power to change.

We must not ask ourselves if we can do it or if we should change with the times. Rather, we must ask ​"How can we do it?" We must come out of the four walls of the operating room and explore opportunities to expand our role in other areas of patient care.

If we believe nothing is going to change in our practice, we are kidding ourselves. Some challenges are already knocking at our door. Five years from now, we may not be able to collect full payments for giving a milligram of Versed for a cataract surgery or a simple podiatric procedure. With the skyrocketing costs of healthcare, practices such as this are unsustainable. Already, there are institutions using non-physician providers to provide this type of care. But, we should not let these inevitable changes discourage us, much less stop us. Instead, we must explore ways to expand our practice. We must enhance our knowledge, our training, our experience and our expertise in the field of perioperative care. We must invest our time in research so we can find new areas in patient care that can improve the lives of patients and also provide us with a unique set of skills. Specialties such as radiology, cardiology and vascular surgery have used new advances, new methods and new technologies to sustain their practices and incomes in the rapidly changing health care world. We must learn from their experience to make a better future for our specialty.

I have come to the realization that CSA needs to do more than just solving yesterday​'s problems and today​'s challenges. Therefore, I ask you to join me in embarking on a journey to a better future for our specialty. It will involve continuous work but will have profound rewards. I have dedicated the year of my Presidency to the theme, the ​'Future of Anesthesiology.' Together, we can prepare anesthesiologists for challenges of changing health care. Among other things, we must work with residency program directors to explore various options to prepare a new generation of anesthesiologists to expand their scope of practice for a better future. Some of this work is already underway.

You may ask: Can we do it? Can we successfully fight for our specialty? I believe we are beyond asking these questions. We must do it, and we must do it now because if we fail, then our patients, our community, and our profession will suffer. So, I urge all of you to join me and your CSA to work together to guide health care policy and develop a plan for the better future of American health care and the pivotal role to be played in that future by Anesthesiology.

At this time, I would like to thank the distinguished leaders of the CSA, those CSA past presidents who have encouraged, guided and mentored me to be ready for the presidency. I offer very special thanks to Drs. Steve Goldfien, Eddie Canada, Steve Jackson, Linda Mason, Dan Cole, and Virgil Airola. Special thanks also are due to ASA Assistant Treasurer Dr. Jim Grant for his friendship and leadership.

There are two very special individuals who have helped me learn how to handle the challenges and problems faced by CSA and a major part of the reason that today I feel confident and ready for this job. Over the past two years they have become trusted friends, and I would like to thank Drs. Michael Champeau and Dr. Linda Hertzberg. I would like also to thank my partners at Permanente Medical Group who have always been my strong supporters. I would like to thank all my Permanente friends of many years for their support and encouragement. Finally I would like to thank my family members who are in the back of the room: My Dad, who has been a great inspiration and a role model for me all my life. My wife Trupti and my two sons, Akash and Nick, have always been there for me: supporting, advising and obviously critiquing me. Without them, I could not succeed in life. Thank you.

I want to thank all of you once again for giving me this great responsibility. I promise I will take this responsibility seriously and work hard to meet or exceed your expectations. Now, let's get ready and work together so that we can achieve these goals and make 2010-2011 the best year for CSA yet, and make CSA a leader in organized medicine. 

ARTICLES by Narendra S. Trivedi, M.D.

CSA Bulletin, Fall 2010 - Volume 59, Number 4: President's Page, "Surgery Without Anesthesiologists"