President’s Address 2012

  • Pregler, Johnathan, MD
| Jun 04, 2012

Editor's Note: This week's CSA Online First is from our 2012-13 president, Johnathan L. Pregler, MD. At the 2012 annual governance meeting of the CSA, the House of Delegates welcomed Dr. Pregler as president of the organization. Here is his speech. 

Officers, delegates and guests, thanks for allowing me to speak to you today.

Everyone has been asking me if I’m ready. Certainly, Dr. Pauker is a tough act to follow. Not only do I get the honor of following his presidency, (assuming, of course, that you approve of that in a few minutes), I also get to follow him up here on the podium. Dr. Pauker, the thanks that you’ve received from this group are well deserved. You had a very busy year and had a lot of accomplishments, but as you pointed out, not necessarily what you planned. (Read Dr. Pauker's speech to the House of Delegates.)

Dr. Pauker has always had great quotations in his speeches. Usually there’s wisdom from Mark Twain, today we got some Yogi Berra and there's always a foreign language. However, I’ve attended this house as a delegate or officer for the past 15 years and I’ve never seen anyone quote the one modern philosopher who really summed up why the plans we make get disrupted. Yes, I’m referring to Yoda. (How many of you guessed it?) In episode 5, the Empire Strikes Back, he says, "Difficult to see. Always in motion is the future."

Every president has had to deal with the unforeseen events. Some, like the opt out, are truly disruptive and consume the majority of a president’s time and effort; in our case, 3 presidencies. There’s a high likelihood that this pattern will happen again this year. So before we get off course with an unknown future event let me talk about where we’ve been and where we’re going.

First we will need to get our office up to full strength so that it can continue to support all of the activities that we want to accomplish. Barbara Baldwin has done a great job this year keeping our society functioning through uncertainty. There were three key staff departures and the office has been short staffed for the last 4 months. Barbara, you truly deserve the award that was presented to you last night not only for your career accomplishments with us but also for this past year. As Barbara stated last night we have some great staff in our central office and I’d like to give you an update on what each is doing at this time.

Dr. Pauker has already introduced Julie Kahlfeldt, our new Executive Director. I hope many of you got a chance to talk to her yesterday. Julie and I will be working closely to transition the office to her leadership. I’m confident that she’ll take on the role of executive director with the same enthusiasm that she’s demonstrated in the past. Our other staff are in alphabetical order:

Melissa Cuen is our newest addition and is our operations assistant. Merrin McGregor continues in her role as our communications manager, both print and electronic media. Terrie Rowe is our Education & Member Services Manager. Ian Sambrano is our Database and Accounting Services Coordinator and Adam Yarbough is our Office Coordinator and supports the Board of Directors and helped Barbara prepare this HOD.

You may notice that we have one person missing from last year. Michael Whitelock who was our COO resigned in January. This was an anticipated event. Michael had graciously given us notice over a year ago that he was in the process of seeking another job that better fit his career goals. When Julie Kahlfeldt starts in June, one of our first tasks will be to evaluate our office staffing. She and I will work with the Task Force on Office Structure and Function to determine how best to complete our personnel needs in the office.

The next big project for our society is, of course, the opt out. The opt out lawsuit is really a question of the necessity of physician supervision of advanced practice nurses. I think I can say that most of us believe that some form of physician supervision of nurse anesthetists is necessary for truly safe patient care. The opt out is both a state and national issue and it has implications beyond the practice of anesthesiology. We have to take into account the role that our local battle plays on a national level. Fortunately for us, the ASA and CMA have been supportive of our efforts at every stage of this battle.

Dr. Sybert and I authored the resolution that you discussed yesterday at the reference committee in order to get your opinions on our options going forward. I greatly appreciate the feedback that many of you provided at the reference committee. It is essential that our Board and Legislative and Practice Affairs Division, under the direction of Dr. Paul Yost, know how you feel about our options. Dr. Pauker predicts that we’ll get our chance before the Supreme Court. Based on your testimony at the reference committee yesterday it appears that you also support continuing our fight in the Supreme Court. You will get to make that decision when you vote on the reference committee report in a few minutes.

If our petition to the Supreme Court does not succeed, we will need an alternative plan. One option is to pursue legislation. The Superior court that first heard our case suggested this solution. If you grant your support to proceeding this way, your Board of Directors and Legislative and Practice Affairs Division will work with our legislative advocates, the Barnaby’s, and the CMA to find the best opportunities in our state legislature. The long-term solution to this and any political battle lies in having public support. Many people, particularly those who have been patients, know who we are and the essential role that we play in ensuring that they are safe while under anesthesia. Yet an equal or greater percent of the public do not understand how crucial we are to safe anesthesia. We need to work on that. Your Committee on Professional and Public Communications chaired by Dr. Karen Sibert will be pursuing methods to reach out to the public as part of our ongoing efforts to win this case.

Rebranding was a major initiative on the part of the Communications committee this past year. Our first step was a redesign of our seal, or logo as it’s known. I would like to show you our new logo. Your CPPC and Executive Committee worked long and hard on it with an outside design firm. I hope you like it. (In fact, I really hope you like it). It symbolically represents us as a medical specialty. It links us graphically to the ASA. I think the tagline, “Physicians for Vital Times”, which was developed by our communications committee and Dr. Sibert, is great. We’re going to roll this out soon. We have a little bit of design work to do to get this on all of our printed materials. We have to integrate into the website design and our bulletin. Then you’ll start seeing it on everything.

Speaking of the bulletin. We thanked Dr. Jackson last night for all his years of service as editor. Steve, the accolades you received are well-deserved. Thank you for continuing to volunteer during this next year to help us with the bulletin and our communication efforts. Your knowledge and experience in these areas are greatly appreciated. At the last Board of Directors meeting Dr. Champeau graciously agreed to come out of Past President retirement to assume the title of editor of the bulletin. I’m confident that Dr. Champeau along with our editor of Electronic Media, Dr. Hertzberg will maintain the excellence that we’ve come to appreciate in our print and web media.

And now on to some new initiatives. We haven’t undertaken a full strategic planning effort in many years. It is essential that we do this this year. We have a fantastic problem in that our members have lots of great ideas. Yet we can’t pursue every idea. Like any organization we have a finite amount of time, money and staff. The CSA needs to identify which projects will get the focus of our resources and then we need to make them happen in a defined period of time. It is also important to identify long term projects. One example of this would be our public communications initiative. Projects like this require continuous effort over many years and ongoing financial support. We need to plan for these initiatives now and in the future. Finally, actions across our committees need to be coordinated. I am honored to have some great committee chairs working with me next year. This is an idea that they brought to me and I will support it by coordinating committee activity across our organization.

One of our first step in our planning process will be to survey of the membership. I’ve already asked the communications committee to prepare a needs assessment survey for distribution to the membership. Hopefully you’ll see this in the summer. It’s incredibly important that we hear from you. Please also ask your partners to take the time to respond. The survey results will guide us with our strategic planning which will occur either at the Fall or Winter Board of Directors meeting.

Our strategic goals will be incorporated into our committee plans and budgets for this and next year. I am hopeful that we can make Strategic Planning part of our usual activity at every Board of Directors meeting. This was one of the goals of Dr. Pauker last year that we were unable to complete. Until we complete our strategic planning process I’ve gotten approval from the Board to evaluate our current activities on the following criteria. First, does an activity add value for our members? With the understanding that some benefits are direct, some are indirect. Criteria two addresses how our activities add to the long term preservation of anesthesiology and our CSA. This is meant to address those initiatives that don’t have an immediate result or financial return to the society. Criteria three is really a simple cost-benefit analysis. We’ll be operating under these rules for the beginning of this year until we complete our strategic planning process. My guess is that some form of these criteria will make into our administrative procedures after we’ve completed the planning process this year.

Engagement and involvement were one of Dr. Pauker’s goals for last year and made it to his prediction list. I plan to support him in completing this mission. First, Ken Pauker, Peter Sybert and I are committed to supporting you in your efforts to communicate with the membership. When I was a district director and put on a local meeting I felt that the presence of an officer from the CSA was key to establishing the connection between the membership and the leadership. If you hold a district meeting this year we are committed to supporting you. We will try to find a way for one of us to be present at your meeting and address your district. Second, I will work with the office to have presentation materials prepared to help you communicate the activities of our society to your membership and to the public. Third, we will evaluate how the society can better support you in organizing district meetings. We will consider both organizational and financial support. I want to remove the barriers that prevent District Directors from communicating with both physicians and the public at a local level.

You may have noticed that Dr. Pauker made a rather bold prediction that there will be a reorganization of the Board of Directors. I’m not sure I can predict how this will progress but I support evaluating how our board functions. I have been fascinated for some time now with how groups make decisions. Some groups make great decisions. Good ideas are proposed, become the focus of discussion and become action. Some groups make less than ideal decisions. I’m sure we’ve all experienced meetings or groups decisions that have resulted in the acceptance of a less than ideal outcome because it’s the only thing the group can agree on. I’ve witnessed successful and suboptimal decision making many time in my career. I’d like to get the CSA to the point that we predominantly make great decisions. We have a task force that was formulated last year to look at how the Board of Directors is structured. It’s chaired by our Treasurer, Dr. Peter Sybert. I plan to fully support this committee in its work over the upcoming year. I anticipate that it’s efforts will mesh with our strategic planning process to determine how best to structure our Board. It is imperative that we make the best decisions as an organization going forward.

And finally, I am very aware that there will be detours. Some will be straightforward one way decisions and others will be really complex. For those of you who haven’t seen this graphic before, it’s a chart representing out new national healthcare program and one can get lost in it. With all of your help we will tackle whatever is thrown in the path of the CSA this year. We’ve made some plans and we’ll make more as the year proceeds. We’ll pick a new route if needed but will get to our destination.

That’s just a highlight of the major efforts underway in our society. There are many individuals that I didn’t specifically mention including officers, committee chairs and members, and you, our delegates. I appreciate each of your efforts and will be depending on you to help us get through the next year. The CSA is an amazing group of physicians and has fantastic staff. It will take all of us to accomplish these tasks. My goal is to make this society better at meeting your expectations over the next year. There’s tremendous energy going into the projects that are underway and I know that we’ll come up with more things to do as the year goes on. I am honored with the trust that you have placed in me for the upcoming year. I plan to do my best to make the CSA achieve your goals.

To answer the question that everyone has been asking me, the answer is I’m ready. I’m ready because I know that we all are ready to make this a great year for the CSA. Thank you all.

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