Nine days ago, as the highlight of the American Society of Anesthesiologists’ annual August Board of Directors (BOD) meeting in suburban Chicago, officers of the society cut the ribbon to open the ASA’s new headquarters in Schaumburg, Ill. Accompanied by local Congresswoman Tammy Duckworth, the society’s elected and administrative leaders officially opened the magnificent, state-of-the-art, 70,000-square-foot facility on a clear and relatively cool late summer afternoon.
|President Paul Yost, MD, ASA Academic Component Director Zeev Kain, MD, and Immediate Past President Peter Sybert, MD
Californians in attendance for the ceremony included the ASA’s First Vice President Dan Cole, MD, Secretary Linda Mason, MD, Vice President for Professional Affairs Stan Stead, MD, and Director for California Mark Singleton, MD, Zeev Kain, MD, Academic Component Director, as well as the CSA’s President Paul Yost, MD, President-Elect James Moore, MD, Immediate Past President Peter Sybert, MD, Treasurer William Feaster, MD, Past Presidents Linda Hertzberg, MD, and Johnathan Pregler, MD, and yours truly.
While much has already been written about the new headquarters, its most impressive feature for the first-time visitor is the remarkable Wood Library and Museum occupying the entranceway and atrium lobby. Walking into the building, one is immediately drawn to an 80-foot-long, floor-to-ceiling timeline of the history of the pharmacologic relief of human suffering depicted on the wall through various artistic media. This then leads the visitor to extensive displays of devices historically associated with the delivery of anesthesia, all presented as professionally and beautifully as in any museum anywhere in the world. It is truly a remarkable exhibit of our specialty’s history, and something in which all anesthesiologists, and especially ASA members, can take great pride.
For Californians, the board meeting weekend got off to a particularly auspicious start when, at its Friday afternoon/evening executive session, ASAPAC voted to contribute $20,000 to match the CSA’s donation to the “NO on 46” campaign to preserve MICRA. This is an important example of funds donated by Californians to ASAPAC returning directly to the state for the benefit not only of our members, but of all physicians.
As for the board meeting itself, the weekend began with the usual educational sessions and Review Committee hearings on Saturday morning and afternoon. The educational sessions began with an update on the Perioperative Surgical Home Learning Collaborative, which held its first meeting earlier this month at the new headquarters. Later, Manuel Bonilla, the ASA’s Chief Advocacy Officer, presented the ASA’s ongoing efforts to derail implementation of the Veterans Health Administration’s proposed Nursing Handbook, which would mandate independent practice for all advanced practice nurses, including nurse anesthetists.
The main work of the weekend-long meeting was, as always, accomplished in the four Review Committees (Administrative, Professional Affairs, Scientific Affairs and Finance), where testimony was heard, and recommendations for board action were developed, on a wide range of proposals relating to the society’s mission and governance. The formal BOD meeting, generally a rubber stamp of the work accomplished the day before, occurred early Sunday morning, after which members dashed to the airport for flights home. Although this year’s session lacked some of the fireworks seen in previous years, differences of opinion were voiced, often reflecting the varying practice situations and perspectives of members of such a diverse organization.
In the Administrative Affairs Review Committee, perhaps the most important fiscal and policy decision was to allocate $470,000 over the 2015-2017 budget years to internally research the association between practice (provider) models and clinical and economic outcomes. This action was the culmination of the proposal first offered by former ASA President John Neeld, MD, last year in the ANESTHESIOLOGY™ 2013 Rovenstine Lecture, and subsequently recommended by the Georgia Society of Anesthesiologists at the March ASA BOD meeting. The board also approved the fiscal arrangements proposed for scaling up the Anesthesia Quality Institute’s (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) to fulfill its newly approved role as a Qualified Clinical Data Registry (QCDR). With approval of NACOR as a QCDR, ASA members will be able to fulfill CMS’s Physician Quality Reporting System reporting requirements via participation in the registry. This is an important benefit of ASA membership, and an excellent example of the ASA’s forward-thinking strategy (when the AQI was first proposed) bearing fruit for its members.
In the Professional Affairs hearing, members voiced strong support for continuing development of the Perioperative Surgical Home concept. In response, the board approved ASA co-sponsorship, along with the University of California, Irvine, Department of Anesthesiology, of a second Annual Perioperative Surgical Home Summit, tentatively in June 2015. The board also approved extending the Perioperative Surgical Home Learning Collaborative into a pilot for a three-year demonstration program.
Another topic of discussion in the Professional Affairs Committee involved the ASA’s response to the continuing expansion of company model arrangements, in which referring surgeons and proceduralists benefit financially from their referrals for anesthesiology services. The board rejected a proposal from the Committee on Practice Management to provide financial support to a selected component (state) society to develop an appeal (legal brief) to its state Attorney General on the topic, but instead approved retaining outside counsel with expertise in antitrust law and health care regulation to develop a white paper outlining regulatory and legislative options through which the ASA can address the company model.
The Scientific Affairs Review Committee received and endorsed a proposal to hold the 2026 Annual Meeting in San Diego and the 2028 meeting in Chicago. As one can see, the ASA ANESTHESIOLOGY™ meetings are planned well in advance! The committee also agreed to a proposal from the Committee on Trauma and Emergency Preparedness calling for the in-house presence of an anesthesiologist trained in the management of trauma care in every Level 1 trauma center. The proposal will be forwarded to the American College of Surgeons for inclusion in their guidelines.
Finally, in the Financial Affairs hearing, the ASA 2015 budget was approved, calling for total revenues of $45,120,163, total expenses of $43,946,420 and a positive change in net assets of $1,173,743. The society remains in a very strong financial position, with total reserves in excess of $70 million.
The ASA board meetings are a twice-yearly professional and social highlight for the leadership of both the California and the national societies. They give California leaders a chance to represent and advocate for CSA members’ interests, as well as to learn about developments nationally and in other states. The ASA BOD meetings offer CSA leadership and interested members an opportunity to see organized anesthesiology at its most productive.