The ASA’s annual meeting, ANESTHESIOLOGY 2016, concluded on Wednesday morning, October 26, after a vocal debate and a vote in the House of Delegates to increase dues from $665 to $750 per year for active members.
Earlier in the morning, Linda Mason, MD, was elected to the office of First Vice President, putting her in line to become the third woman elected President of the ASA. Dr. Mason has served the ASA as Secretary for the past six years. She is a former President of the CSA, and received the CSA Distinguished Service Award at this year’s annual governance meeting. CSA extends our warmest congratulations to Dr. Mason, and looks forward to her continued ascension to the office of President-elect in 2017, and ASA President in 2018!
Two other ASA officers from California were re-elected to serve another year in their current positions: Stan Stead, MD, MBA, as Vice President for Professional Affairs, and Michael Champeau, MD, as Assistant Treasurer. Dan Cole, MD, who served as President this year, moved into the office of Immediate Past President, as Jeff Plagenhoef, MD, became the ASA’s new President for 2016-17.
Why is a dues increase necessary?
During the floor debate over the dues increase, Dr. Plagenhoef argued in favor of an even higher increase, to $800. He told the House that the ASA has had extraordinary expenses between 2011 and 2016, drawing $26.4 million from reserves to fund operating and capital expenses. These funds have supported major advocacy initiatives facing the specialty including MACRA, out-of-network billing, and the VA Nursing Handbook proposal. They have also been used to advance development of a Qualified Clinical Data Registry (QCDR) through the Anesthesia Quality Institute.
A five percent cost-of-living increase, as originally proposed, would not suffice to support ongoing work on these issues, Dr. Plagenhoef said. Even once the VA’s decision over advanced nursing practice is announced, which is expected to happen within the next few weeks, other advocacy issues will continue to consume time and resources due to the unprecedented speed of change in the healthcare environment.
“That fly will be back at the picnic,” Dr. Plagenhoef promised, warning the delegates that a failure to raise dues sufficiently now will only postpone the inevitable need, as ASA experienced flattening revenues from all sources in 2016.
The House ultimately compromised on the $85 (13 percent) increase in dues for active members, with a five percent dues increase for the membership categories of Affiliate, Educational, and Anesthesiologist Assistant.
The Patient Safety Bill of Rights
The CSA sponsored a resolution entitled the “Patient Safety Bill of Rights: Patient Safety Across the Continuum for Deep Sedation/General Anesthesia.” Authored by CSA President Mark Zakowski, MD, this resolution was identical to the one passed by the CSA House of Delegates in June. It supports one standard of anesthesia care and monitoring on behalf of patient safety regardless of route of administration or the location of service, recognizing that the line between deep sedation and general anesthesia is often blurred.
The administrative review of this resolution noted that the Committee on Standards and Practice Parameters is in the process of updating its guidelines on deep sedation administration, and that the concept of patients’ rights has been put forward previously by other ASA committees. It noted also that sedation in dental offices is overseen in most states by a separate dental board.
The final recommendation accepted by the House of Delegates was to refer this resolution to an ad hoc committee of the President’s choice, which has already been constituted. It will be led by Erin Sullivan, MD, who chairs the Committee on Governmental Affairs, and will examine the feasibility of patients’ rights initiatives, the cost-benefit ratio, the likelihood of success, and the opportunity to work with other organizations. If determined to be feasible, the committee will recommend a budget and project plan, and present a report to the August, 2017, Board of Directors. Dr. Sibert will represent CSA on this committee.
Fellow designation, other business
The Committee on Membership recommended, and the House approved, the creation of a new fellow designation, which will enable members to use the title of Fellow of the American Society of Anesthesiologists (FASA) after undergoing an approval process. This process will include an online application, payment of a $350 fee, and submission of documents to be verified by ASA staff. The requirements will include demonstration of exceptional accomplishment in the areas of professionalism and leadership, advocacy, and educational or scholarly activities.
The Committee on Performance and Outcomes Measurement (CPOM), chaired by former CSA President James Moore, MD, recommended five new quality measures which were approved by the House:
- Assessment of patients for obstructive sleep apnea;
- Treatment of hyperglycemia with insulin;
- Adherence to blood conservation guidelines for cardiac operations using CPB;
- Avoidance of baseline laboratory studies in patients without significant systemic disease (ASA I or II) undergoing an outpatient procedure;
- Application of lung protective ventilation during general anesthesia.
These measures will be submitted to CMS for approval for the 2017 QCDR. With the transition away from claims-based reporting, the committee noted, “anesthesiologists must be able to take advantage of other reporting mechanisms to report satisfactorily to PQRS and in the future to the Merit-Based Incentive Payment System (MIPS).” Within the QCDR, anesthesiologists may select the measures to report that they consider most appropriate for their respective practices.
The Ad Hoc Committee on Resident Advocacy submitted a report which recommended dedicated time for advocacy training within the residency curriculum, possibly as a component of the proposed curriculum on perioperative medicine that has recently been drafted. The committee is currently drafting a document to provide further definition and application of advocacy in residency training, and envisions submitting it to the ACGME for incorporation into RRC program requirements.
A resolution was submitted by Kenneth Pauker, MD, a former CSA President, asking ASA to require that state component societies develop and consistently follow delegate selection procedures. This resolution was referred to a committee of the President’s choice for further evaluation.
Other election results
Norman Cohen, MD, a former ASA Vice President for Professional Affairs, was nominated and elected as the winner of the ASA Distinguished Service Award, the society’s highest honor. Dr. Cohen will receive the award at next year’s ASA annual meeting. This year’s award was presented to Alexander Hannenberg, MD, a past president of the ASA, and the president and founder of the ASA Charitable Foundation.
James Grant, MD, ascended to the office of President-elect upon completion of a year as First Vice President. Ronald Harter, MD, ascended from the office of Vice Speaker to Speaker of the House after the decision of Stephen Sween, MD, to step down. Mary Dale Peterson, MD, was reelected to the office of Treasurer. John Dombrowski, MD, the current Assistant Secretary, ascended to the office of Secretary, succeeding Linda Mason, MD.
Patrick Giam, MD, from Texas, was elected to the office of Vice Speaker, in a contested election against Larry Epstein, MD, from New York. Kenneth Elmassian, DO, from Michigan, was elected to the office of Assistant Secretary, in a contested election against former CSA President Linda Hertzberg, MD. Randall Clark, MD, of Colorado, received the Western Caucus endorsement as a candidate for First Vice President in 2019.