By Jane Moon, MD, and Ronald Pearl, MD, PhD, FASA
The year 2023 marks the 75th anniversary, or Diamond Jubilee, of the California Society of Anesthesiologists (CSA). In 1948, the year of its founding, CSA had just over 200 members. Today, we have over 3,000 active members. Throughout the years, CSA has remained a powerful voice for physician anesthesiologists in California.
CSA’s first President was Charles McCuskey, MD, longtime Chief of Anesthesia at the University of Southern California, who also served as President of the American Society of Anesthesiologists (ASA) in the same year. As ASA President, Dr. McCuskey oversaw the formation of most state component societies and convened the first ASA House of Delegates meeting at the October 1948 Annual Meeting.
In this Diamond Jubilee year, we come full circle, with Michael Champeau, MD, FASA, a Past CSA President, now serving as ASA President. CSA will also be the host component society of this year’s ASA Annual Meeting, which will take place in San Francisco in October 2023.
Our current CSA President, Edward Mariano, MD, MAS, FASA, emphasized the important role of our organization in “advanc[ing] the recognition, social standing, and influence of anesthesiologists” during his first President’s report.1 Advocating on behalf of our profession has always been one of our top priorities.
As far back as 1956, Past CSA President Nevin Rupp, MD, had stated, “Administratively, the anesthesiologist should enjoy the same position as the internist, pathologist, surgeon, obstetrician, or any other subdivision of medicine which specialization has engendered.”2 At the time, anesthesiology was still a fledgling medical specialty, only having achieved formal recognition by the American Medical Association (AMA) in 1940.
An anesthesiologist as AMA President would have been unfathomable back then. However, Jesse Ehrenfeld, MD, MPH, FAMIA, FASA, Professor of Anesthesiology at the Medical College of Wisconsin, is making history this year. Coincidentally, Dr. Ehrenfeld’s tenure as the first anesthesiologist President of the AMA immediately follows that of Robert Wailes, MD, an anesthesiologist and pain medicine physician, as President of the California Medical Association (CMA).
During CSA’s early years, great emphasis was placed on developing the physician anesthesiologist’s professional identity and stature. As was culturally acceptable at the time, one’s obligation to patients, surgeons, hospitals, and fellow anesthesiologists was couched in terms of moral calling.
In 1955, Dr. Rupp urged anesthesiologists to uphold the art and science of medicine throughout the preoperative, intraoperative, and postoperative periods: “Certainly this extra time…may require going to a late movie other than an earlier one, but the satisfaction of doing a good job and being respected is more than worth these inconveniences,” he wrote.3
Although Dr. Rupp did not use the now familiar term “perioperative physician,” his concept of the ideal physician anesthesiologist was similar. While anesthesiology has grown in stature since then, elevating the standing of the specialty and ensuring its future remains important today. But while our early leaders focused more on improving individual behavior, the modern emphasis has been on formalizing the anesthesiologist’s perioperative role within the hospital system.
Kathleen “Kay” Belton, MD, a pioneering pediatric anesthesiologist and the first woman CSA President of CSA, similarly stated, “People regard a profession or specialty highly if its members whom they know are admirable. If we behave like doctors, we’ll be treated that way.”4
Dr. Belton was revered within the male-dominated circles of her time. Upon her election as CSA President in 1967, she was described as “an accomplished anesthesiologist in the morning, business-like pounding a gavel in the afternoon, a blur of whirling chiffon in the evening; a great friend.”5
Since its inception, CSA has been recognized for its “progressive attitude” in the political, social, and economic arenas of our specialty.6 Open, accessible, democratic governance has remained a priority, both in active solicitation of member input, as well as in the structure of elected delegates from districts across the state. “Each member IS the Society,” Dr. Rupp emphasized in 1952.7
Early CSA leaders helped set the tone for organized anesthesiology at the national level, initiating the creation of the office of Speaker of the ASA House of Delegates. CSA Past President Forrest Leffingwell, MD, was the first to serve in this role before being elected as ASA President.
For the past 75 years, CSA has also advocated for fair reimbursement of physician anesthesia services. Specifically, CSA members have dedicated their efforts to protecting fee-for-service models of payment, keeping liability insurance costs reasonable, discouraging profiteering physician-nurse anesthetist relationships, and advocating for adequate Medicare payments.
In the words of Dr. Belton in 1967, “Proper recompense for exacting medical work and judgment is necessary to attract well educated, intelligent doctors, and we are fortunate in California to have pioneers and their disciples who worked as private practitioners, establishing proper fees and patiently working through the CMA for their acceptance.”4
California anesthesiologists have also pioneered scientific advancements that have improved perioperative patient safety on our History of Anesthesia page. These innovations, along with high-quality educational programming, have strengthened the reputation of California anesthesiologists as leaders not only in governance but also in scientific excellence.
From the start, CSA has held regional meetings with invited speakers. By the end of its first decade, CSA began holding statewide conferences every two years that alternated with the then popular Biennial Western Regional Conference. Today, CSA hosts three world-class meetings in Hawaii each year, in addition to a large Annual Meeting in San Diego.
Please join us in celebrating CSA’s Diamond Jubilee!
To commemorate this special occasion, we are very excited to share with you CSA’s new 75th anniversary logo. We will continue to use this image in all CSA communications throughout the year.
We will also celebrate CSA’s Diamond Jubilee at all official CSA functions in 2023. Please be on the lookout for the new CSA President’s Impact Awards at the April CSA Annual Meeting, a new website rollout at the June House of Delegates meeting, a special 75th anniversary issue of Vital Times, and a festive CSA All-Member Reception at the City Club of San Francisco during the October ASA Annual Meeting.
Please consider helping us celebrate! We are producing a 75th anniversary video that highlights the value of CSA in the past, present, and future. Photographs of various CSA members and CSA events over the years would be most welcome and greatly appreciated.
We would also like to include in the film your written answers to the following question: “Why has CSA been important to you?”
Please send your photos and quotes! You can either upload them to the CSA Google Drive Here (please include your name & description in file name) or email them to Jane Moon (jsmoon@mednet.ucla.edu), Ron Pearl (rgp@stanford.edu), or Alison MacLeod (amacleod@ka-pow.com).
Thank you for your time, and we look forward to celebrating with you throughout the year.
Jane S. Moon, MD
Ronald G. Pearl, MD, PhD, FASA
Co-Chairs, CSA 75th Anniversary Task Force
References:
- (Mariano ER. My First Report as CSA President. Posted September 3, 2022. www.edmariano.com)
- Rupp NH. From the President’s Pen. CSA Newsletter. 1956 Feb;6(5):2.
- Rupp NH. From the President’s Pen. CSA Newsletter. 1955 Nov;6(3):3-4.
- Belton MK. President-Elect’s Address to the House of Delegates. CSA Bulletin. 1967 June;16(3):11-16.
- I am happy to present… CSA Bulletin. 1967 June;16(3):5.
- Batten DH. From the President’s Desk. CSA Newsletter. Feb 1955;6(1):6-8.
- Rupp NH. CSA Newsletter. 1955 June;6(2):2-4.