May 2001
Volume 65 |
Number 5
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| Letters
To The Editor |
A T-Shirt Suits Some Just Fine
I also was approached at meetings after my rebuttal (November
1998, Emperor’s New Clothes: II) to the Emperor's New Clothes
(September 1998, Ventilations) editorial was published. None was
supportive of you, I must say. A basic point you seem to be missing
in your October editorial Medicine "The Next Potemkin Village"
is that clothes do not a man make.
Yes, there is such a thing as dressing appropriately for the
occasion. However, like the pompous emperor, you continue to worry
about your clothes too much. I would expect you to address more
important topics for discussion. Clearly you must have nothing
better to do.
You justify your argument with flawed examples. My favorite is
that our founding fathers dressed nice. Most of them were slave
owners, Washington included. Why not bring back slavery as well?
And wearing suits may be a tradition at the Mayo Clinic, but it
is not what makes it a highly respected institution.
Patients should be able to tell we are physicians by the way
we care for them, how we answer their questions and work to solve
their medical dilemmas not because we are in suits (nurse
anesthetists also can wear suits). Residency programs should be
required to educate residents on the basics of coding and billing.
Responses such as "I don't know, call the business office"
are ridiculous. They should understand the basics of how they
are reimbursed, not only to be able to protect themselves but
also to avoid cases of unwillingness to provide services due to
incorrect fear of nonpayment (an almost taboo subject, but I have
seen this happen more than once).
1,500 miles from home, severely injured I remember a thank you
note I received from the father of an injured child. I came directly
to the emergency room in a bathing suit and T-shirt. I'm so thankful
you didn't take the time to change clothes, but instead came to
take care of my child.
Please find something better to write about. Or next time, call
me for a better idea.
Eddy Fraifeld, M.D.
Danville, Virginia
It's A Peasant Place to Visit
Are appeals for anesthesiologists to dress for success (October
2000 Ventilations) analogous to the Czarina's minister ordering
the peasants to don pleasing ethnic garb, i.e., a de facto Potemkin
Village? Perhaps yes, for a workforce that lost its professional
status when it gave up personal preanesthetic and postoperative
visits without a fight.1
Kirk Hogan, M.D.
Madison, Wisconsin
Reference:
1. Brodsky JB. Injury to the anesthesiologist. In: Benumof JL,
Saidman LJ, eds. Anesthesia and Perioperative Complications. St.
Louis, MO: Mosby; 1999:641.
Attired and Loving It
I have always enjoyed the Ventilations section in the ASA NEWSLETTER,
under your authorship/scholarship.
So saddening and maddening is the ruling by the judge in the
Diggs case as outlined in Farewell to Corridor Consultations (November
2000 Ventilations). Our eminent trial lawyers continue the slow
strangulation.
Also dear to my heart was the article relating to professional
dress code. In 1995, I retired from the practice of anesthesiology,
yet I still cringe when reviewing the hallway, patient rooms and
the elevator that some of our colleagues frequented. When attired
as a professional, we act differently and we project differently
than when we try to be different in our dress. Keep up the good
work.
McKinley Red Phelps, Jr., M.D.
Albuquerque, New Mexico
Where is ASA 'PAC'king My Money?
I have a question about ASA dues. In 2000, the dues were $350,
with 15 percent for nondeductible activities. This year, the dues
were raised to $450, but 56 percent is not deductible. During
the last election, the Republican Party rightly deplored the practice
of trade unions and teachers’ associations taking member dues
and using them for political activities without their consent.
Is that not what ASA is doing?
I understood the ASA Political Action Committee was responsible
for raising funds for ASA political activities. These funds are
voluntary contributions from ASA members and totaled more than
$1.1 million in 2000. As a member, I do not recall being asked
if I wanted to make further contributions through an increase
in annual dues.
Please explain how I can welcome this move by ASA and still criticize
unions such as the Teamsters and keep a straight face!
Gregory C. Allen, M.D.
Olympia, Washington
We're Just Keeping PACe: Mr. Bonilla Responds
I understand your concern about the reduction in the portion
of your deductible dues. In responding to your questions, however,
it is necessary to differentiate the issue of lobbying expenses
and their deductibility from the issue of political funds used
by “trade unions and teachers’ associations.
Lobbying expenses are nondeductible monies spent trying to influence
legislative outcomes. In the case of ASA, these expenses are supported
through ASA’s operating budget, which is funded through member
dues and association reserves. Last year, as a result of the unusual
congressional and regulatory environment in Washington, D.C.,
ASA was compelled to spend a relatively higher amount on lobbying
expenses than in previous years. Specifically, it was necessary
to spend funds on lobbying related to the Health Care Financing
Administration supervision issue, managed care reform, pain-related
legislation, Medicare payment rules and a number of other legislative
and regulatory issues directly impacting the practice of anesthesiology
and pain management. It is because of this increased level of
lobbying activity, not ASA's political activities, that ASA members
are unable to deduct 56 percent of their membership dues from
their federal income taxes.
Political funds are those monies used to influence election outcomes.
ASA does not use its members’ dues for political activities. Instead,
ASA's political funds are drawn from a separate, segregated account
known as ASAPAC. These funds are used specifically to participate
in political activities through donations to candidates for the
U.S. House of Representatives and the U.S. Senate and to party
committees. All ASAPAC nondeductible contributions are raised
voluntarily separate from ASA membership dues and in complete
compliance with federal election law. In fact, federal law strictly
prohibits the inclusion of ASA membership dues in the ASAPAC account.
ASAPAC is ASA’s sole funding source for election activities.
Regarding your question, it is true that some unions and associations
use other funds, in addition to their federally regulated PAC
accounts, to influence elections. ASA does not support this controversial
practice of soft money, so-called because it is not regulated
by federal election law, because it is frequently drawn from the
dues paid by union and association members many of whom oppose
the use of their monies for political activities. It is also controversial
because it is sometimes used to make extremely large donations
to party committees and to air issue advertisements advertisements
that appear to be political advertisements but, because of the
intentional exclusion of certain words or phrases, cannot be regulated
by federal election law. Indeed, virtually every major campaign
finance reform proposal introduced in recent years seeks to ban
the use of soft money. It is anticipated that any campaign finance
reform proposal ultimately enacted into law will include some
limitation or restriction on this type of political funding.
I hope this answers your questions. Please feel free to contact
me with any further questions at (202) 289-2222.
Manuel E. Bonilla
Assistant Director of Governmental Affairs (Federal)
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