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February 2002
Volume 66 |
Number 2
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ADMINISTRATIVE
UPDATE
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| Science
Matters |
James
E. Cottrell, M.D., President-Elect
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Science and its relationship to clinical care lie at the
heart of our medical specialty, but we recently learned
that the number of submissions to Anesthesiology from American
authors has decreased significantly. Did we lose our way
during the debate on scope of practice? I think not. One
of ASA’s primary missions is to provide education that
will promote research opportunities for its members. The
Scientific Council oversees these educational and research
objectives.
Despite being held just one month after the September 11
attacks in New York, Washington and Pennsylvania, our 2001
Annual Meeting in New Orleans managed to attract more than
13,000 attendees, and our Refresher Courses had only a minimal
decline in attendance.
|
James E. Cottrell, M.D. |
Subscriptions to Anesthesiology continue at an all-time high,
and its Science Citation Index is 3.44. This is the highest quality
rating of any anesthesia journal and is higher than most other
specialty journals. Our Self-Education and Evaluation program
also is very popular, currently drawing more than 7,100 subscribers.
Other ASA educational opportunities for the future will include
anesthesiologist assistants in their new Educational Membership
category and, at the request of the American College of Surgeons,
our Section on Education and Research is developing an educational
program for supervision of physician extenders by nonanesthesiologists.
Research opportunities abound in anesthesiology. The Foundation
for Anesthesia Education and Research, an organization supported
in part by ASA funding, has revised its grant-awarding process
to facilitate awarding larger grants to fewer people, thus making
it possible to compensate clinical faculty for nonclinical time.
Applications from anesthesiologists for National Institutes of
Health grant support have increased along with a three-fold increase
in the amount of funding available. Departments also contribute
significant funds from private practice to support faculty research.
So if our education and research activities are better than ever,
why have we seen a decrease in submissions to Anesthesiology?
I can only guess on this, but let us consider the decline in the
number of medical students entering anesthesiology since 1994.
How might those issues be related? Readers who have been involved
in research know how frustrating and difficult it can be. They
also know where to find help that will keep helping even after
six months’ worth of hard-won data are discarded because
of a flaw in methodology. Where do we find such dedicated workers?
They are among junior faculty and senior residents, whose ranks
have been declining for several years.
It has been estimated that we currently have a shortage of approximately
4,000 anesthesiologists. We also know that, historically, as the
number of anesthesiologists increased, the number of deaths due
to anesthesia mishaps decreased (view figure
- .pdf file).
What is our greatest concern as anesthesiologists? The unanimous
answer should be patient safety. And if we are to continue to
give the same safe care and meet the clinical needs of our patient
population, then something has to give. Under the circumstance
of a workforce shortage, we have chosen wisely. We have chosen
to give more time to patient care and less time to research and
education. If this trend continues, however, our specialty will
be shaken at its foundations — because without the advances
in science that enable us to make anesthesia and surgery safer,
morbidity and mortality will increase.
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