ASA February 2003 Newsletter

It is a question that has been frequently heard over the past year at the ASA-sponsored booth in the exhibit hall of various medical specialty meetings. “Why are you here?” is just one of the many interesting questions asked by our surgical colleagues. At first, nonanesthesiologists seem surprised to see us at their annual meetings. They start approaching our booth slowly at first and then, as if visiting old friends, they visit in droves. Some of them are thrilled to have the opportunity to ask questions about anesthesia practice, some about issues surrounding supervision, others who are interested in ASA guidelines.

Why bother going to a medical meeting so that surgeons can have the opportunity to interact with anesthesiologists?

The answer is communication!

Communication is one of the most important functions of the anesthesiologist and of ASA. The Committee on Communications has been very active in facilitating communication among ASA members with newsletters and brochures. We have focused heavily on improving the flow of information to patients with pamphlets and PowerPoint® slide-based lecture series. With the help of ASA staff, we also have tried to get new and interesting information out via press releases and news articles in the lay press. Now we are embarking on a new effort to enhance our communications with the physicians we most often encounter: surgeons, plastic surgeons, obstetricians and ophthalmologists.

Taking the Show on the Road

The Committee on Communications has become more active and visible in representing ASA at many medical society meetings. Here David J. Birnbach, M.D., left, Patricia A. Dailey, M.D., and Committee Chair R. Lawrence Sullivan, Jr., M.D., staff the ASA booth at a recent ACOG meeting.

As the practice of anesthesiology has grown and changed, we have impacted the practices of the surgeons and other physician specialists with whom we work. Over the past several decades, more surgeries have moved from the hospital setting to alternative locations such as ambulatory care centers, and increasingly, physicians’ offices. This in turn has led to a flurry of state and federal regulations that at times have created some confusion and controversy between surgeons and anesthesiologists.

On another front, the increased popularity of neuraxial analgesia for obstetrics and the frequently changing protocols have created some controversy. ASA is improving the flow of information to obstetricians and surgeons by attending selected national meetings to distribute patient safety literature and to answer questions. The Committee on Communications has represented ASA at national meetings of the American College of Surgeons, American Society of Plastic Surgeons, American Academy of Ophthalmology (AAO) and the American College of Obstetricians and Gynecologists (ACOG). Members of the committee have staffed the ASA booth along with many helpful volunteer ASA members recruited by the component societies of the states in which the meetings are held.

The most frequently asked questions at the surgical meetings have centered around the topics of sedation and office surgery regulations. The definition of levels of anesthesia, from anxiolysis to deep sedation to general anesthesia, has become more important as regulations arise that apply different requirements for the level of anesthesia administered. As many surgeons expand their office surgery practices, they find ASA literature on each of these subjects very helpful. There is also interest in patient education pamphlets. The most popular piece by far is the ASA brochure “What You Should Know About Your Patients’ Use of Herbal Medicines.” There is universal recognition of the frequency with which patients use supplements and great interest on how these drugs can impact patients before, during and after surgery. The inevitable questions about anesthesia providers and equipment have resulted in many spirited discussions and hopefully have improved the understanding of ASA’s positions.

Last April, ASA broadened its communications outreach by adding ACOG to the list of meetings to attend. Our visit there was mutually beneficial to both the attendees and, in the long run, to our Society. While many of the questions asked were similar to those addressed at the other surgical meetings, some were unique to obstetrics and reinforced our decision to attend that meeting. In particular, issues related to guidelines, labor analgesia and ASA joint statements were “hot topics.” Following our attendance at ACOG and potentially as a result of our very positive reception, the organizers of this year’s ACOG annual meeting have invited an obstetric anesthesiologist to give an update lecture on this subject.

Communication goes two ways, and an unexpected benefit of attending the surgical meetings is the information gathered. This information comes not only from discussions with the surgeons but also by observing the format of the meetings and the organization of the exhibit halls.

So, in conclusion, the answer to “Why are you here?” is simple. We are doing what anesthesiologists do best — communicating. In the long run, we believe that these interactions will help us to communicate better and thus improve our relationships with our surgical colleagues, and as a result of better interactions with surgeons, take better care of our patients.

David J. Birnbach, M.D., is Professor and Executive Vice-Chair, Department of Anesthesiology, University of Miami School of Medicine, Miami, Florida.

Rebecca A. Welch, M.D., is Staff Anesthesiologist, Nemours Children’s Clinic-Orlando, Arnold Palmer Hospital for Children and Women, Orlando, Florida.

return to top