Governance Changes to Ensure That All Voices Are Heard
ASA will substantially reorganize its governance this
year. When these changes are fully implemented in October
2003, it will be the third major restructuring of this
Society. The first important change in governance happened
in 1947. That year, ASA created the House of Delegates
as the final authority on Society business, acting as
the primary legislative and governing body. The method
in 1947 for determining the number of delegates authorized
for a component society, one delegate for each 100 voting
members or fraction thereof, is unchanged. Also, the
Society replaced an 18-member, self-perpetuating Board
of Directors with one consisting of 21 democratically
elected members from geographic districts.
The next major change, approved in 1965, formed the
structure under which we operate today. It created the
Administrative and Scientific Councils, authorizing
the former to act on urgent matters that would ordinarily
require an emergency Board of Directors meeting.
The first of the changes scheduled to take place this
year occurred when the Board of Directors convened on
March 2. For the first time, a voting director represented
each component society. At that meeting, the Board considered
resolutions submitted individually by the New Hampshire/Vermont
and the Maryland/Washington, D.C. societies to divide
those societies into two component societies each.
In October 2003, the remaining elements of reorganization
will take place. A candidate will be elected by the
House of Delegates to serve in the newly created office
of Vice-President for Professional Affairs. Three new
divisions will be created for Administrative, Professional
and Scientific Affairs. Correspondingly, new sections
will report to the Administrative Council through these
newly established divisions, each of which will be chaired
by one of the Society’s three vice-presidents.
The goal of these changes is to improve continuity of
committee oversight and communication between committees,
sections and leadership. The need for this change is
most notable in the current Section on Executive Affairs,
with 17 committees and a new section chair every year.
Undoubtedly, some fine-tuning will occur in coming years
as the Society learns the strengths and weaknesses of
the new structure.
The process leading to these changes was deliberate
and thorough, beginning in 1995, when the House of Delegates
approved a resolution “That a committee of the
President’s choice evaluate the feasibility, desirability
and alternatives to a full-time Executive Vice-President
…” Norig Ellison, M.D., ASA President in
1996, appointed a small group of dedicated members to
study the question referred to it. All committee members
were experienced in ASA affairs, including some who
were past ASA and American Board of Anesthesiology presidents.
The committee reported its recommendations in 1996 and
concluded that consideration of a physician executive
would be a fragmentary approach in the absence of a
comprehensive analysis of ASA. Among the committee’s
recommendations was one to initiate a thorough study
of ASA goals and to plan a structure to support those
goals. This and the other recommendations of the committee
were referred for consideration.
A comprehensive strategic planning effort was undertaken.
A Task Force on Strategic Planning was appointed and
met at intervals over the next two years before reporting
in 1998. It established a vision, mission, values and
goals. One of the goals was to make ASA governance more
effective and responsive to member needs.
After three years and two iterations of the Task Force
on Structure and Governance, in 2001, the House approved
numerous recommendations from the task force. In 2002,
the House approved the bylaws to enable those recommendations.
The goals of the changes are to:
| • Improve committee oversight; |
| • Improve communication between committees
and section chairs; and |
| • Improve access to leadership. |
The 1996 Committee on Executive Vice-President demonstrated
great foresight with one of its recommendations and
stated the reasons for it concisely and with clarity;
“The size of the Board of Directors notwithstanding,
we recommend the creation of one full membership
in the ASA Board of Directors, to be filled by an
anesthesiologist selected from its members by the
Association of Anesthesiology Program Directors
(AAPD). This director should also sit as a member
of the House of Delegates and as a full member ex-officio
of ASA’s Committee on Economics. The selected
AAPD representative should serve without limitation
of terms and can thereby provide substantial continuity.
It is the committee’s opinion that the next
few years will be critical relative to the supply
of high-quality physicians entering anesthesiology
and critical as to public policy determinations
about graduate medical education and how it will
be supported. Unlike our subspecialty organizations
whose representatives sit in the House of Delegates,
we believe a Board of Directors seat for this AAPD
representative is necessary. The residency programs
represented by AAPD will produce virtually all of
the physicians who will make up the membership of
ASA itself. The committee is aware that many distinguished
anesthesiologists associated with training programs
are already active in ASA governance. They are usually
elected or appointed, however, with much broader
responsibilities and it is unrealistic to look to
these individuals to be the primary advocates and
agenda setters for training program issues. A senior
AAPD member sitting for a number of years in ASA’s
policy bodies could also play a constructive and
influential role with many organizations with which
ASA’s interaction is variable — the
Association of American Medical Colleges, for example.”
In the interval since introduction of the recommendation
for an academic anesthesiology board seat in 1996,
the threat to the integrity of our specialty through
continued erosion of the strength of our academic
community has increased. This recommendation, originally
proposed in 1996, was referred with the original report
and not directly considered until it was again brought
before the Board at its most recent meeting by the
report of the Committee on Academic Anesthesiology,
chaired by Orin F. Guidry, M.D. This recommendation
comes to the House in October 2003 for final disposition.
Its approval is imperative and deserves the support
of every one of us whether we are in academic or private
practice.
Considerable changes have occurred since 1996. Every
component society now has a vote on the Board of Directors.
The Resident Component is now represented. Creation
of a military/veterans affairs component is being
evaluated at the committee level and will probably
be proposed this year.
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