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IIn the
December 2002 ASA NEWSLETTER, the ASA Political
Action Committee (ASAPAC) published its contribution
statistics. Currently, only 10 percent of ASA members
contribute to ASAPAC compared to approximately 40
percent of nurse anesthetists who contribute to their
PAC. In the past two years, nurse anesthetists have
received gubernatorial support to practice without
physician supervision in Iowa, Nebraska, Idaho, Minnesota,
New Hampshire and New Mexico. At the same time, decisions
are being made about issues such as Medicare reimbursement,
tort reform, and scope of practice for anesthesia
care. A more active membership base is necessary to
ensure the future of our specialty as we know it.
Arguably the most effective time to encourage participation
in the political process and ASA is during residency.
With their entire careers ahead of them, residents
have the most to gain from effective political advocacy.
Moreover, practice patterns are being established,
and residents are open to suggestions on how to manage
and balance their professional careers. Inclusion
of the political process in the residency curriculum,
even in a small way, is an important step toward ensuring
an active and engaged membership.
Residency is, by definition, a busy time. It is easy
to become bogged down by reading and acquiring technical
expertise. However, leadership development is vital
to the future of medicine and to our specialty. While
those interested in research are often given support
in terms of both time and resources, there is little
support for those interested in leadership. Academic
chairs and residency program directors are keys to
the process of finding ways within the residency structure
to support leadership development. Time and financial
backing to attend leadership conferences, inclusion
of the political process in residency didactics and
a regular discussion of political developments within
the department are a few ways that programs can encourage
residents to create a lifelong interest in the political
and financial health of our specialty. ASA could even
consider providing grants to academic departments
to develop the political components of their programs.
As an example, at the University of North Carolina-Chapel
Hill, almost one-quarter of the residents were able
to attend an ASA Annual Meeting. In addition, many
residents are active within the ASA Resident Component,
the North Carolina Society of Anesthesiologists and
the University of North Carolina Hospital. In the
past two years, four members of the ASA Resident Component
Governing Council have come from the University of
North Carolina. This level of involvement would not
be possible without the support and encouragement
from the chair, program director and faculty.
Opportunities abound for resident involvement from
the national to the local level. At the national level,
residents are appointed to many of the ASA committees.
In addition, there are many leadership positions within
the Resident Component itself. For those interested
in resident-specific concerns, two important issues
are currently pending. The first issue is how the
new duty hour regulations will impact anesthesiology
residency programs. The second issue is the debate
regarding the inclusion of the clinical base year
into an integrated four-year anesthesiology residency
curriculum.
It is important to note that the debate over major
issues, such as tort reform and physician supervision
of nurse anesthetists, takes place at the state level.
The state component societies as well as the state
medical boards are always looking for interested members.
Contact information for the state component society
chapters can be found at <www.ASAhq.org/aboutasa/asacomponentsocietyofficers.htm>.
Finally, leadership is needed at the local level.
Anesthesiologists’ perspectives are often valuable
in shaping decisions on hospital committees, such
as the operating room and pharmacy/therapeutics committees,
for the betterment of patient care. Resident-specific
positions also are available with organizations such
as the housestaff council and within anesthesiology
departments.
If we as residents and physicians choose not to sit
at the bargaining table, if we choose not to be part
of the solution, then we have chosen to be satisfied
with what remains after others formulate policy. At
the same time, if we as a profession do not actively
recruit residents to the bargaining table, then we
accept a future where only a minority of anesthesiologists
will be politically involved, and our fate will depend
on the generosity of more organized, competing interests.
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Brian N. Vaughan, M.D., is a CA-1 resident at
the University of North Carolina-Chapel Hill,
North Carolina. |
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