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October 2003
Volume 67 |
Number 10 |
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Section on Fiscal Affairs — ASA’s Financial
Watchdog
If asked their views concerning the ASA’s Section
on Fiscal Affairs, most ASA members might say that it
is a relatively uninteresting committee with little
input or impact on the day-to-day affairs of the Society.
I hope to convince you of the inaccuracy of this perception.
The Section is extremely active in drafting proposals
and recommendations, developing checks and balances
and providing philosophical changes in our approach
to finance. Reverberations of these actions have effects
that penetrate to the very core of the values and missions
of ASA. The Chair of the Section on Fiscal Affairs is
Orin F. Guidry, M.D., with myself serving as Vice-Chair.
Members include: Thomas B. Bralliar, M.D., Jan Ehrenwerth,
M.D., Richard R. Johnston, M.D., Lawrence J. Roy, M.D.,
and James M. West, M.D. Though the Board of Directors
and the House of Delegates are ultimately responsible
for fiscal oversight, they rely heavily on the conscientious
and in-depth evaluation provided through the Section
on Fiscal Affairs in recommending new policies.
Several critical issues have been dealt with by the
Section over the past few years:
Auditors
ASA was surprised, along with many major corporations,
that its auditor for many years, Arthur Andersen, no
longer was able to provide auditing services. Auditors
normally provide a report to the Section on Fiscal Affairs
on a yearly basis with an evaluation of the auditor’s
analysis and recommendations. Since auditing such a
major organization as ASA is an absolute necessity,
a “request for proposal” was sent out to
many auditing firms in order to find a replacement.
After a review of multiple proposals, the Section settled
on Deloitte and Touche. In addition to simply changing
auditors, the Section also came up with a number of
new recommendations concerning the auditing process,
not only for ASA, but for all other organizations and
foundations associated with ASA management.
At the time that Deloitte and Touche was chosen, many
of the organizations used different auditors or had
no auditors at all. After a great deal of discussion,
the Section on Fiscal Affairs proposed that all ASA-managed
or associated foundations and organizations should be
audited by the same firm providing services to ASA.
With that decision came the increased responsibility
for each of those foundations and organizations to take
on the increased cost of the auditing. Based upon the
Section’s recommendations, these proposed changes
have been realized in 2003, resulting in a consistency
in the auditing services of ASA and its associated foundations
and organizations, which had never previously been present.
Foundation Funding
Each year approximately $2 million of ASA’s funds
are distributed to the Wood Library-Museum of Anesthesiology,
the Anesthesia Patient Safety Foundation and the Foundation
for Anesthesia Education and Research. There is no debate
that each of these foundations contribute significantly
to ASA’s mission and that each needs to be preserved
and promoted so that they can effectively carry out
their important purposes.
In 1990 the ASA Board of Directors approved a dues increase
as a way of ensuring funding for the activities of these
foundations while encouraging the foundations to contribute
to their own endowments. This was done with the idea
that after a reasonable period of time, the foundations
could become independent. Each of the foundations has
since made major efforts to increase their endowment
funds, but each has also expanded its scope of involvements,
and thereby the costs, in order to fulfill its respective
mission. Because of this, the Section on Fiscal Affairs
was asked to re-evaluate the status of the three foundations
in regard to continued ASA funding.
After a great deal of reflection and discussion, the
Section has recommended that a philosophic change toward
these three foundations be made. Since these three foundations
can be considered fundamental to the values and missions
of ASA, they should never be totally independent; either
financially or otherwise. At the same time, however,
the amount of funding that will go to each organization
on a yearly basis would have to be tailored to ASA’s
financial situation. Since ASA has gone through a tough
period over the past few years in regard to its own
financial reserves, a mechanism was needed to tailor
contributions from ASA to its foundations based on ASA’s
own economic state. Therefore the House of Delegates
will be considering recommendations that come from the
Section on Fiscal Affairs, authored by Dr. Guidry recommending
a major change in ASA’s philosophic approach to
the three foundations, both in regard to future funding
and to ensuring that each foundation can continue fulfilling
its mission.
Expert Witness Program
The Section on Fiscal Affairs also has taken on the
very important job of developing a reasonable estimate
of the annual fiscal impact should ASA choose to develop
an expert witness evaluation program. Under the guidance
and direction of President-Elect Roger W. Litwiller,
M.D., came a proposal to develop a program by which
“expert” testimony against anesthesiologists
of questionable quality could be evaluated by a committee
within ASA and recommendations made concerning disciplinary
action against members of our Society who provide egregious
testimony. Though some direction is provided for anticipated
costs by the American Association of Neurological Surgeons,
who has instituted a similar program, developing an
estimate for anesthesiology is still problematic. Once
again, the Section took on this challenge and has come
up with what it thinks is a reasonable annual impact
in order to fund a project of this nature.
As these recent activities indicate, the Section on
Fiscal Affairs is not simply a reticent, quiescent group
of anesthesiologists quietly crunching numbers. It is
an active and dynamic committee that is providing direction,
suggestions and recommendations concerning wide-ranging
programs that will affect every anesthesiologist. It
is my great pleasure to have served on this committee
in the past and to continue serving on this committee
that is essential to the financial health of ASA.
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The views expressed herein are those of the authors and
do not necessarily represent or reflect the views, policies
or actions of the American Society of Anesthesiologists.
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