Jack Lansdale (1912-2003), Remembered With Awe and
Affection
Michael Scott, J.D., Director
Governmental and Legal Affairs
For the past decade (exactly), I have been reporting
on legislative and regulatory developments in this
column. Having built this perhaps frail equity month
by month, I hope I can be forgiven for devoting
this 121st column, on the occasion of his death,
to the memory of the finest lawyer I have been privileged
to know, Jack Lansdale.
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Jack Lansdale (1912-2003) as ASA legal counsel
in 1978. |
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Jack died peacefully in his sleep on August 22 at
the age of 91. Because he retired from his role as
ASA legal counsel more than 20 years ago, it is a
safe bet that only a modest percentage of ASA’s
current membership ever knew him, or for that matter
ever heard of him. But his contributions to the specialty
were profound and deserve at least brief remembrance
in these pages. Who knows, they may even serve as
inspiration to the guardians of the specialty today.
Jack did not become involved with ASA until after
World War II. His wartime accomplishments as chief
of intelligence and security on the top-secret atomic
bomb project have been widely documented, and his
testimony supporting the loyalty of J. Robert Oppenheimer
— one of the project’s chief scientists
— was even the subject of a dramatic production
in which Jack was portrayed as a heroic figure bucking
the McCarthyistic hysteria sweeping the country
at that time.
By his own admission, Jack knew nothing of the politics
of health care when he began to represent ASA in
the late 1940s. To this day, he is far better known
for his many accomplishments as a trial lawyer than
as counsel for a national medical specialty society.
But he became counsel to ASA at an incredibly important
time for development of the specialty.
Still in its infancy as a recognized medical discipline,
anesthesiology in those days was regarded, along
with pathology and radiology, as a hospital service.
Through the 1950s, ASA leaders, with Jack’s
legal and strategic counsel, battled with hospitals
and insurers for recognition of the specialty as
the practice of medicine. Had they not succeeded,
it is doubtful that ASA would even exist today;
rather it might have ended up as an “anesthesia
service committee” of the American Hospital
Association.
Culmination of this effort really occurred with
passage of Medicare legislation in 1965. Early drafts
of this legislation during the Kennedy administration
contemplated that anesthesiology services would
be paid for as hospital services under what is now
Medicare Part A, a concept that would represent
a dagger through the heart of anesthesiology as
a recognized, and independent, physician specialty.
Jack, again with several leaders of the Society,
extensively lobbied both the Senate and the House,
and at perhaps the nadir of the Society’s
relationship with the American Medical Association
(AMA), refused to oppose the Medicare program itself
— recognizing that if they did so, any chance
for federal acceptance of anesthesiology as a physician
service would be lost. That this Washington Office
devotes so much time battling with the Centers for
Medicare & Medicaid Services over Part B reimbursement
today is a direct product of the fact that these
guardians of the specialty succeeded in gaining
recognition of anesthesiology as an independent
physician service under Medicare.
It was during this same period that the Society,
responding mainly to the requests of insurers, began
to develop the ASA Relative Value Guide. As most
members know, virtually all anesthesia services
in this country are today reimbursed pursuant to
the guide or some variation thereof. Jack again
served as counsel during this process, and ultimately
in 1975, successfully defended the guide against
antitrust attack in litigation brought by the Department
of Justice. Jack advised the Society to fight the
government at a time when many other specialties
were signing consent orders by which they abandoned
use of their relative value guides and in the face
of strong skepticism expressed by AMA as to the
wisdom of ASA’s course of action.
Jack retired from active ASA representation in the
late 1970s, some 30 years after he began. The first
nonphysician invited to present the Emery A. Rovenstine
Memorial Lecture, Jack exhorted his audience in
1985 not to “abandon the dream of making safe,
effective anesthesia available to all the people.”
Today’s ASA members should be aware that perhaps
more than any other single person, Jack Lansdale
was the head shepherd in its early years of a Society
that remains today in a position to make good on
that dream.
Jack Lansdale was a father figure to me for many,
many years, and quite frankly, I revere his memory.
He was the most disciplined man I ever met. Afraid
early in his career that he was becoming too reliant
on alcohol and tobacco, he stopped both, cold turkey.
No Alcoholics Anonymous, no nicotine patches, just
will power. No book that entered his home could
be shelved until he had read it, a trait that he
continued long after his retirement. When he decided
he was overweight, he started to run, and run, and
in relatively short time, lost 40 pounds that he
never regained. And when he tried a lawsuit, as
former ASA President Jess B. Weiss, M.D., will attest,
the intensity of his focus on the objective was
literally frightening to those around him.
Early in my career, I was Jack’s research
assistant for about two years. I second-chaired
him on a case involving construction of part of
the Ohio Turnpike. After a long trial, the judge
entered a judgment virtually all in our favor. On
appeal the appellate court sustained most of what
the trial judge had done. When I walked into Jack’s
office with the opinion, I noted that the appellate
judges had upheld our position, but, I said, “for
all the wrong reasons.” Jack responded: “I
don’t give a damn what their reasoning was.
The client won, and that’s what counts.”
ASA has been enormously fortunate to have been served
by a lawyer who put its interests above all else.
That’s what Jack did, always with great passion.
Except for his wife and five daughters, Jack never
expressed much pride. But I’m pretty sure
he’d take pride today in the ASA he helped
nurture. As one fortunate to have been among his
disciples, I will miss him.
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