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December 2003
Volume 67 |
Number 12 |
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ASA Since 1981 – A Retrospective
When ASA Executive Secretary John W. Andes hired yours
truly as a new junior administrator in January 1981,
the Society had a staff of approximately 20, a membership
of less than 16,000 and a budget of about $3 million.
Its 1980 Annual Meeting in St. Louis, Missouri, attracted
6,112 participants.
In the two decades since, the growth of the Society
has been nothing short of remarkable. Many of the ASA
attributes that our members now enjoy and from which
the American public benefits were not always available.
Following is a capsule of ASA’s impressive evolution
over that period of time.
One of ASA’s significant ongoing contributions
to patient safety began in 1982 when the Anesthesia
Consultation Program came into existence. Since then
the anesthesiology departments of more than 150 hospitals
have been reviewed by consultants from the Committee
on Quality Management and Departmental Administration.
In 1984 the Society hired its first Director of Communications
after 15 years of outside consultants. The increase
of activity in this area has been significant, including
the growth of the monthly NEWSLETTER from eight
pages in the early 1980s to up to 44 pages today. In
addition the development of a vast array of publications
in the past two decades has greatly served ASA and its
constituents.
With the mission that “no patient be harmed by
the effects of anesthesia,” the 1985 House of
Delegates approved the creation of the Anesthesia Patient
Safety Foundation, with Ellison C. Pierce, Jr., M.D.,
as its first president. Worth mentioning is the fact
that Dr. Pierce was honored at the 2003 Annual Meeting
for his long-standing service in this role, which concluded
with his retirement this year.
Also of note in 1985 was the introduction of the Closed
Claims Project under the auspices of Frederick W. Cheney,
M.D., and the Committee on Professional Liability. This
program has been the subject of 22 papers that have
been published in peer-reviewed journals and has contributed
to the development of ASA positions relating to pulse
oximetry and capnography as well as a reduction of professional
liability premiums.
In 1986 the “Standards for Basic Intraoperative
Monitoring” were approved by the House of Delegates.
These were the first “standards” published
by the Society. On another front, ASA opened its Washington
Office under the direction of Adrienne C. Lang.
Jack Andes passed away in 1987 after serving as Executive
Secretary for 29 years. Glenn W. Johnson assumed that
position until his retirement in 2003. Also in 1987,
the Foundation for Anesthesia Education and Research
enjoyed its first year of operation and since that time
has contributed $12.3 million in research funding.
In 1988 the Society reached a milestone of 25,000 members.
Another highlight of that year was ASA’s hosting
of the Ninth World Congress of Anaesthesiologists, which
was held in Washington, D.C., with an attendance of
7,456.
Of interest, the profits from hosting the Congress have
funded, in part, the ASA Overseas Teaching Program (OTP)
for the past 14 years. OTP was approved by the House
of Delegates in 1989 under the direction of Nicholas
M. Greene, M.D., and continues to supply volunteers
to two African locations for the purpose of training
anesthesia providers.
The first meeting of the Resident Component House of
Delegates was held in Las Vegas, Nevada, during the
1990 Annual Meeting. A small group of residents attended.
This modest beginning now pales in comparison to the
Resident Component activities of today, which includes
a typical House of Delegates attendance of 100-plus
residents who represent most of ASA’s 52 component
societies.
Although not without controversy, the ASA Political
Action Committee (ASAPAC) was established in 1991. In
its first full year, ASAPAC raised $303,955. Contributions
peaked in 2000 during the height of the Medicare supervision
issue when contributions totaled $1,120,852. Also in
1991, ASA membership exceeded 30,000 for the first time.
In 1992 “Practice Guidelines for the Management
of the Difficult Airway” and “Practice Guidelines
for Pulmonary Artery Catheterization” were introduced.
These were the first of a long line of evidence-based
ASA practice parameters that continue to be published
under the direction of James F. Arens, M.D. Also that
year, the ASA staff moved into a new $4 million Headquarters
Office. This building tripled the amount of available
workspace and greatly expanded the facilities of the
Wood Library-Museum.
The year 1994 marked a new record for Annual Meeting
attendance as 18,377 participants traveled to San Francisco,
California, for the event. New strides were under way
that year in the practice management arena, ultimately
leading to the first annual practice management conference
in 1995. Three hundred anesthesiologists and practice
administrators attended this initial conference in San
Antonio, Texas.
To accommodate the increased demand for improved safety
measures in the office setting, ASA in 1999 adopted
its “Guidelines for Office-Based Anesthesia”
and “Statement on Qualifications of Anesthesia
Providers in the Office-Based Setting.”
ASA membership reached 35,000 in 2000. Another stride
forward on the practice management front was the development
that year of the Certificate in Business Administration
(CBA) program under the guidance of Asa C. Lockhart,
M.D. To date 232 members have earned this certificate.
In an unprecedented move, the acceptance of anesthesiologist
assistants (AAs) as Educational members was approved
by the House of Delegates in 2001. At present the Society
has 171 AA members. This was preceded by the acceptance
into membership of medical students in 1999, of which
we now have 541 members, and followed by acceptance
of nurse anesthetist members in October 2003.
As we approach 2004, the differences from 1981 are striking:
55 staff, 38,000 members, a $20 million budget and an
average Annual Meeting attendance of more than 17,000.
ASA’s past leadership has been responsible for
overseeing tremendous growth while representing a diverse
constituency — anesthesiologists who practice
one-on-one; those who supervise nonphysicians; those
in academia; and the large segment who subspecialize
and support their smaller subspecialty societies. Although
widely varied in their philosophy and modes of practice,
all of these factions seem to agree on one thing: membership
in their national specialty society should be part of
their professional lives.
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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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