As the ASA liaison to the American Society of Anesthesia Technologists and Technicians (ASATT), I am grateful for the opportunity to provide this update to the membership. I will concentrate on the following areas: a brief history of ASATT and its accomplishments to date, future visions for ASATT and an overview of the relationship between ASA and ASATT.

History and Accomplishments
Fourteen years ago in October 1989, a charter group of 100 anesthesiology technicians assembled in New Orleans, Louisiana, for the purpose of establishing a national organization for their respective fields of anesthesiology technology. The meeting was held concurrently with the ASA Annual Meeting, a tradition that continues to this day. Eventually ASATT was incorporated under the laws of the state of Washington. Besides facing the initial arduous tasks of simply getting organized and establishing the membership, the charter group realized quickly there would be serious obstacles to overcome, some of which continue to this day in one form or another. Among others these challenges included the necessity of more clearly defining what an anesthesiology technologist/technician (AT) is and does; helping other technicians, anesthesiologists and hospitals realize the value ATs provide to the anesthesia care team; establishing formal educational opportunities; developing and administering examinations for certification; and developing an ongoing societal relationship with the individuals ATs work with every day, anesthesiologists. Other notable historical moments of ASATT are summarized in the table below.

From what may be considered humble beginnings, ASATT has grown to a membership in excess of 1,200. Although this represents a small number of ATs relative to the number working in the United States (an estimated 10,000), it underscores one of those ongoing challenges, namely, recognition. Nonetheless ASATT has accomplished a great deal in the last 14 years. Annual meetings are held and have been tremendous educational successes. Anesthesiologists frequently give lectures during these meetings, and their lectures are always popular and greatly appreciated. Certification examinations have been developed and implemented, e.g., examinations can now be taken online. Three schools for ATs are currently recognized by ASATT, including Western School of Health and Business in Pittsburgh, Pennsylvania, Milwaukee Area Technical College in Milwaukee, Wisconsin, and Stony Brook University in Stony Brook, New York. Further educational opportunities also are afforded through the seven regional meetings and the 21 state society meetings held on at least an annual basis. The Sensor, ASATT’s newsletter, is published quarterly and is a major communication and educational tool for the society. Standards and scope of practice as well as a “Core Curriculum” for educational institutions are now available, and a job hotline has even been established. More information on these topics is available at ASATT’s Web site <www.asatt.org>. Please visit this site; I believe you will find it worth the effort. You may even recognize someone with whom you work among the ASATT Board of Directors!

A Vision for the Future
Not resting after its accomplishments, the ASATT Board of Directors continues sowing a vision for the future of the Society. Expanding membership and establishing more educational institutions are perennial challenges. Encouraging current members to obtain and maintain certification also are worthwhile goals. The possibility of the Joint Commission on Accreditation of Healthcare Organizations requiring (or at least strongly recommending) certification and/or state licensure for technicians has been raised as a potential endeavor for the Society to consider. Perhaps the biggest desire of all for the Society, however, is the one that has proven most difficult since the beginning — the promotion of the awareness of ATs and their discipline throughout the medical community. Impossible goals? Maybe, maybe not. I believe we, as anesthesiologists, may be instrumental in answering this question.

The Relationship
Since the earliest moments of its inception, ASATT has sought a vibrant relationship with ASA for obvious reasons, again: recognition, moral support, organizational guidance and participation in educational opportunities. ASA President Roger W. Litwiller, M.D., served as the first liaison to ASATT. William H. King, M.D., subsequently followed in that position (1994-01). Their efforts in nurturing the ASA/ASATT relationship are still remembered and appreciated by the membership. I was vividly reminded of this fact at the most recent ASATT meeting in San Francisco, California. While I was talking with Dr. King during a lecture break, several ATs reacquainted themselves with him and thanked him for his past support in a variety of venues. It was as if long lost friends had found each other once again. That incident further cemented in my mind beliefs I have held since I was medical director of the ATs at the University of North Carolina Department of Anesthesiology. Namely, although much can be accomplished in the ASA/ASATT relationship at the national societal level, the all-important foundation is laid at the grassroots — working with and establishing professional relationships with ATs one day at a time in the operating room.

While at North Carolina, I was fortunate to work under the encouragement of Robert W. Vaughan, M.D., and Philip G. Boysen, M.D. Together we believed that working with ATs could (and should) be a win-win situation. Specifically our interactions with ATs would represent a positive feedback cycle. The more we could help them educationally in their jobs, the more they could, in turn, help us in ours. To that end, we established an in-house educational program that served both orientation and continuing education purposes; we also helped to establish the North Carolina Society of Anesthesiology Technicians. Technicians were encouraged to participate in state, regional and national educational seminars, and monetary funds were provided to underwrite these activities. Was all of this time and effort worth it? Absolutely! The ATs became highly respected, visible and valued members of the anesthesia care team. They rose to meet the challenges of the high level of expectations we held for them. The ATs made a difference in the department’s routine management of equipment for case setups, emergency troubleshooting of equipment, preventive maintenance of equipment, shorter room-turnover times, development of capital equipment budgets and securing purchases and simply being available to assist in a myriad of ways.

All of this discussion brings us to a final point worth considering. How can the anesthesia provider “help” the anesthesiology technician? In providing insight to this question, keep in mind the value of the positive feedback cycle previously mentioned. Here are a few suggestions:

• Encourage technicians to learn more and do more by attending local, regional and national educational seminars (and financially support them, if possible). Try to expand the scope of their job descriptions within the limits of hospital allowance. If you have the resources to establish your own continuing education program, do it.

• Encourage them to join ASATT and to experience the benefits. You will receive benefits, too! Of note an “Associate” membership category is available for $60 per year to physicians who choose to support the Society.

• Encourage them to study for and take the national certification examination. Such an accomplishment is a huge morale booster.

• Encourage them frequently with words and attitudes that demonstrate your support and recognition of them both personally and professionally. A simple pat on the back goes a long way!

Remember to celebrate with your technicians on March 31, National Anesthesia Technician Day.

In closing I am reminded of the story of a little boy walking on the beach after a major storm. Innumerable starfish dotted the shoreline. One by one, he started throwing them back into the ocean. A somewhat grumpy and skeptical old gentleman happened by. He lamented, “Why are you doing that? It’s foolishness! There are too many! You can’t possibly make a difference!” Without breaking stride, the little boy tossed another starfish into the ocean. He then looked at the old man and said with conviction, “I made a difference to that one!”

I encourage each of you to make a difference in the lives of your technicians. The benefits are worth the investment! For more information, contact: ASATT, P.O. Box 624, Franklin Lakes, NJ 07417; telephone (201) 337-1555; fax (201) 337-5073, or visit the Web site at <www.asatt.org>.

Earl S. Ransom, Jr., M.D., is a partner in Durham Anesthesia Associate, P.A., Durham Regional Hospital, Davis Ambulatory Surgical Center, North Carolina Specialty Hospital, Durham, North Carolina.