Alexander A. Hannenberg, M.D.

Nearly every week, ASA volunteers leave home for distant meeting locations at which they will represent our specialty at a bewildering variety of organizations. Some of these are closely, and others only remotely, related to the practice of anesthesiology. Why do they make these treks, and what value do they bring to the specialty?

ASA has more than 40 official liaison positions with external organizations and almost as many temporary or informal representation arrangements. Some are obvious, such as our liaison with the American College of Surgeons or the American College of Obstetricians and Gynecologists. But many are quite obscure, such as the X12N Committee of the American National Standards Institute (ANSI) or the American Medical Association (AMA) Correct Coding Policy Committee. There is, it seems, no clear relationship between the obscurity of the organization and its importance to ASA members.

Service as anesthesiology’s representative to an external organization has several phases. Our volunteers typically spend time listening to and learning the protocols and often arcane language and acronyms used to conduct business in the respective board, committee or workgroup. Having done so, they become better able to contribute to the mission of the group. To the extent that the external organization and ASA share a common mission, advancing the organization’s agenda brings value directly to ASA. This contribution also builds stature and credibility for the individual and, by extension, the specialty. With stature and credibility come influence and the ability to effectively advocate for the interests of anesthesiology. Perhaps the most notable recent example of an anesthesiologist being recognized for her stature and credibility is Rebecca J. Patchin, M.D., who was elected to the AMA Board of Trustees in June 2003.

We particularly enjoy the liaison activities that bring quantifiable benefit to ASA members, such as the participation by ASA Assistant Director of Governmental Affairs Karin Bierstein, J.D., and Keith J. Ruskin, M.D., in the deliberations of the ANSI X12N Committee, which developed specifications for the uniform electronic claims format required by the Health Insurance Portability and Accountability Act. Their efforts to preserve anesthesiologists’ ability to report “rounded up” time units was critical in preventing the claim form from interfering with private payer contracts allowing payment for a time unit “or fraction thereof.” The benefit to anesthesiologists has previously been estimated at more than $125 million annually.¹

We recognize that the movement toward electronic recording of patient care is both an inevitable and valuable step toward effective benchmarking and quality improvement. The implications in an environment in which insurers want to “pay for performance” and patients demand “report cards” on quality and safety are enormous. These considerations undoubtedly motivate ASA members Ronald A. Gabel, M.D., Terri G. Monk, M.D., and Iain C. Sanderson, M.D., to volunteer their time as members of the International Organization of Terminology in Anesthesia. This group is working to produce an international standard lexicon for electronic anesthesia records and other purposes, without which future data recording will produce nothing but chaos.

Other ASA members have learned the ways of organizations as diverse as the National Fire Protection Association and the International Organization for Standardization, both of which deal with the highly technical aspects of the equipment we use daily and the manufacturing standards of such equipment. Members participate in these organizations to contribute the views of the practicing anesthesiologist or “end user” of equipment on which the safety of our patients depends. Would any reader of this NEWSLETTER want these standards developed without the voice of anesthesiology being heard? How about the United Network for Organ Sharing’s criteria for credentialing of transplant anesthesiologists? Or Medicare’s Surgical Infection Prevention Project?

To the ASA members named in this column, and literally scores of others unmentioned who take time away from family and practice to toil in the meeting rooms of organizations whose existence is unknown to nearly all in the specialty, we owe heartfelt thanks. ASA’s support and coordination of this representation is an often overlooked, yet vital, function of your Society. Together we ensure that anesthesiology always has a “seat at the table.”


Reference:

1. Bierstein K. HIPAA-compliant claims — test now. ASA Newsl. 2003; 67(6):24-26.



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