The
House of Delegates and the Gift of Giving?
 n
the eve of our centennial celebration, it’s
appropriate to reflect on our past and to contemplate
the future. There are many individuals more qualified
than I to relate the accomplishments and milestones
of the past, and as such, the nature of this brief
column is to simply reflect on the one consistent
feature of these past 100 years — change.
In 1990, William Manchester wrote an essay reflecting
on the changes this country experienced from 1930
to 1990. After a very thoughtful discourse and account
of these six decades, he concludes that it is not
change in and of itself that is peculiar to any given
time but rather the pace at which change occurs in
each of the subsequent periods of time. To paraphrase
a final comment in his writing: If the American
of the 21st century plans to succeed amid the accelerations
of the next century, he or she must be supple and
malleable to change, cloaked in resilience and not
self-righteousness.
The fact that ASA is at the dawn of its 100-year celebration
is perhaps testimony to our resilience over the past
10 decades. As the pace of change accelerates, though,
are we reasonably “supple and malleable”
to absorb the challenges of the future that will allow
us to shape our destiny?
ASA is an organization that possesses those legendary
qualities identified by authors such as James Collins
and Jerry Porras in their book Built to Last.
In addition to talented leadership, the essence of
these companies is identified by a culture that is
characterized by “Core Ideology,” “Core
Purpose” and “Core Values.” It is
somewhat ironic that it is a firm and unyielding commitment
to these three principles that allows organizations
to be “supple and malleable” to the many
challenges of the future.
Our Core Ideology is the firm belief that anesthesiology
is the practice of medicine. It is an understanding
that emerges from our Core Purpose to be the organization
that represents all anesthesiologists in all aspects
of the practice of anesthesiology. This Core Purpose
is driven and guided by our commitment to certain
Core Values, which include patient welfare first and
foremost, education and research, ethical principles,
professionalism and service.
It is the role of leadership to bring hope and optimism
to our purpose, vision and values. It does not stop
there. It is equally important to create and sustain
an architecture that will allow members’ ideas
to become reality. Through the years, ASA has been
committed to creating and sustaining the “architecture”
that allows the voice of the member to be heard. Unlike
many other professional organizations, ASA is committed
to a robust participatory governance structure that
encourages members to bring their talents to bear
for the good of the profession. Though it requires
at times significant resources in both time and money,
ASA can boast a membership second to none in this
country and the entire practice of medicine.
It is somewhat dispiriting that the “winds of
change” have disheartened many physicians, including
some of our own ASA members, to reflect on the practice
of medicine as something less than a noble calling.
Certainly the business and practice of medicine have
changed enormously, even in my relatively brief career.
In an address to the Medical Group Management Association,
one speaker, Kevin Frieberg, said, “Don’t
let the business of medicine destroy the heart of
medicine. It’s too heroic.” As I reflected
on the content of this column, I reread something
from the “Historical Notes on the Origin and
Development of the Texas Society of Anesthesiologists”
by Charles R. Allen, M.D. This particular piece is
titled “Recollections of Anesthesia Practice
(1906-1948),” by Claudia Potter, M.D., who is
considered to be the first full-time physician anesthesiologist
in Texas. The manuscript is filled with wonderful
personal accounts of her practice at the Scott and
White Hospital in Temple, Texas. More importantly
it is an inspiring story of one person’s ability
to accommodate change because of an unyielding devotion
to serve her patients and fellow physicians through
her practice. The final paragraph in her manuscript
reads:
“I have tried to relate
some of the facts of the early history that probably
I am the only one left to tell the story. Many doctors
have come and gone during my stay, some good, some
good riddance in my humble judgment. But to the
many with whom it has been my privilege to be a
co-worker, I want to express my appreciation and
gratitude for the many happy years that we have
worked together. Most of my life has been spent
in this hospital. It has had its ups and downs,
a full life, with its share of joys and sorrows,
laughter and tears, barrels of the latter, a moderate
amount of success, a full measure of failures, but
I can truthfully say in retrospect I wish I could
live it all over.”
ASA enjoys a legacy of service to its
members, patients and the medical profession. It is
through this servant leadership that we stand as a
shining star among many other professions. Our resilience,
and our future, is vested in that unwavering commitment
to excellence, professionalism and patient welfare.
As illustrated in Dr. Potter’s recollections,
being supple and malleable to change will allow us
as a profession and a Society to truthfully say that
we wish we could live it all over.
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