2005 Offers New Opportunities,
Old Challenges for Incoming Director
Ronald Szabat, J.D., L.L.M., Director
Governmental and Legal Affairs
s I begin 2005 in my new position as Director of Governmental
and Legal Affairs for ASA, I am struck by the rich
combination of new opportunities and old challenges.
For instance, based on nearly 18 years of working
for our federation partner, the American Medical Association
(AMA), a familiar rhythm for part of the next year
is already set. I am thinking, of course, of the cycle
of national meetings where physician leaders from
many state and national medical specialty societies
come together to learn, discuss and set policy and
be challenged to advance the overall profession of
medicine.
Cleverly, ASA’s own cycle of important gatherings
weaves in and around these other events, adding substantial
depth for our own members. One need only look at the
program book for the ASA Annual Meeting this past
October to understand this in spades. The countless
research presentations and continuing medical education
offerings convened by ASA attract anesthesiologists
from the four corners of America as well as those
from around the globe.
Closer to the everyday demands of your ASA advocacy
team, many weighty issues remain in 2005 that still
require urgent action, whether it be in Washington
or the states. Here in D.C., fixing the Medicare sustainable
growth rate update formula to avoid a new round of
cutbacks continues to rank high on every physician
organization’s “to do” list for
2005. Given federal budget realities, this will not
prove an easy campaign.
At the same time, the vexing need to achieve meaningful
medical liability reform against runaway trial lawyers
also must remain at the forefront of physicians’
legislative agendas. Again, this is a tough task,
even with better overall support in the U.S. Senate
this year, but it is hardly a new issue for physician
organizations.
Both of these challenges will remain a major focus
of ASA advocacy until they are accomplished. And,
fortunately, our efforts will continue as we work
cooperatively with like-minded coalition partners
across all of organized medicine, led by AMA.
What is different about anesthesiology, though? How
can our own grassroots anesthesiologists make a difference?
Unfortunately the short space of this column does
not permit the answer that is fully deserved, but
please allow me to share one major initial impression
and specific opportunity that I believe should guide
much of our work together this year.
First and foremost, I believe anesthesiologists need
to be better known for what they do and how they do
it. Admittedly this is not an original thought, but
in the world of public relations and political opinion
that holds sway with our elected governmental leaders,
the ability to translate and better explain what it
is that anesthesiologists do is urgently needed. As
part of my own education in this regard, I have recently
visited and seen critical care anesthesia in medical
practice in North Carolina. There, I also witnessed
the excitement and elaborate work of a large hospital
anesthesia care team, as I did in a major metropolitan
hospital in Atlanta just prior to AMA’s Interim
Meeting. In the coming months, I will visit a major
academic training program as well as learn more, firsthand,
about the ways in which anesthesiologists practice
pain medicine and do research. Why? Well, certainly
not to become expert in
practicing anesthesiology!
In fact, that is just the point.
Without years of hard work, medical education and
actual clinical practice or research, there is simply
no way that any layperson could hope to begin to fully
understand the complexity of what a mere four or five
days of anesthesiology “site visits” can
offer, not to mention what happens on the other 360
days in any year. More to the point, unless we collectively
can begin to translate and describe the intricacies
of anesthesiology medical care so that public officials
and their staffs can understand it more completely,
it will be harder to win legislatively and with state
and federal regulators. Outlining the distinctive
markers of professionalism that are unique to anesthesiology
is part of this need for better definition, but the
fact remains that more and better “sound bites”
also will be needed as we fight major legislative
battles in the months to come. We are all competing
for attention in an information age, which should
never be confused with a newfound age of wisdom or
knowledge.
Simple vignettes and stories can tell a lot and advance
our cause. An excellent piece by George T. Blike,
M.D., called
“Human
Factors Engineering: It’s All About ‘Usability’”
from the October 2004
NEWSLETTER has great
value far beyond its insightful predictions for the
future of anesthesiology medical care. The straightforward
questions asked in that piece by the promising anesthesiology
medical resident working with Dr. Blike speak volumes
about what needs to be learned, explained and re-explained
to the lay public and public policy opinion leaders.
In fact, in that same
NEWSLETTER, Warren
K. Eng, M.D., a resident at the University of North
Carolina Hospitals, makes this same point, citing
a well-written piece about anesthesiology and other
“Hidden Specialties” in a widely read
national periodical,
U.S. News and World Report.
So, my new friends and colleagues, as you educate
our decision-makers in government (and me), remember
also to speak from your heart about what it is that
you do to help patients on a daily basis. This is
the “value-added” that each and every
anesthesiologist can bring to ASA’s advocacy
agenda as we work hard together to advance our unique
issues. As I have told physician audiences for many
years, no one can discount your personal medical stories,
thoughtfully delivered.
If we truly want to prevail in achieving an enhanced
Medicare anesthesia conversion factor, reverse the
discriminatory anesthesia teaching rule and advance
ourselves on numerous other issues, including quality
of care, we will need to add the patient dimension
to our repository of economic and practice management
advocacy examples and arguments. Both our new President,
Eugene P. Sinclair, M.D., and Immediate Past President
Roger W. Litwiller, M.D., echoed this theme in their
remarks before the ASA House of Delegates last October.
Their words were wise and should be heeded. I have
made it a New Year’s resolution to do so. May
I boldly ask you to do the same?
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