The moment one definitely commits oneself,
then Providence moves too. All sorts of things occur
to help that would never otherwise have occurred.
A whole stream of events issues from the decision, raising
in one’s favor all manner of unforeseen incidents
and meetings and material assistance which no man could
have dreamed would come his way.

— William H. Murray
(Quoting Johann Wolfgang von Goethe)

n 1998, the Committee on Communications submitted a proposal to the Board of Directors noting that “It would be beneficial for anesthesiologists and surgeons alike to have a booth in the exhibit hall at the ACS (American College of Surgeons) meeting [from October 25-30, 1998] to promote the anesthesiologist as a perioperative physician and as a physician consultant member of the O.R. team. ASA reference materials such as standards, practice guidelines, recommendations on anesthesia department development, etc. [should] be provided.”¹ It was suggested that personnel to staff the booth would be recruited from local members of the state’s component anesthesiology society. After due consideration, ASA Committee on Communications attendance at the first specialty meeting was set for 2000 at the Annual Meeting of the American College of Surgeons (ACS).

Additionally, as the Committee on Communications was approved to exhibit at these meetings, ASA became involved in the national patient safety issue of governors being allowed to “opt out” of the Medicare requirement that a physician be available to participate in an anesthetic.  ASA’s presence at these specialty meetings gave ASA an additional forum to speak to the need for a physician, preferably an anesthesiologist, to be present for every surgical case involving an anesthetic.

History of Meeting Attendance
In the intervening years, between 2000 and 2004, the Board of Directors has continued to support this important activity; the committee, with the ASA’s financial and personnel support, has sponsored attendance at 14 annual surgical specialty and subspecialty meetings. The group that attends these meetings generally includes an ASA Communications Department staff member, local members of the state component society and, on many occasions, a member of the ASA Committee on Communications. From the beginning, these meetings were considered very successful, and over the last three years (2002-04), ASA has supported attendance at three to four meetings a year; it is hoped that the board will continue to sustain a minimum of three to four meetings yearly.

Meetings attended have included the ACS (2000-03), the American Society of Plastic Surgeons (2001), the American Academy of Ophthalmologists (2002-03), the American College of Obstetricians and Gynecologists (2002-03), the American Society of Plastic Surgeons (2002-04), the American Association of Oral and Maxillofacial Surgeons (2004) and Digestive Disease Week (2004).

The booth is set up with patient safety as a theme; copies of most of the ASA practice parameters and many informational/educational ASA publications are available. Emphasis is placed on office practice guidelines and other information applicable to various office arrangements. A luggage tag laminator keeps the booth busy as physicians stop by to have their business card made into a tag that sports an ASA patient safety message.

Experiences at the Booth
It is clear that all of the ASA mandates for these booths are being met. Physicians have stopped by in increasing numbers to gather written materials, talk about office-based surgery and inquire about various aspects of ASA practice guidelines, practice advisories and herb and dietary supplement use, among many other issues. Surgeon attendees have let us know repeatedly that they are glad that ASA exhibits at their meeting, and they consistently tell us how important they believe it is to have an anesthesiologist involved in their cases, whether it be in an office, ambulatory surgical center or hospital.

A Bird’s Eye View
As a former long-time member of the Committee on Communications, I have personally represented ASA at four of these specialty society meetings. The experience has been everything that the committee intended it to be and more. I was fortunate enough to be able to attend the first meeting, the ACS in 2000 and again in 2001. Additionally I attended the American Society of Plastic Surgeons in 2003 and 2004. The major function that I and other local component society anesthesiologists played was being a resource for questions involving the various practice parameters that ASA has published, to discuss the ins and outs of office-based surgery and to simply be available for inquiries and consultation about the various practice styles of the attendees. Also many surgeons have asked about anesthesiologist recruitment for their hospitals. Almost all of those who stopped by left with written materials and the address for the ASA Web site.

The most noticeable thing to me over the years has been the increasing number of physicians who mandate the use of anesthesiologist-administered anesthetics for office-based surgery. This may be in part due to specialty society mandates, but more important, it is my belief that these physicians realize that they cannot supervise an anesthetic and give their patients the best care that they deserve on the surgical side. Many of the surgeons with whom I spoke at the 2004 plastic surgery meeting in October in Philadelphia, Pennsylvania, are actually getting Joint Commission on Accreditation of Healthcare Organizations certification in their offices!

A Chance to Educate
The anesthesiologists who attended these meetings also were able to network with these specialists to enhance ASA’s chances of being invited to participate in the educational portion of these meetings. As a result of introductions to the responsible leadership, at least two ASA members have received speaking invitations for the educational portion of these specialty meetings for the following year.

It is the goal of the Committee on Communications to pursue more opportunities for ASA members to become participants on these programs; our specialty is one that finds overlap with almost every surgical subspecialty, particularly with the growing responsibility of the perioperative anesthesiologist — one who performs transesophageal echocardiography, reads electroencephalograms, takes care of the surgical intensive care patient, etc. It is my belief that the surgeons I have had the pleasure to meet are acutely aware of our expanding role both in and out of the operating room and want/need to hear from our outstanding spokespersons on these myriad subjects.

I am hopeful that the ASA Board of Directors will continue its generous support of this program, as I consider that being present at our surgical colleagues’ meetings is of paramount importance in our quest to build consensus regarding many issues, the most important of which is patient safety. The goal of pursuing speaking engagements at these meetings for ASA members should not be forgotten. Our surgical associates need to be kept aware of advances in our field that can enhance a positive surgical outcome. I believe that if we are to truly maintain our role as a “consultant” in anesthesiology, then we will continue to make ourselves available at as many of these meetings as possible, now and in the future.


“Most communication problems can be solved with proximity.”

— John Maxwell

Reference:

1. Committee on Communications Annual Report, August 1998.

Jessica A. Alexander, M.D., is Clinical Professor of Anesthesiology, University of Texas Health Science Center, San Antonio, Texas.