s a neophyte anesthesiologist, I had the impression that anesthesiologists practiced in either a “supervisory” or a “personally delivered” practice arrangement. Each was of a different philosophy, and nary did the two mix. After working in busy private practice and academic practices for several years, I have learned that anesthesiology is so much more than a practice arrangement, preference or style. Anesthesiology is a complex discipline of medicine, utilizing a team of talented and well-trained people. The numerous aspects of anesthesia perioperative and critical care require tremendous effort on the part of many individuals to create a system of care that is organized, efficient, effective and, above all, safe. No matter the specialty, the practice of medicine is a physician-driven team effort. The anesthesia care team encompasses the members of a system of care.

In the 1960s, then-ASA President John J. Bonica, M.D., in an annual report, called for a liaison committee between ASA and the American Association of Nurse Anesthetists “to rapidly pursue discussion of mutual problems that have impaired relationships.” To that end, a liaison committee was formed. Over the years, there were some successes and failures, waxing and waning of relationships and understandings, joint statements issued and retracted, and political agreements and disagreements. As a part of this process, the need for a committee dealing with the representatives of each part of the care team was realized. The Committee on Anesthesia Care Team (ACT) is the end result of that process.

The ACT committee has three duties: 1) to maintain liaison with the organizations representing other members of the anesthesia care team, 2) to make recommendations concerning the development of policies relating to other members of the anesthesia care team and 3) to advise and assist in the development of educational programs of value to members of the anesthesia care team.

ASA appoints members to act as liaisons between our organization and others involved in the care of our patients. These anesthesiologists interact with and assist other organizations where input from ASA is needed or requested. Joseph P. Annis, M.D., serves as liaison to the Association of periOperative Registered Nurses (AORN). Dr. Annis recently attended AORN’s Recommended Practice Committee where he provided input into new policy generation for the topics of traffic patterns in the perioperative setting and prevention of transmissible perioperative infections. Arthur M. Boudreaux, M.D., serves as liaison to the American Society of PeriAnesthesia Nurses (ASPAN). This year ASPAN requested ASA’s participation in two ongoing research projects and a task force. The projects deal with postanesthesia care unit discharge criteria for patients recovering from major conduction anesthesia, discharge criteria and voiding requirements and the generation of a postoperative nausea and vomiting algorithm. Three ASA members with specific expertise in these areas, Terese T. Horlocker, M.D., Beverly K. Philip, M.D., and Christian C. Apfel, M.D., were appointed to assist with the projects.

John F. Dombrowski, M.D., attended an American Academy of Anesthesiologist Assistants annual meeting and was an invited speaker. David C. Mackey, M.D., is liaison to the Association for Anesthesiologist Assistant Education. Michael H. Lasecki, M.D., is liaison to the National Commission for Certification of Anesthesiologist Assistants. Earl S. Ransom, Jr., M.D., is liaison to the American Society of Anesthesia Technologists and Technicians. Andrew Herlich, M.D., serves as liaison to our dental and oral surgery colleagues at the American Dental Association, the American Association of Oral and Maxillofacial Surgeons and the American Dental Society of Anesthesiology. Holly C. Gunn, M.D., is liaison to the Association of Women’s Health, Obstetric and Neonatal Nurses. Noticeably absent is a liaison with our nurse anesthetist colleagues. Both of our organizations are now talking — a step in the right direction.

Each ASA policy statement must be reviewed and updated at least every five years. As part of our work plan for this year, the committee will update the statement on “The Anesthesia Care Team.” Our committee will work toward improvement in the wording of the statement to reflect current practice. The current statement defines the care team and its members, describes the concept of medical direction and addresses some ethical issues involving the care team.

Also for this year, the ACT Committee will review ways in which anesthesiologists can become more involved in continuing education activities for all care team members.

The committee composition ensures input and expertise from all areas of anesthesiology practice. The list includes private and academic practitioners, anesthesiologists who were prior anesthetists, resident physicians, residency program directors, those with multiple-specialty training, members who practice in all-physician groups and those who work with anesthetists.

I would like to thank the members of our committee for their input and service to ASA. The Committee on Anesthesia Care Team represents a host of professionals dedicated to the safe care of our patients. It is truly a committee for all.

Arthur M. Boudreaux, M.D., is Professor and Vice-Chair for Clinical Affairs and Assistant Chief of Staff, University of Alabama Hospital, Birmingham, Alabama.