Jeffrey L. Apfelbaum, M.D., First Vice-President

Two Minutes Twice a Week Will Enable You to Better Control Your Destiny …

he days of “snail mail” are long behind us. And many of us have begun to ignore “blast” e-mails because we are seemingly inundated with them each and every day from a multitude of sources. An easy way to stay on top of rapidly evolving changes in the medical specialty of anesthesiology is to simply visit the ASA Web site <www.ASAhq.org> and peruse the “What’s New” section. New items of importance are posted regularly as they evolve, typically several times weekly. I have chosen to summarize just a few examples of the dozens of items that appeared in recent weeks on the “What’s New” portion of our Web site.

Is Reimbursement for Medicare Patients Important to Your Practice?
At several key junctures in the legislative process, a “call to action” related to Medicare physician reimbursement adjustment appeared on the ASA Web site. Typically in the 24 to 72 hours prior to a vote in both the U.S. House of Representatives and the U.S. Senate, ASA members were urged to contact their legislators in support of a pending piece of legislation. By providing a hyperlink to the Washington Office “Capwiz” tool, in a mere two to three minutes, ASA members could electronically contact their legislators and express their opinions. In spite of the rapidity with which legislation changes in Washington, ASA members were always afforded an easy, simple-to-use tool enabling them to immediately contact their legislators to express their opinions.

Would You Like to Contribute to the Development of ASA Practice Standards, Guidelines or Advisories?
At the 2005 ASA Annual Meeting, the House of Delegates approved the following documents, which will be published in Anesthesiology over the next several months:

• “Practice Guidelines for the Perioperative Management of Patients With Obstructive Sleep Apnea”

• “Practice Advisory for Perioperative Visual Loss Associated With Spine Surgery”

• “Practice Guidelines for Perioperative Blood Transfusion and Adjuvant Therapies”

• “Practice Advisory for Intraoperative Awareness and Brain Function Monitoring.”

Each of these guidelines and advisories deals with extremely important areas of our daily clinical practice. At one time or another during the past two years of development for each of these documents, members were offered the opportunity to review a draft of each document and provide input for consideration by the task force charged with preparing the document. Typically these drafts were only made available for a limited time, so checking the Web site frequently would have enabled you to provide input on all four drafts while they were still in preparation.

Does One Need to Have Training in Anesthesia to Provide Anesthesia Services?
In late January, ASA was made aware of a proposed revision of the Anesthesia Care Standards at the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Many anesthesiologists felt two of the proposed changes would have a profoundly detrimental effect on patient safety. The first was to remove the requirement that a licensed independent practitioner be involved during the performance of surgery and sedation or anesthesia [PC.13.20]. The second proposed change was to remove the requirement for involvement of a licensed independent practitioner in the planning of sedation or anesthesia [EP.11]. JCAHO had posted these proposed revisions on its Web site and was actively soliciting input from health care professionals through its Field Review process. A subgroup of the ASA Committee on Quality Management and Departmental Administration prepared a draft set of responses and posted those responses on the ASA Web site with a “hot link” to the JCAHO Field Review. If you had not checked the Web site during the short 10-day “window” in which we were afforded the opportunity to provide input to JCAHO, you would have missed the chance to do so.

Do You Practice Pain Medicine?
On February 17, 2006, ASA announced an initiative to form a multidisciplinary pain coding partnership. Other multispecialty partnerships have achieved admirable success by working collaboratively to create and obtain appropriate valuation for Current Procedural Terminology^® codes that describe safe and effective medical practices. To that end, ASA believes it is important that the myriad specialists involved in pain medicine speak with one voice on matters concerning coding coverage and patient care, and ASA has invited many of these specialties to join together in an organized coalition to further our common goals. To date, the following specialties have been invited to participate in this partnership, and discussion is under way with several additional interested organizations:

• American Academy of Orthopaedic Surgeons

• American Academy of Pain Medicine

• American Academy of Physical Medicine and Rehabilitation

• American Association of Neurological Surgeons/Congress of Neurological Surgeons

• American College of Radiology

• American Society of Interventional Pain Physicians

• International Spine Intervention Society

• North American Spine Society.

Has Anyone in Your Hospital or Ambulatory Surgical Treatment Center Asked About Nonanesthesiologists Administering Propofol?
In fall 2005, the American College of Gastroenterology (ACGE) petitioned the Food and Drug Administration (FDA) Advisory Committee on Anesthetic and Life Support Drugs to remove the following language from the propofol (Diprivan^®) labeling: “For general anesthesia or monitored anesthesia care (MAC) sedation, DIPRIVAN Injectable Emulsion should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure.” On November 10, 2005, ASA Immediate Past President Eugene P. Sinclair, M.D., testified before the committee as did Carol E. Rose, M.D., of the University of Pittsburgh Medical Center, and Marc E. Koch, M.D., M.B.A., all of whom testified in favor of keeping a warning on the propofol labeling. Shortly after the hearing, a copy of ASA’s letter commenting on the ACGE petition was filed with the FDA, and a copy of Dr. Sinclair’s testimony was made available on the ASA Web site. Many anesthesiologists found it useful to have full access to these documents when addressing the same issue in their local institutions.

Would Productivity Benchmarking Information Be Useful in Your Practice?
In late February 2006, it was announced on the ASA Web site that the Cost Survey for Anesthesia Practices, 2005 Report Based on 2004 Data was available for purchase. Produced by the Medical Group Management Association in collaboration with ASA, this book serves as an incomparable resource for anesthesiology financial and productivity benchmarking. In addition to providing a link to purchase this book, ASA members were offered a substantially discounted price negotiated by ASA. Even better, ASA members who completed the 2004 cost survey (also made available through a hyperlink on the Web site) received this information free of charge!

I urge all of our members to take two minutes twice a week and check out ASA’s Web site!


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