Local Activism Reaps Major Rewards: Organized Medicine at the State Level

Joshua H. Atkins, M.D., Secretary
ASA Resident Component Governing Council

nesthesiology residents train in 42 states across the country, and there are more than 4,000 anesthesiology residents and fellows currently training. Our ranks are diverse and spread out to all corners of the country. Resident and fellow participation on the national stage by membership in ASA, attendance at the ASA Annual Meeting Resident House of Delegates and annual ASA Legislative Conference helps to establish some unity of voice and purpose. Involvement in the legislative process through meetings with and letters to the U.S. House of Representatives and the U.S. Senate does make a difference and is to be commended.

At the same time, active participation at the state level is critically important and offers a tremendous learning opportunity. Local participation provides a training ground for residents to learn about organized medicine and builds the foundation for leadership roles throughout your career. At its core, ASA is a collection of state component societies and their representatives and can do nothing but benefit from vigorous grassroots local activity. As we enter the workforce, most of us will find that the day-to-day practice of medicine is influenced to a tremendous extent by the regulations and practice environment established by the state in which we work as well as by the national health care landscape.

Indeed many issues, such as scope of practice by nurse anesthetists or medical liability reform, are tackled on a state-by-state basis, with parallel activity at the national level. The ASA NEWSLETTER monthly “State Beat” column provides a great window into the tremendous amount of activity that takes place in state legislatures and medical boards <www.ASAhq.org/Newsletters/2005/12-05/stateBeat12_05.html>. Moreover, active anesthesiologist participation in state-based or county-based medical groups serves not only to improve the anesthesia care received by state residents but also serves to raise the profile of anesthesiologists as physicians across the broader scope of medical practice and health care delivery.

A great starting point is to contact your state anesthesiology society <www.ASAhq.org/aboutAsa/asaComponentSocietyOfficers.htm> and volunteer to be involved on a committee or as an appointed state delegate to the Resident Component House of Delegates. Many states already have an active resident component, and if not, this is your opportunity to take the lead in organizing one. State anesthesiology societies tend to be well-organized with a core group of very active physicians who are extremely well-informed on issues facing anesthesiology and well-positioned at the national level. They love to hear from residents. Many state societies also have organized a state-focused political action committee, or PAC, to which you can contribute and thereby help to elect state legislators who support quality patient care and the medical profession.

Cognizant of the need to promote regional activities, the ASA Resident Component Governing Council continues to work to foster participation by residents in the state components and to improve communication between states. Toward this end, the new Regional Grants Program was initiated this year. The program provides a $1,000 grant to groups of residents who organize a regional meeting for residents from several nearby states.

Another project under way is the Resident Component State Involvement Initiative. This long-term project is headed by the former co-presidents of the ASA Medical Student Delegation and soon-to-be anesthesiology residents Cheri A. Camacho, M.D., and Emmett E. Whitaker, M.D. With their long-term involvement over the next four years, the ASA Resident Component will collect data on resident component activities at the state level across the country and work to support the establishment of a state resident component in all 42 states with active training programs. The rich state resident communication network and grassroots resident involvement fostered by this effort will ultimately improve the training and professional development of all anesthesiology residents.

It is critically important to recognize that your involvement as an anesthesiology resident or fellow need not be limited to anesthesiology-specific organizations. In fact one of the most important contributions you can make is to raise the profile of anesthesiologists in your state medical societies and the American Medical Association, where it is already quite high, and (in doing so) with the general public.

State and county medical societies <www.ama-assn.org/ama/pub/category/7630.html> are excellent vehicles by which to initiate your local involvement with great potential to progress to national involvement through representation to the American Medical Association Resident and Fellow Section <www.ama-assn.org/ama/pub/category/189.html>. I encourage each of you to visit the Web page of your state medical society to check out the offerings and fill out a membership form. These societies support a diverse range of activities from community health education to public policy involvement in raising physician and patient awareness of health legislation and charitable health-related activities.

As we progress from residency and fellowship to become attendings, the opportunities for high-profile activity expand further, and those who have demonstrated a sustained long-term commitment to organized medicine are rewarded with exciting opportunities to make major contributions.

State medical boards <www.fsmb.org/smb_overview.html> are powerful legal authorities charged with the task of regulating physician licensure and scope of practice in the interest of patient protection. Members consist primarily of physicians across a broad range of specialties and are typically appointed by the governor. Issues they address that are of particular relevance to anesthesiologists include the promulgation of guidelines on the administration of office-based sedation and the licensure and scope of practice of anesthesiologist assistants. The presence of anesthesiologists on these boards allows us a voice in these critical issues and is important to our patients.

All residents and fellows must become active in organized medicine in order to maintain a voice in the future of the medical profession and delivery of health care to our patients. Ultimately it is a disservice both to your patients and to your investment in a burgeoning career to leave the future to chance and the whims of others. All it really takes to get involved is sincere desire and a few e-mail contacts within your hospital, your county or your state and, PRESTO! You are an activist. Go ahead and give it a try — it really could be your calling, and it will be rewarding. Do contact any of us on the Resident Component Governing Council <www.ASAhq.org/asarc/officers.html> with questions or for assistance.

Joshua H. Atkins, M.D., Ph.D., is a CA-3 resident at the University of Pennsylvania, Philadelphia, Pennsylvania.