ASA Launches Legislative
Effort to Save Anesthesiology Residency Programs,
Ensure Future of Specialty
Ronald Szabat, J.D., L.L.M., Director
Governmental and Legal Affairs
ust
in time for this year’s ASA Legislative Conference
in Washington, Representatives E. Clay Shaw (R-FL)
and Pete Sessions (R-TX) introduced H.R. 5246, the
“Medicare Teaching Anesthesiology Funding Restoration
Act of 2006.” This bill — along with companion
legislation H.R. 5348, championed by House Ways and
Means Health Subcommittee ranking member Rep. Fortney
“Pete” H. Stark (D-CA) and a Senate bill,
S. 2990, vigorously being advanced by Senator David
Vitter (R-LA) — would halt and reverse the ruinous
1991 Medicare policy change that has uniquely shortchanged
academic anesthesiology teaching programs by 50 percent
for more than a decade. To date there are approximately
100 members who support the bills in both the House
and the Senate.
The bill would right an obvious wrong. Unfunded anesthesiology
care for Medicare patients in teaching hospitals has
now reached an average of $400,000 per academic anesthesiology
program, and some programs are now losing more than
$1 million per year when treating Medicare patients
needing anesthesiology medical care. There is no policy
justification for such a shortfall, and passage of
the bill is vital if an adequate supply of anesthesiologists,
pain medicine physicians and critical care physicians
is to be guaranteed for now and the future.
“This bill is about the very future of our profession,”
ASA President Orin F. Guidry, M.D., told a recent
gathering of the Association of University Anesthesiologists
(AUA), “and would ensure that academic anesthesiology
programs will be there to train current and future
generations of medical students matching in anesthesiology
residency physician training programs.” Such
programs are capped nationally by the Accreditation
Council for Graduate Medical Education, and the bills
would do nothing to change that.
Unlike programs for limited-license practitioners,
such as those for nurse anesthetists, that are for-profit
and continue to grow rapidly in number with surging
graduation rates, the number of training programs
for physician anesthesiologists has actually declined
rapidly since 1994, when the Centers for Medicare
& Medicaid Services Medicare payment penalty first
hit academic anesthesiology programs. This means more
states and regions are seeing patients lose access
to academic medicine and the medical care that anesthesiologists
provide.
Today, academic anesthesiology programs stand at less
than 130 in number, down from 165 a decade ago. While
medical students continue to regard anesthesiology
as an attractive, even fashionable, medical specialty
career choice, the stark truth is that academic programs
are struggling to survive and more could close this
year. Across America, faculty slots in academic anesthesiology
go unfilled, recruitment and retention are tremendous
challenges, and anesthesiology research, so vital
to patient welfare, is drying up.
Fortunately academic anesthesiologists, through the
Society of Academic Anesthesiology Chairs/Association
of Anesthesiology Program Directors and AUA, have
joined as full partners in this legislative crusade
with ASA to end the Medicare anesthesiology teaching
rule payment penalty.
As an election year, 2006 has a short calendar for
legislative business before Congress. It is therefore
imperative that every ASA member visit our Web site
at
<www.ASAhq.org/news/hr5246.htm>
and
<www.ASAhq.org/news/asanews052406.htm>
to compose electronic letters to members of Congress.
More critical are the face-to-face discussions with
our elected senators and representatives that have
proved so effective in educating them on the facts
of this priority issue.
As always, members of Congress appreciate being apprised
of the singular truth that the Medicare anesthesiology
teaching rules uniquely disadvantages our ASA members
and the patients they serve. As we continue to lobby
on other issues such as sustainable growth rate reform,
the Medicare rural pass-through and truth and transparency
in patient choice issues, ASA members are reminded
to stay alert to updated items on our Web site and
special electronic messages from our ASA officers.
Together we will win this and other battles, saving
our residency programs and ensuring an adequate supply
of anesthesiologists for the future.
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