Get Active in ASA!
Our Future Depends on It
Michael Axley, M.D., M.S., Co-Editor
“Residents’ Review”
 t
has been an eventful and productive year for the ASA
Resident Component, and I would like to take a moment
to recognize the governing council members for their
achievements as well as those of the other residents
and medical students who have been involved.
First, congratulations to the members of the 2006
council itself: Benjamin D. Unger, M.D., president;
Paloma Toledo, M.D., president-elect; Joshua H. Atkins,
M.D., secretary; Jerome Adams, M.D., ASA American
Medical Association (AMA) resident delegate; Jesse
M. Ehrenfeld, M.D., AMA alternate delegate; Maggie
A. Jeffries, M.D., Residency Review Committee for
Anesthesiology representative; and Warren K. Eng,
M.D., “Residents’ Review” Co-Editor.
In addition the ASA Medical Student Delegation has
grown and continued to develop, and numerous other
residents have been lively participants in the Resident
Component as committee representatives, at the legislative
session and leading up to the national session.
These physicians have tangled with a great number
of issues, both large and small, on behalf of anesthesiology
residents across the country and have shown an impressive,
thorough and, indeed, relentless dedication to their
task. It is difficult to imagine that the Resident
Component could have been better served, and it has
been a tremendous experience for me personally to
observe these very capable individuals at their work.
I also want to highlight several key issues that I
feel we should be prepared to discuss and actively
engage in both as residents and as we move into the
professional realm. These issues include current legislation,
the Resident Component itself, the ASA Political Action
Committee (ASAPAC), resident and medical student education
and research, and disaster awareness. Obviously one
paragraph in a column does not do justice to these
complex issues, but they have all been touched upon
in previous columns during the past year, and the
ASA Web site <www.ASAhq.org/index.htm>
offers extensive primers on these and many other points
of interest.
ASA is actively engaged in pushing a full agenda of
legislative issues. The most important of these, from
a resident perspective, continues to be the anesthesia
teaching rule. It is important to be familiar with
this legislation. In essence, academic anesthesiology
programs are penalized in terms of compensation if
staff attendings supervise more than one resident
at a time. This is true in no other specialty, and
it costs our programs a significant amount of funding.
The bureaucracy responsible for this state of affairs,
the Centers for Medicare & Medicaid Services,
has refused to address the matter. In response, ASA
has introduced bipartisan legislation to correctly
change the teaching rule. Congress continues to struggle
with moving the needed fix this year. We cannot let
them leave Washington without taking action. Of note,
the national organization for nurse anesthetists has
lobbied heavily in opposition to what effectively
means increased reimbursement for our teaching programs.
The ASA Resident Component needs your support. We
need residents to spend the time to become familiar
with the issues, serve on ASA committees, attend the
Annual Meeting as delegates and attend the ASA Legislative
Conference. We need residents to think ahead and commit
themselves to the preparation necessary to run for
Resident Component office. This is your Society —
make the decision to own it.
ASAPAC funds the Society’s political initiatives,
and supporting it must be a priority for any anesthesiology
resident who desires to ensure that anesthesiology’s
message is heard. It is naïve to think that representation
at a national level, whatever your political stripe,
comes free of charge. Any amount counts, and information
on how our resident mebers can make contributions
can be obtained on the ASA Web site.
It also is not enough to passively march through residency,
even if the educational offerings at your particular
institution are quite thorough. We can and should
make changes in our residency curricula to improve
our skill sets both as we progress through residency
and enter into practice. With our input, advocacy
and enthusiasm, residency directors and attending
staff will prepare didactic events to suit specific
needs. These opportunities need not be limited solely
to the academic environment; for example, resident
workshops on regional anesthesia can be offered at
ASA state society meetings.
With regard to research, I believe it is clear that
anesthesiologists are going to have to re-commit to
the academic and research roots underpinning our specialty.
There is simply too much competition, both from allied
health professionals and other specialties, for us
to do otherwise. It may come in the form of changes
to the residency framework — increased critical
care months, for example. It may come in the form
of additional research years for specialty fellows.
Some of this work is ongoing; I would suggest that
we, as residents, embrace it because without this
renewed focus, our future security as medical professionals
will be imperiled.
I would like to offer a comment about disaster preparedness.
I believe there should be an element of real urgency
to this work. Katrina aside, the next disaster we
face may be on a national scale. I am talking specifically
about epidemic influenza or a similar emerging illness.
Just because the media has focused on new and entertaining
spectacles does not mean this threat has gone away.
Just because we have not yet experienced an event
this particular year does not mean all is well.
Do we have a grip on what plans our individual medical
centers have in place for events of this magnitude?
We, as anesthesiology residents, need to know; our
skills will be among the most valuable in place for
any sort of massive disaster, and we will be in the
forefront of any wave of first responders. Ventilators,
emergency response, critical care, medical management,
triage — it does not take much time before realizing
the type of leadership role our specialty might be
called upon to perform, and rightly so. I would encourage
you to take a moment to reflect on what this might
mean for you personally.
In closing I would like to state the admiration I
feel for those residents and staff who have engaged
in the rebuilding of academic anesthesiology in New
Orleans after the city was destroyed by the hurricane.
For example, next year the Ochsner Department of Anesthesiology
will be hosting the Gulf Atlantic Resident Research
Conference, or GAARRC, in New Orleans on April 13-15,
2007. For information on GAARRC, visit <www.ochsner.org/cme>.
To paraphrase Kristie Osteen, M.D., one of New Orleans’
anesthesiology residents: “We’ve come
a long way, but there is still more to be done.”
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Michael S. Axley, M.D., is a CA-2 resident
at Oregon Health and Science University, Portland,
Oregon. |
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