J.P. Abenstein, M.S.E.E., M.D.

t the time of this writing, the ASA Annual Meeting occurred about two weeks ago. The specifics of the meeting will be reviewed in another ASA NEWSLETTER article. However, I don’t think I’ll be giving anything away by saying that some of the most contentious issues at the House of Delegates meeting were related to government regulation and reimbursement. The same was true several months ago at the annual meeting of the American Medical Association.

More than most specialty organizations, ASA has been very active in engaging both our elected representatives and regulatory agencies. Recent issues include pay for performance, reimbursement of teaching anesthesiologists and the gross underpayment of anesthesiology services by the Medicare system. As of today, the latter issue may be significantly improved in 2008. The Centers for Medicare & Medicaid Services has acknowledged that anesthesiology reimbursement is undervalued by 32 percent, and there is pending regulation to significantly increase the Medicare anesthesia conversion factor. This success can be directly attributable to the efforts of many anesthesiologists working in conjunction with the ASA Washington Office.

The ASA Political Action Committee (ASAPAC) also contributed to this success. The money ASA members contribute to ASAPAC is used to support legislators that have been or are expected to be supportive of issues important to anesthesiologists. To be clear, this does not suggest a quid pro quo relationship. Instead, it is intended to help elect individuals who recognize the importance of physicians and medical care. While ASAPAC is one of the most successful medical PACs, the proportion of our members who join ASAPAC is disappointing. When one considers the direct benefit of ASA’s successes to each and every anesthesiologist, it is hard for me to understand why a $100 annual membership is so difficult for many ASA members. This is a small fraction of what ASAPAC returns to us.

Only about one year remains until the next national election, and health care reform is one of the top issues for most candidates. Many of the proposed “solutions” could have significant consequences to our profession. Therefore, PAC contributions will no longer be enough. It is increasingly apparent that we must become actively engaged in the political process and do more than write a check and expect others to do the work.

Fortunately, this is easy to do and does not have to consume a lot of time. Attending meetings of your local political party can be a good start. This is usually done at the county level and is open to any voter. You can get meeting information at the local office. Having physicians attend these meeting is immediately noticed, and your knowledge and experience will be put to good use. You can also volunteer to help on a campaign. Contacting a candidate’s staff is usually all you have to do. Again, having a physician as even a small part of a campaign can have significant influence. It’s a good way to get to know both the candidate and his/her staff who will be, if your candidate wins, in office and making policy. When issues related to medicine come up, the physician who helped with the campaign can become the go-to person for these issues. Who better than an anesthesiologist — who cares for patients throughout their lives for any and all diseases and procedures — to answer questions regarding health care? It doesn’t matter at what level you get involved, whether for a U.S. Senator or a state representative. In fact, investing your time at the state level can pay huge dividends since these politicians often become the next congressperson or senator. The work you do early in their careers will be remembered and appreciated.

If this degree of involvement is too much, you can still participate. Attend a local fundraiser. You don’t have to give a lot of money; in fact, often you are not required to give any money to attend a fundraiser. It gives you the opportunity to meet the candidate, ask questions and express your opinions. Even better, host a fundraiser in your home or office. The staff in your component society can often do most of the work, and you just have to help by getting your colleagues, friends and neighbors to attend. In my experience, this can be a lot of fun; the time commitment is easily managed, and it can have a real impact on how the candidate views physicians.

The time is long past where physicians could sit on the sidelines and expect society and the government to defer to their interests. Today, we have a real stake in the political process. It is imperative that active participation is not limited to just a small fraction of ASA members. Join ASAPAC. Hold a fundraiser. Attend political party meetings. Volunteer on a campaign. If we don’t, decisions that directly impact our profession and our patients will be made without our involvement or input. Show up, or the world will pass you by.

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