ince my election as First Vice President two years ago, I have had the good fortune to represent ASA leadership at many component and subspecialty society meetings. I have had the privilege of speaking with ASA members from diverse geographic and practice backgrounds and had frank discussions about how ASA could better serve their needs. I am profoundly appreciative for the wisdom, experience and challenges imparted to me from these discussions with our members. From just this type of dialogue with our members, a singular, focused, driven vision has emerged. ASA will become the world’s premiere medical specialty organization, leading through innovation in patient safety, clinical care, research (i.e., creation of new knowledge), education and advocacy. Our members recognize patient safety as our paramount “reason d’etre.” Past ASA President Roger W. Litwiller, M.D. [2004] may well have said it best: “It’s all about the patient.” During my term as President, ASA leadership will remain focused on our principle long-term strategic objective to promote continued improvement in quality of patient care and patient safety through the involvement of an anesthesiologist in the care of every patient receiving anesthesia services. Simply put, we must ensure that future generations of patients continue to enjoy the safety and quality benefits afforded through the expertise provided by a physician in the medical specialty of anesthesiology. To that end, we will continue to passionately address these specific issues:

• Inequities in the Medicare anesthesiology teaching rule.

• Funding for the creation of new knowledge in all aspects of the medical specialty of anesthesiology (e.g., perioperative care, periprocedural care, critical care medicine, pain medicine).

• Lack of Medicare payment parity.

• Scope-of-practice issues.

As Chief Executive Officer of ASA, it is important for me to set as one of my critical objectives the continued implementation of the Organizational Improvement Initiative. We must build the ASA’s infrastructure not only to meet the needs of current members but also to ensure that the needs of future generations of ASA members will be met.

One of the major findings of the Gordon Group management consultation is that the current ASA infrastructure does not easily enable its leadership to meet their responsibilities fully. ASA officers are elected to provide leadership for the Society and to ensure that the directives from the Board of Directors, the House of Delegates and, above all, our members, are implemented. Thus, one of the principal goals for my term will be to provide the resources necessary to enable the officers to meet their responsibilities more readily.

One of the most significant accomplishments of the change initiative to date is our updated strategic plan. During the next year, I will do my very best to make our new strategic plan operational. To do so requires the following activities:

• Prioritize yearly initiatives in critically important areas of research, education and training, advocacy, member value and research.

• Ensure that staff operations plans address the objectives of the strategic plan.

• Ensure that the work of the volunteer physicians within committees and other ASA entities (e.g., task forces, sections and divisions) addresses the objectives of the strategic plan appropriately.

• Ensure that the staff has adequate resources to quickly pursue initiatives that are deemed highest priority by the Board of Directors, House of Delegates and general membership.

• Monitor progress toward meeting the objectives of the strategic plan.

• Develop a process for refreshing the strategic plan on an annual basis.

We must continue to create and implement processes that are best practices because our members expect and deserve exceptional service. It has become apparent that given the yearly transition of officers, it is critically important that ASA senior leadership work together effectively, with considerable frequency. During the past year, virtually every management decision, regardless of how large or small, was thoroughly vetted by all three members of the Executive Committee. In order to improve the ability of officers to work together, we will:

• Continue to foster teamwork among the members of the Executive Committee and the Administrative Council with regular and frequent meetings;

• Continue to champion the clarification of officer roles and the development of corresponding “job descriptions” for each of these roles; and

• Develop and implement an orientation process for the first vice president and, eventually, all other newly elected officers.

Finally, the organizational assessment resulted in a finding that will not surprise you: The survival of our subspecialty societies is critical to ASA. Unfortunately, our current business model does not allow us to provide the management services needed by many of the subspecialty societies. Thus, I include as a goal for my term the launching of a process improvement effort that will result in the redesign of the entire set of cross-functional subspecialty support activities within the ASA staff infrastructure, with the aim of better cost-effective subspecialty management and support of subspecialty society and ASA membership growth.

I will continue to work with the Executive Committee, the Administrative Council and ASA staff to ensure that the aforementioned goals and objectives are met. We must ensure that the strength we have today continues, and we must build new strengths if we are going to create the future we all want for our patients and our profession. Management scholar Peter Drucker stated it simply: “The best way to predict the future is to create it.” Together, we will do just that.

In conclusion, I commend Dr. Lema for his decisive action to move ASA to the next level of organizational excellence at this critical time in our history. It is my hope to continue the courageous and exemplary leadership shown by him.

I also wish to thank Dr. Roger Moore, Past-President Dr. Gene Sinclair, and all the members of the Administrative Council, for their yeoman’s effort in the past year. I’d like to recognize the members of my department and medical center for their support, and to my administrative assistant, Ms. Julie Garrity. And a special and profound thank you to my wife, Carol, and children, Sean and Sara, for so graciously encouraging me to serve the Society.

During the coming year, I will call upon many of you, the members of this House of Delegates, to share your experience, knowledge and wisdom. Together, we can achieve our goals. Together, we can fulfill our vision to move from an organization of excellence and become the world’s premiere medical specialty organization, leading through innovation in patient safety, clinical care, research, education and advocacy. Together we will thrive.

Thank you for your trust and for your confidence in my abilities as I embark on the leadership of the ASA.