2007 in San Francisco: A Meeting to Remember

Erica J. Stein, M.D., President-Elect
Resident Component Governing Council

ike many others, I arrived in San Francisco late Friday night, October 12, after an exhausting day of traveling and being stranded in airports because of rain delays. I had never been to San Francisco and wanted to take in the famous sites of the city: Chinatown, Fisherman’s Wharf and the Golden Gate Bridge, to name a few. As it turned out, attending my first ASA Annual Meeting was even more exciting.

The ASA Resident Component (ASARC) activities began Friday evening with the Grassroots Advocacy/Leadership Training Workshop. The panelists, Jeffrey S. Plagenhoef, M.D., Paloma Toledo, M.D., and ASA staff members Chip Amoe, J.D., and Sarah Paff, M.A., highlighted the political issues facing our specialty. They discussed the importance of contributing to ASAPAC — ASA’s bipartisan political component — and of lobbying to protect our specialty’s interests on Capitol Hill, such as passing the Medicare Anesthesiology Teaching Rule (H.R. 2053, S. 2056). In 1994, the Centers for Medicare & Medicaid Services (CMS) revised the teaching payment policy only with respect to anesthesiologists. As a result, Medicare payment was reduced by 50 percent per case when a teaching anesthesiologist supervised two residents on overlapping cases. No other medical specialty was affected in this way. For example, teaching surgeons who supervise residents during multiple overlapping cases collect full fees for each case. Since 1994, payment reduction for anesthesiologists has resulted in an estimated loss of approximately $400,000 to $1 million annually per anesthesiology teaching program and a 20-percent decrease in the number of anesthesiology teaching programs. In the past seven years, ASAPAC, through support from ASA members, has achieved unprecedented strides in advocating for the safety of our patients and for the protection of our specialty. Currently, resident contribution to ASAPAC is $20 per year. Resident participation in the PAC was approximately 14 percent this past year; nonresident ASA members had 12 percent participation. For further information on ASAPAC, visit www2.ASAhq.org/pac/web or follow the links through the “Members Only” section of the ASA Web site at www.ASAhq.org.

The ASARC House of Delegates, which convened Saturday morning, engaged in lively debate and passed several resolutions aimed at increasing resident and medical student involvement in ASA. Those resolutions included the following: increasing resident participation in the ASA Legislative Conference and Leadership Spokesperson Training Program; recommending the establishment of a residency fair for medical students during the Annual Meeting; improving the current anesthesiology fellowship application process with a universal process that standardized the time period for interviews and contracts; and improving ASARC participation through increases in funding and scholarships. Of particular importance, the ASA House of Delegates acted upon the ASARC recommendation to create a Medical Student Component that would function as a separate component society within ASA.

During the course of the meeting, elections for the ASARC Governing Council were held. Congratulations to Todd R. Gleaves, M.D, Resident’s Review Junior Co-Editor; Joshua L. Lumbley, M.D., American Medical Association (AMA) Alternate Delegate; and Cheri A. Camacho, M.D., Secretary. I also offer my sincere thanks to the resident delegates for supporting me as your new President-Elect. Governing Council officers continuing their terms include Christopher R. Cook, D.O., President; Joseph A. Walker III, M.D., AMA Delegate; Todd J. Smaka, M.D., Residents’ Review Co-Editor; and Samuel C. Seiden, M.D., Accreditation Council for Graduate Medical Education Residency Review Representative. We are grateful for the contributions and leadership of Immediate Past President Paloma Toledo, M.D., AMA Delegate Jesse M. Ehrenfeld, M.D., Secretary Melissa Matte, M.D., and Residents’ Review Co-Editor Michael S. Axley, M.D.

Saturday afternoon was devoted to the Resident Research Forum and the Resident Practice Management Seminar. The research forum emphasized the importance of resident involvement in research. Many residents showcased their research and competed for scholarships from the Foundation for Anesthesia Education and Research. The Resident Practice Management Seminar addressed the question “Private Practice or Academics?” The pros and cons of both fields were presented, and contract negotiations and billing standards for reimbursement were reviewed. Other resident events held during the Annual Meeting were the Resident Regional Anesthesia Workshop and the Resident Communications Workshop. At the regional anesthesia workshop, residents were able to practice first-hand techniques in regional anesthesia using ultrasound-guidance and nerve stimulator techniques. The Resident Communications Workshop suggested the skills needed for improving interpersonal communication with colleagues, interviewers and patients. This workshop has received rave reviews from former attendees, and I believe it is a “must-attend” for all residents. To round out the ASARC events, several social functions gave us the opportunity to experience San Francisco and, more importantly, build contacts with residents across the nation.

I found the ASA Annual Meeting to be much more than I had expected. After examining the program itinerary on the plane, I had anticipated the meeting to be like many conferences that I had attended in the past. I was wrong. I was amazed to see so many people taking pride in their careers, whether through teaching at the review sessions, presenting research posters, conducting workshops or simply attending the many workshops that were offered. I met so many people who had worked and are still working toward the advancement of patient safety and our specialty. It is my hope that resident involvement in ASA will soar within the coming years and that residents will take advantage of the leadership, service and scholarship opportunities that ASARC has to offer.

I encourage everyone to become involved in ASARC and to visit the ASARC Web site www.ASAhq.org/asarc/index.html for a calendar of events for this year. Be sure to look for the monthly ASA NEWSLETTER and sign up for the ASARC listserv to receive updates on ASARC activity. I look forward to an exciting, rewarding year ahead as president-elect. Please feel free to contact me at estein@dacc.uchicago.edu if you have any questions, comments or suggestions.

Erica Stein, M.D., is a CA-2 resident, University of Chicago Department of Anesthesia and Critical Care, Chicago, Illinois.