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The American Society of Anesthesiologists is an educational, research and scientific association of physicians organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.

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N. Martin Giesecke, M.D., Chair

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June 1, 2013 Volume 77, Number 6
State Beat: The Impact of Political Involvement Ramani (Ram) Peruvemba, M.D.


There has never been a more exciting time to be an anesthesiologist, but our field is confronted with myriad challenges in the future. The Affordable Care Act encourages significant change in the areas of payment and delivery of health care services, particularly in the hospital setting. If we are to maintain our autonomy, payment structure and care delivery methodologies, we must demonstrate that we significantly contribute to achieving the triple aim of improved patient outcomes, decreased health care costs and improved health of populations.1

To protect and promote my patients, practice and profession, I have taken a very proactive approach in Maryland regarding legislative and regulatory activity. My efforts demonstrate that our involvement in legislative and regulatory affairs can have a positive and significant impact. My involvement began with developing legislative language for a favorable assignment of benefits bill that was ultimately signed into law. As a result of my continued involvement, I was appointed by the Secretary of the Maryland Department of Health and Mental Hygiene to the Maryland Health Care Reform Coordinating Council’s Health Care Delivery Reform Subcommittee. I am the only private practice physician serving on this committee. As a member of the committee, I have exposed fellow committee members, including large payers, regulatory officials and legislators, to the Perioperative Surgical Home model of care, and I’m enabled to speak about the importance of anesthesiologists in the health care reform process. In general, I have encountered only favorable feedback. I continue to use this opportunity to educate these officials about our role in improving outcomes and reducing costs. For instance, I recently expressed my concerns about the “Company Model,” particularly its impact on patient safety and increased costs. My continued involvement in reform efforts has also allowed me to engage in meaningful discussions with the Maryland Attorney General’s Office and Board of Medicine regarding the potential negative effects of the “Company Model.”

Involvement is a two-way street, and it has become apparent to me that offering my medical expertise and time has enabled me to have a seat at the table during the implementation of the Affordable Care Act and to serve as a voice for our specialty and our patients. I believe that any one of us can become involved in a meaningful way. The challenges ahead can only be overcome by our aggressive involvement in the development of delivery and payment methodologies that preserve the integrity and patient safety emphasis that has been the mainstay of anesthesiology for decades. I encourage all those with an interest to become involved with their legislative and regulatory officials because each and every one of us can and should make a dramatic difference.



Ramani (Ram) Peruvemba, M.D. is President, Pain Management Specialists, and Member, Maryland Health Care Delivery Reform Subcommittee, Shady Grove Adventist Hospital, Rockville, Maryland.

References
1. Berwick D, Nolan TW, Whittington J. The triple aim: care, health and cost. Health Aff. 2008;27(3):759-769.