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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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September 1, 2013 Volume 77, Number 9
Administrative Update: ASA Financial Check-Up … No Margin, No Mission James D. Grant, M.D.
ASA Treasurer



ASA is a member driven organization – as it should be –and much of what supports our mission is the great financial support from our membership. Your ASA financial team is keenly aware of the investment you have made to maintain ASA as the world’s premier professional society.


It is our responsibility to be as open and transparent with your hard-earned dollars as possible. This is why we have multiple reports delivered to various layers of the organization each year. Examples include monthly reports delivered to the Administrative Council and members of the Section on Fiscal Affairs (SFA). In addition, quarterly reports are given to the Board of Directors. This is on top of the twice-yearly reports to the Board from the Treasurer and the SFA. At the annual meeting, the House of Delegates receives a financial report in addition to its review of the summaries given to the Board of Directors each March and October.


With a budget of our magnitude, how do we prioritize and decide where to focus our dollars? We try to make each decision based upon ASA’s strategic plan and in alignment with our mission. If we are doing our job right, you should have two sources to check the ASA strategic plan – one is the actual document itself and the other is looking directly at our annual budget. The spending plan for ASA and the official strategic plan need to be clear reflections of one another. Like many organizations our size, our strategic plan is updated each year with a major look and overhaul every three years. The First Vice President leads this effort, as the plan will stretch into their years as both President-Elect and eventually President. The House of Delegates represents the voice of our more than 50,000 members. Their direction sets the course for a budget that is really determined by their vision for our organization and our specialty. ASA First Vice President John P. Abenstein, M.D. and ASA CEO Paul Pomerantz are currently leading a process to further align the timing and relevancy of the strategic planning cycle to be in appropriate synchronization with the budget development.

 

ASA Financial Checkup - Figure 1


As an example, we, as an organization, have determined that advocacy is one of our highest priorities. That being said, the dollars need to follow. Since 2009, ASA has increased spending on advocacy-related activities by $3.6 million (Figure 1). This gives the needed strength to our Washington office, led so well by Manuel Bonilla, M.S., ASA Chief Advocacy Officer, to continue to be one of the most respected and effective teams in organized medicine.


Our members are increasingly using ASA as their educational warehouse. Each year more than 1,500 diplomates enter the Maintenance of Certification in Anesthesiology, or MOCA®, program; ASA wants to do everything possible to allow its members to have seamless access to the resources needed to maintain certification. With that in mind, we have increased our investment in the development of educational tools by 45 percent over the past few years.

 

ASA Financial Checkup - Figure 2


Like so many organizations, ASA has a fiscal calendar based on the calendar year (January through December). We conservatively budget each year so we can remain fiscally strong and use this surplus to invest in the future and have adequate resources for unexpected contingencies that develop throughout the year. Despite these unpredictable expenses, we have continued to meet or exceed budgetary projections. This is due to a refined and sophisticated budgeting process and continual scrutiny of our financial resources by everyone in the organization. Special kudos should be given to our staff and physician leaders who continue to pay close attention to every dollar spent. Each time there is a new request for funding a project, it needs be accompanied by a clear explanation of why the money is needed and, more importantly, where exactly the request falls within our approved strategic plan.


 

ASA Financial Checkup - Figure 3

Last year, dues generated just over $19 million of our $40 million in revenue. This shows that about 48 percent of our income comes from membership dues. The other 52 percent comes from areas outside of dues, including products purchased by members (for a substantial discount), non-members (no discount), various royalties, advertising, corporate supporters and, when possible, taking a small percentage of our investment income and using it for our operational needs. ASA revenue outside of dues has increased from $13.9 million to $21.3 million since 2008 (Figure 4). We are aggressively seeking to decrease our dependence on dues, while being extremely cognizant of the fact that ASA is driven by our members and always remembering who is paying the bill – the members. Some organizations are less reliant on dues, but we believe that investment by members ensures that we stay driven by our members’ needs and desires. That being said, we are constantly trying to maintain an appropriate balance, relieving some burden on dues while maintaining it is our members who support and contribute to the vitality of ASA.

 

ASA Financial Checkup - Figure 4


The SFA meets in person twice yearly, in March and August. Each quarter, we meet by conference call to review the previous three months and to discuss our investment portfolio performance and ongoing strategies with our outside consultants. Twice yearly, we meet with our auditors at Plante and Moran; once by conference call and another face-to-face in executive session (without staff present). For the third year in a row, we have had an unqualified review of our financial state. This means our auditors not only could not recommend any change to our accounting systems, they actually said our processes are exemplary.


When we meet with the auditors, we also review our “Form 990,” a detailed financial report to the IRS detailing the activities of the organization. These reports, required for every non-profit organization, are filed yearly and made available to the public.


A special thanks to an amazing Section on Fiscal Affairs: Assistant Treasurer Mary Dale Peterson, M.D., Claude D. Brunson, M.D., Donald E. Arnold, M.D., Randall M. Clark, M.D., James D. Kindscher, M.D., and Mark A. Singleton, M.D. We could not do any of this without the tremendous support staff led by ASA Chief Administrative Officer Thomas P. Conway and Director of Finance Dawn Winkelmann.


ASA spends and invests your money wisely. Each and every expenditure is consistent with the overall mission of the organization and our strategic plan. “Advancing the specialty, securing the future” is more than a tagline. It is what drives the financial decisions every day of your ASA.



James D. Grant, M.D. is Chair, Department of Anesthesiology, Beaumont Health System, Royal Oak, Michigan and practices at American Anesthesiology of Michigan.




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