Administrative Update: Sailing Into Uncharted Waters With Confidence

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January 1, 2014 Volume 78, Number 1
Administrative Update: Sailing Into Uncharted Waters With Confidence Jane C.K. Fitch, M.D.
ASA President

What a year 2014 is going to be! As I mentioned in my address to our House of Delegates (HOD) in October 2013 (see YouTube video at, ASA will navigate this year based on our strategic plan, developed by your Administrative Council (AC) and additional Society thought leaders, and prioritized by your Board of Directors (BOD).


We will navigate the uncharted waters of health care reform, including the Affordable Care Act (ACA). We will work tirelessly to repeal two of the most unfavorable aspects of this law: the Independent Payment Advisory Board (IPAB) and the non-discrimination clause. In fact, your ASA delegation to the American Medical Association (AMA) worked successfully this past year to have repeal of this non-discrimination clause placed as a priority advocacy item for the AMA.


It is in these uncharted waters that ASA will launch a new model of care delivery – our Perioperative Surgical Home (PSH) model of care. Who better than a physician anesthesiologist to lead and guide the care of our patients during the perioperative and/or periprocedural period? This model of care allows us to maximize our medical education and training, take full advantage of our subspecialty areas of expertise, and further highlight the differences between us and our non-physician providers. Because this model transcends multiple areas within ASA, I have created a steering committee, chaired by Dan Cole, M.D., ASA First Vice President, to oversee this critically important project. The project involves many of our ASA committees, including Future Models of Anesthesia Practice, Practice Management, Economics, and Surgical Anesthesia. By the actions taken at our October 2013 HOD, these Society leaders will be presenting a business plan to the AC at our meeting at the end of this month. Celeste Kirschner has been appointed as our anchor Project Executive to work with our physician leaders in helping our PSH project take sail.


It is also possible that we may finally see repeal of the Sustainable Growth Rate (SGR). If so, that will also place us in an unfamiliar realm relative to the whole of physician payment, presumably to be based upon quality and outcomes. What a golden opportunity for specialty societies such as ASA to innovate and navigate these new waters. We have many committees, such as Performance and Outcomes Measure-ment, Quality Management and Departmental Administration, and Economics, working on measure development. The critical role of our Anesthesia Quality Institute, especially as it pertains to registry development, will serve ASA well. What an advance to be able to take a critical look at what we do locally as well as nationally and to ask how we can improve. In addition, with the development of our Health Policy Research department, we are now able to gather data in order to help provide that beacon of light, guiding us in the development of our health policies.


Patient safety is our first and foremost concern as we navigate the intricacies of health care reform. ASA’s history is rich in patient safety, from coining the term, to creating the first patient safety committee, to creating the Anesthesia Patient Safety Foundation. It is through the research of physician anesthesiologists, making better drugs, equipment and monitors, that we have made dramatic improvements in the mortality and morbidity related to anesthesia. Yet nothing is so critical as anesthesia care, whether young or old or in between – and this highlights once again the critical need for the role of physician supervision of non-physician providers. Whether at the state or federal level or within the Veterans Health Administration (VHA), ASA is committed to maintaining the critical patient safety net of physician supervision of anesthesia care. Please also remember and support the fact that our Committee on Global Humanitarian Outreach and our ASA Charitable Foundation are making great strides at helping to make anesthesia safer all around the world.


Relative to our foundations, I have also appointed a task force to explore the relationship between ASA and all of our related organizations. This task force, led by Jim Grant, M.D., our Treasurer, will explore all aspects of the relationships, including, but not limited to, funds flow, structure and governance.


As we prepare for the aforementioned uncharted waters,we must equip our members with the life jackets and life preservers they will need to survive and thrive. In order to accomplish this, our Education Division has just held its second Education Summit, charting the course for the next three to five years. Our education offerings in our meetings portfolio continue to grow. Our education product portfolio also continues to expand. ASA must be the lighthouse of education offerings to whom all our members turn whether for new knowledge, specialty information or for maintenance of certification needs.


Successful navigation requires excellent communication. This is the year for ASA to focus on our communications, in the broadest sense. We have launched our “When Seconds CountTM” education endeavor in an attempt to educate our patients, colleagues and policymakers about who we are as physician anesthesiologists and what it is we have to offer as perioperative consultant leaders. Also, this year we are developing our multi-staged on-boarding process for all of our volunteer and elected physician leaders serving in our HOD, BOD, committees, sections and divisions. In addition to the weekly updates from the Executive Committee (EC) to the AC, the monthly updates from the AC to the BOD and the quarterly updates from the BOD to the HOD, we will also be hosting additional webinars before and after the interim and annual BOD meetings, as well as prior to the annual HOD meeting. These communication venues will facilitate more efficient meetings and aid in the bi-directional flow of information within ASA.


Bridging the gap between education and communication is our Ad Hoc Committee on Information Resources. This ad hoc committee, led by Arnold Berry, M.D., is looking at all the ways in which ASA communicates information with our members and will be making recommendations in order to best match information content with specific publications. This ad hoc committee will also make recommendations on media for information sharing, as well as frequency of sharing information. They will work closely with our Ad Hoc Committee on Web Oversight.


The Society leadership realized that ASA is not a professional management company. Because of that realization, ASA has just completed facilitating the transition of several of our anesthesiology subspecialty organizations that we managed to professional management organizations. ASA can now return its focus where it should be – partnering with all of our anesthesiology subspecialty organizations in order to grow and strengthen our relationships. I have appointed a steering committee, led by Beverly Philip, M.D., our Vice President for Scientific Affairs, to oversee this critical area of focus and communication. She will work closely with our Committee on Specialty Societies as well as with our subspecialty committees. Whether communicating about continuing medical education activities or products, meeting arrangements, or providing input into committee and chair appointments, this steering committee will successfully navigate these relationships.


Membership is at an all-time high of more than 51,000 total members, representing over 31,000 active members. Our ASA Political Action Committee is the strongest it has ever been. However, we must do a better job reaching out and engaging all anesthesiologists. We will continue to be successful in this endeavor only if we continue to meet the needs and expectations of our members.


ASA is blessed to have so many dedicated physician volunteers. We truly are a bottom-up, member-driven organization. What a privilege that any individual member can come up with an idea, have the idea vetted through the appropriate channels and then watch that idea become ASA policy! Hopefully you are all taking advantage of the call for committee appointments, which ends January 15 for the 2015 cycle!


ASA is also blessed to have so many dedicated staff to partner with our physician leaders. Our staff makes the work of our physician leaders easier and more fun! This year is exciting because this summer we will be moving into our new headquarters building. Not only will this building be home to our terrific staff, it will also be home for our committee meetings and activities. Perhaps the best aspect of our new building is the fact that, due to a partnership with the Wood Library Museum of Anesthesiology, we will be able to bring the rich tradition of our specialty back to life with prominent historical displays.


It is my honor and privilege to serve our patients – as well as you and ASA – in the coming year. Cheers to all our members and our staff for a great 2014!

Jane C.K. Fitch, M.D. is John L. Plewes Professor and Chair with Tenure, Department of Anesthesiology, University of Oklahoma, Oklahoma City.