Who and What do we Represent?

by
  • Hertzberg, Linda, MD, FASA
| Aug 27, 2012

Most people would rather go to the dentist than read the bylaws of the organizations to which they belong. The length and dryness of the content can be yawn inducing and even intimidating to those not familiar with bylaws. Fortunately for those who opt for bylaws over the dental visit, there is a lot of insight to be gained.

Bylaws really do have a lot to tell us. They determine how an organization interacts with its members, and how members have input and effect on the policies and governance of a professional organization such as the ASA or CSA. Without bylaws we would lack a framework for functioning in a structured, effective manner.

Recently I had the opportunity to attend the ASA Board of Directors (BOD) meeting as part of the California delegation. Much of what happens at the August BOD is a preview of what will be considered at the House of Delegates (HOD) at the ASA Annual Meeting in October. One of the most controversial topics at the recent BOD meeting revolved around the duties, powers, responsibilities and authority of the three governing bodies of the ASA: the Administrative Council, Board of Directors and House of Delegates.

A professional medical society must conduct its business and policies consistent with its stated mission, representing the interests of its members, while planning for future trends in the political, economic and practice arenas. So how do we reconcile the sometimes diverging interests of a having nimble organization able to respond to issues in a timely manner, while still having broad representation from membership on policy, finance and governance?

This particular issue has troubled the ASA for several years, ever since some members of the ASA BOD expressed concern about the position on health care reform taken by ASA officers on behalf of the organization. Since then, at least two special committees have worked on governance re-design in an effort to make the day-to-day management of the society more responsive to short-term or critical, time-sensitive issues, while still allowing the membership to retain authority over the society’s affairs and policies via the BOD and HOD.

There are some who would assign more power, especially in the financial arena, to the BOD and elected officers, retaining the HOD as a representative and policy setting body only; others resist this change, believing that the voice of the membership will not be properly heard or considered if the powers of the HOD are limited. The ASA officers—as a consequence of living with the need to respond to issues quickly—tend to believe that is generally best to vest more operational power with the officers and the BOD. However, the officers are clearly sensitive to the tension this issue represents, as evidenced in the speeches given by the two candidates for First Vice President of the ASA (a position tracked to become President in two years). John P. Abenstein, current Speaker of the HOD, noted the need to “increase the value added of ASA membership for every practicing anesthesiologist.” Arthur Boudreaux, Secretary of the ASA, stated, “effective leadership requires adherence to values, solicitation of ideas from every level of an organization, energy, and the ability to make decisions."

That the disagreement and discussion exists at all is a good problem to have, in that our elected representatives to the ASA care deeply about the specialty of anesthesiology and the health of the ASA. Obviously an organization as large as the ASA cannot operate solely with all power vested in a HOD of 384 members that meets once a year. It is also impossible to operate by consensus with a BOD of 65 members. However, it appears unlikely that the HOD would vote to limit its own powers in at the October meeting, just as the BOD resists limiting its own powers.

Those of us from California who represent you at the ASA take the responsibility of reflecting the interests of California members at the national level seriously. We are the largest component society of the ASA and the practice of anesthesia here in California differs remarkably from other parts of the country. In order to reflect issues critical to California at the national level, the California delegation to the HOD needs to be confident that if a change in the division of responsibilities and power within the ASA occurs, the concerns of California anesthesiologists will continue to be heard at the national level. 

The one thing that all involved in this discussion have going for us is that the conversation is civil, and that we all believe that those considering these issues have the best interests of the members, the ASA as an organization, and anesthesiology as a profession at heart. Depending on how the next iteration of the proposed bylaws changes turn out, some of us may again consider spending days in the dental office. This year’s ASA Annual Meeting in October certainly promises to be filled with lively, vigorous debate on the issues, trying to figure out what will best serve the ASA and its members.

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