The ASA 2018 Annual Meeting was held in San Francisco on October 13-17, 2018. The CSA was represented by 31 delegates (and a number of alternates) as well as ASA President Elect, Linda Mason, MD, FASA, ASA Vice President for Professional Affairs, Stanley Stead, MD, MBA, FASA, ASA Treasurer, Michael Champeau, MD, FASA, Linda B Hertzberg, MD, FASA, ASA Director from California, and David Butler, CSA Executive Director.
Preceding ASA 2018, the CSA sponsored its first half-day Business of Anesthesiology (BOA) Conference on Friday October 12, 2018 at the Moscone center. The participants who managed to brave the construction at Moscone Center and picket lines at multiple area hotels, had an opportunity to learn about contracts, financial planning, negotiation, and lessons learned from a group of national leaders.
The first presentation was from Judith J. Semo, Esq, who talked about “Anesthesia Business Practice & Its Relationship to Finances for Every Career Stage”. She reviewed items concerning contracts and financial planning, including things that could put physicians at personal risk. Topics included the classifications of independent contractor vs employee (see https://www.csahq.org/news/blog/detail/csa-online-first/2018/08/13/california-supreme-court-reclassifies-your-independent-contractors for our CSA attorney’s analysis of a recent change), potential repayment obligations, and indemnification. Ms. Semo also reviewed asset protection, including insurance, prenuptial agreements, and estate planning.
The second presentation was a mini-workshop on negotiation led by Margaret Neale, PhD. http://csahq.org/news/blog/detail/csa-online-first/2018/10/10/margaret-neale-phd-interview Dr. Neale is the Adams Distinguished Professor of Management at the Stanford Graduate School of Business. She made a key point that negotiation can be distributive or integrative, and emphasized that integrative negotiation is not a zero-sum game, or to put it another way, the pie can get bigger! Integrative and congruent value negotiations provide opportunities to maximize both monetary value and relational value. This negotiation strategy provides long-term benefits for both sides, and works best with multiple issues. More information is available on her website: https://gettingmoreofwhatyouwant.com/
The third presentation was a panel discussion that included CSA President Sam Wald, MD, MBA (VP and Associate CMO, Stanford), Dena Janigian, MD ( Past President, Anesthesia Medical Group of Santa Cruz), Amy Lu, MD (Medical Director for Clinical Effectiveness and Value, Stanford), Asha Padmanabhan, MD (Envision Healthcare, Chief of Anesthesiology, Plantation General Hospital, Florida), and Smitha Warrier, MD (President, Utah Society of Anesthesiology). Each of them spoke about their pathways to leadership and emphasized how important it to their careers, when they went after unexpected opportunities. They also noted the importance of mentors in their careers, and each has stepped into that role, mentoring junior partners and residents.
The BOA conference was very well-received, and we will be exploring doing something similar in the future within the CSA framework.
First, we should note with pride the ascendancy of CSA’s own Linda Mason, MD, FASA, to the position of ASA President. Congratulations Dr. Mason! We are looking forward to a great year.
Several months ago, John Dombrowski, MD, FASA, resigned from his position as the ASA Secretary for family and personal reasons. ASA Assistant Secretary Kenneth Elmassian, DO, FASA immediately moved up to the Secretary position, leaving the Assistant Secretary spot vacant. Accordingly, there was an election (on very short notice) in October, 2018 for this position. Three candidates ran for Assistant Secretary:
David Broussard, MD, MBA, ASA Alternate Director from Louisiana
Kraig de Lanzac, MD, FASA, ASA Director from Louisiana
David Martin, MD, PhD, FASA, ASA Director from Minnesota
This was a hard-fought (and sometimes bitter) election which saw all three candidates heavily vying for votes from California and the Western caucus. Drs. de Lanzac and Martin were each nominated by members from California, while Dr. Broussard was nominated by a member from Texas. The election went to a runoff between Drs. De-Lanzac and Martin, with Dr. de Lanzac prevailing to become ASA Assistant Secretary.
There were two other contested elections:
For First Vice-President:
Claude Brunson, MD, FASA, ASA Director from Mississippi
Beverly Philip MD, FACA, FASA, ASA Vice President for Scientific Affairs
For Vice-President for Scientific Affairs:
Jeffery Kirsch, MD, FASA, Oregon
Andrew Rosenberg, MD, FASA, New York
Dr. Beverly Philip was elected to the position of ASA First Vice President and Dr. Andrew Rosenberg was elected as Vice President for Scientific Affairs.
After five years in the position, CSA member Stanley W Stead, MD, MBA, FASA, retired from the position of Vice President for Professional Affairs (VPPA). Dr. Stead’s dedication to the ASA, his wisdom, and encyclopedic knowledge and understanding of the issues will be sorely missed. Jeff Mueller, MD, FASA was elected to the VPPA position in an uncontested election.
Other officers elected were:
President-Elect, Mary Dale Peterson, M.D., FASA
Immediate Past President, James D. Grant, M.D., M.B.A., FASA
Secretary, Kenneth Elmassian, D.O., FASA
Treasurer, Michael Champeau, M.D., FASA
Assistant Treasurer, Donald Arnold, M.D., FASA
Speaker, House of Delegates, Ronald L. Harter, M.D., FASA
Vice Speaker, House of Delegates, Patrick Giam, M.D., FASA
In addition, since Dr. Dombrowski has withdrawn from ASA leadership, CSA Past President and ASA Treasurer Dr. Michael Champeau has declared as a candidate for ASA first Vice President in 2020.
ASA Finances and Budget
- There continues to be a budget shortfall for 2018 of over $1.5 million.
- The reserve situation has improved with $100.6 million total and $24.7 million unrestricted available.
- The 2019 budget contains a projection of $ 3.5 million in new revenue, of which $0.5 million is projected to come from increase in membership, $1.3 million from educational products, $0.3 million from other income and $1.4 million from reclassification of items related to the office.
- The 2019 budget is currently projected to have a surplus of approximately $0.1 million
- ASA differs from other like organizations since it has a large dependence on membership dues; other organizations have signature products which produce revenue.
- AQI continues to be an expense for the ASA and the status of AQI will be re-evaluated in the coming year.
- The complete proposed 2019 budget was presented to the BOD in a webinar in September and approved at the BOD meeting after the HOD in October.
ASA finances continue to be of concern to members of the board since any variance in fact from the assumptions behind the budget projections could again easily lead to a net negative financial performance.
ASA House of Delegates (HOD)
Key items in the HOD packet are discussed below. All items discussed here may be found on the ASA website ( member login required) in the HOD materials. https://www.asahq.org/member-center/governance-resources/meeting-materials/2018-hod-meeting-materials
The following items are of note:
300-4 Administrative Council Report
The Administrative Council considered recommendations from the Ad-Hoc Committee on ASA elections and suggested approval of some, but not all of the recommendations for making changes to the election process. However, there was some disagreement with these recommendations in the Reference Committee at the ASA BOD in August and the item was referred back to a committee of the president’s choice. This item has now been referred to the Committee on Governance Effectiveness and Efficiencies for consideration.
322-1 President Elect
This contains ASA 2020, the updated strategic plan. The top-rated strategic tactics are:
- Engage administration agencies, Congress and other stakeholders in a unified effort to address drug shortages.
- Based on the 2018-member survey feedback--create a pathway to develop computer-aided clinical decision support tools; will work with Anesthesia Quality Institute and/or Education Department as appropriate on business plan development.
- Medical Direction/QZ issue/Anesthesia Practice Models – Identify, develop and build consensus on appropriate physician-led anesthesia practice models and related payment policies.
- Research/Foundation for Anesthesia Education and Research/Subspecialty Societies Collaboration.
- Member Growth Initiatives – Address component performance.
- Business plan modeling for Anesthesia Quality Institute.
340-2 (AA) Committee on Governance Effectiveness and Efficiencies: Annual Report
Approval of the following recommendations:
- Continuation of the Committee on Professional Liability as a standing committee.
- Continuation of the Committee on Rural Access to Anesthesia Care as a standing committee.
- Not sustaining the Committee on Large Group Practice as it currently exists.
340-3 (AA) Committee on Governance Effectiveness and Efficiencies: Annual Report, Supplemental
Approval of the proposed standing Committee on Professional Development. This committee has been constituted as an ad-hoc committee for now, with CSA President Sam Wald, MD, MBA as its chair.
357-3 (AA) Committee on Anesthesia Care Team: Standards, Guidelines and Statements: Five-Year Review
The committee and BOD recommended approval of the Statement on the Anesthesia Care Team as revised. The document had undergone extensive review and revision in committee. However, this item proved to be quite controversial and a number of changes were suggested in the Reference Committee and at the HOD. A final document was approved, (and not referred back to committee, as is often the case with difficult or controversial items). It is not yet posted on the main ASA website but may be found with the HOD materials.
365-1 (AA) Committee on Young Physicians: Annual Report
The document, Statement on Personal Leave was approved at the HOD. This item was spearheaded by the Committee on Young Physicians but was created in collaboration with a number of committees. It is a very thoughtful document which touches on personal, parental, and family leave policies as they apply to physician anesthesiologists. Although the Statement on Personal Leave originated in the Committee on Young Physicians, it applies to physicians in all career stages. It is not yet posted on the ASA website but may be found in the Administrative Affairs bundle in the HOD materials
The following items are of note:
“The Reference Committee acknowledge Dr. Stanley Stead with the following statement.
Throughout his tenure in the many capacities in which Stanley W. Stead, M.D., M.B.A., FASA has served the more than 75,000 anesthesiologists in America, and by extension the world, he continually delivered content and service of the highest quality. In so doing Dr. Stead advocated for fair compensation for quality work and for the presence of well-trained anesthesiologists when patients needed that most. Dr. Stead’s efforts have extended the influence and impact of anesthesiologists in all settings. Dr. Stead deserves the highest level of gratitude that a society can give a member.”
The following items are of note:
512-1 (SA) Committee on Occupational Health: Annual Report
Approval of the proposed Statement on the Aging Anesthesiologist, which appears in this handbook as report 512-1.2. This item had undergone extensive legal review and is very generic in its statements and recommendations.
The BOD had asked that the issue of establishment a new standing Committee on Physician Health and Well-Being be referred to a committee of the president’s choice. However, the review committee heard extensive testimony on the importance of physician well-being and asked the HOD to approve the creation of this committee, which it did.
516-1 (SA) Committee on Trauma and Emergency Preparedness: Annual Report Approval of the recommendation that a standing or ad hoc committee of the president’s choice be appointed to determine whether ASA should have a role to play in addressing firearm violence in America and, if yes, what that role should be.
This is obviously somewhat controversial, but the recommendation was bland and generic enough that it was approved.
Given recent current events, it would seem that this recommendation is both timely and highly appropriate.
Lastly, it is again time to self-nominate for ASA Committees for 2019-2020. The self-nomination process is open until January 15, 2019. Follow the link below to find all the information you need to understand and initiate the process. Review the committee list and descriptions to find the committee(s) that interest you and then follow the link to self-nominate. You will need to submit an up to date CV. It is also helpful to have one or two members recommend you for a committee. This is ASA at the grass roots level; ASA committee work is often an entry level to other positions within the state component and ASA structure.