The August meeting of the ASA Board of Directors (BOD) offers a preview of issues that will be subject to discussion, and potentially controversial, at the ASA House of Delegates (HOD). The ASA HOD meeting in October in Boston held true to form in continuing the discussions from the BOD.
There has been great deal of discussion about resident dues and the appropriate amount to charge for this category. A recommendation had been made to raise resident and fellow dues from $25 to $50 effective 2019. This was opposed by the resident section and several BOD members at the August ASA BOD meeting. A few directors (myself included) voted against the proposal. Our primary concern was the impact increased dues could have on recruiting the next generation of members. Despite our objections, the recommendation passed and went to the HOD for final disposition. There was extensive and passionate discussion in the Administrative Affairs Reference Committee regarding the increase in resident/fellow dues. Ultimately the Reference Committee supported the BOD recommendation to raise the resident dues to $50 annually. The HOD, however, had different ideas and went with a recommendation to raise the resident dues from $25 to $30 annually.
Funding for the ASA delegation to the AMA was another source of controversy, as this has been a large expense item in the past and the expense compensation for these meetings has not conformed to the usual ASA standard. Ultimately a compromise was reached, and the matter will be referred to a committee of the President’s choice for further deliberation.
A sunset of the Committee on Future Models of Anesthesia Practice after October 2017 was recommended; this was referred to the Committee on Governance Effectiveness and Efficiencies (CGEE) for consideration of the committee’s future function within the ASA. In the meantime, Aman Mahajan, MD, PhD, of UCLA is the new chair of this committee as it continues to explore different practice models and population health.
The President Elect’s Report contained the update of the ASA Strategic Plan, titled ASA2020 Strategic Plan. The plan contains seven strategic pillars, each with its own identified strategies over the near future. These pillars are:
- Quality and Practice Advancement
- Educational Resources
- Member Experience
- Health Systems Leadership
- Organizational Excellence/ Internal Operations
- Organizational Excellence/Growth and Business Development
Specific ASA Officers and staff are assigned as responsible for each pillar.
For more information see the article by Dr. Grant.
A long-anticipated update to the Practice Guidelines for Moderate Procedural Sedation and Analgesia was considered and approved at the ASA August BOD. The prior version of this document is one of the most frequently viewed and downloaded on the ASA website. It was produced by the ASA Committee on Standards and Practice Parameters, working in collaboration with the American Association of Oral and Maxillofacial Surgeons, American College of Cardiology, American College of Emergency Physicians, American College of Radiology, American Dental Association, American Society for Gastrointestinal Endoscopy and American Society of Dentist Anesthesiologists, and is subject to approval by these organizations as well. This document could not be amended on the floor of the HOD and it required an up or down vote as written. There was testimony regarding the need for future refinements of this Practice Guideline, but ultimately this item was approved by the HOD and is now being considered by the other involved organizations.
The ASA Statement on Sedation & Anesthesia in Dental Office-Based Settings was developed by a subcommittee of the Committee on Quality Management and Departmental Administration (QMDA), co-chaired by Scott Kercheville, MD, Director from Texas, and myself. The request to create this statement was the result of increased public awareness of adverse outcomes in dental offices, and the risks associated with dental sedation and anesthesia. Several states in addition to California have confronted this issue on a regulatory and/or legislative level. ASA leadership believed that a national position statement should be drafted. Language generated in California stating that children under the age of seven should have a dedicated qualified anesthesia provider for moderate or deep sedation, and for general anesthesia is included in the statement. The passed in the August BOD and was approved by the HOD.
An ASA Statement on Developing Policy for Infection Prevention and Surgical Attire generated vigorous debate in both the Western Caucus (WC) and the Review Committee in August. Debate reflected the opinion that the statement as written was too generic. Revisions were drafted to the Statement and approved by the BOD. The desire and request for a more specific document relating to surgical attire and evidence about its relationship to infection control in the OR came up again in Boston at the WC and in Professional Affairs Reference Committee. Members are looking to ASA to take a stronger evidence based stand; ASA leadership has committed to pursuing studies and generating further recommendations on this issue.
There were no items which generated major discussion or controversy in the Scientific Affairs packet, at the Reference Committee, or at the HOD.
A recommendation that the Certificate in Business Administration (CBA) program take a hiatus for reevaluation and comparison to other options in the market was changed in the August BOD to a recommendation that the program’s content and format be evaluated and modified as appropriate. The CBA will continue this year in its current form, but may move to Schaumberg in the future
Of note, the 2018 operating budget contains a large line item of $249,000 to initiate redesign and realignment of the ASA’s Finance Department to modernize its structure and functions. More detail on this is available in the ASA2020 Strategic Plan.
Multiple bylaws revisions were passed as written and presented by the Committee on Bylaws.
Distinguished Service Award
Norm Cohen, MD, received the ASA’s highest honor, the Distinguished Service Award (DSA), following his nomination and election for the DSA at last year’s HOD. From Portland Oregon, Dr. Cohen, is well-known to the California ASA delegation as part of the Western caucus. Prior to his retirement from day-to-day ASA involvement, Dr. Cohen served as a section chair and Vice-President for Professional Affairs during a particularly turbulent period of economic change within the ASA and medicine in general. The California delegation is proud to call Norm Cohen, MD, our friend and congratulates him on this well-deserved award.
ASA Past President Jerry Cohen, MD, was nominated to receive the DSA award at the 2018 Annual Meeting. The HOD voted in favor of this nomination and Dr. Cohen will receive the DSA at the next ASA Annual Meeting.
Western Caucus Candidates
Jeff Kirsch, MD, of Oregon, is running for ASA Vice President for Scientific Affairs in 2018, as Beverly Philip, MD, who currently serves in that position is running for ASA First Vice President. Dr. Kirsch spoke to the caucus regarding his candidacy. He is the Chair of the Department of Anesthesiology and Perioperative Medicine at Oregon Health Sciences University (OHSU). Dr. Kirsch’s qualifications include his active participation on the ACGME Board, and involvement at the ASA and SAAA. He currently chairs the academic caucus at the ASA. Dr. Kirsch received Western Caucus endorsement of his candidacy.
Jeff Mueller, MD, of Arizona is running for Vice President for Professional Affairs (VPPA) in 2018 when Stan Stead, MD, steps down from this position. Dr. Mueller addressed the caucus regarding his candidacy and reviewed his professional cv and leadership qualifications, particularly his extensive experience in leading the ASAPAC. Dr. Mueller received Western Caucus endorsement of his candidacy.
2017-2018 ASA Officers
There were no contested elections this year, although there were several officer changes as officers moved up. ASA officers this year are:
James D. Grant, M.D., M.B.A., FASA
Bloomfield Hills, MI
Linda J. Mason, M.D., FASA
First Vice President (formerly Treasurer)
Mary Dale Peterson, M.D., FASA
Corpus Christi, TX
Immediate Past President
Jeffrey Plagenhoef, M.D., FASA
Vice President for Scientific Affairs
Beverly K. Philip, M.D., FACA, FASA
Vice President for Professional Affairs
Stanley W. Stead, M.D., M.B.A., FASA
John F. Dombrowski, M.D., FASA
Kenneth Elmassian, D.O., FASA
East Lansing, MI
Treasurer (formerly Assistant Treasurer)
Michael Champeau, M.D., FASA
Palo Alto, CA
Assistant Treasurer (new officer, formerly ASA Director from Missouri)
Donald Arnold, M.D., FASA
St. Louis, MO
Speaker, House of Delegates
Ronald L. Harter, M.D., FASA
Vice Speaker, House of Delegates
Patrick Giam, M.D., FASA
California Representatives to the ASA
Representing California the ASA Annual Meeting were:
John Brock-Utne, MD, PhD, Keith Chamberlin, MD, MBA, FASA, Lee-lyn Chen, MD, Neal Cohen, MD, MPH, MS, Christine Doyle, MD, FASA, Adrian Gelb, MD, ChB, DA, FRCPC, Linda Hertzberg, MD, FASA, T. John Hsieh, MD, Zeev Kain, MD, MBA, Annie Lee, MD, Norm Levin, MD Philip Levin, MD, Edward Mariano, MD, MAS, Robert Martin, MD, Rima Matevosian, MD, James Moore, MD, Manuel Pardo, MD, Rajesh Patel, MD, Ronald Pearl, MD, PhD, Jeffrey Poage, MD, Johnathan Pregler, MD, Todd Primack, MD, Jeffrey Rusheen, MD, Robin Seaberg, MD, Shalini Shah, MD, Karen Sibert, MD, FASA, Mark Singleton, MD, Earl Strum, MD, Peter Sybert, MD, Narendra Trivedi, MD, FASA, Judi Turner, MD, PhD, Samuel Wald, MD, MBA, Paul Yost, MD, and Mark Zakowski, MD, FASA.