The ASA House of Delegates met this past October 22-26. It brought together hundreds of delegates representing eight regions in the nation. Over the span of five days, I had the opportunity to partake in this gathering of innovative minds as the physician anesthesiologists who function as the primary legislative and governing body of the ASA met in Chicago.

As a younger anesthesiologist, participating in the ASA House of Delegates provided an insightful experience to the internal mechanisms that occur which impacts the daily practice of all anesthesiologists from the academic, private, and large corporate practices. Intermixed with structured agendas and meetings of state and regional caucuses, are informal moments to meet other physician anesthesiologists to discuss current issues. In addition, whether it was the Welcome Wine Reception, ASA Come Together for a Cause, or the President/President Elect Reception, these festivities included food, wine and spirits with accompanied discussions of common key issues such as VHA Nursing Handbook, Out of Network Billing, MACRA, and the current national opioid epidemic. It was evident that this open communication with delegates across the nation facilitated awareness and further emphasized the importance of advocacy for our patients and specialty.

As a first time alternate delegate, participating in the meeting can be intimidating but yet also an exciting experience. Regardless of being a recent graduate or developing new interests in being active with the ASA, there is a significant amount of eagerness to mentor the inexperienced delegate from those who are experienced at the ISA. Mary Hines provided an organized itinerary of events for the week, HOD handbook, and additional resources   Members of the ISA were guides in navigating through uncharted waters as being a new delegate. In addition, the ASA and ISA offers support through a formal introductory orientation and ongoing guidance for the physician Anesthesiologists in order to maximize the ability to observe and learn the process.

The Issues

At the forefront of the ASA House of Delegates meeting were 4 key issues: VHA Nursing Handbook, Out of Network Billing, MACRA, and the National Opioid Epidemic. Dr. Cole, ASA Immediate Past President, addressed the House of Delegates to review the ASA’s grassroots efforts over the past year. At the forefront of the ASA’s initiatives was the VHA Nursing Handbook which was advanced this year by the Department of Veterans Affairs’ Office of Nursing Services. This policy would mandate independent practice for all Advanced Nurse Practitioners. This mandate would compromise Veteran’s access to safe physician led care. Despite the VA’s own report, “Independent Assessment of the Health Care Delivery Systems and Management Processes of the Department of Veterans Affairs,” which demonstrated no shortage of anesthesia services within the VA Health System, proponents of this rule change argue its need for “increased access”.

October 2016 ASA Elections brought the candidates for Uncontested, Contested, and New Positions Offices to meet with each state and regional caucus. Each candidate discussed their experience within the state’s society and the ASA, and provided opportunity to answer questions from the ASA delegates. Topics addressed included evaluating the previous ASA budget and questioning on the current recommendations to consider an increase in non-dues funding.

House of Delegates

Thirteen voting members represented the Illinois Society of Anesthesiologists. The ASA House of Delegates convened over two days, October 23rd and the 26th. The major focus of debate was the ASA’s 2017 Budget and approval of increase of dues.   Much debate, thought, and consideration were discussed on ensuring ASA members received value with contributions and also meet the current demands to ensure funding was available for addressing ASA’s current key issues. During the debate, increase in operational costs were attributed to increased efforts in combating the VHA Nursing Handbook, MOCA 2.0, AQI, MACRA, and Out of Network Billing initiatives. The Committee on Finance received approval on recommendation 321-2 (F1) to increase in 2017 Active member dues from $665 to $698, Affiliate and education member dues from $335 to $352, and Anesthesiologist Assistant dues from $200 to $210.  

ASA Elected Officers

President: Jeffrey Plagenhoef, MD

President Elect: James D. Grant, MD

First Vice President: Linda J. Mason, MD

Immediate Past President: Daniel J. Cole, MD

Vice President for Scientific Affairs: Beverly K. Philip, MD

Vice President for Professional Affairs: Stanley W. Stead, MD

Secretary: John F. Dombrowski, MD

Assistant Secretary: Kenneth Elmassian, MD

Treasurer: Mary Dale Peterson, MD

Assistant Treasurer: Michael Champeau, MD

Speaker, House of Delegates: Ronald L. Harter, MD

Vice Speaker, House of Delegates: Patrick Giam, MD


Professional Citizenship, Advocacy, and Physician Anesthesiologists Engagement

Central core themes consisted of professional citizenship, advocacy, and physician engagement. Currently, physicians are facing the challenges of healthcare delivery in a scrutinized environment. It is evident that decisions made at the state and national level are influenced by non-physicians which ultimately compromises patients and physicians.   Dr. Plagenhoef addressed the House of Delegates to invigorate the ASA’s commitment to encourage professional citizenship.

Physician anesthesiologists were encouraged to embrace not only being advocates for our patients but accept the personal responsibility of being a solution to the challenges. Dr. Plagenhoef emphasized the need to teach advocacy early in medical education through medical school and Anesthesia residency programs.

All Physician anesthesiologists must be encouraged to be engaged in the ongoing efforts of protecting our patients. In particular, the ASA recognized the need to encourage diversity within ASA representation through the ongoing efforts of the ASA Committee on Professional Diversity. Women, minority physician anesthesiologists, and younger physician anesthesiologists were encouraged to actively become involved in being solutions to safe anesthetic care.

The ASA House of Delegates Meeting had this clear message. Physician Anesthesiologists must avoid being complacent by sitting on the side lines and rise up to commit to professional citizenship. Each physician Anesthesiologist must encourage their colleagues and future Anesthesiologists to be engaged and continuously involved. It is only through ongoing effort and commitment of each physician Anesthesiologists in which we can truly provide safe anesthesia care for our patients.