VOLUME NO. 52
ISSUE NO. 1
What’s Your Talent? Pres-Elect Dr. Brian Birmingham Offers Ideas for Helping Out
It’s Easy to Sign Up for ISA’s House of Delegates Virtual Meeting on April 17th
Information on Physician Medical Conditions and Questions on Applications
An Update from ISA’s Diversity and Inclusion Committee
In a Year of Drastic Changes, One Thing Remains the Same
Tripti C. Kataria, MD, MPH, FASA
As I write this column, we have passed a couple of significant milestones in history. It is the 1 year anniversary of the first case of COVID-19 in the United States and we have just surpassed 500,000 deaths due to this deadly pandemic.
Life changed so drastically a year ago. Our cities, schools, and operating rooms shut down. We were in a state of confusion and disbelief. How could it be with all of the technology and advancement in medical knowledge we could be so helpless? How could we be taken hostage by a virus – something that does not have a nucleus, or mitochondria and that cannot live independently?
With all of the change and at times chaos, an innate characteristic was put into gear – survival mode. Remember the 30 days of night shift from residency? You didn’t get to see your friends or family – your days and nights were confused – you just had to get through. Your body and mind shifted into a state in which you knew you had a task at hand and you had to get through it. While evolution had created this survival method for us to run away from dinosaurs and bears, it was not meant to be used for the long term.
Hence, we need to pause… and take a breath. The change in our environment has required us to do some deep introspection. While the newscasts are broadcasting the numbers of the pandemic and things outside still have not gone back to normal, there are some incredible things that have happened over this last year.
I believe the biggest evolutionary shift is in the use of technology. The ISA realized that the need for connection is even more important now than it was in the past. We use Zoom as a platform to educate and exchange ideas. The fact that you can participate in a meeting without the challenge of distance, traffic and the lost travel time was a breath of fresh air. Plus, you have the ability to “see” everyone! While this doesn’t replace the side conversations that occur in person, it did break a barrier allowing us to increase participation from all corners of the state. Without this pandemic, who knows how long it would have been for us to leverage this technology.
We have an opportunity to use this new world to re-examine what is truly important to us as individuals and as an organization. Where do we want to put our energy and resources? How can we achieve our goals?
Physician-led care is a core value of the ISA. We put our patients first and know that when a physician is involved in their care the outcomes are superior. All Illinoisans deserve a physician to be involved in their care. ASA polling shows:
- 8 in 10 patients want a physician anesthesiologist by their side to keep them safe in surgery.
- 9 in 10 surgeons believe physician anesthesiologists are the best-qualified to respond to complications and emergencies in the operating room.
The CRNAs pushed for independent practice in our state by introducing HB1820. Due to your advocacy, we were able to hold off an independent practice bill put forward by the CRNAs. You reached out to your colleagues, family and friends and called your IL representative to urge them to oppose HB1820. Almost 1200 witness slips were filed opposing this bill! It was the efforts of our membership and a coalition of physician organizations that helped us to preserve physician-led care. THANK YOU for standing up for physician-led anesthesia care. Thank you for supporting your ISA.
Throughout 2020, anesthesiologists answered the call of patients and healthcare. We stepped into the ICUs and ERs, and served as intubation teams that traveled throughout the hospital to save patients with COVID in respiratory distress. We innovated, converting anesthesia machines into ventilators, and turning ORs and PACUs into ICUs. Please take a moment to reach out to your legislators, and tell them a story of your daily life and how YOU continue to save patients’ lives.
This last year has been life altering, but we have made incredible strides to ensure we continue to keep connected. What hasn’t changed is our core values of patient safety and physician-led care. I want to thank all of you for your sacrifice and hard work on behalf of our patients.
ISA House of Delegates Virtual Annual Meeting
Saturday, April 17th
How does this work?
ISA is governed by a House of Delegates which is the process we follow to elect officers and formalize a discussion into an action plan. Join us virtually on Saturday, April 17, 2021 – it’s simple sign up today to participate in the meeting.
Who is eligible to participate?
Any Active Status member interested in advancing the Society’s mission to educate, advocate, and represent anesthesiologists practicing in Illinois. Your District and/or Area is based on your practice location.
What’s my role?
Attend a virtual meeting to discuss issues affecting our specialty and formulate an action plan for the Board to implement. Bring us issues you think deserve the Society’s attention and keep your colleagues informed. Your participation will influence the practice of anesthesia in Illinois.
FROM THE PRESIDENT-ELECT
To the Physician Anesthesiologists of Illinois
Brian Birmingham, MD
2020 was undoubtedly a year like no other! The challenges were truly unprecedented. Nevertheless, under the energetic leadership of Drs. Sean Adams and Tripti Kataria, the Illinois Society of Anesthesiologists not only survived but thrived!
Physician Anesthesiologists in Illinois rose to the occasion, demonstrating the value of their extensive education and training. ‘Crisis Management’ applied not only to individual patients but to the whole medical system. Physician anesthesiologists’ skills were applied in the ICU, developing new treatment modalities, hospital-wide on special airway management teams, and in the OR, guiding safe perioperative care as surgical cases proceeded.
Now the citizens of Illinois need our support, and all should have access to high-quality physician-led care. To accomplish this, the Illinois Society of Anesthesiologists needs your participation. Now more than ever, there are opportunities to make important and specific contributions.
For example, consider signing up to participate on one of these committees:
The Diversity and Inclusion Committee has advanced the inclusion of all patients in high-quality care and the need for diverse leadership in our specialty.
The mission of the Physician Wellness Committee is essential in supporting physicians’ physical and psychological wellbeing in this time of trial and disruption.
A growing percentage of Physician Anesthesiologists are women, yet they are often underrepresented in leadership positions throughout our specialty. Mentoring, networking, and communication are all needed. Hence the importance of our Women in Anesthesiology Committee.
The Bylaws Committee evaluates and updates the rules, the infrastructure of our Society so that timely adjustments can keep the ISA adaptable and nimble in these tumultuous times.
The Governmental Affairs Committee engages legislators, administrators, and executive leaders in state government to continue physician leadership in anesthesia care.
Anesthesiologists practicing in less populated and rural settings face unique challenges. The new Ad-Hoc Committee on Rural and Downstate Affairs provides the collaborative action needed to ensure their continued success.
Getting our message out is critical, and communication methods have evolved dramatically in the past few years. Furthermore, different demographics communicate differently. Hence the need for a Committee on Communications to make sure our messaging reaches desired audiences.
There is power in numbers, and outreach to all practicing anesthesiologists in Illinois on an ongoing basis is crucial. This is the role of the Committee on Membership.
Of course, all these activities require money, and the Finance Committee works closely with the Board of Directors to ensure responsible fiscal management.
Furthermore, physicians in Anesthesiology training programs represent our future, so their participation in the Illinois Society’s Resident component is paramount.
Overseeing all this, the House of Delegates meets annually to ensure physician anesthesiologists from all regions, demographics, and practice models are represented in the Society’s decisions.
Also, the Society sponsors multiple opportunities for online and in-person education, collaboration, and networking. These are all designed to facilitate our members’ professional advancement and satisfaction.
We have all certainly learned over the past year that close collaboration is essential for survival and success. Your active participation is both welcome and vital!
Physician Medical Conditions and Questions on Applications for Medical Licensure, Specialty Boards, and Institutional Privilege and Credentialing
Despite the fact that burnout, depression, and suicide are increasing in physicians, those physicians who have or have had mental health concerns may not seek medical treatment. They fear that they may experience difficulty in obtaining and/or renewing their medical license or institutional privileges. A medical licensure or institutional privilege application may inquire if a physician has ever been diagnosed with, for example, depression. Those physicians who give a positive response to this inquiry and disclose a current or past medical condition on medical license applications, medical specialty boards, and institutional privilege applications may be investigated and sanctioned and receive a demand for access to their private medical records. Yet, physicians who do not receive treatment for their mental health issues can harm themselves and pose harm to their patients. To support physicians’ rights to receive the same care as their patients without retribution and with respect of the privacy of physicians’ protected health information, questions on these applications should be stated in a manner consistent with the Americans with Disabilities Act.
I have written a resolution addressing this issue which was approved and adopted by the Chicago Medical Society’s Executive Committee and Board of Trustees. The Illinois State Medical Society Council on Education & Health Workforce considered the resolution, and the Illinois State Medical Society Board adopted the substitute resolution in May 2020. The American Society of Anesthesiologists (ASA) Board of Directors approved the resolution in 2020. This resolution is also supported by the Illinois Society of Anesthesiologists and the ASA Committee on Physician Well-Being. As a result of the resolution, on a national and state level, efforts are currently being made to advocate for medical licensure bodies, accrediting organizations, and medical specialty boards to change all new and renewal state medical licensure applications and mandate institutional privilege applications and medical specialty boards to be in compliance with the American Disability Act standards. Inquiries about a physician’s mental and physical health will be limited to those
conditions that currently impair their ability to practice medicine, i.e., “Do you have a medical condition that currently impairs your ability to practice medicine?”
What We Know
- There is an increasing number of physicians experiencing burnout, a potential factor in the increased rates of physicians having depression and committing suicide.1,2,3
- Physicians who have mental health concerns may be reluctant to seek mental health care as it may cause difficulty in obtaining and/or renewing a medical license as well as obtaining institutional privileges.4,5
- Physicians not receiving treatment for mental health issues may pose harm to patients and can contribute to untreated burnout, depression as well as increased rates of suicide.
- Physicians have the right to obtain the same care as patients without retribution and with respect of the privacy of physicians’ protected health information.
- The American Psychiatric Association has found no evidence that a physician who has been treated for a mental illness is any more likely to harm a patient than a physician with no mental health issues.6
- The Americans with Disabilities Act in 1990 states that employers can’t discriminate against employees based on mental or physical health.7
- The 2018 American Psychiatric Association Position Statement on Inquiries About Diagnosis and Treatment of Mental Disorders in Connection with Professional Credentialing and Licensing recommends that medical license bodies not inquire of applicants about prior diagnosis and treatment of mental health disorders.8
- In 2019, the American Medical Association reaffirmed policy H-295.858, Access to Confidential Health Services for Medical Students and Physicians, which states “Our AMA will urge state medical boards to refrain from asking applicants about past history of mental health or substance use disorder diagnosis or treatment, and only focus on current impairment by mental illness or addiction, and to accept “safe haven” non-reporting for physicians seeking licensure or re-licensure who are undergoing treatment for mental health or addiction issues, to help ensure confidentiality of such treatment for the individual physician while providing assurance of patient safety…. Our AMA… encourages state medical boards to recognize that the presence of a mental health condition does not necessarily equate with an impaired ability to practice medicine.”9 Yet, medical license bodies continue to inquire of applicants about prior diagnosis and treatment of mental health disorders.10
- There is a precedent of some states but not all states that ask questions on medical licensing applications in a manner consistent with Americans with Disabilities Act standards.10
What You Can Do Today at Your Institution
To support physician wellness, contact leadership at your hospital to ensure that wording of questions on new and renewal privilege and credentialing applications are consistent with the Americans with Disabilities Act standards and state
“Do you have a medical condition that currently impairs your ability to practice medicine?”
- Fitzpatrick, O, Biesma, R, Conroy, RM, McGarvey, A. Prevalence and relationship between burnout and depression in our future doctors: a cross-sectional study in a cohort of preclinical and clinical medical students in Ireland. BMJ open. 2019;9(4): e023297.doi:1136/bmjopen-2018-023297.
- Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population.Arch Intern Med. 2012;172(18):1377–1385. doi:10.1001/archinternmed.2012.3199
- Anderson P. Doctors’ suicide rate highest of any profession. WebMD. May 18, 2018. Source Accessed November 13, 2019.
- Gold KJ, Andrew LB, Goldman EB, Schwenk TL. “I would never want to have a mental health diagnosis on my record”: a survey of female physicians on mental health diagnosis, treatment, and reporting. General hospital psychiatry. 2016 Nov 1;43:51-7.
- Morris NP: Why are doctors leery about seeking mental health care for themselves. The Washington Post. January 7, 2017. Available here.
- Resource Document on Recommended Guidelines Concerning Disclosure and Confidentiality: Washington, DC, American Psychiatric Association, Approved by the Board of Trustees, March 1999. Original document, 1992; first revision, 1997. Available here.
- Americans With Disabilities Act (ADA), 42 U.S.C. Sections 12101-12213, which was enacted on July 26, 1990.
- American Psychiatric Association: APA official action: position statement on inquiries about diagnosis and treatment of mental disorders in connection with professional credentialing and licensing, 2018. Approved by the Board of Trustees, July 2018. Approved by the assembly, May 2018. Click here for PDF.
- American Medical Association Policy H-295.858, Access to Confidential Health Services for Medical Students and Physicians. Reaffirmed 2019.
- Jones JT, North CS, Vogel-Scibilia S, Myers MF, Owen RR. Medical Licensure Questions About Mental Illness and Compliance with the Americans With Disabilities Act. The journal of the American Academy of Psychiatry and the Law. 2018 Dec;46(4):458-71.
DIVERSITY AND INCLUSION COMMITTEE
Diversity and Inclusion Update
Audrey Oware, MD
The Illinois Society of Anesthesiologists Diversity and Inclusion Committee was formed as the recent events of 2020 brought forth to public awareness the long-standing issue of structural racism and health inequity as a result. We strive to educate our fellow anesthesiologists as well as the general public regarding issues concerning equity and inclusion to improve patient outcomes as well as the working environments of physicians of various backgrounds. The committee met for the first time in October of 2020. We have lent our voices on proposed legislation that we hope will positively impact communities of color, including educating physicians and other health care providers on the harmful impacts of implicit bias.
On January 20, 2021, we hosted our first of many virtual events, which was an informative and excellent presentation by Dr. Renee Navarro, the Vice Chancellor for Diversity and Outreach at UCSF. We most recently held a multidisciplinary virtual discussion forum on an insightful movie entitled “Black Men in White Coats,” which addressed multiple barriers that result in disproportionately low numbers of black male physicians, which has negative impacts on patient outcomes, particularly of African American patients. We provided free access to the viewing of this film the last weekend of February in honor of Black History Month. In addition, we highlighted and honored a few of our own notable African American anesthesiologists here in Illinois throughout the month.
At this time, we are also in the midst of developing a research scholarship pertaining to parity in health care, and we are pleased that the funding for this scholarship was approved at the House of Delegates 2020 meeting. Given the limitations of the pandemic, we will continue to plan additional social virtual events to engage ISA members as well as residents and medical students. Our next upcoming event is a virtual presentation on June 9 at 6:00 pm, by Montrece McNeill Ransom, JD, MPH an empowerment coach, professional speaker and belonging strategist.
ISA Webinar: Phenomena of Belonging
Wednesday, June 9 at 6pm
Join speaker Montrece Ransom, JD, MPH in a discussion on how belonging represents—and gives power and force to—the concepts of diversity and inclusion. Belonging means acceptance, not tolerance. It means more than feeling like you fit in. Belonging is a mindset characterized by being able to be authentic, knowing you matter and that your voice is essential.
Read more about this exciting presentation on our Events page.
To RSVP directly for this event, click here.
ISA’s PAC Needs You
Scope of practice issues will continue to be battled in the Illinois General Assembly. ISA advocates for Illinois anesthesiologists in Springfield, but it is the ISA-PAC that helps elect those legislative candidates and incumbents who support anesthesiology. Both efforts are necessary to advance our mutual causes as anesthesiologists. Without your financial support of the ISA-PAC, the society’s legislative mission is much harder to fulfill.
Make an impact in Springfield – please donate to the ISA-PAC!
Individual donations: https://isahq.org/isapac/
Group donations: Send to ISA PAC at 20 N. Michigan Ave., Suite 700, Chicago, IL 60602
The ISA does not claim any responsibility for the contents of advertising and the acceptance of advertising does not in any way constitute endorsement or approval by the Society of a product, service or company. Advertising rates and information can be obtained by calling the ISA.
Editor: Stephen Rublaitus, DO
Staff Editor: Mary Hines, CAE
Design & Production: Anne Behrens
President: Tripti Kataria, MD, MPH
President-Elect: Brian Birmingham, MD
Vice President: Adamina Podraza, MD
Secretary: Ajay Gopalka, MD
Treasurer: William Hauter, MD
Immed. Past President: Sean Adams, MD
ASA Director: Asokumar Buvanendran, MD
ASA Alternate Director: Lisa Solomon, DO
Speaker: Jason Mitchell, MD
Vice-Speaker: Adam Young, MD
Assistant Secretary: Michael Ander, MD
Assistant Treasurer: Charles Kim, MD
ISA District Directors
I. Stephan Cohn, MD
II. Michael Haske, Jr., MD
III. Sasha Demos, MD
IV. John Sudkamp, MD
ISA PAC Chair: George Hefner, MD