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    Articles, press releases and announcements about what is happening for anesthesiologists and our patients.

PAST-PRESIDENT's MESSAGE

Reflections from the 2018 ISA House of Delegates

Gary Tzeng, MD

What a wonderful weekend!  Those who were able to join us at Sunda on Friday evening for the President's Dinner enjoyed fantastic food, libations and company.  We were fortunate to have distinguished guests from across the country including our next ASA President, Linda Mason MD, join us!  Great conversations and food fueled our spirits as well as our bodies!

We honored Timothy Starck, MD with ISA's 2018 Distinguished Service Award for his work in revamping our HOD meeting during his ISA Presidency.  And of course, I had the opportunity to thank all of our members, ISA Delegates & Alternate Delegates, Executive Director Mary Hines, my partners at Dupage Valley Anesthesia, and most importantly, my family, for helping me achieve a very productive year!  I could not have done it without any of you!

Saturday's House of Delegates was equally spirited and stimulating! Our morning District Caucuses were visited by the Candidates for ASA Offices:
ASA Office of First VP:                      Claude Brunson, MD (MS) & Beverly Philip, MD (MA)
ASA Office of VP Scientific Affairs:
Jeffrey Kirsch, MD (OR) & Andrew Rosenberg, MD (NY)
during which each candidate discussed their qualifications and visions for ASA's future.

Following ASA President-Elect Dr. Linda Mason's enthusiastic and informative update on ASA affairs, we quickly moved on to the business of the House electing our next Officers, ASA Delegates and 2019 DSA recipient, Dr. Eric Werner.

But most significantly, the House expressed its rousing opinions and desires regarding the ongoing PHARMA shortages and passed a Resolution to be presented at the 2018 ASA House of Delegates in SF!!  This Resolution requests specific actions for the ASA to act upon to help address this problem.  This Resolution is significant for its mission AND the first to have originated from Illinois in over 20 years!  We thank Dr. Sean Adams for spearheading this Resolution and look forward to even more passionate discussion from across the nation at the ASA Annual Meeting in October!  Join us in SF and add to the conversation!

And by the way, we accomplished all of this by lunchtime!

Have an idea? Have a common issue that ISA should address? Let us know and come to next year's House of Delegates!​  Speak your voice and play an active part of your future!  OF OUR FUTURE!  Until then, please join us in DC for the ASA Legislative Conference in May and in SF for the ASA Annual Meeting in October!

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SB 3431: Makes Opioid Prescriptions Too Restrictive

SB 3431 seeks to impose many restrictions on opioid prescriptions including duration and amount.

Contact your state legislator and let them know that:

  • Prescribing opioids for our patients cannot be arbitrarily dictated. Not by age or type of pain. Each patient is unique and requires individualized therapy.
  • Our country and our state suffers from an opiate crisis in which prescriptions do play a role. However, creating barriers with arbitrary boundaries will only create more needless suffering and do little to curb our crisis. These arbitrary boundaries are not based upon scientific research.
  • We all need to work together to curb this opiate crisis. But we must do it in a methodical, practical and non-prescriptive manner including but not limited to practical and safe disposal, effective prescription monitoring and prescriber education.
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ISA Members advocating for you in Springfield

​ISA members Active in the Community 

ISA members & AAAA President, Laura Knoblauch, meet with Illinois State Senators Iris Martinez and Emil Jones, III during the 2018 Lobby Day in Springfield.
ISA members & AAAA President, Laura Knoblauch, meet with Illinois State Senator Don Harmon during the 2018 Lobby Day in Springfield.
ISA members meet with Illinois State Senator William Haine during the 2018 Lobby Day in Springfield.
The ISA Delegation welcomed Laura Knoblauch, President of the American Academy of Anesthesiologist Assistants (AAAA), to Springfield as she joined us for our 2018 Lobby Day.
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The Legislative Journey to Independent Practice Continues

The Legislative Journey to Independent Practice for APRN Continues...

In most other states, Advance Practice Registered Nurses (APRNs) already have full practice authority to diagnose, treat, and prescribe. Currently, there are 24 states and the District of Columbia that don't require any physician involvement for APRNs to diagnose, treat or prescribe. In addition to those, eight states allow APRNs to diagnose and treat independently but require physician involvement to prescribe.

There was strong support this year, within the Illinois legislature to grant APRNs with full independent practice. Instead of voting against physicians, legislators asked that the Illinois State Medical Society (ISMS) draft an alternative. The Illinois Society for Advanced Practice Nursing bill as introduced would have granted full independent practice and full prescriptive authority, after completing additional clinical training under the supervision of either another APRN or physician.

After numerous negotiating sessions and intense advocacy from physicians, an agreement was reached in 2017.  This agreement was passed by the Legislature, signed into law by Governor Rauner, and took effect on January 1, 2018. 

Below is a summary of the language that was eventually accepted by the APRNs:

  • 1.Maintains the requirement that APRNs have a written collaborative agreement, unless the APRN receives substantial post-graduate training under the direct supervision of a physician (4,000 clinical training and 250 hours in additional educational/training components). The physician then must sign a written attestation confirming that the training was completed.  
  • 2.Does not change current practice within a hospital setting; APRNs must still be recommended for credentialing by the hospital medical staff.
  • 3.Requires APRNs to maintain a formalized relationship with a physician that must be noted in the state's prescription monitoring program (PMP) if that APRN wishes to prescribe schedule II opioids and benzodiazepines. The opioids to be prescribed must be specifically noted in the PMP and APRNs and the consulting physician must meet at least monthly to discuss the patient's care.
  • 4.Says APRNs are prohibited from administering opiates via injection. APRNs are also prohibited from performing operative surgery.
  • 5.Prohibits APRNs from advertising as "Dr.," which is extremely misleading to patients. APRNs who have doctorate degrees must tell patients that they are not medical doctors or physicians.
  • 6.Makes clear that nurse anesthetists are NOT included in the agreement; nothing changes as to how nurse anesthetists currently practice.


ISA has worked closely with ISMS on scope of practice issues and greatly appreciates that anesthesia services have been uniquely identified in the medical practice acts. While ISA has traditionally been opposed to the independent practice of non-physician providers, we've conceded that mainstream support exists for APRNs in Illinois. ISA will vigilantly advocate that anesthesia services are not the same as primary health care. We believe that the Anesthesia Care Team model provides excellent access to quality care for our patients.

Despite this expansion of privileges, the push for further independence continues. The ISA and ISMS are keeping a sharp eye focused on the APRN Compact legislation that is making ts way across the country. The APRN Compact legislates that once ten states "sign on", all states that belong to this Compact will honor an APRN's state licensure and rights of that licensure, regardless of the other states' rules and regulations. In other words, the nursing practice rules of a conservative state's license would not apply to an APRN with a very liberal license. This Compact attempts to supersede state nursing licensing requirements and regulations and is a pathway for national APRN independence.Unlike other medical and nursing compacts, this legislation does NOT respect state law.

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HB 2975: Anesthesiologist Assistants Add Value to the Team

HB 2975 would license Anesthesiologist Assistants as part of a physician-led team. New health care delivery system reforms hinge on a team-based approach to patient care. Anesthesiologists have been the leaders by practicing in a team care model for decades. Anesthesiologist Assistants are a welcome addition to the anesthesia team!

Contact your state legislator and ask for their support :

* A physician-led team model of care with flexibility under physician leadership ensures access to cost-effective and high quality health care. 

* The team model of care was found to be the safest compared to working alone. 

* Anesthesiologist Assistants (AA's) are providers that will help ensure that physician-led team based anesthesiology care will be available to all patients in Illinois.

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MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA)

Background

In 1997 congress passed the Balanced Budget Act (BBA), to replace the Medicare Volume Performance Standard (MVPS), in an attempt to rein in the growth in physician expenditure and healthcare costs. The BBA was designed to ensure that the annual increase in expense per Medicare beneficiary did not exceed the growth in Gross Domestic Product (GDP), and tied physician reimbursement to GDP.

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CONFESSIONS OF NEW DELEGATES AT THE ASA HOUSE OF DELEGATES

CONFESSIONS OF NEW DELEGATES AT THE ASA HOUSE OF DELEGATES

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. 

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ISA LEADERSHIP CONFERENCE HIGHLIGHTS

As I reflect upon last weekend’s 2016 ISA Leadership Conference, I am thankful to be a member of our organization.  The ISA continues to provide rich educational experiences at minimal to no cost for its members.  Drs. Torin Shear and Michael Shane continue to develop an amazing conference with excellent, thought-provoking speakers from around the nation.   As a short summary:

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