2014: A Look Back and a Look Forward

  • Hertzberg, Linda, MD, FASA
| Jan 13, 2014

Editor's Note:
At the start of the New Year I asked CSA leaders to write about their goals for the CSA for 2014. First, however, it is helpful to reflect upon the value we as anesthesiologists can add to the care in areas where access to anesthesia care is limited. These are places where an oximeter alone can make a huge difference. In 2013, Adrian Gelb, MBChB and several other California anesthesiologists participated in a volunteer trip sponsored by the ASA to provide oximeters through the Lifebox Foundation.

Others in CSA leadership shared their thoughts for the challenges we face in the year ahead within the CSA and the practice of anesthesiology. What follows is a diverse and complementary group of ideas from our dedicated and talented physician leaders.


Adrian W. Gelb, MBChB
Chair, Educational Programs Division

The first Lifebox teaching trip in conjunction with both the ASA and the CSA transpired in Guatemala and Nicaragua, November 11-15, 2013.

Lifebox is a charitable foundation with the vision of working for sustainable changes in perioperative practice that will raise safety and quality standards globally. Key components of this mission include not only the provision of the high quality Lifebox pulse oximeters but equally importantly also providing education, training, and peer support to those who will be using these oximeters in practice. The initial first step is to fundraise and distribute a pulse oximeters for every operating room in the world without one; an estimated 75,000 ORs.

Five physician anesthesiologists from across California and the country traveled to Central America to teach pulse oximetry and the WHO Surgical Safety Checklist to over 400 healthcare providers, and helped deliver over 250 oximeters to these countries. Colleagues from across the USA helped raise $65,000 to provide these devices and the CSA funded 50% of the oximeters for Nicaragua.

You can follow the trip at the blog ably maintained by Christina Menor, MD. 

http://lifeboxjourneys.tumblr.com/tagged/Guatemala http://lifeboxjourneys.tumblr.com/tagged/nicaragua

Peter E. Sybert, MD

As I look forward to this New Year, as I expect you do also, I see any number of challenges. But I also see many thoughtful, involved, and passionate people. Every day physician anesthesiologists provide outstanding clinical care to their patients. That care constantly evolves with changing patient demographics and economic pressures. Sicker patients get more complex procedures, do better, and go home sooner than before. 

The ability to accomplish this comes from the application of information developed in our vibrant academic community. The venues to disseminate the information continue to multiply, from journals and onsite meetings, to whole topics available on the Internet, to interactive sites, among others. These approaches require more people who bring their skills and energy to organizations that support the development, dissemination, and delivery of clinical care.

That is where we focus, the point where one patient receives the care they need. From there, it scales, in different directions: in service lines between facilities, across the same facility, across systems and beyond. 

It is a time full of change, but has been so for decades. After all, without change how would we have achieved our terrific track record of improved patient safety? What is very new is the number of entities that are seeking venues to offer their experience, or to just impose change.  Exciting clinical advances continue to be created, disseminated, and implemented. Our patients continue to get better care.

To meet the challenges we face in California, in addition to our physicians, we have new CSA staff. They are an exciting group. We have engaged new advocates to help make our voices heard to decision makers.

Yes, it is a time filled with challenges. And, yes, there is much to be optimistic about as we work to create a better future.

Jeffrey A. Poage, MD
Vice Chair Legislative and Practice Affairs Division

The battle to preserve MICRA looms large for 2014.  Strong political advocacy is a key goal for this year.

On a professional level, I am working to improve team dynamics in the OR by helping implement a new simulation program in a community hospital setting.

Overall, I plan to express more gratitude to family and friends, colleagues and co-workers.   We should all appreciate those who make each day a good one!

Keith Chamberlin, MD, MBA
Vice Chair, Legislative and Practice Affairs Division

As I watch ACA and other agendas develop around us, I am concerned more about my well-being as a patient than as an anesthesiologist or physician.

My personal goal and for the CSA and physicians in general, is to do what I can to ensure physicians either regain control or stop the erosion of physician-led medicine, not just anesthesiology. As physicians, we appear to have become targets in a campaign to devalue education and training in medicine, as some with less education and training may think they are equal to fully-trained physicians. The ACA seems to be designed to help people without insurance while hurting those with insurance. I hope to make a difference through the CSA and through the Health Council of my local congressman.  

But I am worried as a patient.  I want the doctor who WANTS to stay with me and care about me, not the one who just wants to get the boxes completed in the electronic health record.  I want my doctor to break the rules for ME and anyone else who falls outside the "guidelines."  This is a critical time in medicine and it has nothing to do with incomes, it has to do with who has control over those providing direct patient care.

William W. Feaster, MD, MBA, FAAP

As CSA Treasurer I plan to assist our Executive Director, accountant, and our new CSA staff in re-establishing accurate and timely (prior month before current month end) reporting of financial statements to the Treasurer and Assistant Treasurer and to the Executive Committee. I will assist them in assuring that all necessary contracts are in place and funding identified for our new relationships with IT vendors (database and website) and our newly selected PR firm.

I plan to work with CSA leadership to better define the value CSA membership brings to current and potential members and support any strategic initiatives to increase membership.

Paul Yost, MD FAAP
President Elect

As the President Elect of the CSA, my first goal is develop a keener sense of hearing.  What I mean is that I would like to hear from physician anesthesiologists in private practice, academic centers, the military, and surgery centers, and those practicing pain, working ICUs, and working in any of the subspecialties of anesthesiology.   I would especially like to hear from residents and fellows in anesthesiology, and its many subspecialties.  The one piece of information that would be most helpful is the answer to the question:  How the CSA can best serve your interests now and into the future?  We would love for the CSA to be your CSA.

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