A New Year and New Leadership at the CSA

  • Sibert, Karen, MD, FASA
| Jun 16, 2014

Paul Yost MD took office as the CSA’s new President at the 55th annual governance meeting of the House of Delegates (HOD) last weekend, receiving the gavel from Peter Sybert MD, the immediate past president.

Past President Peter Sybert MD and
President Paul Yost MD

The meeting, held in San Francisco on June 7 and 8, drew anesthesiologists from all over California to decide on governance issues facing the CSA for the year ahead.

The CSA’s slate of newly elected officers for 2014-15 includes:

  • James Moore MD, President-Elect
  • Christine Doyle MD, Speaker of the House
  • Edward Mariano MD, Vice Speaker
  • Karen Sibert MD, Secretary
  • Rima Matevosian MD, Assistant Secretary

Michael Champeau MD will succeed Mark Singleton MD as the next ASA Director for California. In a contested election, Linda Hertzberg MD was elected by the HOD to serve as the next ASA Alternate Director. The ASA Director and Alternate Director represent California’s interests at ASA Board of Directors meetings.

For the first time this year, the CSA Board of Directors chose among candidates for a new position: President Emeritus. This is a voting position on the Board open only to candidates who are past CSA presidents, and is intended to provide experienced guidance and historical perspective to board discussions. Narendra Trivedi MD was elected to a two-year term as the CSA’s first President Emeritus.

Adrian Gelb MBChB stepped down after a distinguished six years as chair of the Educational Programs Division, and will be succeeded in that post by Sam Wald MD MBA.

Resolutions passed

Nassim Moradi MD chaired the Reference Committee, which hears testimony for and against each resolution, and recommends final language before submitting resolutions to the HOD for their deciding votes.

The HOD voted to establish a committee to represent the interests of anesthesiologists practicing pain medicine in California, with the goals of supporting the safe care of acute and chronic pain patients, and fostering a closer relationship with the California anesthesiologists who specialize in pain medicine. The HOD voted also to pursue the recognition and practice of Anesthesiologist Assistants within the state of California.

The CSA increasingly uses electronic communication rather than print, and the HOD approved the Board of Directors’ recommendation to discontinue publication of the printed quarterly Bulletin. Instead, the HOD voted in favor of one annual publication, which will be produced under the direction of the Editor of Print Media and the Committee on Professional and Public Communications.

Karen Sibert MD will succeed Michael Champeau MD as the society’s next Editor of Print Media, and Linda Hertzberg MD will continue in her present position as Editor of Electronic Media.

Sedation, simulation and patient satisfaction

More than 100 delegates, alternate delegates, district directors, residents, past CSA presidents, and other guests attended the HOD meeting, and heard talks from three featured speakers: Jay Mesrobian MD, David Gaba MD, and Linda Mason MD, the ASA’s Secretary.

ASA Secretary Linda Mason MD

Dr. Mason gave the annual update on the ASA’s initiatives, highlighting key trends facing anesthesiology nationally and at the state level. She told the audience that ASA is working with regulators and lawmakers on the 2014 Medicare fee schedule, specifically targeting the unacceptable cuts in payment for pain management that CMS has enacted for this year.

ASA is pursuing regulatory and legislative action to block proposed VA Nursing Handbook changes, she explained, since these changes—if adopted—would negatively affect veterans’ access to physician anesthesia care.

Dr. Mason discussed ASA’s public education campaign, ”When Seconds Count…Physician Anesthesiologists Save Lives,” and spoke in detail about the Perioperative Surgical Home initiative. She emphasized the importance of ASAPAC contributions, and of ASA members advocating individually with their patients, colleagues, administrators, and lawmakers.

 Chair of the ASA Practice Management Committee James Mesrobian MD

Dr. Mesrobian, chair of the ASA Practice Management Committee, spoke first about the critical role that anesthesiologists play in developing sedation policies for their hospitals. “You are required to oversee all sedation in your organization,” he told the audience. “It’s no longer enough just to say here’s the right thing to do.”

Even mild or moderate sedation must be under the auspices of each department’s Director of Anesthesia per the Centers for Medicare & Medicaid Services (CMS) Interpretive Guidelines, Dr. Mesrobian explained. Complex issues to be negotiated include sedation protocols in the emergency department and ICUs, the future role of computer-assisted sedation devices such as Sedasys® and whether to credential nurses and midlevel practitioners to administer deep sedation. “Facts are important, but communication is critical,” he said.

In a separate talk, Dr. Mesrobian spoke about patient satisfaction in anesthesiology, which remains “poorly defined, difficult to measure, and challenging to implement.” He explained that CMS now wants to link measures of patient satisfaction with physician payment, so this isn’t an issue we can afford to ignore.

Typically, patient satisfaction surveys focus on courtesy, communication, and friendliness, Dr. Mesrobian said, and reflect the patient’s subjective assessment. “The challenge is for the ASA to develop a valid and easily applied methodology to assess patient experience,” he said, since “the link between physician payment and patient satisfaction measures appears here to stay.”

Associate Dean for Immersive and Simulation-Based Learning at Stanford University School of Medicine David Gaba MD

David Gaba MD, the associate dean for immersive and simulation-based learning at Stanford University School of Medicine, spoke to the CSA audience about the role of simulation in anesthesia education. Simulation was probably used even in prehistoric times, he said, as preparation for hunting or for war. It’s a technique for introducing students to an arena of high dynamism and intrinsic risk without doing any harm, he explained.

What is the evidence base for the benefits of simulation? “It’s slim,” Dr. Gaba acknowledged. Even in aviation, he said, “there’s no evidence that it saves lives or planes.” But no pilot wants to be in the control group to learn to fly without the aid of simulation. “No industry has waited for proof of the benefits of simulation where human lives depend on the skilled performance of individuals,” Dr. Gaba asserted. “Anesthesiology is about saving lives. Just do it!”

Other CSA offices and appointments

CSA officers who will continue in their present posts for another year include:

  • William Feaster MD MBA, Treasurer
  • Judi Turner MD PhD, Assistant Treasurer
  • Mark Zakowski MD, Chair, LPAD
  • Keith Chamberlin MD MBA, Vice Chair, LPAD
  • Jeff Poage MD, Vice Chair, LPAD

The CSA gained two additional seats at the ASA House of Delegates for this year, bringing our total up to 30. Newly elected and re-elected delegates are Edgar Canada MD, Lee-Lynn Chen MD, Adrian Gelb MBChB, Linda Hertzberg MD, Edward Mariano MD, Rima Matevosian MD, Jeff Poage MD, Karen Sibert MD, Peter Sybert MD, Mark Zakowski MD, Jeffrey Rusheen MD, and Mark Singleton MD. Delegates who are continuing to serve the remainder of their three year terms are Stanley Brauer MD, Keith Chamberlin MD MBA, Neal Cohen MD MPH MS, Christine Doyle MD, William Feaster MD MBA, James Futrell Jr. MD, John Hsieh MD, Robert Martin MD, James Moore MD, John McDonald MD, Manuel Pardo MD, Kenneth Pauker MD, Johnathan Pregler MD, Earl Strum MD, Narendra Trivedi MD, Judi Turner MD PhD, Samuel Wald MD MBA, and Paul Yost MD.

For more photos from the CSA 2014 HOD Meeting, please visit our Facebook Event Page!

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