It was a clear but cold weekend in Chicago when the American Society of Anesthesiologists (ASA), our “parent” organization, held its Interim Board meeting on March 7 and 8. Representing the CSA were Drs. Paul Yost, Mike Champeau, Peter Sybert, Jim Moore, Mark Zakowski, Johnathan Pregler, Linda Hertzberg, Zeev Kain, and myself, along with ASA officers Drs. Dan Cole (President-Elect), Linda Mason (Secretary) and Stan Stead (Vice President for Professional Affairs).
California is in the Western Caucus, which is currently led by Dr. Scott Kercheville (Texas), Dr. Peter Dunbar (Washington) and our own Dr. Champeau. Dr. Hertzberg is the chair of the caucus Rules Committee. The meeting of the caucus, early Saturday morning, is our first opportunity to discuss the issues before the Board. All ASA members who are part of the Western Caucus are welcome, and it can be a good opportunity for newer members to meet others. Some ASA committees also meet in association with the Board meeting (this year the Committee on Electronic Media and Information Technology, which I chair, and Committee on Trauma and Emergency Preparedness met at the ASA office on Friday).
After the caucus meetings, there are a series of review committee meetings. Essentially the same as the reference committees at the ASA House of Delegates, these meetings are open forums for discussion of topics that are grouped by the major divisions of the ASA: Administrative Affairs, Professional Affairs, Scientific Affairs, and Finance.
There were a number of issues under consideration, both major and minor. Spending money is always a major topic, and there were two items on the agenda involving expenditures of more than $1 million. The first was for advocacy of the ASA’s opposition to possible revisions to the VA Nursing Handbook. These changes would eradicate all existing VHA policies concerning physician supervision, and would designate all advanced practice registered nurses including nurse anesthetists, as licensed independent practitioners. This means that they would be able to practice on their own without any requirement for physician oversight or support. The second allocation was for funds to take the infrastructure of the Anesthesia Quality Institute to the next level in its role as a Qualified Clinical Data Registry.
Maintenance of Certification in Anesthesiology (MOCA) was a topic of conversation, with many having strong opinions regarding the current process. Ongoing concerns included the degree of maintenance of certification requirements from American Board of Anesthesiology (ABA), and its parent organization, American Board of Medical Specialties, while there is no similar level of recertification requirements on non-physician advanced practice providers. There will certainly be further discussion at the BOD and HOD of how the ASA may have input into and influence on the ABA regarding the current MOCA process.
Dr. Cole, who is currently on the board of the ABA, indicated that “MOCA 2.0” is still under development. Some options in the works include being able to better tailor your personal MOCA process to your current practice. The new “MOCA Minute” was launched by the ABA while we were in Chicago. If you sign up for this, you will get a weekly email from the ABA with an exam question. You have a minute to answer and then you will receive the correct answer with explanation.
Perioperative medicine and the Perioperative Surgical Home continue to be on the front burner. There is a new perioperative educational track for the Annual Meeting, ANESTHESIOLOGY 2015, this year.
Concern was raised about a specific recommendation from the Committee on Governance Effectiveness & Efficiencies involving questions as to whether any specific action item is “policy” and whether it would be put before the House of Delegates. Within the bylaws, items that are business or financial fall under the purview of the Board, while all other business is the responsibility of the House. The recommendation as to how to handle these questions when they arise was sent back to the committee for refinement.
Saturday afternoon was an opportunity for a variety of updates. The current strategic plan was reviewed, and small-group input was solicited for some items. Dr. Beverly Philip spoke about upcoming issues related to Scientific Affairs and our various educational programs. Dr. Stan Stead spoke about ongoing issues related to Professional Affairs. Manuel Bonilla, the ASA’s Chief Advocacy Officer, spoke about our current advocacy issues and upcoming Congressional and Senate topics.
The President’s Reception was an opportunity for all to mingle, meet new colleagues, catch up with old colleagues, and generally relax after a long day.
Sunday started early again, with the actual Board meeting. The Review Committee reports were discussed, and decisions made. The meeting seemed a bit anticlimactic after the frenzy of Saturday’s events. We all headed off to O’Hare Airport and our various flights home, ready to face Monday knowing what the ASA has “done for us lately.”
Dr. Doyle serves as Speaker of the California Society of Anesthesiologists, Delegate to the American Society of Anesthesiologists, and Chair, Committee on Electronic Media & Information Technology Committee, ASA.