The Big Picture

  • Zakowski, Mark, MD
| Mar 20, 2017

Mark_ZakowskiAs CSA President, one of my goals is to give you the “big picture”— my perspective on our recent Board of Directors meeting, which was among the most significant I have ever attended in my 17 years as a board member. Last week’s blog reported many of the meeting’s highlights.

Now I want to take a few minutes of your time to put the board’s actions into a broader context that illustrates the strategic direction of CSA – your professional home as a physician anesthesiologist.

action-plan2Following extensive discussion, the board crafted a clear action plan that is consistent with the results of our last two membership surveys:

  • To improve CSA’s effectiveness at the State Capitol
  • To serve our members better with activities and benefits that are specifically aligned with member needs
  • To enhance our standing with the public, legislators, regulators, and our patients as the premier advocate for patient safety in California. 

Ensure Sustainable Funding for Advocacy and GASPAC

Advocacy always ranks #1 in member and board surveys. A robust political action committee (PAC) fund is essential to any effective advocacy strategy. Contributions to GASPAC, our political action fund, have dropped significantly since CSA joined unified billing with ASA, because we were required to eliminate simultaneous check-off and collection of GASPAC contributions. PAC funding levels are public information, and are closely watched by politicians and lobbyists. Without a substantial PAC, lobbying efforts stand a poor chance of success.


The Legislative and Practice Affairs Division (LPAD), chaired by Jeffrey Poage, MD, recommended that CSA set a target of raising $400,000 annually for GASPAC – with $200,000 dedicated each year to state political contributions, and another $200,000 dedicated to building a $1 million ‘war chest’ over five years. Funding would be drawn from surplus revenue and from member dues. The board agreed with LPAD’s recommendation, which would put GASPAC’s funding on a par with other major professional societies including California’s dentists, chiropractors, and orthopedists. 

The board will finalize the proposal for presentation in June to the CSA House of Delegates. If a member chooses to “opt out” of contributing part of dues payment to GASPAC, the same amount would be assigned to a non-political fund that supports other CSA activities. This is the same approach that other professional state societies have employed over the last several years to increase their PAC funds and enhance their presence in Sacramento.

Establish a Separate Practice Affairs Committee

In recent surveys, members have consistently expressed interest in meetings, web-based resources, and strategies to improve the performance of their practices and enhance their individual careers. At LPAD’s recommendation, the board agreed to establish a separate Practice Management Committee to guide this effort.

Dr. Keith Chamberlin

Led by Keith Chamberlin, MD, MBA, current Vice Chair for Practice Affairs, the new committee will develop programming for an inaugural Practice Management Conference in conjunction with CSA’s 2018 Annual Educational Meeting, to be held in Palm Springs in March 2018. The committee will also develop resources for the CSA web site, and it will work collaboratively with the Education and Programs Division (EPD) to develop practice management CME content for the Fall and Winter Hawaii meetings, and for online access.

Develop and Fund Resident Resources, Activities

Residents represent the future of CSA. The board approved two new resident activities and agreed to fund others:

  • A resident advocacy workshop will be held each February in Sacramento to introduce resident leaders to the work of advocacy, and equip them to be effective advocates on behalf of CSA in the State Capitol and in their home districts. The advocacy skillset can be used in Sacramento, in Washington, in each local hospital, and in every practice.
  • A resident practice management program will be developed for CSA’s annual meeting, providing an opportunity for residents to learn cutting-edge strategies to grow their businesses and careers.
  • A set of member benefits will be developed by the Membership Committee especially geared to help younger physicians, including discounts on home mortgages, preferred pricing on anesthesia services and equipment, and information about job openings and career development.
  • CSA will fund resident participation when residents are invited to participate in CSA or ASA activities, including the ASA Legislative Conference in Washington, the CMA Legislative Day in Sacramento, and the ASA Practice Management Conference.

Establish the CSA Foundation for Education

To enhance CSA’s visibility with the public and our patients, the board approved the formation of the CSA Foundation for Education, a 501c3 non-profit corporation that will fund activities in three primary areas:

  • STEM Education Partnerships among CSA, California anesthesia residency programs, and public high schools to teach and support the Project Lead the Way (PLTW) Biomedical Science curriculum. A pilot project has been established with UCLA’s Department of Anesthesiology and Perioperative Medicine and three local high schools – El Segundo, Venice, and the Girls’ Academic Leadership Academy (GALA) – and will launch this fall.
  • Resident and fellow grants to support and publicize research projects to improve patient safety and anesthesia outcomes.
  • Public awareness activities to highlight the role of the physician anesthesiologist in patient safety.

The Foundation will enable CSA members at all levels – attending, resident, and fellow – to participate in activities for the public good that extend beyond traditional professional parameters. Our younger members have identified this goal as a priority. We extend special thanks to Gabriel Sarah, MD, who chairs the Foundation Task Force.

Implementing a “Best Practices” Governance Model

best_pracFor the last two years, our Executive Director, David Butler, and your incoming presidents – Drs. James Moore, Karen Sibert and myself – have attended a meeting called the Symposium for Chief Executive and Chief Elected Officers, hosted by the American Society of Association Executives (ASAE).  The symposium brings together volunteer and staff leadership of non-profit organizations to teach best practices of organizational management, and provide specific strategies to create effective, high-performing membership organizations.

Among these best practices are commitments to provide staff and committees with clear directives, and to allow the board to maximize its role in the areas of strategic planning, oversight, and evaluation. To these ends, the CSA board approved a three-year action plan to be presented to the House of Delegates, including specific objectives in four key areas: 

  • Advocacy and political action
  • Member engagement and value
  • Effective governance  
  • Communications 

The specific objectives within each area will identify benchmarks, timelines, and assignments so that the board can ensure implementation, provide oversight, and evaluate the performance of executive staff, committees, and volunteer leaders alike.

I frequently remark that the two most significant decisions CSA has made in the last decade were to hire KP Public Affairs to conduct our lobbying in Sacramento, and to hire Advocacy Management Group as our association management company. These two decisions have provided CSA with a professional and highly capable staff. We have been able to build a strong base of advocacy, run first-class CME meetings, and improve central office functions.

I am extremely proud of my association with CSA over these last two decades, and especially this year as your President. My objective this year, in partnership with our talented board and capable staff, has been to help take CSA to the next level of effectiveness and transparency.  I hope that after reading this – and after reviewing our results over these next three years – you will agree we have indeed positioned CSA to better serve our members, our patients and our profession.

Top ten strategic priorities for 2017-19, identified by the CSA Board of Directors:

Rank Objective Segment Committee
1 Fund GASAPC equal to or greater than other specialties in CA Advocacy LPAD/GASPAC Board
2 Education and Programs Division – Add Practice Management content; Grow Annual Meeting; Investigate on-line CME Member Value EPD; Practice Management
3 Adopt foundational tools of governance Governance Executive Committee
4 Establish set of tangible member benefits Member Value Membership/Practice Management
5 Develop and deliver resources for district directors Member Value Membership
6 Solidify additional fundraising strategies for GASPAC Advocacy LPAD/GASPAC Board
7 Develop engagement strategy for residents Member Value Resident Engagement/ LPAD/Membership
8 Separate Practice Affairs from LPAD; Establish Practice Management Committee, Program, Resources Member Value Practice Management
9 Ensure AMG delivers on day to day operation Governance Executive Committee
10 Dissect membership into key segments Communications CPPC/Membership

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