The ASA Could Use A Little Liposuction.

If anybody wanted to know why the American Society of Anesthesiologists needs an enormous new headquarters building, part of the answer was revealed by the former ASA president himself. In the March issue of the ASA Newsletter, John Zerwas, MD, the immediate former president of the group wrote a piece praising the number of anesthesiologists who volunteer to work with the ASA. Titled "ASA Exceptionalism," Dr. Zerwas gives a heartfelt thanks to all the people who help run the organization. He writes that there are 100 committees in the ASA with over 1,500 anesthesiologists working in these groups.

While having a lot of people willing to volunteer for the ASA appears nice, to me that sounds like a lot of committees for our field. I can't even think of 100 issues that needs to be urgently addressed by the organization. I think perhaps ten topics are truly affecting anesthesiologists and maybe if I try really hard a total of 20-25 concerns that rise to the level of a national problem. I'll even give them a list of big topics I think they should be most involved with:

1. CRNA's and the states that are opting out of physician supervision.
2. The VA's proposal to allow CRNA's to practice independently.
3. Medicare's low reimbursement for anesthesia services.
4. Medical malpractice reform.
5. Persistent drug shortages.
6. Insurance denial of payments for GI anesthesia.
7. Attracting bright medical students to choose anesthesiology.
8. The abuse of the Company Model for anesthesia services.
9. Publicizing the patient safety advances made by anesthesiologists to the media.
10. Improving the swag handed out at the ASA annual meeting to increase turnout.

Okay so this sounds pretty simple but it was the best I could do at the spur of the moment. I'm sure there are a few more legitimate matters that should be addressed by the ASA. But ninety more? I doubt it. After awhile, committees create their own problems to justify their existence. Then they need to increase their annual budgets to prove they are working on grander issues than their original intent. Like Congress, once a committee is set up, it is rarely phased out.

So instead of praising the large number of people who work at the ASA, how about the leadership downsize a bit and concentrate on a few core issues that affect us plebes down here in the trenches. I think they would find that the membership will be more responsive to real problems than to a committee that investigates romantic relationships in the operating room (warning: gross out kissing pictured if you follow the link).