Do Not Donate Money To The ASAPAC Yet

It's that time of year again. Like the Salvation Army's brigade of Santas and their red kettles who appear before Christmas each year, August marks the ASAPAC's annual donation drive, or Day of Contributing. This year it will occur on Thursday, August 10th.

But I'm here to tell you not to give any money on that date. Only a fool would give them any moolah this week. I'm not saying don't contribute to the ASAPAC. They are the most effective political action committee in medicine and one of the most effective in Congress. The more money we anesthesiologists give to them, the more the profession can effectively fight the encroachment of CRNA's, poor payer reimbursements, and other major concerns.

The reason I suggest holding off on giving to the DoC Thursday is because you will get nothing in return. Though the yearly event always reminds me of a public television donation drive, you will receive nothing for your generosity. PBS will give you a nice mug or towel, maybe even a book or DVD if you are generous enough. By comparison, the ASAPAC gives you bupkis.

What really got on my nerves last year though was that the goodies are given the weeks AFTER the DoC. In the past I've dutifully made my online contribution to the ASAPAC and urged others to do the same. Then I realized that if you wait just a few weeks, they will actually give you free stuff to show their appreciation. It's nothing significant, just little tchotchkes like pens or flashlights with the ASAPAC logo. But it's still better than nothing.

When I saw the gifts they were handing out, I emailed the ASAPAC to ask if I could have some of the items too, since I had JUST given them a few hundred dollars. "Sorry, no can do," was my reply. They were only for that particular fund drive. Giving to the DoC was purely out of the goodness of your heart. If you want ASA paraphernalia, you'll have to wait for a different event where they actually promise to give you things. Gee, thanks a lot. I feel like I just got shafted by my own professional society.

So please contribute to the ASAPAC. But you don't have to give them money on the arbitrary day of August 10th. They will take your money any day of the year. Just wait until they pass out ASA logo'ed hats or T shirts if you truly want to feel appreciated.

Proof CRNA's Don't Care About Patient Access To Anesthesia

This will finally put to rest the lie that CRNA's want to practice independently without supervision from physician anesthesiologists for altruistic reasons. They say nurse anesthetists should be able to work without anesthesiologists watching over their shoulders because they can increase the availability of anesthesia care since there are not enough anesthesiologists for all the cases that need to be done. It doesn't matter that studies have shown that states who opt out of physician supervision do not have more anesthesia cases than non opt out states.

Now we have this tweet from Juan Quintana, the immediate past president of the AANA. After the Department of Veteran Affairs denied CRNA's the right to practice without physician anesthesiologists in VA hospitals, he tweeted, "stick to your guns. In the meantime we will keep taking MDA jobs." For good measure he added a laughing so hard he's crying emoji.

Does this sound like he wants to give patients more access to expert anesthesia care? How can taking jobs from physician anesthesiologists lead to greater anesthesia access? All the propaganda from the AANA about CRNA's giving patients and surgeons more anesthesia choices have just been shown by their own society president to be a bunch of baloney. Their blatant bald faced lying would make even Hillary Clinton blush.

So next time you hear anything out of the AANA pushing their agenda for independent practice without physician anesthesiologist supervision, know that it is all fake news. Their real agenda is to prevent as many anesthesiologists as possible from observing and correcting their errors.

ASA Loves All Nurses, Except CRNA's

The American Society of Anesthesiologists sent out a crowing email yesterday announcing a new bill introduced in the Senate by Mark Kirk, Republican Senator from Illinois. S. 297 would allow most nurses in the VA to practice independently of physicians. These independent nurses include: Nurse Midwives, Clinical Nurse Specialists for mental health, and Nurse Practitioners.

Notably absent from this list of nursing professionals are, of course, CRNA's. The email proudly states, "The ASA is pleased that S. 297 appropriately excludes nurse anesthetists. The legislation reflects a growing Congressional consensus that the surgical/anesthesia setting is a high-risk health care environment requiring physician involvement in care."

Naturally the AANA is not taking any of this lying down. They also sent out their own press release, "Please help stop this damaging course of action by contacting your U.S. Senators today. We have reason to believe that the ASA is now behind S. 297 as a political maneuver to halt further Veterans Health Administration action." Gee I wonder how they figured out that the ASA was behind this bill?

I'm not sure what the ASA's strategy for this legislation is. In my opinion, by endorsing a bill to allow other nurses like NP's to have independent practice taking care of our nations veterans, it weakens their argument that CRNA's are not able to perform their duties without physician oversight. If the ASA thinks NP's and Midwives are good enough to see patients on their own, how can they make a distinction with CRNA's? And how thrilled are the Internists and OB/GYN's with Congress allowing nurses to compete with their practices? Did the ASA just make enemies with these two large physician organizations?

Of course this battle is far from over. This is only one bill that has yet to make its way through the entire Legislative branch and hopefully avoid the President's veto pen. There is still a long ways to go before any of these new rules become reality.

Cheapskate Anesthesiologists

On August 13, ASAPAC, the political action committee of the ASA, held a 24 hour marathon to try to raise $100,000 from its members to cover a shortfall in contributions this fiscal year. All day ASA members were bombarded with urgent emails imploring us to make any monetary donations. The state with the most contributors would even get a special mention in ASAPAC publications. Woohoo!

Now you would think that raising $100,000 from a group of anesthesiologists should be relatively easy. First of all, the ASA boasts over 50,000 members in its ranks. Then you consider that the average salary of an anesthesiologist is $338,000. Right there we're talking about almost $17 BILLION of earnings power to forward our society's political agenda. So raising a measly $100K shouldn't be that hard, right?

Well, yes and no. Yes the ASAPAC did reach its fundraising goal of $100,000. As a matter of fact, they raised $195,304. So the society got almost twice what it was looking for, giving a healthy boost towards next year's contributions already. But it was the manner in which it was raised that is shameful.

Out of 50,000 ASA members, just 867 of them decided to open their wallets a little bit to help their profession further its causes, like opposing the new VA Nurses Handbook or demanding Medicare reimbursement equivalency with other physicians. That is not even two percent of the membership that could be bothered to help out their own future.

The state with the most contributors was California, with eighty. That should not be a surprise since California has the most ASA members. However California anesthesiologists gave on average a paltry $179.37 each. That is below the national average donation of $225.26. Full disclosure--I too donated to the ASAPAC that day. Alabama took the prize for most money given per physician. Its 46 donors gave a mean of $503.70. At least we didn't bring up the bottom of the list. Ironically that dubious honor belongs to the anesthesiologists in the District of Columbia. They of all ASA members should realize how important money is to get any traction with our nation's representatives. D.C.'s five anesthesiologist donors only contributed a mere $73.33 each. That's just pathetic.

So congratulations to the ASA and the ASAPAC for making your goal this year. We need our voices heard loud and clear in Washington to make sure anesthesiologists remain a formidable presence in all healthcare related legislation. However I think a stronger outreach needs to be undertaken to get members more heavily invested in the society. When 98% of the members choose to ignore an urgent plea to contribute to their own professional future, the membership is telling the society that they don't feel they are getting their voices heard inside the new glass headquarters up there in Schaumberg.

Sometimes You Have To Get Yourself A Little Dirty

I got this email from the American Society of Anesthesiologists Political Action Committee (ASAPAC).  Full disclosure: I am a proud contributor to ASAPAC, donating every year for the last several years. Besides highlighting the PAC's accomplishments, the email gave step by step instructions on how to influence your congressman.  The following is quoted directly from the ASAPAC email that I received.

One of the easiest ways to get involved with the political process locally is to attend a political fundraiser, and ASAPAC is here to make it even easier for you!

Step 1: Make sure you are on your lawmakers' campaign mailing lists so you know when and where these events will be taking place. They are a great opportunity to spend time with your representatives in Washington, advocating for anesthesiology and our patients.

Step 2: Please contact the Washington office to see if support is available for your Representative or Senator.

Step 3: If support is available, we'll have a check mailed directly to you to deliver at the event.

There you have it, how to buy congressional attention in three easy steps.  You don't even have to give any money out of your own pocket; the PAC will mail you a check to give to the congressman at his neighborhood meeting.  How much simpler can it get?  

Yes the whole process sounds sleazy, but that is the way the game is played.  Perhaps if the entire medical community had been as generous to their congressional delegates as the lawyers and insurance companies we wouldn't be in the current mess we are facing with ObamaCare.  For instance, of all the ASA members in California, less than 10% donated to ASAPAC, which is quite pitiful.  Let's not kid ourselves, money talks in Washington.  We can't strut around naively hoping that the government will take care of us because we are on some noble mission to help the poor and infirmed.  The government will help those that feed its immense bureaucracy and screw everybody else.  So if you haven't already, take a deep breath, hold your nose, and with your other hand write a check to ASAPAC or your medical society's PAC.  Then take a shower to wash that slimy feeling from your conscious.