VOLUME 36, ISSUE 1

Anesthesiology 2023, “Oro en Paz, Fierro en Guerra”¹. The Annual Meeting of the American Society of Anesthesiologists met from October 14th to 18th in San Francisco, California. There were 11,555 registered members who attended all or some of the meeting in person and 645 signed up for the virtual format only but as with the previous year more than 3,000 attendees were resident and medical student members. Most members of the Texas Delegation were housed at the San Francisco Marriott Marquis, the site of most of the Governance activities except for the House of Delegates that occurred in the Moscone West of the Convention Center.

The Annual Meeting began on Saturday with a welcome address by AMOC Chair, Dr. Sheela Pai Cole of San Francisco with a preview of activities and educational opportunities. She concluded with an introduction of ASA President, Michael Champeau also of California.

Dr. Champeau formally began the Opening Session with the presentation of the 2022 Distinguished Service Award to Dr. Stanley Stead (CA). Dr. Stead is a well-known leader to most for his years of service as the developer of the CPT Crosswalk, as member of the CMS Relative Value Update Committee (RUC) and former ASA VP of Professional Affairs. He highlighted ASA wins and losses during his tenure. The leadership worked to defeat the APRN compact in 18 states, another state (NV) added AA licensure and Delaware unexpectedly opt-ed out of the CMS supervision requirement of nurse anesthetists.² The biggest efforts were concentrated on the attempt to eliminate supervision of nurse anesthetists in the VHA system and the failed implementation of the “No Surprises Act” that affects so many members.

The Keynote Address was given by Dr. Siddhartha Mukherjee, an oncologist and philosopher on the implication of artificial intelligence (AI) on medicine and patient care. Although most of his talk related to cancer research, the most interesting line to many was “Don’t fear AI taking your job, the real fear for medical professionals is that someone proficient in AI will take your job”.

https://education.asahq.org/course/view.php?id=4724

The ASA Delegates and the Alternate Delegates met for the Texas Caucus from 1:00 to 2:30 PM on Saturday, October 14th at the Marriott. Dr. Scott E. Kercheville, Director conducted the meeting (Alternate Director, George Williams was unable to attend). The group then reviewed the House of Delegates Handbook and discussed the ASA elections. The members then broke into sub-groups with the work divided by Reference Committees with Drs. Jeremie Perry, Vijay Saluja, January Tsai and Brian Dewan chairing these groups.

The members moved onto the Western Caucus at 2:30 PM for further deliberations and discussions. Dr. Brian Mitchell, Director (OR) as the Western Caucus Chair convened the meeting and was assisted by Dr. Johnathan Pregler, Alternate Director (CA), Alt. Director serving as Vice Chair and Dr. Amr Abouleish (President-Elect, TX) serving as Secretary. Both Caucus meetings were abridged to allow the Annual Meeting Opening Reception in the Exhibit Hall at Moscone North of the Convention Center.

Dr. Champeau convened the first session of the House of Delegates at 8:00 AM on Sunday, October 15th at the Moscone West. Maybe as a sign of the economy or workforce shortages, the Texas delegation with all available delegates and alternates could not fill our 30 voting members for the HOD (neither Session). Two of the Texas living former ASA Presidents were in attendance, Drs. Mary Dale Peterson, and Jeffrey Plagenhoef.

Dr. Paul Yost, Chair of the ASAPAC was then introduced to give the annual PAC update. With a strong year-end push, total contributions reached just over $2 million reversing the trend since the pandemic but overall participation still lags at 10%. Texas returned to prominence with the number one position as the leader in total contributions with just over $180,000. Baylor-Scott & White was again the only residency program in Texas to achieve 100% participation for its residents. I would be remiss if I did not thank and congratulate Dr. John Scott, who deserves so much credit for our success, for his six years of service on the ASAPAC Executive Board.

Next was Mr. Paul Pomerantz, ASA CEO who is currently finishing his 11 years of service to our members and will retire at the conclusion of 2023. His presentation was more sentimental than usual because of that fact but there were some ominous warnings in his speech. Membership is slowly increasing but is flat or decreasing for active members. Dues remain our major source of income with a budget that is currently negative. His major concern as he retires is a fear of increased specialty fragmentation that will threaten overall strength within the organization.

Per House tradition Dr. Champeau turned the meeting over to the Speaker, Patrick Giam, who then began the normal business of the House including the adoption of the Rules of Order for the 2023 House of Delegates. Most of the nomination speeches were given from the floor except for those of the 1st Vice President and the Vice Speaker which was the only contested race. Dr. Williams gave the nominating speech for Dr. Giam.

The following members were nominated for the election scheduled for Wednesday, October18.

Dr. Champeau returned for his final address to the House as President. Dr. Champeau recounted many of the ASA activities for the year that he presented at the Opening Session but finished with the formal announcement of the new ASA CEO, Mr. Brian Reilly (current ASA COO) who will take over in January 2024. The selection was made after the work of a search committee chaired by Dr. Peterson assisted by Dr. Wright and many others.

Dr. Ronald L. Harter President Elect (OH) gave his address to the House and voiced strong concerns regarding the issue of physician burnout. He said that unlike many other specialists, drug use is not as strong of a contributing factor, but the three main issues appear to be depression, binge eating and alcohol use.

Dr. Clark Chair of the Committee on the DSA submitted the name of Dr. Mary Dale Peterson for the 2023 ASA Distinguished Service Award (DSA). This award will be presented next year in Philadelphia, PA.

The House was recessed prior to 10:30 AM to resume business on October 18, 2023

Later on Sunday, October 15th the Reference Committees were held in a staggered fashion beginning from 1:00 PM to 2:30 PM also at the Marriott. Drs. Padakandla and Williams served on the Reference Committees for Scientific Affairs and Administrative Affairs respectively.

The usual highlights on Monday of the Annual Meeting are the presentations of the DSA (this year changed to Saturday) and the Rovenstine Memorial Lecture. This year’s presenter of the Lecture was Dr. Daniel I. Sessler, former editor of Anesthesiology and of too many academic credentials to recount. The date of his talk was October 16th, “Ether Day”. On this date in 1846, the first ether anesthetic was demonstrated. His talk, the Gathering Storm was sobering, controversial and filled with data. I will leave the recounting and review of this talk to others.³

The Texas Delegation met again on Tuesday, October 17th at 1:00 PM in Caucus to review the recommendations of the Reference Committees and to discuss the upcoming House of Delegates on Wednesday. There were a few concerns with the wording of statements within some of the reports that our delegation took issue with and did not agree with Reference Committee recommendations. Plans were made to create specific amended language, work with the authors of the reports and to brief the Speakers to extract these reports at the House (more details are below).

The Western Caucus began at 3:30 PM. Dr. Mitchell chaired the meeting and was ably assisted by Dr. Abouleish while Dr. Pregler was touring the other caucus meetings as part of his campaign. Besides the discussion of the handbook reports, the Caucus did give full endorsement for the election for 1st Vice President to Dr. Jeff Mueller of Arizona for 2024. Dr. Mitchell adjourned the Caucus before 5:00 PM.

The Speaker, Dr. Giam reconvened the House of Delegates at 8:00 AM on Wednesday, October 18h with the first order of business being the voting by the Delegates on the DSA and the officer elections.

Election results were as follows:

Dr. Peterson received the necessary 2/3 votes to be awarded the ASA 2023 DSA.⁴

All the unopposed candidates listed above were elected by unanimous consent at the HOD.

The result of the one contested race was as follows:

• Vice Speaker      Dr. Tracey Straker, NY

Most importantly, Dr. Giam succeeded in his final step towards becoming our next ASA President from Texas.

References:

1 A very strong city motto that might be used by the ASA on occasion.
2 There was also a partial opt-out last year in Wyoming for rural hospitals only and since this Meeting, the Governor of Colorado has extended their partial opt-out to statewide.
3 This speech is not available online nor will it be reprinted in our journal at the request of members at the Meeting.
4 https://usagif.com/wp-content/uploads/gif/confetti-20.gif