VOLUME 33, ISSUE 2

Scott E. Kercheville, M.D.

ASA District Director, District 19 Texas
San Antonio, TX

Interim Report - March 2021

The ASA Board of Directors 2021 March Interim Meeting was held virtually March 7th to 8th.

Dr. Scott E. Kercheville (Director, TX) and Dr. Crystal C. Wright (Alt. Director, TX) were in attendance for the two days. However, Dr. Kercheville was also attending a family funeral in the Rio Grande Valley, therefore, Dr. Wright contributed greatly to the generation of this report by covering for him at times. Other TSA members in attendance were Drs. Mary Dale Peterson (ASA Immediate Past President), Patrick Y. Giam (ASA Vice Speaker), Evan G. Pivalizza (TSA Immediate Past President) and Jeffrey S. Plagenhoef (ASA Past President). This report will follow the traditional format of the live meetings and as such some portions are not in chronological order.

Meeting of the Western Caucus:

The meeting of the Western Caucus occurred on the Thursday night preceding the Board Meeting with Dr. Wright serving as the Chair, Dr. Brian Mitchell (Alt. Director, OR) served as Vice Chair and Dr. Johnathan Pregler (Director, CA) served as Secretary. It also occurred virtually and consisted mainly of the usual discussions of the pending reports in the Board of Directors’ packet. Dr. Kercheville, as a member of the Finance Review Committee and the Section on Fiscal Affairs presented the reports from that section.

Dr. Pregler, Chair of the Rules Committee reported to the Chair that there were no rule changes for this year and his term was complete with an entire new committee needing to be appointed. The new members consisted of Drs. Roland Flores, Jr. (CO), James Moore (CA) and Daniela Alexianu (Director, WA).

There was a subsequent Western Caucus Candidates Committee Meeting chaired by Dr. Kercheville where upcoming ASA races involving members of the Western Caucus were discussed. Of note, Dr. Wright will be running for ASA Assistant Treasurer in 2022 and is currently unopposed.

Section on Fiscal Affairs (SFA):

Drs. Kercheville and Wright also participated on Friday afternoon before the Board Meeting in the monthly budget meetings of the SFA. A substantial portion of the meeting consisted of presentations and recommendations by the ASA financial managers, DiMeo, Schneider & Associates. The ASA investment portfolio remains strong and has rebounded following the “pandemic stock market crash”. Both the Schaumburg Headquarters and the Washington Office were discussed as avenues for cost cutting as both have less utilization since the pandemic and most likely there will be more “working from home” in the future. A sublease of space in the Washington Office has already occurred and will go into effect later this year.

Dr. Wright gave an update on the “membership retention” subgroup that is looking at methods and programs to prevent membership falloff especially among younger members and in particular recent transitional members from resident to active status. The group is looking at reduced rates for early membership or membership “bundles” to include CME packets and registration in virtual meetings.

Morning and Afternoon Educational Sessions:

President Dr. Beverly Philip convened the Morning Educational Meeting at 8:30 AM on Saturday and gave a brief recap of activities within the Society since the last Board meeting and actions taken by the Administrative Council and Executive Committee. Mr. Paul Pomerantz, ASA CEO then reported that membership as the major source of revenue continues to be of concern. Currently, annual renewals are behind previous years and projections.

The morning education session began with a financial update from Drs. Don Arnold (MO), Treasurer and Jay Mesrobian (WI) and a summary of the 2020 fiscal year. ASA ended 2020 with a $1.4M operating budget despite operating revenue being almost $10M lower than budget. In 2020, the ASA adhered conservative revenue outlooks and proactive cost mitigation strategies during a time of uncertainty. Revenue was decreased due to the inability to hold in person meetings, decreased membership as physicians and practices joined at lower rates. The virtual meeting exceeded break even expectations, generating a profit of $0.7M vs historical levels of $3M. Education sales rebounded and were 98% of budget. Expenses were lower due to a lack of spend on in-person meetings, travel and proactive steps to reduce staff and vendor costs. Net assets increased $3.9M, driven by investment gains of $6.8M and partially offset by an operating deficit of 2.5M, which includes $3.2M of depreciated net assets. Available unrestricted reserves are up $5.4M from year end 2019, reflective of investment gains.

After the financial update, Drs. Elmassian (MI) and de Lanzac (LA), ASA Secretary and Assistant Secretary, presented. The title of their presentation was “Membership: How You Can Help” The primary theme focused on membership being everyone’s responsibility and that as members of the ASABOD it is our responsibility to engage in bringing members to the ASA. Continued efforts remain on members and encouraging component societies to be a part of the process. State components should engage in conversations with residency programs and group practices in their communities to speak to the importance of engagement. The ASA has a group practice and resident talking points toolkit to assist component society members that engage in presentations.

The ASA Committee on Communication discussed the “Made for this Moment Campaign” that the ASA is developing with the goals to protect and preserve the specialty. Through a sustained, holistic campaign the ASA wants to raise the volume of ASA’s collective voice and effectively position and promote ASA’s agenda to increase awareness of the specialty’s role in health care, engage policymakers and health care executives given the growing need to educate and persuade them and combat aggressive scope of practice efforts by nurse anesthetist. The target audience include policy makers, health care executives, and ASA members. The final component of the morning’s education session discussed the ASA website’s (www.ASAHQ.org) new navigation and menu to make the site more user friendly.

The afternoon session began with a presentation by a representative from Tecker Internaction, LLC discussing “Best Practices for Boards”. He led an excellent presentation on the unique role of associations for successful boards in today’s environment. He discussed the strategic and fiduciary responsibilities of board members and the relationship amongst board members with membership, staff, and committees. Next Dr. William McDade, anesthesiologist and Former AMA Trustee, and current Chief Diversity Equity Inclusion Officer at the ACGME, gave an outstanding presentation on DEI in graduate medical education and important steps for board members to consider in engaging in the next steps for DEI in organizations. Finally, a presentation on the AQI and update on the progress and strategic planning of the future of AQI was presented by the Drs. Mueller, McCormick, Guffey, and Schmitz.

Board Review Committees:

Review Committees began at 11:00 AM and concluded at 1:30 PM. These consisted of reports from committees under each of the following divisions of the Board of Directors:

Committee on Administrative Affairs
Committee on Professional Affairs
Committee on Scientific Affairs
Committee on Finance
Drs. Kercheville and Wright both served as members of the Board Committee on Finance.

Meeting of the Board of Directors:

The Board of Directors convened at 10:31 AM on Sunday, March 7th and following the Pledge of Allegiance and morning announcements, Dr. Philip turned the order of business over to the Speaker, Dr. Ronald Harter (OH). As with all new format meetings, it began with a recap and explanation of speaking from the floor, making motions, calling questions and voting on the virtual platform.

Items of interest included:

  • 150-2 (AA) Secretary: Representatives to External Organizations. This report contained the appointments from the ASA to various external organizations. It was amended by the Review Committee to delete the reappointment of Dr. James Grant (MI) as chair of the delegation to the AMA for reconsideration at the August Board Meeting. Various members testified to concerns regarding Dr. Grant’s perceived conflicts of interest with his new employment with BCBS.
  • 300-1 (AA) Administrative Council: Interim Report. This report contained the recent request for the authorization of a board designated fund of $500,000 for a possible legal response and a targeted communication campaign to counter the recent name change and branding by the American Association of Nurse Anesthetists (AANA). Effective July of this year, the AANA will now be called the American Association of Nurse Anesthesiologists. This was funding approved.
  • 605-1 (PA) California Society of Anesthesiologists: Interim Report. This report contained a recommendation to amend the ASA Statement on Fatigue, approved by the 2019 House of Delegates. Due to concerns about the reference to fatigue and blood alcohol levels, the statement was amended from “Sleep deprivation impairs performance and 24-hours of wakefulness have been shown to be equivalent to a blood alcohol of 0.1” to “Twenty-four hours of wakefulness have been shown to impair performance.”. The Statement will remain unchanged until this amendment is approved in October by the HOD.
  • 687-2 (FI) Treasurer: Current Year Budget (2021). The current budget of $42.8 million in revenues and $46 million in expenses with a $3.3 million projected deficit was accepted for information.

Dr. Philip adjourned the ASA Interim Board Meeting at 11:30 AM after all items in the reports were accepted or had action taken and all the business of the meeting was deemed complete.