Texas Society of Anesthesiologists

TSA President's Acceptance Speech

Crystal C. Wright, MD, FASA
Crystal C. Wright, MD, FASA
San Antonio

It is an honor for me to close this meeting with you all this evening.  You are on the frontlines of this pandemic and have been for over 18 months.  Thank you for your commitment to the patients that rely on our provision of care for them.  Thank you for also being here tonight. It goes without saying that stepping up to the plate and engaging in organized medicine even in the most difficult of times is a true testament to the passion you all have for our specialty.  Your presence and service to this organization is what makes the practice of Anesthesiology one of the safest specialties in medicine.

I would like to first thank Dr. Bryant for his leadership during an emotional year full of challenges and uncertainty. His strong leadership allowed our society to thrive during a time when anesthesiologists of Texas needed a strong society representing them and their patients.

I would also like to pay respect to one of our own who is not here today but who impacted myself and so many others with his generosity of being, steadfastness as a physician and loyalty. Last winter we lost Dr. Charles Cowles to a tragedy, but his spirit is still with us and the love he had for this profession will never be forgotten.

For those of you that don’t know me, my name is Crystal Wright.

Not only am I a Physician, but I am also a mother, wife, daughter, and friend. I enjoy the beach when time allows me to get to one. I enjoy traveling when time allows for that. But every day I enjoy being a mother to my two boys Andrew and Reid and wife to my husband, Dr. Randall Wright.

I also adore being a daughter and sister. I have many experiences to be grateful for along my journey, but I would fail if I did not first thank God for keeping myself, my family and you all safe during this past year.

At the age of 16 I knew I was called to medicine. It was a deep inner knowing that I was meant to serve, and I decided to answer that call to service in that of being a physician. I attended Baylor College of Medicine Medical School and got married somewhere in between that time of training.  After graduating from medical school, I remained at Baylor College of Medicine for residency and fellowship.  It was during my residency where I was introduced to the TSA and as the saying goes, the rest is history! 

As a resident I became passionate about advocacy and advocating for our patients. It was the mentorship of several past TSA presidents in this photo that had encouraged me to become involved in both the TSA and ASA. I can remember Drs. Giesecke, Mercier and Zerwas encouraging me to run in the ASA Leadership Council as a resident.  I can remember Dr. Giam as my attending in neuro anesthesiology giving me all sorts of advice on advocating effectively for our patients.  This is a picture of me representing the Texas Society of Anesthesiologists for my first ASA Legislative Conference in 2004.  

In this photo you can look and see a picture of our most recent surgeon general as a resident.  While the years have been kind to both of us, obviously one of us got a different invitation to The White House or just got lucky and just found a better seat?

After completing residency and graduating from my fellowship at Texas Heart Institute, I started my career at Baylor College of Medicine.

I was blessed to have a thriving career at BCM for 10 years. I am not only grateful for the experiences I had during that time, but I am tremendously grateful for the colleagues that I was able to strengthen relationships with.  After leaving BCM I went to MD Anderson Cancer Center. Thank you to my MD Anderson family for your support and encouragement as I begin my role as President of the TSA The colleagues that I work with are some of the most passionate clinicians that I know.  Thank you to all of you for what you have taught me over the past 5 years. To the leaders of our department, Dr. Hagberg, Dr. Rahlfs, and Dr. Soliz thank you for your unwavering support to allow me to pursue this role for our specialty.  

As an anesthesiologist in Texas, it is my great honor to lead this society of anesthesiologists into the change, as your president of the TSA. So, I humbly thank you all for the opportunity.  I recently read that No vaccine is going to take away the grief and trauma experienced by each of us during this pandemic. We all need to recognize that regardless of what our circumstances were over the past 18 months our lives have forever changed. Our values have changed. Our thoughts have changed.  There’s a saying that the world you live in is very different from the world you grew up in. The recent pandemic and its resultant life changing effects, make that statement, a truth at its core. The seismic shifts that have occurred in our society due to the past 18 months ensured that our world will be undeniably different.  I’d like to impart that saying into our lives as physicians; “The world we were trained in to practice medicine will be different from the world we actually practice medicine in.” I’d even like to take it a step further; “The world we practice medicine in will be different post pandemic”. The details of those differences are obviously unfolding but when we look back a few years from now those differences will be clear and the way we treat our patients will undeniably be different.

We are not a monolithic organization and as such I commend my former colleagues in their roles as president, to what they each brought into our organization, each adding dynamic vision to help us grow as a team and expand as a collective.

One example of this vision came from Dr. Callas when he recommended that we develop a text communication alert when advocacy for hot topics needed to be addressed.  As I pondered about our future it became clear we need to continue with the efforts of our former President Callas updating the TSA Website by furthering our ability to communicate our advocacy efforts.  It is imperative that we understand the value of enhancing our communication modalities. Our advocacy efforts are strong.  Effective communication efforts are critical to our patients and to other practicing anesthesiologists. One thing is for certain, Anesthesiologists were made known during the COVID19 pandemic.  We went from an unknown specialty to one that anyone that paid attention to the news knew what we did, and we should ensure that we continue to highlight what we do in the name of patient safety.  Our communication efforts should be a part of an ecosystem of transparency and trust for both internal members and the public. Healthcare legislation continues to be a key portion of the agenda at the State Capital.  As frontline physicians, we need to ensure that our patient safety advocacy efforts are being discussed with stakeholders to ensure that our messages are heard. I therefore, recommend that the Communications Committee and a triad of the committees involved in advocacy, the Governmental Affairs Committee, the Key Contact Committee, and the Political Action Committee, further enrich our communication efforts to patients, anesthesiologists, and other physicians through a quarterly TSA Health Policy podcast.

Through our robust advocacy efforts led by our advocacy triad, The PAC, The Key Contact and Governmental Affairs Committees making up the backbone of TSA advocacy efforts, we have amassed significant wins over the years, and we will continue to make that focus a part of the armamentarium of our efforts.

In addition to ensuring that our messages are reaching our stakeholders we need to continue to empower members of the TSA to effectively advocate on our issues.  I recommend that the TSA Advocacy Triad Committees of the Governmental Affairs Committee, PAC, and Key Contact Committee, develop a TSA Advocacy Bootcamp to conduct training of anesthesiologists in testifying and advocating for our patients.  A TSA Advocacy Bootcamp training will prepare our members when called upon to testify in front of legislatures, providing them with skills to advocate for our issues independently and effectively with state and national legislatures. 

We were also fortunate to have had the strong leadership from Dr. Joshi who acknowledged the strength of TSA, stating in his own Presidential speech and I quote “Our society is in great health, and I am sure other societies desire to emulate us”. This was true then and it is now, as proven in the published member survey, released in April 2021, illustrating an overwhelming desire to place additional emphasis on Education while embracing satisfaction on membership involvement.

We all play a part in the collective success of the organizational structure of the TSA, but the commitment and dedication of our TSA staff keeps the well-oiled machine running and I recommend acknowledgement of Chris Bacak and the TSA Staff for their unwavering commitment and dedication.  Chris Bacak holds a special place in my heart for the relationship that I have had the ability to develop with her since I started engagement in the TSA.

My professional life here at TSA, being mentored, guided, and coached, bridging the transition from Resident to now President, is a living testimonial to what authentic mentorship and allyship brings forth. That guidance is important for many reasons to help grow our residents into the patient centric, mentally strong, and whole-life balanced physicians that we need.  In a recent ASA Monitor article authored by me, Dr. Jennifer Root, and Dr. Erin Sullivan, we recognized the changing landscape of resident education.  Physicians are being called upon to engage outside of the scope of their daily medical practices.  As a society we must ensure that while our residents train to care for patients effectively and with empathy, they must also understand the value they bring to ensure that society understands what is essential for our patients and their safety.  The understanding of health policy begins in residency with the essential tools.  We have a dedicated and committed group of anesthesiologists that are engaged already in resident education and are passionate in the development of Anesthesiology Residents in Texas.  I therefore recommend that we transition the Sub-Committee on Resident Education to a standing TSA Committee on Resident and Medical Student Education.  

A large part of the success of TSA is the willingness to see beyond what is in front of us and delve into the roadmap of where we need to go.  Several past presidents were leaders in that vision, Dr. Arens and Dr. Kercheville, have imparted that wisdom to me through our involvement in the ASA and we need to continue to move it forward.    

The shadow side of the pandemic has also taught us not all patients feel they can trust medical experts and their recommendations, but often are unable to advocate for themselves because they do not understand their rights.  It is known that health literacy not only affects individuals’ perception and management of health status but also their health activities. Many people regardless of education or socioeconomic background are not clear on understanding health information. I know you agree with me, that every individual in America today should have access to care and should have a clear understanding of the care they are receiving.  Most of our advocacy efforts have focused on issues that protect ourselves and our patients; however, we have more opportunities to advance health care policy that will protect physician-led care and ensure that the communication of that care to our patients occurs effectively.  Serving as TSA president, I will lead the anesthesiologists of our state as we advocate for our specialty through the undeveloped pathways and forge a genuine connection that demonstrates our ability to take the perspective and empathize with others.

To do that the TSA must join in the national conversation in restoring that trust back to our patients.  As anesthesiologists, our engagement at both the State and National level with other organizations can allow us to be a part of that national conversation.  I recommend that the TSA’s Patient Safety & Medical Quality Committee develop a Transparency and Patient-Centered Health initiative.  We will accomplish this new long-term initiative through expanding communication modalities and public resources.  Understandably these are issues that are NOT going to be resolved overnight, but as physicians in Texas that are leaders in patient safety, we have an obligation to develop a short-term plan in conjunction with a long-term strategy to build trust, strengthen relationships and expand our integrity within the medical community.  To quote one of our own - Richard Dutton, Chair of the TSA Patient Safety & Medical Quality Committee our “Patients do better when they are treated by someone that looks like them and when effective communication is provided to them.” I believe that through consistent work led by TSA Patient Safety & Medical Quality Committee a strategic framework can be developed, and the TSA can be a part of that process.

A recent study suggests the state of Texas had more than a 30% increase in opioid usage in 2020. Although as anesthesiologists only a small demographic of us prescribes pain medication, it would be remiss to not acknowledge we are in a National Crisis in opioid overuse leading to addiction and death that has been exacerbated by the pandemic. In treating the whole patient, we also must acknowledge we should do everything possible to be a part of that solution.

I recommend that the TSA aligns with the ASA’s REVIVE me initiative. https://www.asahq.org/advocating-for-you/reviveme that has objectives of the REVIVE me initiatives are to educate the public and membership about naloxone availability and remove the stigma of addiction. The ASA will be reaching out to state societies for further support, and it is my recommendation that we align with the ASA and incorporate this into the TSA’s fight against opioid abuse.

In recognizing that the strength of the TSA lies in our diversity and highlighting the importance of the fact that we speak with one voice in patient safety, Dr. Debbie Plagenhoef during her tenure as President hosted the first TSA Women in Anesthesia breakfast and 5 years later this is still an integral component of the TSA Annual Meeting. As members of the Texas Society of Anesthesiologists collectively we have recognized the disparities in diversity equity and inclusion in Texas and amongst our physician colleagues.  It is imperative, I believe, that we continue to move forward and move the needle with healthcare disparities in Texas and support the future of Anesthesiologists from all backgrounds, ethnicities, and gender. The TSA has always been an inclusive organization that has always looked outside of ourselves to ensure the success of our fellow physicians and ensure equity in patient safety.  As we look to strengthen our steadfastness in maintaining diversity, equity, and inclusion let's continue to make it a visible aim for the organization.  I recommend that all TSA committees ensure initiatives related to diversity, equity, and inclusion for anesthesiologists and/or the diverse groups of patients we serve into their annual planning instead of calling for a separate DEI committee.

While we have moved the needle in past accomplishments till now and what we are able to envision for our future, each step we make has an impact on our patients, peers, communities, and families, from a fiscal, emotional, and physical perspective. I am a witness to the fact that I am not alone in taking this responsibility to heart, within the works I see from you my fellow colleagues, members, and friends.

As Former TSA President Dr. Mary Dale Peterson said last year in her Outgoing ASA Presidential speech, “we have been tested and we have passed the test, despite all of our economic and scope of practice challenges we have never wavered in the care of our patients”.

We are at the center of a mighty change, but we are ready to meet this change with a carefully calibrated playlist and dedicated team members executing the plays so we can move forward towards the goal line scoring a touchdown every time forging the genuine connections and empathy with those we serve. 

I value your trust in my ability to navigate us forward knowing I have your support through any challenges that will come.  I will continue to look to you for continued counsel and steadfast support for we are all collectively made up of vast information, incredible resolve and a determined Texas can Do.

Crystal C. Wright, MD, FASA
TSA President