TSA President's Acceptance Speech
Amr E Abouleish, MD, FASA
TSA President 2024-2025
Thank you.
I am very honored that you chose me to be your President this upcoming year.
In these remarks, my goal is to communicate my overall vision for TSA and the year to come. I do not plan on repeating my President-elect report. For more details about the issues I will discuss, I refer you to the excellent committee reports in the House of Delegates handbook.
Amr E Abouleish, MD, FASA
Houston
The TSA’s Purpose Statement is: “It shall be the purpose of the Texas Society of Anesthesiologists to advance, promote, and support the practice of the medical specialty of Anesthesiology in the State of Texas.” I want to note that the TSA is doing this because we believe it is best for “Patient Safety.” In our new logo, you will see that we included “Physicians for Patients” to emphasize Patients. Therefore, promoting patient safety will be a guiding principle for me when making decisions.
In my lectures on economics, I often use the saying: Healing is an Art, Medicine is a Science, and Healthcare is a Business. Patient safety is found in all three parts of this saying.“Healing is an Art” means we must engage and participate in direct patient care. I know that the safest anesthesia care is when an anesthesiologist is involved in the care, has evaluated and communicated with the patient in the pre-anesthesia period, is involved with the anesthesia care, and is available to intervene in the post-anesthesia period. This view is consistent with Texas law, and the positions of the TSA, Texas Medical Association (TMA), ASA, and World Federation of Societies of Anesthesiologists (WFSA). It is clear from the strong interest in our specialty by medical students and the enthusiasm of our residents that TSA anesthesiologists throughout the State of Texas are demonstrating the art of healing every day to the next generation.
For “Medicine is a Science”, we must continue to improve our knowledge and make anesthesia even safer. As physician anesthesiologists, we are the anesthesia clinicians who have and continue to do this vital work. We must continue to support and promote our academic mission. We must show the value of continued science and discovery to the public, regulators, and, especially, facility decision-makers, who seem only to value the clinical mission.
We all understand that “Healthcare is a Business”. In our current economic situation, there are urgent challenges and long-term challenges to anesthesiologists and anesthesiology groups. Medicare's low payment rates for anesthesia services are a long-standing economic challenge to our specialty. In the last couple of years, the flawed implementation of the No Surprises Act (NSA) and the Independent Dispute Resolution (IDR) process has had negative economic impacts. This past year, we have seen Insurance companies become even more emboldened by the flawed NSA and IDR process. They have started implementing unilateral changes in payment policies. On the other hand, the TMA lawsuits continue to be won in the courts, and we hope it will lead to substantive changes in the implementation of the NSA and IDR process.
The good news is we are fortunate to have Texas anesthesiologists in leadership positions inside and outside anesthesiology. At the ASA, we are fortunate to have Pat Giam, who will become ASA President-Elect in October, and Crystal Wright, who will become ASA Treasurer then. We have also been well represented at the ASA Board of Directors by Scott Kercheville for over a decade. In October, George Williams will become your ASA Director. TSA and all our members are grateful to Dr. Ray Callas, a former TSA president, and the current TMA president. He continues to lead the efforts in the upholding of patient safety and physician-led care. Elizabeth Rebello is a leader in Anesthesiology safety and a Board Member of Anesthesia Patient Safety Foundation. She will also be the chair of the ASA annual meeting organizing committee when the ASA will hold its annual meeting in 2025 here in San Antonio. Tom Olverison, is a prominent state representative and committee chair. John Zerwas is the University of Texas System’s Executive Vice Chancellor of Health Affairs. Sherif Zaafran and, now, Zach Jones, are leaders on the Texas Medical Board.
Within TSA, no one person can do the work or lead our society. Fortunately, TSA work is truly a team sport. So, before going any further, I want to recognize our dedicated staff who hear our vision and make it a reality. So let me stop and recognize our TSA staff –Chris Bacak (Executive Director), Judy Garcia-Bigger (Associate Executive Director), Elizabeth Farley (Governmental Affairs Director), Jasmine Owen (Governmental Affairs Associate), Jessica Shepherd (Executive Associate), Clayton Devin (Legal Counsel), and Claire Foster (Social Media Associate). The TSA is a volunteer organization. I am very thankful for all the time and effort so many give to our society. Your officers, board of directors, and committee chairs help lead TSA. I am also appreciative to all members who are part of our committees. We have a lot on our plate in the upcoming year. I am genuinely thankful this is a Team Sport. TSA is fortunate to have so many of you who are involved and willing to do the work needed. Thank you.
Although I will refer you to the many reports in the House of Delegates handbook for details of activities, challenges and the upcoming year, I will highlight several things.
Advocacy is vital. Some of our members shy away from advocacy and say they dislike getting involved in politics. My response to them is “Who should lead in the development and implementation of health policy?” The answer is obvious – Physicians! Otherwise, others will make policies that will control how we practice. So my response to those that look down on advocacy is that instead I ask them to get involved in health policy discussion, development, and implementation. In other words, get them involved with advocacy.
TSA advocacy and health policy are truly a group effort, involving many people and committees, including the Government Affairs Committee, the TSA PAC, the Key Contacts Committee, the Communications Committee, the Economics Committee, the Patient Safety and Medical Quality Committee, and the Education Committee.
We will be communicating more on the issues as the year progresses. For now, I am creating a call to action for the TSA Delegates:
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Go back to your departments and talk with your colleagues about legislative and health policy issues.
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Contribute to the TSA PAC .. and get your colleagues to contribute.
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Look for email blasts throughout the year – we need help in the legislative year to have members contact their representatives.
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Save the date for TSA Capitol Days – February 24-25, 2025– ask for the time off NOW. Because there are so many new legislators and staff this year, we need as much help educating them on the issues.
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Join TMA – they are protecting patient safety and physician led care.
TSA is much more than simply advocacy. This year, you will see a new website unveiled. Our communication committee is in charge of the new website and will work with other committees to make the website more accessible to use, and informative. The committee is also involved with social media presence. Our TSA newsletter and the editorial board must be recognized for creating a fabulous newsletter. The “On the Shoulders of Giants” series is a wonderful and informative series. If you have not read them, you should! I hope we do a better job of informing our members of the articles when they come out. On the educational front, several committees are involved – including the educational committee, resident and medical student education, practice management, and the newly formed TSA Meeting Organizing Committee. The Patient Safety and Medical Quality Committee has reorganized into subcommittees to provide members more opportunities to get involved with TSA. And the TSA does even more.
You don’t have to wait a year if you want to help but are not on a committee or subcommittee. Much of the committee work is done virtually – via emails and Zoom meetings. Email the current committee chair to express your interest and ask to be added to the list serve. If you are interested in being on a subcommittee, contact the committee chair or subcommittee chair. I am happy to appoint more people to subcommittees this year. In other words, get involved this year! And then apply to be on the committee next year. More importantly, if you have colleagues who want to become involved and are unsure how, these steps are a great way to get started. The more our junior colleagues are involved in TSA, the better our society today and in the future. We need to all be looking at developing our future leaders.
TSA is a society of ANESTHESIOLOGISTS – As an organization, we need to make sure we support the individual members. The ASA Statement on the Fundamentals of a Safe and Healthy Workplace compiles existing ASA statements and recommendations on what anesthesiologists should expect in a safe and healthy workplace. We need to create a way for TSA to recognize employers (groups, companies, facilities) who support and have policies consistent with the ASA statement. In this way, if you are trying to decide between two different employment opportunities, and one supports the ASA statement, and one does not, you can make a more informed decision. Peer-to-Peer support is important to combat the second victim syndrome. My hope is at next year’s annual meeting, we can offer a train-the-trainer session to allow you to start your own program at your facility. The workforce shortage is on everyone’s mind, and it can lead to burnout if it is not addressed. One of the ways to address the shortage is to increase the number of anesthesia clinicians in our state. If our CAAs can be licensed, groups can better recruit CAAs from outside Texas and help reduce the shortage. For this reason, CAA licensure is one of TSA’s legislative priorities.
My final ask for you today is to ensure everyone you work with is a TSA member.
Before I finish, I want to make some personal comments. I am honored to be a TSA member and a TSA leader. I have been a member of TSA for over 30 years and have found our society and its members very inclusive. We work together for the betterment of our patients and specialty. We do this despite having different backgrounds, political views, or faiths. We always return to doing what is right for the patient.
I have been supported by many in my career. I want to thank my UTMB family, my TSA colleagues, my parents—Atiya Abouleish and my late father, Dr. Ezzat Abouleish—and my family—my wife, Dr. Lamia Elerian, and my children—Kareem, Ayman, and Sharif—who are in the audience today. Thank you all.