summer 2016 asa rc newsletter - american society of .../media/sites/asahq/files... · internal...

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asahq.org Summer 2016 ASA Legislative Conference Recap I recently was afforded the opportunity to a4end the ASA Legisla9ve Conference in Washington, D.C. as part of the Florida Delega9on. This was my second trip to the Legisla9ve Conference and it could not have been a be4er experience! It was a jam-packed two and a half days, filled with engaging talks from some of our na9on’s poli9cal leaders as well as a number of very produc9ve mee9ngs on Capitol Hill with our state’s legislators. I’d like to review the events of the conference followed by what I believe to be the most important messages that I’ve brought home to share with my colleagues. The conference began on Monday with a review of the structure and organiza9on of the legisla9ve branch, legisla9ve process, and general guidelines to a successful Hill visit by Nora Matus, ASA’s Director of Congressional and Poli9cal Affairs. Jason Hansen, ASA’s Director of State Affairs, then provided a wonderful overview of current state topics including opt-outs, pain medicine, anesthesiology assistants, and truth in adver9sing. This was followed by an interac9ve panel on advocacy skills led by Dr. Kenneth Elmassian, Dr. John Zerwas, Dr. Tom George, and Dr. Sam Page. Drs. Zerwas, George, and Page shared stories reflec9ng on their 9me spent as state representa9ves in Texas, Michigan, and Missouri respec9vely. Monday’s session concluded with an interac9ve panel on state topics led by Dr. Erin Sullivan, Dr. Sherif Zaafran, Dr. Randall Clark, and Dr. Jeffrey Plagenhoef covering out-of-network payments, anesthesiology assistants, and upcoming state advocacy priori9es. Tuesday morning kicked off with physician anesthesiologist and U.S. Congressman Andy Harris, member of the U.S. House Commi4ee on Appropria9ons, providing an insider’s update on healthcare topics being discussed on Capitol Hill. Among other things, he emphasized the VA Nursing Handbook; growing na9onal health expenditures and their effect on the federal budget; the importance of biomedical innova9on; the Affordable Care Act; drug shortages; and looking ahead to the 2016 elec9ons. Congressman Harris was followed by Manuel Bonilla, ASA’s Chief Advocacy Officer, who prepared a4endees for our Hill mee9ngs. Michael Bobcelli, Director of the White House Office of Na9onal Drug Control 1 Run for Office Call for applica9ons for the 2016-2017 Resident Component (ASARC) Governing Council - Due September 1, 2016 Interested? Click here or visit the ASA Resident Component Website The ASA Resident Component hopes you will join us in support of our three primary goals: 1. To encourage resident par9cipa9on in ASA Join ASA and learn about the ASA Resident Component Get involved in the ASARC Run for an office on the Resident Component Governing Council Mee9ng and event informa9on 2. To develop experience in organized medicine among young physician leaders • Become a leader: ASARC leadership opportuni9es are available • Publish your thoughts: Write a Resident Review ar9cle for the ASA Monitor • Apply for the Resident Research Essay Contest 3. To improve resident awareness of the ASA’s role in the evolu9on of the specialty of anesthesiology • View informa9on on residency and fellowship opportuni9es • Discover a wealth of resident resources and links Learn about the ASAPAC and help increase your program’s par9cipa9on Single Graduate Medical Educa9on Accredita9on System The Official Newsletter of the ASA Resident Component NEWSLETTER Connect with ASA on LinkedIn , Facebook , Twi/er and YouTube

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Page 1: Summer 2016 ASA RC Newsletter - American Society of .../media/sites/asahq/files... · internal review and on September 1, 2015 published “Assessment B” which iden9fied 12 special9es

asahq.org Summer 2016

ASA Legislative Conference Recap Irecentlywasaffordedtheopportunitytoa4endtheASALegisla9veConferenceinWashington,D.C.aspartoftheFloridaDelega9on.ThiswasmysecondtriptotheLegisla9veConferenceanditcouldnothavebeenabe4erexperience!Itwasajam-packedtwoandahalfdays,filledwithengagingtalksfromsomeofourna9on’spoli9calleadersaswellasanumberofveryproduc9vemee9ngsonCapitolHillwithourstate’slegislators.I’dliketoreviewtheeventsoftheconferencefollowedbywhatIbelievetobethemostimportantmessagesthatI’vebroughthometosharewithmycolleagues.

TheconferencebeganonMondaywithareviewofthestructureandorganiza9onofthelegisla9vebranch,legisla9veprocess,andgeneralguidelinestoasuccessfulHillvisitbyNoraMatus,ASA’sDirectorofCongressionalandPoli9calAffairs.JasonHansen,ASA’sDirectorofStateAffairs,thenprovidedawonderfuloverviewofcurrentstatetopicsincludingopt-outs,painmedicine,anesthesiologyassistants,andtruthinadver9sing.Thiswasfollowedbyaninterac9vepanelonadvocacyskillsledbyDr.KennethElmassian,Dr.JohnZerwas,Dr.TomGeorge,andDr.SamPage.Drs.Zerwas,George,andPagesharedstoriesreflec9ngontheir9mespentasstaterepresenta9vesinTexas,Michigan,andMissourirespec9vely.Monday’ssessionconcludedwithaninterac9vepanelonstatetopicsledbyDr.ErinSullivan,Dr.SherifZaafran,Dr.RandallClark,andDr.JeffreyPlagenhoefcoveringout-of-networkpayments,anesthesiologyassistants,andupcomingstateadvocacypriori9es.

TuesdaymorningkickedoffwithphysiciananesthesiologistandU.S.CongressmanAndyHarris,memberoftheU.S.HouseCommi4eeonAppropria9ons,providinganinsider’supdateonhealthcaretopicsbeingdiscussedonCapitolHill.Amongotherthings,heemphasizedtheVANursingHandbook;growingna9onalhealthexpendituresandtheireffectonthefederalbudget;theimportanceofbiomedicalinnova9on;theAffordableCareAct;drugshortages;andlookingaheadtothe2016elec9ons.CongressmanHarriswasfollowedbyManuelBonilla,ASA’sChiefAdvocacyOfficer,whoprepareda4endeesforourHillmee9ngs.MichaelBobcelli,DirectoroftheWhiteHouseOfficeofNa9onalDrugControl

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Run for Office

C a l l f o r a p p l i c a 9 o n s f o rt h e 2 0 1 6 - 2 0 1 7 R e s i d e n tComponent (ASARC) GoverningCouncil-DueSeptember1,2016

Interested? Click here or visit theASAResidentComponentWebsite

TheASAResidentComponenthopesyouwilljoinusinsupportofourthreeprimarygoals:

1.Toencourageresidentpar9cipa9oninASA •JoinASAandlearnabouttheASAResidentComponent•GetinvolvedintheASARC•RunforanofficeontheResidentComponentGoverningCouncil•Mee9ngandeventinforma9on2.Todevelopexperienceinorganizedmedicineamongyoungphysicianleaders•Becomealeader:ASARCleadershipopportuni9esareavailable•Publishyourthoughts:WriteaResidentReviewar9clefortheASAMonitor•ApplyfortheResidentResearchEssayContest3.ToimproveresidentawarenessoftheASA’sroleintheevolu9onofthespecialtyofanesthesiology •Viewinforma9ononresidencyandfellowshipopportuni9es•Discoverawealthofresidentresourcesandlinks•LearnabouttheASAPACandhelpincreaseyourprogram’spar9cipa9on•SingleGraduateMedicalEduca9onAccredita9onSystem

The Official Newsletter of the ASA Resident Component

NEWSLETTER

ConnectwithASAonLinkedIn,Facebook,Twi/erandYouTube

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asahq.org Summer 2016

Policy,thenspokeabouttheongoingopioidepidemicandwhatisbeingdonetofightit.WeheardfromCongresswomanJuliaBrownley,co-sponsorofthebipar9sanBenishek(R-MI)-Brownley(D-CA)le4ercallingformaintenanceofthephysician-ledanesthesiacareteamwithintheVA.LarrySabato,Founderof“Sabato’sCrystalBall”andDirectoroftheUniversityofVirginiaCenterforPoli9cs,thengaveahighlyentertainingoverviewofthestateofthepresiden9alelec9on.Thealernoonwasfast-pacedwithaseriesofexcellentspeakers.Dr.StanleySteadspokeonevolvingadvocacychallengesinanesthesiology.CongressmanJohnNygren(R-WI)sharedhisstate’sba4leagainsttheopioidepidemic.DianeZuma4o,Na9onalLegisla9veDirectorforAMVETS,gaveanimpassionedspeechsuppor9ngASA’sstanceontheVANursingHandbook.Dr.DouglasFridsma,presidentandCEOoftheAmericanMedicalInforma9csAssocia9on,discussedalterna9vepaymentmodelsandqualityrepor9ng.ASAPastPresidentDr.AlexHannenbergbrokedownthehighlycomplexMACRAhandbook.Finally,thealernoonconcludedwithsomeadviceon(cont’dnextpage)

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Write for the ASA Monitor

We are accepting submissions for the "Residents Review" section of the ASA Monitor.  If you are interested in writing an article, please submit the following:   • Topic or possible title of article, and • Sample paragraph   Potential authors do not need to submit the entire piece, although we will accept full articles as well. Mark and I are happy to help edit and develop your idea if needed.  Articles are typically 1000-1500 words.  Please visit the ASA website to view our most recently published articles and to get a sense for what we publish.     We look forward to hearing your ideas!   Sincerely,   Elena Koepke M.D., M.B.A.  Junior Editor, ASA Resident Component Governing Council UT Southwestern Medical Center Department of Anesthesiology and Pain Management [email protected]   Mark Jensen, M.D. Senior Editor,  ASA Resident Component Governing Council SUNY Downstate Department of Anesthesiology  [email protected]

The American Society of Anesthesiologists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This live activity has been approved for 42 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Register today and savegoanesthesiology.org

Be part of the Residents and Fellows Track designed based on where you are in your academic journey.

• Engage with 15,000 anesthesia professionals from around the globe.• Take part in world-class education from thought leaders in the specialty.• Enhance your professional skills.

NEW! Residents’ Leadership WorkshopDo you have what it takes to be an effective leader? This session will explore leadership styles, skills and goals. Engage in discussions and small group activities.

NEW! Subspecialty Panel – Fellowship or Not?Subspecialists representing major anesthesiology fellowships such as pediatric, OB, critical care, cardiothoracic, regional and pain management will present an overview of their subspecialty practice. Get answers to your questions regarding subspecialty training impact on patient safety, the pros and cons of their subspecialty training, practice and job perspectives.

Resident Written Board PrepDiscover the most challenging concepts including frequently missed items (keywords) from the 2016 in-training examination, divided into basic and advanced topics by the ABA. Gain insights from facilitators about study strategies and discuss available study resources and test-taking tips.

Save $100 on registration when you book your hotel room through the ASA housing block.

ASA Membership Matters! Attend ANESTHESIOLOGY 2016 at no charge when you become an ASA member and register online.

Early-bird

rates end

July 24!

Join the conversation #ANES16

Come Together for a Cause

Enjoy a night of fundraising, food and fun with friends benefiting the Anesthesia Patient Safety Foundation, ASA Charitable Foundation, Foundation for Anesthesia Education and Research, and the Wood Library-Museum of Anesthesiology

Hyatt Regency Chicago, Grand BallroomSunday, October 23, 6-10 p.m.

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effec9vemessagedeliverybyTheresaHill,ASA’sDirectorofPublicRela9ons,andLeighWagner,SeniorVicePresidentofPublicCommunica9onsInc.AllASAPACdonorsweretheninvitedtoarecep9onattheUnitedStatesBotanicGarden.

WednesdaywasourdayonCapitolHill,whereourbusyFloridaDelega9onwasabletomeetwithfourteenstaterepresenta9ves!

I’dliketoclosewithwhatIconsidertobethetakehomemessagesfromthisvisit.First,andmostimportantly,ourprimaryfocuswasontheVANursingHandbook-nowofficiallyreferredtoastheAPRNProposedRule-whichcompleteditsreviewwithintheOfficeofManagementandBudgetandonMay25waspostedtotheFederalRegistry,openingupthepubliccommentperiod.Forthoseofyounotasfamiliarwiththisissue,allowmetopresentthreefacts:FACT#1:ThisrulewouldrequireCRNAstoprac9ceindependentlywithintheVAsystem,completelyremovingphysiciansfromtheanesthesiacareteam.YouandIwouldnolongerbeinvolvedinthedeliveryofanesthesiatoourna9on’sveterans.FACT#2:Therearenoissueswithaccesstophysician-ledanesthesiacarewithintheVAsystem.

ThoseinfavorofmakingCRNAsindependentaretryingtopushtheissueforwardbyci9ngissueswithaccesstocare.Thisissimplyfalse.Whilewell-publicizedissuesareplaguingveterans’accesstoprimarycareaswellaspsychiatriccare,therearenoaccessproblemswithinourspecialty.TheVAconductedanindependentinternalreviewandonSeptember1,2015published“AssessmentB”whichiden9fied12special9eswithprovidershortages–anesthesiologywasNOToneofthem.Addi9onally,onDecember10,2015theVAreleaseditsannual“MissionCri9calOccupa9onsReport”whichiden9fiedthetenhighestrankinghard-to-filloccupa9onsintheVHA.Neitherphysiciananesthesiologistsnornurseanesthe9stsappearedonthatlist.FACT#3:Thisisnotaboutscopeofprac9ceorsomean9-nurse“turfwar”.

Thisisaboutpa<entsafety.Wearetheul9matepa9entadvocatesanditisourdutytoensurethatourna9on’sveteransreceivethebestandsafestanesthe9ccare.IpersonallyserveintheU.S.AirForce.Iknowsomeofyouserveaswell.Someday,IwillbereceivingmycarethroughtheVAhealthsystem.Iwillexpecttohaveaphysicianoverseeingthemostdangerousthingthatoccursinmedicine:induc9onofamedicinalcomawhileassumingcontrolofmyphysiologicfunc9ons,onlytobringmebacktomybaselineattheendofit.Thisisthestandardofcarethatourcivilianpa9entsexpect.Ifyouhavenotyetvisitedwww.safevacare.org,Iimploreyoutotaketwominutesrightnowanddoso.Onceyouhavedoneso,encouragefiveotherpeople–familymembers,friends,coworkers,todothesame!OnJuly25thepubliccommentperiodwillendandthedecisionwillbemadebyweighingthesecommentspostedonthefederalregistry.

Thesecondtakehomemessagefromtheconferenceisthatifanissuepopsupinyourstate,chancesareithasbeenalreadybeenbroughtupinanotherstatebefore.JasonHansen’steamdoesamazingworkandcanprovideyouwithinforma9onandguidanceonhowitwashandledelsewhere,sousehisteamasaresource!

Lastly,abitofhomework:Therearealimitednumberofcongressionalcommi4eesthatdirectlyoverseeand/orregulatehealthcarepolicy,sorepresenta9vesonthesecommi4eescanbepar9cularlypowerfulallies.IntheHouse,thesecommi4eesare:theCommi4eeonWays&Means;theEnergy&CommerceCommi4ee;andtheCommi4eeonVeterans’Affairs.IntheSenate,thesecommi4eesare:theCommi4eeonFinance;theCommi4eeonHealth,Educa9on,Labor,andPensions(HELP);andtheCommi4eeonVeterans’Affairs.Ifyouhaveacongressmanorcongresswomanononeofthesecommi4eespleasereachouttothemtodayandmakeyourvoiceheardregardingtheAPRNProposedRuleandaskthemtosignontotheBenishek(R-MI)-Brownley(D-CA)le4er!Thelistofcommi4eesandmemberscanbefoundath4ps://www.govtrack.us/congress/commi4ees.

Shane Cherry, M.D. CA-3, University of Miami Health System [email protected]

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asahq.org Summer 2016

LIFEBOX ChallengeItisnearlyimpossibletolisteverythingASAdoesforusas resident physician anesthesiologists;we olenwriteyouwithentrea9estosupportitsworkonourcollec9vebehalf, whether those efforts pertain to educa9on,advocacy, career planning or other areas that directlybenefitmembers.

Today,we'dliketoaskforyoutopar<cipateinoneofthe most important and successful charitableini<a<ves of the ASA - the ASA Resident LifeboxChallenge.

Lifebox Founda9on is an interna9onal organiza9ondedicated to making surgery safer in low-resourcecountries; the ASA Resident Lifebox Challenge isspecifically focused on providing all opera9ng roomsworldwide with pulse oximeters and training inoximetry. Itcostsamere$250topurchaseoneLifeboxpulse oximetry package, which includes the oximeteritselfaswellasmul9-languagetrainingmaterials.

The Challenge raised roughly $25,000 last year, but,withyourhelp,wecandoevenbe4er.Ifeveryprogramcouldraise just$250,we'dhavemorethan$35,000tomake global surgery safer—think of all of the pa9ents

wecouldhelp!

Thereareseveralwaystopar9cipateinthechallenge: 1 Submitasanindividual;or 2 Collect group dona9ons at an organized event.

Think crea9vely: golf tournaments, bake sales,rafflesorevenapparelsaleshaveworkedinthepast.

Thereisalsoanewstudentsandtraineessec9onoftheLifeboxwebsite.Whatevermethodyouchoose,youcanmake your contribu9on at the official portal: h4ps://www.asacharity.org/donate?cid=2. Be sure to list yourresidency program in the tribute sec9on so that yourins9tu9oncanbecountedinthechallenge!

ContactLifeboxifyouwantinforma9onabouttheirworkor images for slides and presenta9on materials. Thechallenge ends September 1, 2016. The residencyprogramswith the largest overall contribu9on and thelargest contribu9on per resident will be recognized atthe ASA annual mee9ng in October. So, pool yourresources, get some recogni9on for your program, andhelpmakesurgerysaferworldwide!

Sincerely,HaleMcMichael,President-Elect([email protected])DanHansen,President([email protected])

Graduating Residents Resources

For those graduating residents going into practice or Fellowship, please

access our Young Physicians site to learn more about your ASA

membership, benefits and resources!

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TO THE NEXT GENERATION OF PHYSICIAN LEADERS I was recently invited to visit an academicanesthesiology department to speak to the residentsaboutbecomingaleader.Inaddi9ontorecognizingthehonor and privilege of addressing this important topicwiththenextgenera9onofphysiciananesthesiologists,Ihadtwootherini9althoughts:1)Imustbegebngold;and2)Thisisn’tgoingtobeeasy.

I cameupwitha short list of lessons that I’ve learnedover the years. While some examples I included areanesthesiology-specific,thelessonsthemselvesarenot.Pleasefeelfreetoedit,adapt,andaddtothislist;thendisseminate it to the futurephysician leaderswhowillonedaytakeourplaces.

1. First and foremost, be a good doctor. Alwaysremember that we as physicians take an oath. In themodern version of the Hippocra9c Oath commonlyrecited at medical school gradua9ons today, we say,“MayIalwaysactsoastopreservethefinesttradi9onsof my calling and may I long experience the joy ofhealing those who seek my help.” As a physiciananesthesiologist, we care for the most vulnerable ofpa9ents—thosewho under anesthesia cannot care forthemselves. Examples of anesthesiologistswho do nothonortheircallingexist inthenewsandevenscien9ficjournals,butwecannotfollowthispath.

Medicine is, and always should be, a calling.

2. Define your iden<ty. We live in the era of the“provider,” and this some9mes causes role confusionfromtheperspec9veofourpa9ents.Wealsodon’ttendto do ourselves any favors.Howmany9mes have youheard someone say, “Hi I’m [first name only] withanesthesia”? According to the American Society ofAnesthesiologistsnewsle4er,approximately60%of thepublicmaynotknowthatphysiciananesthesiologistsgotomedicalschool.Whileeverymemberoftheanesthesia

care team plays a crucial role, the next level of non-physician provider in this model has one-tenth theamount of clinical training when compared to aphysician anesthesiologist at gradua9on. I’ve wri4enbefore about what I l ove about be ing ananesthesiologist,andbeingthephysicianwhompa9entstrust to keep them safe during surgery is a privilegewhichcomeswithagreatdealofresponsibility.

3.Considerthe“bigpicture.”Thehealthcareenterpriseis constantly evolving. Today, the emphasis is on valueand not volume. Value takes into account quality andcost with the highest quality care at the lowest costbeing the ul9mate goal. The private prac9cemodel ofanesthesiologyhaschangeddrama9cally inthe lastfewyears with the growth of “mega-groups” created byver9cal and horizontal integra9on of smaller prac9cesand some9mes purchased by private investors. In thisenvironment, physician anesthesiologists andanesthesiology groups will have to consider ways theycan add value, improve the pa9ent experience, andreduce costs of care in order to stay relevant andcompe99ve.

4. Promote posi<ve change. Observe, ask ques9ons,hypothesize solu9ons, collect data, evaluate results,drawconclusions,andformnewhypotheses—theseareall elements of the scien9fic method and clinicalmedicine. These steps are also common to processimprovement, making physicians perfectly capable ofsystem redesign. The key is establishing your team’smission and vision, strategic planning and goal-sebng,and regularly evalua9ng progress. Books have beenwri4en on these subjects, so I can’t do these topicsjus9cehere.Inmyopinion,physiciansofferanimportantand necessary perspec9ve that cannot be lost ashealthcarebecomesmoreandmorebusiness-like.

5. Be open to opportuni<es. Thomas Edison said,“Opportunity is missed by most people because it isdressed in overalls and looks likework.” I havewri4enpreviouslyaboutthemeritsofsayingyes.Asaresidentornewstaffphysician, itolenseems impossible togetinvolved. However, most hospital commi4ee mee9ngsareopentoguests.Considergoingtoonethatcoversatopic of interest and volunteer for a task if theopportunity presents itself. In addi9on, manyprofessional socie9es invite members to self-nominatefor commi4ees or submit proposals for educa9onalac9vi9esattheirannualmee9ngs.

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asahq.org Summer 2016

6.Thankyourteam.Takingthefirststepsonthepathtoleadership is not going to be easy. Therewill bemanyobstacles,nottheleastofwhichis9memanagement.Ahigh-func9oning healthcare team of diversebackgrounds, skills, and abili9es will accomplish muchmore thanwhat an individual can do alone. Celebrateteamwins.Respecteach teammember’sopinionevenwhenitdiffersfromyours.

Always remember to thank your team, and do

it early and often. #leadership

Edward R. Mariano, M.D., M.A.S. Professor of Anesthesiology, Perioperative and Pain Medicine Stanford University School of Medicine @EMARIANOMD

Contact Your Resident Component Governing Council Daniel A. Hansen M.D. President ASA Resident Component Mayo Clinic Arizona [email protected]

Douglas Hale McMichael, M.D. President-Elect ASA Resident Component

Northwestern University - Feinberg School of Medicine [email protected]

Chad R. Greene, D.O. Secretary ASA Resident Component Vanderbilt University Medical Center [email protected]

Linda W. Young, M.D., M.S. Delegate to AMA Resident and Fellow Section University of Texas - Houston [email protected]

Michael C. Lubrano, M.D., MPH Alt. Delegate to AMA Resident and Fellow Section University of California - San Francisco [email protected]

Mark Jensen, M.D. Senior Resident’s Review Editor SUNY Downstate Medical Center [email protected]

Elena J. Koepke, M.D., M.B.A. Junior Resident’s Review Editor University of Texas Southwestern Medical Center [email protected]

�6Thank you for reading! If you are interested in writing for the newsletter, please email the ASA Resident

Component Secretary at [email protected]

NEW! ApplyToday

Duke University Medical Center

Now accepting applications for this interdisciplinary, transatlantic fellowship in perioperative medicine!

Duke Perioperative Medicine Fellowshipin collaboration with University College London

Start Date: July 2017

Interested? Email Dr. Tim Miller at [email protected]

for additional information.

TinyURL.com/DukePeriopFellow

University College London