I would like to thank the SCSA for allowing me to be a delegate to the 2011 ASA annual meeting, and will briefly summarize my experience.

Chicago was the site of the 2011 ASA annual meeting. I probably should have stayed closer to the convention center. The shuttle bus route 3 picked up right outside of my hotel, but the waiting on the bus and the actual bus ride, ate up a lot of my time. I usually had to wait 10- 20 minutes for the shuttle to arrive, and the shuttle ride took 25 minutes to get to the convention center. At past ASA meetings the shuttle was more frequent and much quicker. The convention center was very spread out and I really did not think it was very well suited for a meeting this big.

The Southern Caucus met Saturday for 2-3 hours and again Tuesday for 3 hours. The caucus met in a room that was too small to seat everyone and as usually occurs at most political meetings, the same people controlled the conversation. On Saturday the topics of interest included the following:

1. The officers to be elected dropped by for an introduction.
2. A proposal for the ASA to teach a course on deep sedation to physicians other than anesthesiologists, including rescue from general anesthesia, was discussed. I think most members of the caucus were against this proposal but the ASA leadership seemed to support it. The southern caucus was either against teaching this to other physicians or they wanted propofol excluded.
3. A seal of quality initiative was introduced. The ASA would charge practices to obtain this seal, and each practice would be inspected by the ASA and approved at a gold or silver level, or disapproved. Each practice would have to pass numerous inspection points similar to a JACHO inspection. The initial reaction to this was mixed.
4. The budget was introduced which included a 25$ dues increase.
5. A proposal to make Mr. Thorner CEO instead of whatever title he already held was discussed. The CEO would report to the President and the board of directors and would be under them. Metrics will be written and if the CEO does not meet those metrics then in a year a national search will be undertaken to find a new CEO. The reaction in the caucus was tepid.
6. A proposal suggesting the routine use of ultrasound when placing a central line was brought forth as a guideline. There was pro and con discussion.

I left the caucus meeting on Saturday somewhat disappointed thinking that the ASA was going to teach other physicians to do our job which would ultimately lead to CRNAs working in the GI lab, Cath lab, and radiology without anesthesiologist medical direction. I was disappointed in the seal of quality program as another unnecessary beaurocracy, and I felt that ultrasound was going to be a requirement for central line placement. I also felt that the officer’s opinion on most issues did not reflect those of private practice anesthesiologists.

The HOD meeting was on Sunday morning and consisted of recognizing the officers to be and certain award winners.

The reference committees met after the HOD meeting that afternoon. I attended the professional affairs committee so that I could hear the discussion on the deep sedation program, central line placement, and the seal of quality. The discussion was heated and lengthy. Both side made some good points.

Tuesday afternoon 3-6 PM the Southern Caucus met again and discussed the reference committee reports and was introduced to the candidates for the new vice president. Jane Fitch and Bob Johnstone were the candidates and the caucus seemed to overwhelmingly support Jane Fitch. She is a former CRNA and might be a useful person to testify in our state during the next scope of practice battle.

Tuesday evening the SC delegation and 2 residents had dinner at the Rosebud. Dinner was very nice and I thank Chris for setting it up. The food was excellent and it was great to talk with everyone.

Wednesday Morning the HOD met again from 8-1115 am. The current officers moved up one notch and Jane Fitch was elected as the new 2cd VP. Then the reference committee reports were brought up individually. The deep sedation course for non anesthesiology physicians was referred back to committee so it is on hold for another year. This required a >75 % vote which was barely obtained. Some of us were afraid if it can to an up/down vote that it might pass and I did not want that to happen. Propofol was removed from the course but it was referred anyway. The seal of quality program was defeated. Everything else passed with minimal discussion. The dues increase which was included in the budget was passed with the budget.

Overall, this was a good experience for me, and if I am allowed to participate again in the future, I will certainly know what to expect and be more comfortable being a delegate. It did take a little more time than I anticipated, but it was for the most part, interesting.

Respectfully submitted,

Stan Ulmer, MD

October 21, 2011

interesting to see how the ASA's governing body functions.  Stan's excellent

report covered the major articles of discussion.

There were a couple of PAC accolades:  MUSC once again had 100% resident

participation.  Additionally, the Southern Caucus received the Alabama Cup

Special Distinction Award by accounting for 38% of ASAPAC contributions (31%

participation - still some gains to be made).

Guidelines for Pediatric PONV were referred to committee, so we likely will be

seeing those again next year.  While I do not agree with the Deep Sedation

training that was referred to committee, and would have preferred to see it

defeated outright, keeping it from a certainly contentious and potentially

passing vote seemed the best course.

Some of us in the HOD had interest in reopening discussion of the dues increase

after the budget was passed, however this was voted down.

Respectfully submitted,