Actively Engaged

As I reflect and write this article near the end of 2023, my thoughts turn to the quickening pace of activities as I have begun my service as ASA President-Elect. It has been a privilege to travel, meet, and work alongside many of you and to learn from your experiences and perspectives on our profession and our ASA.

The current environment is challenging for clinicians in every practice domain, specialties across the house of medicine, and their respective professional organizations. I have learned from your concerns, resolve, and recommendations. Of note, I have appreciated your thoughtful perspectives on the essentiality of our specialty within our health care ecosystem, ASA’s potential, and your insights on our path forward. I have heard your concerns and recommendations regarding macro trends and the impact on individual members and your practices:

• Economic challenges for anesthesiology departments and practices, and health facilities and systems.
• Workforce imbalances and changes in employment structures.
• Consolidation and development of scale in health care mergers.
• Changes in health care delivery, including incentives increasing ambulatory surgery, increased anesthesia coverage requirements for discrete clinical units and specialty services, non-OR procedural demands, and care delivery models.
• The need to respond to concerns of health equity, disparities in health care outcomes, and access.
• Potential impact of artificial intelligence, remote monitoring, and other emerging technologies.
• Advocacy and public relations resources to address headwinds, including growing scope challenges.

All of this has been an enduring reminder for me that our active, engaged members, informed by the diversity of our backgrounds and professional roles, drive the organized efforts of our ASA.

It is essential to have a plan. On an annual basis, ASA advances organizational work in a goal-directed manner through approving strategic plan priorities that are most critical to ASA and aligning resources accordingly. Work is performed by Administrative Council members collaborating with staff leaders, and that work benefits from information available from our Board of Directors, House of Delegates, and ASA members. For the past several years, ASA has employed a three-year strategic plan development cycle, aligned in timing with the budget process. The first year of the plan is considered a build or rewrite, while in the second and third years of each cycle, the plan is reviewed and revised to align it with evolving organizational needs.

We enter the new year guided by our 2024 governance year strategic plan, which includes seven Strategic Pillars and Strategic Initiatives aligned with each Pillar (see graphic above) (asamonitor.pub/48freJk).

Our current plan includes both continuing and several new areas of emphasis. I would like to highlight a few of these:

• Advocacy is a core function of ASA. Strategic commitments continue in advocacy for patient safety, quality of care through physician-led care, and in efforts to ensure the economic integrity of the specialty.
  • We remain committed to essential work to preserve the economic integrity of our specialty by addressing governmental and commercial payer challenges and supporting our members in articulating the value proposition their departments and practices bring to facilities and health systems.
  • Moving forward, the developing Center for Anesthesiology and Perioperative Economics (CAPE) will be developing and coordinating long-term economic strategies and raising the visibility of our efforts. Based on feedback and questions received from members, we have made a new commitment to expand member awareness of the breadth of the advocacy work being done on behalf of members and the specialty.
• In the area of Member Engagement, we have reinforced our commitment to advance inclusion, community, and belonging throughout the organization and to seek and adopt future-looking models for service to members.
  • With nearly 58,000 members, ASA has grown its ranks by focusing on relevance to members and our drive to improve value in belonging to the society.
  • Our member value and satisfaction survey helps define evolving member challenges, expectations, and needs; we are redesigning membership to meet the needs of our diverse community. In addition to tangible and other intangible benefits of membership, ASA creates “shared value” for members – generating value for the profession by addressing its challenges. Maintaining awareness of this shared value connects us with progress in adding value for members – value that otherwise may be less readily recognized.
• Work in the Leadership and Professional Development pillar continues programming to support professional development, satisfaction, and success and includes initiatives to strengthen the visibility and voice of our specialty as a leader in the health care ecosystem.
• In the area of Patient Safety, Quality, and Practice Advancement, we are recognized as the leading resource for anesthesia patient safety and quality programming, and initiatives in these areas continue.
  • Workforce is a critical area receiving increasing attention, and we are making progress in identifying and addressing anesthesia workforce imbalances. In 2024, we look forward to deliverables from the recently concluded Anesthesia Workforce Summit II.
• As a priority, support for Research and Scientific Discovery will be maintained. Two key leadership roles have been filled by individuals who will build on the prior success of the Foundation for Anesthesia Education and Research (FAER) and our flagship journal Anesthesiology.
  • FAER: Max B. Kelz, MD, PhD, as the President and Chief Scientific Officer of FAER, is beginning leadership of the foundation and continuing to help develop the next generation of physician-investigators (asamonitor.pub/3RDV58U).
  • Anesthesiology: James P. Rathmell, MD, MBA, as Editor-in-Chief of Anesthesiology, will ensure identification and dissemination of innovative research and the highest-quality work that will inform daily clinical practice and transform the practice of anesthesiology (asamonitor.pub/46ZI9yC). ASA has agreed, along with FAER and the International Anesthesia Research Society, to extend our collaboration on the Anesthesia Research Council for another five-year period.
• Finally, ASA is expanding and strengthening work in Stewardship of our ASA and our Specialty.

  As captured above, confronting emerging issues and trends drives essential initiatives that may require substantial ASA leadership and management resources. We are responding with three initiatives:

  • Program and Resource Prioritization to assess and optimize programmatic spending, to best steward member resources.
  • Revenue Growth Strategy to identify new products and services for new markets.
  • Business Development Competency to complement other activities.

Importantly, we are also working closely with our ASA Foundations to ensure strategic and operational alignment between ASA, and we are advancing collaboration with subspecialty and other anesthesiology-related societies so we can enhance our collective capabilities to address challenges facing our specialty and the patients we serve.

As we enter 2024, and plan for the future, our physician and staff leadership are informed by important trends that are affecting our members and the members of all medical societies. These include changing generational expectations, professional society and educational preferences, and workforce imbalances on volunteerism, engagement, and meeting participation. As we address current challenges, we are also preparing for the future.

Your physician leadership collaborates with accomplished executive ASA staff members who have developed a focus on service, learning, and improvement. That staff will be led by our new Chief Executive Officer, Brian Reilly, MBA, CAE (asamonitor.pub/41h15YD). Through his prior tenure as Chief Operating Officer and close work during the transition with immediate past CEO Paul Pomerantz, FACHE, Brian has already played a major role in preparing ASA for the future (ASA Monitor 2023;87:8-9). Along with your entire physician leadership team, I look forward to continuing to work closely with him.

We recognize the challenges our ASA and the specialty face at this time. We are also a well-positioned, vibrant, and prepared organization with a bright future. Continue to share your concerns, expectations, and recommendations with me at d.arnold@asahq.org. Together, we will define the future of our calling as anesthesiologists, advancing patient safety, evolving and strengthening our roles in physician-led care, and supporting scientific discovery.