John B. Neeld, Jr., M.D., Chair
ASA Delegation to AMA

nesthesiology continued to expand its presence and influence at the Interim Meeting of the American Medical Association (AMA), held in Honolulu on November 10-13, 2007.

Four members of the ASA delegation filled leadership positions at the meeting: Jane C.K. Fitch, M.D., chaired the Reference Committee on Amendments to Constitution and Bylaws, Candace E. Keller, M.D., served on the Committee on Rules and Credentials, Jesse M. Ehrenfeld, M.D., Resident and Fellow Section Delegate, served on Reference Committee J (Advocacy in the Public Sector) and Gary P. Thal, M.D., served on Reference Committee F (AMA Finance and Governance) which was chaired by Alan M. Harvey, M.D., ASA member and delegate from Massachusetts.

Other anesthesiologists with important AMA leadership positions include two members of the Board of Trustees, Rebecca J. Patchin, M.D., and Joseph P. Annis, M.D. Claudette E. Dalton, M.D., is chair-elect of the Council on Medical Education. C. Alvin Head, M.D., is a member of the Council on Science and Public Health, and William L. Hamilton, M.D., is a member of the AMA Political Action Committee (AMPAC), which is chaired by John B. Neeld, Jr., M.D., who also serves as chair of the ASA Delegation.

Initiatives of the ASA delegation were consistent with those of ASA on the national level; we addressed the issue of payment reductions for anesthesiology teaching programs and approached the broad issue of scope of practice in two fashions.

Your delegation was successful in passing Resolution 719, which called for AMA opposition to payment cuts to teaching physicians on the basis that the attending physician is concurrently or sequentially supervising more than one resident, fellow or student. Based on the recommendation of the Council on Medical Education, the resolution was broadened in scope to include all teaching programs, since the House of Delegates recognized that this problem could potentially affect other specialties.

Additionally, we were successful in passing Resolution 903, “Interventional Pain Management: Advancing Advocacy to Protect Patients from Treatment by Unqualified Providers,” as amended, which states that interventional pain management of patients suffering from chronic pain constitutes the practice of medicine.

Initially led by your ASA delegation, issues related to scope of practice and appropriate identification of the education of providers have become major issues for AMA as the Federation of Medicine has recognized the risk to patient welfare that is posed by less qualified practitioners.

Consistent with our initiatives related to scope of practice within the AMA House of Delegates, ASA continues to work on these issues at the national level within the Scope of Practice Partnership (SOPP), of which ASA is a founding member and member of the executive committee. The SOPP works to coordinate actions on scope issues across specialties in every state and offers financial assistance to state medical associations where scope of practice is a major issue (Pennsylvania and California, among others).

Additionally, ASA is working within the framework of AMA to recommend that the Physicians Consortium for Performance Improvement not provide full voting membership in the consortium for nonphysician groups, since that would be incompatible with the responsibility of the medical profession to define standards of medical practice.
Lastly, on a personal note as chair of the board of AMPAC, I am pleased to announce that the ASA delegation to AMA was the first to have 100-percent delegation membership in the new Capital Club Gold membership level ($1,000 annually) and that AMPAC raised a record amount (greater than $170,000) at the interim meeting for political activity during the 2008 election cycle.

It is clear that political action will become increasingly important for all of medicine in the years ahead. Your ASA delegation to AMA will continue to provide effective and knowledgeable leadership to the Federation of Medicine as the relationship of medicine to government continues to evolve.

John B. Neeld, Jr., M.D., is a partner in Northside Anesthesiology Consultants and a staff anesthesiologist, Northside Hospital, Atlanta, Georgia. He was ASA President in 1999.