Is the ASA doing enough?

[GeddyLee]

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Members do not see this ad.

wondering what your thoughts are regarding the ASA's activity regarding CRNA scope of practice, reimburesement issues, etc.

I'm concerned that the ASA seems to think our future lies in peri-operative medicine and critical care. Seems they are all but bowing out of the fight for the OR and telling us we should embrace a future that all but a few do not want! I for one did not go into anesthesiology residency to work in an ICU.

Is the ASA just not up for lobbying congress? Is funding an issue? Or do the politicians and the public just see doctors as being the fat that needs to be cut?

BTW...i think it's funny that PETA called out Michael Moore for being Obese. The healthcare system is in dire straights BECAUSE of self-inflictied illness such as those caused by alcoholism, tobacco, and obesity. Yet the legislators think cutting reimbursements and finding cheaper staffing are the answers.

 

[MacGyver]

Probalby 80% of the members of the ASA use CRNAs to make money because 300k is not enough and they want 350k by "supervising" CRNAs.

Thats why the ASA is impotent. Too many people in your ranks are chasing the dollars.

 

[cchoukal]

I'm an anesthesiology resident in Chicago and I recently attended the ASA's annual legislative session in DC, and here are a few things I learned:

1) the ASA spends a lot of time and resources lobbying congress. They have a staff of attorneys and physicians who act as lobbyists with the specific goal of introducing/passing legislation favorable for anesthesiology and the house of medicine. I'm starting to see that the job of the higher-ups in the ASA (my chair is the president-elect) seems to have much more to do with politics, policy, and money than science, per se. Is it enough? I don't really know, but it IS happening.

2) Anyone in the ASA can attend this session (and your state society will more than likely subsidize or outright fund the trip). A huge part of the session is education about the key issues in a given year and visits with your congresspeople for direct conversations about these issues. Very few members actually talk to/write their representatives, and congresspeople notice this.

3) EVERYONE has a lobby. The CRNAs, the hospitals, asphalt; literally everyone throws money at congress to try to sway legislation their way. It's sad, counterproductive to society as a whole (in my opinion), but it seems to be the way to get things done.

4) Membership in the ASAPAC (that is to say, the percentage of ASA members who give anything to the PAC) is among the lowest of all the groups that lobby congress. Membership in the trial lawyers' PAC is nearly 100%. We're told membership in the AANA PAC (CRNA's political arm) is much, much higher than ours. Congress people know this and will actually ask things like, "how important is this legislation if only 20% or your own members are concerned enough to be in the PAC?"

So, I'm not an ASA stooge and I don't believe that they have all the answers, but these are the things I learned on the trip. My advice based on what I saw:

1) Give to the PAC and encourage your colleagues to do so. The proportion of members is probably more important than the actual amount.

2) We may think the ASA isn't doing enough in DC to protect our profession, but, as far as I can tell, they're the only ones that are there specifically with our profession/future in mind.

3) Writing your congresspeople is easy and might even be effective. A quick google search will give you a way to find your reps' addresses.

 

[pd4emergence]

wondering what your thoughts are regarding the ASA's activity regarding CRNA scope of practice, reimburesement issues, etc.

I'm concerned that the ASA seems to think our future lies in peri-operative medicine and critical care. Seems they are all but bowing out of the fight for the OR and telling us we should embrace a future that all but a few do not want! I for one did not go into anesthesiology residency to work in an ICU.

Is the ASA just not up for lobbying congress? Is funding an issue? Or do the politicians and the public just see doctors as being the fat that needs to be cut?

BTW...i think it's funny that PETA called out Michael Moore for being Obese. The healthcare system is in dire straights BECAUSE of self-inflictied illness such as those caused by alcoholism, tobacco, and obesity. Yet the legislators think cutting reimbursements and finding cheaper staffing are the answers.

It seems that in recent years the ASA has been very active in fighting scope of practice issues and reimbursment for increases. A big problem lies in the fact that many anesthesiologists are not active in their state and the national societies. I forgot the small number of anesthesiologists who actually give to the AMA PAC and the ASA PAC but it is pretty shameful. As far as politics goes money talks and you know what walks. I think we got into these fights late but are making ground. I do think a big PR campaign would be helpful. The average citizen has no idea what we do in the OR. The AANA has been very good at blurring the line between physicians and nurses especially to legislators and the general public. If you haven't seen Blade's video you should watch it. That is what we are up against. I do not think we need to disparage what CRNA's do but I do think we need to emphasize expertise levels and training differences. Some of this junk research re anesthesia safety that seem to only make it into throw away journals should be revealed for what they are total BS. All of this needs to be done in the national forum. We should have the ASA president on Oprah and Good Morning America. Anyway those are my thoughts.

 

[cfdavid]

Come over to the private forum. We're in the process of putting together a website that will augment any efforts of the ASA in terms of educating the public on issues relative to anesthesiology.

 

[toughlife]

wondering what your thoughts are regarding the ASA's activity regarding CRNA scope of practice, reimburesement issues, etc.

I'm concerned that the ASA seems to think our future lies in peri-operative medicine and critical care. Seems they are all but bowing out of the fight for the OR and telling us we should embrace a future that all but a few do not want! I for one did not go into anesthesiology residency to work in an ICU.

Is the ASA just not up for lobbying congress? Is funding an issue? Or do the politicians and the public just see doctors as being the fat that needs to be cut?

BTW...i think it's funny that PETA called out Michael Moore for being Obese. The healthcare system is in dire straights BECAUSE of self-inflictied illness such as those caused by alcoholism, tobacco, and obesity. Yet the legislators think cutting reimbursements and finding cheaper staffing are the answers.

Not sure where you are in your training but the problem is complex, and as two posters suggested, it's a combination of our inability to be content with a smaller paycheck as well as our lax attitude when it comes to politics. The competition knows that and wants to keep it that way.

Heck, they even come to this forum to argue why political posts are even allowed. Keeping people ignorant is how the masses are controlled. Just look at americans overall.

What you need to do is learn about the issues and support your specialty. talk to your fellow residents about what is going on, ask them to at least support the PAC and write to their congressmen.

Like someone said before, "if you are not part of the discussion at the lunch table, you are probably on the menu". So be active and don't let the current situation discourage you.

 

[toughlife]

It seems that in recent years the ASA has been very active in fighting scope of practice issues and reimbursment for increases. A big problem lies in the fact that many anesthesiologists are not active in their state and the national societies. I forgot the small number of anesthesiologists who actually give to the AMA PAC and the ASA PAC but it is pretty shameful. As far as politics goes money talks and you know what walks. I think we got into these fights late but are making ground. I do think a big PR campaign would be helpful. The average citizen has no idea what we do in the OR. The AANA has been very good at blurring the line between physicians and nurses especially to legislators and the general public. If you haven't seen Blade's video you should watch it. That is what we are up against. I do not think we need to disparage what CRNA's do but I do think we need to emphasize expertise levels and training differences. Some of this junk research re anesthesia safety that seem to only make it into throw away journals should be revealed for what they are total BS. All of this needs to be done in the national forum. We should have the ASA president on Oprah and Good Morning America. Anyway those are my thoughts.

Are you an ASA member? If so please send me a PM. We are doing this very thing now thanks to a few caring members.

 

[jwk]

I'm an anesthesiology resident in Chicago and I recently attended the ASA's annual legislative session in DC, and here are a few things I learned:

1) the ASA spends a lot of time and resources lobbying congress. They have a staff of attorneys and physicians who act as lobbyists with the specific goal of introducing/passing legislation favorable for anesthesiology and the house of medicine. I'm starting to see that the job of the higher-ups in the ASA (my chair is the president-elect) seems to have much more to do with politics, policy, and money than science, per se. Is it enough? I don't really know, but it IS happening.

2) Anyone in the ASA can attend this session (and your state society will more than likely subsidize or outright fund the trip). A huge part of the session is education about the key issues in a given year and visits with your congresspeople for direct conversations about these issues. Very few members actually talk to/write their representatives, and congresspeople notice this.

3) EVERYONE has a lobby. The CRNAs, the hospitals, asphalt; literally everyone throws money at congress to try to sway legislation their way. It's sad, counterproductive to society as a whole (in my opinion), but it seems to be the way to get things done.

4) Membership in the ASAPAC (that is to say, the percentage of ASA members who give anything to the PAC) is among the lowest of all the groups that lobby congress. Membership in the trial lawyers' PAC is nearly 100%. We're told membership in the AANA PAC (CRNA's political arm) is much, much higher than ours. Congress people know this and will actually ask things like, "how important is this legislation if only 20% or your own members are concerned enough to be in the PAC?"

So, I'm not an ASA stooge and I don't believe that they have all the answers, but these are the things I learned on the trip. My advice based on what I saw:

1) Give to the PAC and encourage your colleagues to do so. The proportion of members is probably more important than the actual amount.

2) We may think the ASA isn't doing enough in DC to protect our profession, but, as far as I can tell, they're the only ones that are there specifically with our profession/future in mind.

3) Writing your congresspeople is easy and might even be effective. A quick google search will give you a way to find your reps' addresses.

You're part of a small but increasingly active minority that are getting involved in the politics. You got a good taste, as I did a couple years ago when I went to the ASA Legislative Conference, of how difficult the political side of all this can be. There are no easy answers to the problems facing the profession, but those of you who think the ASA is simply sitting on the sidelines watching time go by are simply incorrect.

 

[BLADEMDA]

No. I contribute to my Federal and State PAc's. I will continue to do so.
But, I would contribute even more to an ASA that was OPENLY fighting the AANA with a good PR/Education campaign. HOLDING our ground is not good enough anymore. The enemy is at our door and in some states actually in the house. Time to take back the specialty from the Nurses.

It is high time we go OFFENSIVE against the AANA. Join the Private Forum and Join the battle against the AANA.

Blade

 

[CremeSickle]

🙄

 

[GeddyLee]

Good replies. To some extent I agree with Blade. I think if the ASA were more visible in their efforts to fight the AANA, contribution from its members would increase.

Take the video posted in the sticky for instance, where the AANA president if giving testimony regarding the PA legislation. Where is the video of the ASA's rebuttal?? Surely someone stepped up to the plate to rebut the comment that the anesthesiologist is not needed in the OR. This needs to be a high visibility national effort on the part of the ASA to let the public know why an anesthesiologist in the OR is in everyone's best interest.

Instead, the feedback I seem to hear loudest from the ASA is that our future is in the ICU and in peri-operative medicine. This is all but conceding the OR to the CRNA's and differing ourselves by taking hold of territory that no one wants! I wouldn't feel comfortable working the ICU personally. Sure, the airway and hemodynamics issues would be second nature, but we are in no position to take the helm of an ICU. Hey, the leapfrog study indicates that the future of the ICU is in the direction of fellowship trained intensivists. I'm not sure why we are headed toward being half-arse trained ICU doc as a means to "differentiate" ourselves.

 

[atrxnasd]

With regard to the Pa legislation. It was defeated!! Do you think anyone except CRNAS and anesthesiologists watched that testimony. They would if ASA and AANA made it into a circus. We can either fight this nonsense publicly and give it more publicity or we can handle this the same way other physicians deal with infringement into their scope (Mid-wives OB, pychologist pyschiatrist,DDS oral surgeons, opthalmology,etc). Most legislators recognize that they would want a physician responsible for their anesthesia. Remember this bill was defeated. I think if we get into a public debate about whether anesthesia is the practice of medicine then the AANA has already won.
Fighting with the AANA will convince people there are two anesthesia groups. We will be serving an AANA political objective by isolating the AAAA. There is one group of physicians that practice anesthesia and two groups of physician extenders. Be assured the anesthesiologists of PA are better represented when their legislature is privately educated that the testimony they were given was misleading at best. It does not win the AANA many friends and does not provide a circus where a bunch of doctors look like they are publicly persecuting nurses. By the way, the public in the latest poll has higher respect and more confidence in nurses over doctors.
It is often better to let that nonsense pass rather than have it played on the 6PM news.

 

[cfdavid]

Are you an ASA member? If so please send me a PM. We are doing this very thing now thanks to a few caring members.

True, but we really need more involvement from other residents and, especially attendings. Come on guys!

 

[IN2B8R]

While I agree with some of your comments, you need to be clear about one thing: the bill in PA was withdrawn for lack of support, i.e., it never went to a vote before the House legislators. That is a far cry from a "defeat." Just replying as a clarification, so do not think that I disagree with everything that you have said. Regards.

With regard to the Pa legislation. It was defeated!! Do you think anyone except CRNAS and anesthesiologists watched that testimony. They would if ASA and AANA made it into a circus. We can either fight this nonsense publicly and give it more publicity or we can handle this the same way other physicians deal with infringement into their scope (Mid-wives OB, pychologist pyschiatrist,DDS oral surgeons, opthalmology,etc). Most legislators recognize that they would want a physician responsible for their anesthesia. Remember this bill was defeated. I think if we get into a public debate about whether anesthesia is the practice of medicine then the AANA has already won.
Fighting with the AANA will convince people there are two anesthesia groups. We will be serving an AANA political objective by isolating the AAAA. There is one group of physicians that practice anesthesia and two groups of physician extenders. Be assured the anesthesiologists of PA are better represented when their legislature is privately educated that the testimony they were given was misleading at best. It does not win the AANA many friends and does not provide a circus where a bunch of doctors look like they are publicly persecuting nurses. By the way, the public in the latest poll has higher respect and more confidence in nurses over doctors.
It is often better to let that nonsense pass rather than have it played on the 6PM news.

 

[BLADEMDA]

With regard to the Pa legislation. It was defeated!! Do you think anyone except CRNAS and anesthesiologists watched that testimony. They would if ASA and AANA made it into a circus. We can either fight this nonsense publicly and give it more publicity or we can handle this the same way other physicians deal with infringement into their scope (Mid-wives OB, pychologist pyschiatrist,DDS oral surgeons, opthalmology,etc). Most legislators recognize that they would want a physician responsible for their anesthesia. Remember this bill was defeated. I think if we get into a public debate about whether anesthesia is the practice of medicine then the AANA has already won.
Fighting with the AANA will convince people there are two anesthesia groups. We will be serving an AANA political objective by isolating the AAAA. There is one group of physicians that practice anesthesia and two groups of physician extenders. Be assured the anesthesiologists of PA are better represented when their legislature is privately educated that the testimony they were given was misleading at best. It does not win the AANA many friends and does not provide a circus where a bunch of doctors look like they are publicly persecuting nurses. By the way, the public in the latest poll has higher respect and more confidence in nurses over doctors.
It is often better to let that nonsense pass rather than have it played on the 6PM news.

In theory your post sounds very nice. In addition, the ASA has been doing "business" your way for the past thirty years. Times are a changin'.

14 states have already "opted-out" due to the AANA political propoganda machine. Do those Citizens know the difference between MD Anesthesiology and CRNA? Do they care? Or, for that matter, does it make a "difference" in patient outcomes?

The AANA is not finished with its ultimate goal of 100% Independence. Once the DNAP becomes the "norm" in 7 years the push for complete autonomy will ramp up. Those 14 states provide the fuel for the AANA's claim that CRNA's are "equal" in safety and outcome to their MD/DO "colleagues." While it is true this fight will take place at the State Levels throughout the USA it is foolish to assume every state will see the "obvious" and ignore the DNAP degree and AANA safety "data."

I propose a counter-measure to the AANA. A PR/Education campaign explaining the education differences between a CRNA and MD. Like Moore's "SICKO" movie the public must be brought into the discussion about who is in charge of their ANESTHETIC and why they should demand the BEST provider.
Nurses practicing a CRITICAL medical specialty like Anesthesiology SOLO at our medical centers is a bad idea. The public has a right to know which provider is going to bill his/her Blue Cross/Blue Shield Insurance.

In short, if we continue to do business strictly the "old way" we will soon have no business at all.

Blade

 

[jwk]

With regard to the Pa legislation. It was defeated!! Do you think anyone except CRNAS and anesthesiologists watched that testimony. They would if ASA and AANA made it into a circus. We can either fight this nonsense publicly and give it more publicity or we can handle this the same way other physicians deal with infringement into their scope (Mid-wives OB, pychologist pyschiatrist,DDS oral surgeons, opthalmology,etc). Most legislators recognize that they would want a physician responsible for their anesthesia. Remember this bill was defeated. I think if we get into a public debate about whether anesthesia is the practice of medicine then the AANA has already won.
Fighting with the AANA will convince people there are two anesthesia groups. We will be serving an AANA political objective by isolating the AAAA. There is one group of physicians that practice anesthesia and two groups of physician extenders. Be assured the anesthesiologists of PA are better represented when their legislature is privately educated that the testimony they were given was misleading at best. It does not win the AANA many friends and does not provide a circus where a bunch of doctors look like they are publicly persecuting nurses. By the way, the public in the latest poll has higher respect and more confidence in nurses over doctors.
It is often better to let that nonsense pass rather than have it played on the 6PM news.

Do you have a source/cite that this legislation was defeated? Nothing is showing on the Pennsylvania Legislature website to indicate that.

At some point, don't you think public testimony has to be on the record somewhere? Opposing viewpoints need to be formally presented. Can we afford to let the AANA's statements stand unopposed as "fact"?

The AANA and it's state associations have never let facts get in the way of their testimony among the various state legislatures. They give their opinions, cite flawed studies, play the "chicken little" game, etc. At some point, someone has to step up, on the record, and simply say "they're wrong".

 

[m3unsure]

I'm wondering which schools are training these CRNAs. I think limiting their "use" during the training process would keep numbers down. We should actively take down MDAs getting kickbacks by increasing CRNA training. It shouldn't be a mafia mentality, but what the hell, if everyone else wants to kick us in the @ss, then we might as well return the favor. Universities need to be forced into cutting out CRNA programs, and ASA should attempt to regulate their presence since who trains them. MDs who stab their own colleagues in the back need to be make public amongst the anesthesia community.

ASA Jan 07 Newsletter comments:
The AANA staffer erroneously compares physician resident training that is heavily regulated and capped by CMS, ACGME and the RRC with graduate nurse training regulated only by a university’s or hospital’s desire to expand tuition-generating slots and their ability to secure clinical training sites with CRNA faculty.
From where I sit, it might be an attempt to kick us when we’re vulnerable by hurting our academic programs while alleging that they’re in trouble as well. I also believe that by lumping doctor training with nurse training, they subliminally try to elevate their education to that of a physician, purposefully trying to mislead the public through the legislative process.

 

[InductionAgent]

I'm wondering which schools are training these CRNAs. I think limiting their "use" during the training process would keep numbers down. .

I agree with the spirit of this statement, but reality continues to vex the situation. In my program, we don't have SRNAs in training, but we do have CRNAs as part of the group. The state university anesthesiology department contracts with the county hospital to provide anesthesia services. There are not enough residents to cover all the ORs (and cysto/angio suites) that are running during the day. We recently increased the size of the residency, which reduced the need for CRNAs somewhat. Getting faculty to cover the ORs is not practical, because a) it is difficult to recruit faculty for academic anesthesiology because private practice is more lucrative, b) funding for faculty positions is limited in state institutions/county hospitals.

I hope the OP realizes that the solution is in his hands: if he doesn't like the direction he perceives the ASA and anesthesia to be headed, then he should get involved, make what change he can, refuse to take a job that involves supervision of CRNAs (even if it means making less money), work in academics or an MDA-only group.

 

[Pooh & Annie]

Speaking for myself, (and there are probably others in my boat), I just started my CA1 year and just sent in my ASA app. I should get my number and join the forum soon

 

[zzzlob]

While I agree with some of your comments, you need to be clear about one thing: the bill in PA was withdrawn for lack of support, i.e., it never went to a vote before the House legislators. That is a far cry from a "defeat." Just replying as a clarification, so do not think that I disagree with everything that you have said. Regards.

There was a "lack of support" because the PSA and the ASA worked to defeat the bill. 🙂

The PSA orchestrated a grassroots and lobbying campaign to stop this ill-advised and potentially dangerous legislation. That's a "defeat." It didn't happen by itself. The Pennsylvania nurse anesthetists spend enormous amounts of time and money to win through legislation what they don't have through training.

If you talk to folks in PA you find that many anesthesiologists in PA have made investments of time to know their lawmakers. These anesthesiologists were able to educate the lawmakers about the AANA orchestrated effort.
It wasn't a massive "public relations" campaign that helped them. (The public doesn't care about who is providing their anesthesia until the case is about to start.) It was one-on-one lobbying.

Anesthesiologists can educate lawmakers and lawmakers are open to being educated if anesthesiologist take the time to do it. The nurses have an excellent grassroots programs. In contrast, too many of us think someone else will do it for us. If we aren't doing it the only information the lawmakres are getting is from the nurses.

If you haven't personally spoken to your state or federal lawmaker (state senator, state representative, U.S. Congressman or U.S. Senator) or their staff within the past 6 months you are part of the problem and not the solution.

The time to educate lawmakers is before the AANA drops into your state to begin a new campaign. If you wait until the opt-out or independent practice initiative starts, you lose because the nurses have been working with those lawmakers for the proceeding year.

 

[zzzlob]

While I agree with some of your comments, you need to be clear about one thing: the bill in PA was withdrawn for lack of support, i.e., it never went to a vote before the House legislators. That is a far cry from a "defeat." Just replying as a clarification, so do not think that I disagree with everything that you have said. Regards.

There was a "lack of support" because the PSA and the ASA worked to defeat the bill. 🙂

The PSA orchestrated a grassroots and lobbying campaign to stop this ill-advised and potentially dangerous legislation. That's a "defeat." It didn't happen by itself. The Pennsylvania nurse anesthetists spend enormous amounts of time and money to win through legislation what they don't have through training.

If you talk to folks in PA you find that many anesthesiologists in PA have made investments of time to know their lawmakers. These anesthesiologists were able to educate the lawmakers about the AANA orchestrated effort.
It wasn't a massive "public relations" campaign that helped them. (The public doesn't care about who is providing their anesthesia until the case is about to start.) It was one-on-one lobbying.

Anesthesiologists can educate lawmakers and lawmakers are open to being educated if anesthesiologist take the time to do it. The nurses have an excellent grassroots programs. In contrast, too many of us think someone else will do it for us. If we aren't doing it the only information the lawmakres are getting is from the nurses.

If you haven't personally spoken to your state or federal lawmaker (state senator, state representative, U.S. Congressman or U.S. Senator) or their staff within the past 6 months you are part of the problem and not the solution.

The time to educate lawmakers is before the AANA drops into your state to begin a new campaign. If you wait until the opt-out or independent practice initiative starts, you lose because the nurses have been working with those lawmakers for the proceeding year.

 

[IN2B8R]

Thanks for the reply. I am a PA anesthesiologist/Pain doc who lobbied his local representative. I am in agreement with your comments. But, do not forget that this bill can be reintroduced, which is what I was getting at in my initial reply. best regards.

p.s. a prior vote against the bill would have been a bigger victory, that was my only message.

There was a "lack of support" because the PSA and the ASA worked to defeat the bill. 🙂

The PSA orchestrated a grassroots and lobbying campaign to stop this ill-advised and potentially dangerous legislation. That's a "defeat." It didn't happen by itself. The Pennsylvania nurse anesthetists spend enormous amounts of time and money to win through legislation what they don't have through training.

If you talk to folks in PA you find that many anesthesiologists in PA have made investments of time to know their lawmakers. These anesthesiologists were able to educate the lawmakers about the AANA orchestrated effort.
It wasn't a massive "public relations" campaign that helped them. (The public doesn't care about who is providing their anesthesia until the case is about to start.) It was one-on-one lobbying.

Anesthesiologists can educate lawmakers and lawmakers are open to being educated if anesthesiologist take the time to do it. The nurses have an excellent grassroots programs. In contrast, too many of us think someone else will do it for us. If we aren't doing it the only information the lawmakres are getting is from the nurses.

If you haven't personally spoken to your state or federal lawmaker (state senator, state representative, U.S. Congressman or U.S. Senator) or their staff within the past 6 months you are part of the problem and not the solution.

The time to educate lawmakers is before the AANA drops into your state to begin a new campaign. If you wait until the opt-out or independent practice initiative starts, you lose because the nurses have been working with those lawmakers for the proceeding year.

 

[epidural man]

I'm an anesthesiology resident in Chicago and I recently attended the ASA's annual legislative session in DC, and here are a few things I learned:

1) the ASA spends a lot of time and resources lobbying congress. They have a staff of attorneys and physicians who act as lobbyists with the specific goal of introducing/passing legislation favorable for anesthesiology and the house of medicine. I'm starting to see that the job of the higher-ups in the ASA (my chair is the president-elect) seems to have much more to do with politics, policy, and money than science, per se. Is it enough? I don't really know, but it IS happening.

2) Anyone in the ASA can attend this session (and your state society will more than likely subsidize or outright fund the trip). A huge part of the session is education about the key issues in a given year and visits with your congresspeople for direct conversations about these issues. Very few members actually talk to/write their representatives, and congresspeople notice this.

3) EVERYONE has a lobby. The CRNAs, the hospitals, asphalt; literally everyone throws money at congress to try to sway legislation their way. It's sad, counterproductive to society as a whole (in my opinion), but it seems to be the way to get things done.

4) Membership in the ASAPAC (that is to say, the percentage of ASA members who give anything to the PAC) is among the lowest of all the groups that lobby congress. Membership in the trial lawyers' PAC is nearly 100%. We're told membership in the AANA PAC (CRNA's political arm) is much, much higher than ours. Congress people know this and will actually ask things like, "how important is this legislation if only 20% or your own members are concerned enough to be in the PAC?"

So, I'm not an ASA stooge and I don't believe that they have all the answers, but these are the things I learned on the trip. My advice based on what I saw:

1) Give to the PAC and encourage your colleagues to do so. The proportion of members is probably more important than the actual amount.

2) We may think the ASA isn't doing enough in DC to protect our profession, but, as far as I can tell, they're the only ones that are there specifically with our profession/future in mind.

3) Writing your congresspeople is easy and might even be effective. A quick google search will give you a way to find your reps' addresses.

Agreed!

Because of posts like this and my exposure to this forum, I have changed my mind about joining the ASA after residency. Sheesh, the $25 as a resident was easy, but the $400 after was looking like a waste for me, but I realize know how important being a member of our foundation is. (...turn to camera, smile big...music crescendo....scene fades.....and cut...commercial ends)