Association of Veterans Affairs Anesthesiologists

The 2002 AVAA Annual Meeting was held on October 14 at Mings Court in sunny Orlando, Florida. The turnout was great (especially for a small city ASA meeting) with over 35 AVAA attendees, including several spouses and representatives from our very gracious supporting sponsor (Pharma). Many thanks to Bob Simms for arranging quite a gala Chinese feast! Old and new members gathered together to exchange ideas, information and just have a good time! The executive branch of AVAA also changed with the new President entering and the outgoing president assuming "senior statesman" status on the Executive Committee. Many thanks to Al Perrino for his great work, support for the rapid growth spurt (and website introduction) of the AVAA under pressure from a hyperactive secretary/treasurer/webgeek....But on a serious note, also for his tireless efforts on VA Physician Pay Scales which he presented at the meeting (his slides are posted in the annual meeting minutes section) and numerous other "behind the scenes" administrative issues. No doubt Al will continue to assume a decisive role in advocating fair and equitable working conditions for all VA Anesthesiologists in these turbulent economic times.

The meeting also heard reports from Dr. Mike Bishop, Director of the National Anesthesia Service. Mike spoke without slides this year after a bruising technical experience last year in New Orleans but was powerful nonetheless! Much of the information presented is on the most excellent NAS website which is truly required surfing for all AVAA members (www.anesthesia.med.va.gov). Dr. Bishop and his assistant, Doug Rotter, are able to provide assistance to any VA anesthesiologist with administrative issues.

The always informative (and amusing) Dr. Bill Schmeling, Milwaukee, Head of the Field Advisory Committee, presented a detailed presentation on a variety of topics being addressed by the FAC including the Quadrennial Report on Physicians Salaries, VISTA surgical package review, billing, contracts, etc. etc. .Unfortunately we were running out of time as Bill spoke, so I'm going to try to have Bill provide us with an update and field questions on the clinical forum side of the website.

Our featured guest speaker (sponsored by Pharma) was Dr. Jeffrey Katz, Associate Professor of Anesthesiology, Northwestern University, Chicago on the Role of Cox-2 Technology in the Perioperative Period. This was a very erudite presentation of a complex topic and Dr. Katz also brought down the house with his humor! Many thanks to Dr. Katz for attending and enlightening the crowd on an emerging tool in perioperative pain management.

I provided an update on our web activities as well as an impassioned plea (well, maybe just passioned...) for all members of AVAA to GET INVOLVED and COMMUNICATE between centers via our organization. I'm playing the old "power in numbers" game and I really do think that we can, and are ripe for, a much greater role at all levels of the DVA to make our opinions and clinical expertise known. Although many of us have felt our voices are not always heeded by policy makers and clinical opinion leaders in the DVA, many of us sense that this is rapidly changing. But, the "quiet wheel" won't get any grease, so lets speak up! I would very much like to develop survey instruments and data collection on various critical processes of care that we deal with day in and day out (eg. pain services, perioperative monitoring, anesthesia techniques, automated anesthesia records, etc.) that we can internally circulate and perhaps even publish in the peer reviewed literature. As many of you may know, I (along with Dr. Perrino and others) recently circulated a web based survey on the use of perioperative beta blockade in the DVA amongst the AVAA, the AVAS (Association of VA Surgeons) and selected cardiologists. Over 65 of your responded. The results are very interesting and have been submitted for publication. I will keep you appraised of this and plan to circulate the results shortly.

The meeting closed with the election of our new secretary/treasurer/president-elect, Dr. Grace Chien, Chief, Anesthesia Service, Portland VAMC. As all of you are aware Grace is a tireless clinician, researcher and administrator and serves on the Field Advisory Committee. She is nationally respected and will no doubt be a great asset to the organization. Welcome aboard Grace!

For those of you who were unable to attend we hope to see you along with a host of new members in the always popular San Francisco in October. If you have ideas or recommendations for speakers, topics, themes, etc for next years meeting, please let me know! In the meantime, if you haven't paid your dues for this calendar year, please forward them to me ASAP. Of course, those that haven't will be getting a gentle reminder from us via email. And please keep us appraised of your current email address since just as CPRS we are now truly a "paperless organization". I'm looking forward to working with you all over the next couple of years. Please feel free to contact me via email or phone with any questions, comments or gripes!

Finally, as I write this light hearted tome a number of months after the meeting, we have just gone to war in Iraq and our military forces, as well trained and advanced as they are, will be exposed to the horrible risks of both conventional and non-conventional (biological, chemical, etc.) war. We all wish them the best for a safe and speedy return home. With the changing geo-political climate, particularly with regards to international and domestic terrorism, it is indeed a bit chilling just how important and how expansive the credo of our specialty has become. We must all strive to be "Vigilant" in all aspects of our lives. Hopefully, we as anesthesiologists can stay on the forefront and strive to provide state of the art medical care to our nation's Veterans....

Martin J. London, M.D.
President, AVAA
Attending Physician, San Francisco VA Medical Center
Professor of Clinical Anesthesia
University of California, San Francisco