President's Message

Splendid Isolation

Our cardiology colleagues provide us with the detailed patient information that is essential to the good practice of cardiothoracic anesthesiology, while we rub elbows or exchange barbs with our surgical colleagues in the actual treatment of the patients. Over the years, these daily interactions often evolve into long-lasting relationships based on friendship and mutual respect. They are solidified by a common dedication to the well being of our patients.

Given such close associations in our daily environment, one would expect the same to be true at the level of national organizations. Unfortunately, such is not the case. I am aware of at least 3 large professional organizations dedicated to the care of cardiac patients that welcome participation and membership of anesthesiologists. The largest by far is the American Heart Association (AHA), a powerful national organization with many chapters and councils representing a wide variety of professional interests. One of these is the Cardiothoracic and Vascular Surgery Council. Jerry Reeves, M.D. has represented our specialty and SCA more specifically, on the Executive Committee of this council. Over the years, Jerry has often indicated that input and power on the Committee was directly proportional to the number of constituents one represented. He has repeatedly encouraged anesthesiologists to join the American Heart Association through direct mailings and other means, but the response has remained light. As our specialty is being challenged, having a powerful ally like AHA would be a true blessing.

In our daily practice of cardiothoracic anesthesiology, interactions with physicians from other specialties are common and essential to the fulfillment of our professional activities. Another organization that has invited membership by anesthesiologists is the American College of Cardiology (ACC). Membership requires nomination by two fellows of the college, but is otherwise open to anyone with a strong commitment to the care of cardiac patients. The ACC is a leader in continuing medical education offering a variety of educational programs, as well as enduring materials. Their Heart House in Bethesda, MD, is a truly amazing facility that provides intense education in a serene and high-tech environment. In addition, the ACC also participates with several other organizations in the development of practice guidelines that often impact on our daily practice. At present, only 20 anesthesiologists are listed as Fellows of the American College of Cardiology. Recently, ACC has approached SCA about the joint marketing of educational programs that are of mutual interest. The Board of Directors of SCA has enthusiastically endorsed the concept of such collaboration, although the details remain to be determined. Again, our voice at ACC would be louder if more anesthesiologists were fellows of the ACC.

The last organization I would like to mention is the American Society of Echocardiography (ASE). We have had multiple interactions with ASE that have benefited both societies. Initially, membership in ASE by anesthesiologists was minimal. The leadership of ASE deserves credit for maintaining an attitude of openness towards cardiothoracic anesthesiologists despite our lackluster response. Today, when reimbursement for intraoperative TEE is being threatened, we truly need ASE to defend our financial interests. Fortunately, the number of anesthesiologists who have joined ASE has grown significantly and so has our influence. The SCA Economics Task Force has reported that one of the obstacles to the reimbursement of intraoperative TEE is the absence of up-to-date published indications for its use. While the ASA/SCA Practice Guidelines partially fulfill this need, the document is dated. The AHA, ACC, and ASE are jointly developing a new version of their Practice Guidelines for Echocardiography. It will include a section on intraoperative echocardiography that I was invited to contribute on behalf of SCA. Without the active intervention of the leadership of ASE such invitation would not have been forthcoming and our specialty might have been ignored in this important activity.

For all of these reasons, I would encourage you to join the AHA, ACC and ASE. Our specialty needs strong representation in organizations with which we share a common interest. I believe that you will find a welcoming environment while your professional relationships with colleagues at home may become even better.

If you have comments or suggestions on these issues, please feel free to communicate them to me at sca@societyhq.com or at dthys@slrhc.org. After editorial review by the Newsletter Committee, they will be published.

Daniel M. Thys, MD, FACC
President, SCA

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