As I assume the role of SOAP president for 1998-1999, I would like to begin by thanking you all for your continued support. SOAP continues to grow and flourish due to the hard work of our members, many of whom take a very active role in our society. Having just finished what I believe to be one of the best SOAP meetings ever, I can't help but notice that although our society continues to grow, we miraculously keep the warmth that SOAP has always separated SOAP from other societies.
This year’s annual meeting not only broke attendance records but also weather records, with 4 straight days of sunshine and warm weather in Vancouver, BC. It is a tribute to our membership that despite the perfect weather, every session of our meeting was fully attended. Our formula including a mixture of posters and oral research presentations, debates, lectures and workshops once again proved to be successful as evidenced by glowing evaluations and comments from attendees. An enlightening pre-SOAP symposium titled Management of Critical Events in Obstetric Anesthesia was offered at this year’s meeting and was thoroughly enjoyed by all who participated. Our society thanks Rita Patel and Dick Wissler, the Team Leaders, and their hardworking faculty for doing such a magnificent job with the combined simulator and airway workshops.
Attendees at this year’s meeting also heard a wonderful inaugural Ostheimer Lecture, given by David Cambell. Our re-named "What’s New" lecture, which will be a part of our annual meeting, was named after the late Gerard W. Ostheimer, MD a leader in obstetric anesthesia and previous SOAP president. My personal thanks to Abbott, Astra, B.Braun, and Becton Dickinson for their support of this eponymous lecture. In addition, special thanks to the Board of Directors of the American Society of Regional Anesthesia (ASRA), who also generously donated to support this lecture in memory of Gerry who was also a previous president of ASRA.
This year we launched our affiliation with Anesthesiology and as part of our agreement we produced and mailed an abstract supplement to almost 40,000 readers. Unfortunately, this abstract book caused some confusion to some of our members. To help simplify matters, next year we will again publish only the top graded fifty abstracts into an Anesthesiology supplement, but our own abstract book which will be available to the meeting will contain all abstracts, so that there will be no need to fumble between the two books while attending the annual meeting. In addition, next year’s Anesthesiology abstract supplement will clearly state that it represents only a partial selection of abstracts to be presented at the annual meeting, so that we don’t once again insult those who submitted excellent abstracts which were accepted for presentation at our meeting but not selected for the Anesthesiology supplement. In an attempt to make judging more equitable, the abstracts will be judged by a much larger pool of SOAP members and in an attempt to give members enough time to produce superior abstracts, we will delay the submission deadline by almost a month. Change is inevitable if we are to continue to grow, but we will endeavor to listen to our members and reduce the hassles wherever possible.
As in previous years, our friends from Astra, B.Braun, and Becton Dickinson also generously supported our SOAP Travel Scholars and this year we were able to bring anesthesiologists from Kenya, Chile, and Thailand to spend some time at major centers in the US followed by attendance at our annual meeting. We are now accepting applications for next years Visiting Scholars, so please contact me or SOAP headquarters if you know of any appropriate candidate.
A few changes to our Board occurred as a result of elections at our annual meeting. Valerie Arkoosh has stepped down from Secretary after winning election as Second Vice President, and Don Penning was elected as our new Secretary. Sam Hughes has stepped down after serving our society so well as our representative to the ASA house of delegates and Patsy Daily will take his place as our delegate, with Joy Hawkins to replace Patsy as Alternate Delegate.
Some of our colleagues have received some negative press in an LA Times article entitled "Childbirth Anesthesia Refusals Spur Probe". This expose reveals a double standard which purportedly exists. The article disclosed that some anesthesiologists in California are refusing to place epidurals in Medicaid patients, unless the patients pay for the epidural in cash beforehand. Dr. Bassell and I were contacted by reporters for the LA Times and the Associated Press and denounced the practice of refusing anesthesia care to those patients who do not have private insurance. In the several days since the article was released, I have received several calls and e-mails suggesting that SOAP has no business interfering in this issue. Having spent many years convincing our colleagues in Obstetrics and our patients that neuraxial analgesia was dramatically better than the alternatives, we cannot now state that obstetrical epidurals are an elective procedure that should only be placed in insured patients or if "medically indicated". I have yet to figure out a medical indication for experiencing pain in childbirth, especially in the patient who requests analgesia. I feel strongly that SOAP does indeed have business to be involved in this issue. We need to show the public that the majority of anesthesiologists do not practice two standards of care, but rather that we are concerned about all of our patients and that no patient is denied our services based on an inability to pay. This news article and the lawsuit it is reporting are just the tip of the iceberg, since this practice is clearly not limited to California. For example, as President of SOAP, I have recently received complaints and a request for help from a group of obstetricians in North Carolina and from an insurance carrier in Florida. Discriminatory practices of all sorts are unfair to our patients and will inevitably hurt us all.
THAT SAID, IT IS ABSOLUTLY OBSCENE FOR ANESTHESIOLOGISTS TO PROVIDE OUR SERVICES AND NOT TO BE REIMBURSED. SOAP WILL HELP THE ASA AND STATE SOCIETIES IN ORDER TO IMPROVE THIS SITUATION. AS A FIRST STEP, I HAVE ACCEPTED AN INVITATION TO APPEAR ON ABC’S NIGHTLINE PROGRAM TO DEBATE THE ISSUE OF UNFAIR REIMBURSEMENT FOR ANESTHESIOLOGISTS PERFORMING LABOR ANALGESIA. IN THE MEANTIME, WE SHOULD NOT FIGHT THE BATTLE OF UNFAIR REIMBURSEMENT FOR EPIDURALS AT THE PATIENTS BEDSIDE.
I am grateful to those who have proceeded me as President of this Society. The three previous SOAP Presidents, Drs. Finster, Cohen, and Bassell who I have grown to know and love while I have shifted from Secretary to Second Vice President to First Vice President to President, have strengthened this society and helped bring us to where we are now- respected and recognized as the official obstetric anesthesia body in this country. I will try my best to follow their lead and to represent you during this next year. Please call, fax, or e-mail me with your comments and suggestions.
David J. Birnbach, MD, President
E-mail: djb2@columbia.edu