President's Message

 

Summer 1999

 

This year's annual meeting in Denver was outstanding! I should like to thank Meeting Host, Joy Hawkins as well as Stewart Hinckley and his excellent staff at Ruggles for organizing and directing such an excellent meeting. And I especially should like to thank every participant in the scientific and educational programs. The Fred Hehre and "What's New" lectures given by Drs. Sheila Cohen, Larry Gilstrap, Callie Hoyt, and Susan Townsend were of exceptional quality. The Practice Management Workshop and the Breakfast with the Experts led by Drs. Patricia Dailey and Chris Rout, respectively were helpful and well attended. The posters were ably reviewed by Drs. Don Penning and David Wlody. Some attendees continue to talk about the four superb debates an excellent addition to the program these last several years. And hearty congratulations go to the recipients of this year's awards (listed elsewhere in this newsletter). Special congratulations go to Dr. Ezzat Abouleish, recipient of the 1999 Nils Lofgren Award.

This year's meeting was preceded by an all-day meeting of the Long-Range Planning Committee, which was appointed and convened by Past-President, David Birnbach. Many of you will recall the results of the last SOAP Long-Range Planning Committee in 1993. That committee's recommendations led to the decisions to engage professional management, separate the presidency from the meeting host, establish standing committees with defined responsibilities and objectives, and redefine the criteria for membership. Most if not all of us would agree that SOAP is a stronger society today as a result of the vision of the 1993 Long-Range Planning Committee. Now another Long-Range Planning Committee has met and thoughtfully considered the current state and health of SOAP. David Birnbach has summarized the committee's recommendations and the rationale for same elsewhere in this newsletter. I encourage you to read his summary in its entirety.

Without attempting to duplicate David's discussion, I should like to offer some personal thoughts regarding the committee's recommendations and the future of SOAP:

  1. The most difficult task in most organizations is to effect change.


  2. Members of the Long-Range Planning Committee volunteered to spend an extra day away from their jobs and families at their own expense to give careful thought to the future of our society. Their recommendations represent the consensus views of a broad-based group of our membership. (Half of the members of the committee were members of the Board of Directors, and half were not.) Let us be gracious and generous in our praise of their efforts.


  3. The response to the committee's report at the Denver business meeting and in subsequent private conversations suggests that the committee's recommendations will be debated with vigor and passion. That is good! A casual endorsement of the committee's recommendations would suggest that apathy reigns. The fact that our members have strong feelings regarding the committee's report suggests that SOAP is and will remain a vibrant society. However, passionate debate does not necessitate hard or hurt feelings. Let us resolve to maintain the friendships and collegiality for which SOAP is well known throughout this debate.


  4. One of the key issues is as follows: What is the nature and purpose of SOAP? Is SOAP a society of obstetric anesthesiologists, or is SOAP a society of anesthesiologists with an interest in obstetric anesthesia? What is the primary purpose of the annual meeting continuing medical education, presentation of research, or fellowship?

    Historically, SOAP has been a society of modest size, largely composed of anesthesiologists who identify themselves as obstetric anesthesiologists. Some members practice obstetric anesthesia full- time; others participate in other areas of anesthesia practice, but identify themselves as obstetric anesthesiologists. The majority of "active" members practice in an academic setting. The Long- Range Planning Committee has suggested that we should make a greater effort to include a much larger group of community hospital anesthesiologists, who provide obstetric anesthesia as part of their "general practice."

    Some might attempt to frame this debate as exclusivism versus inclusivism. Perhaps those labels help define the debate, but I believe that they evoke an unnecessarily emotional response. I contend that there is nothing inherently wrong with either model! On the one hand, we might decide that we prefer to remain a relatively small society, and retain the opportunity to meet once a year with a relatively small group of individuals of like mind and interest. Some other societies (e.g., AUA) make no apology for limiting their membership to a small group. Advocates of this approach will undoubtedly call attention to the fact that membership is open to all anesthesiologists, and that we already invite all "general" anesthesiologists to attend our meetings. However, these members may prefer to maintain the unique, historical character of SOAP, and not attempt to be "all things to all anesthesiologists."

    Alternatively, other members will argue that our failure to attract more "general" community anesthesiologists has limited our ability to affect the practice of obstetric anesthesia in many community hospitals. (Most deliveries occur in hospitals not represented by SOAP membership.) They may argue that we incur the risk of isolation, and that our research is often considered irrelevant to the practice of obstetric anesthesia in the "real world." Further, some members will call attention to the potential economic consequences of limited membership.

    This debate is not a matter of right versus wrong. Each of these positions may be argued successfully. But the question remains: What kind of society do we want SOAP to be?

  5. In response to the suggestions of several members, we have scheduled an Open Forum which will be held at the Hyatt Regency from 0700 to 1000 on Sunday, October 10, during the ASA annual meeting in Dallas. The purpose of this forum is to allow discussion of the recommendations of the Long-Range Planning Committee. I encourage each of you to attend. Further, in preparation for next year's annual meeting in Montreal, we have allowed three hours rather than 90 minutes for the annual business meeting. Be assured that the Board of Directors is committed to open discussion and debate of the Long-Range Planning Committee's recommendations. Let us dispel any suggestions that a small group is attempting to strong-arm the membership.

This will be a tough, spirited, but hopefully collegial debate. What is the nature and purpose of SOAP? What kind of society do we want SOAP to be? It is our society, and we will make these decisions together.

David H. Chestnut, MD