As with any year, the past 12 months brought their share of successes, as well as challenges to our Society. Fortunately, we didn’t tackle the issues impacting our specialty alone; instead, the American Society of Anesthesiologists (ASA) took the lead in creating partnerships across the health care ecosystem to collaborate and achieve real results. And, in areas where we haven’t yet made significant progress, we’re laying the groundwork for a stronger future.
You’ll see much more detail on our 2023 accomplishments in this report, but here are a few key highlights.
Our most visible advocacy successes over the past year were in support of our profession and our patients. ASA’s state advocacy team, working arm in arm with our component societies, ran the table, beating back nursing scope-of-practice expansion legislation in 18 states, and defeating the Advanced Practice Registered Nurse Compact in seven states. We also had a strong year in protecting medical titles at the state level with robust legislation in Oregon and Georgia, and a new truth-in-advertising law in North Dakota. Our Safe VA Care campaign aimed at protecting physician-led care in the nation’s largest health care system saw legislation introduced in both houses of Congress that would block the changes sought by the nursing administration, and we’ve worked with two of the most influential Veterans Service Organizations—the Vietnam Veterans of America and the American Legion—to ensure that their voice in support of the highest quality care for the nation’s Veterans is heard.
On the payment front, we supported the Texas Medical Association in its four lawsuits challenging the flawed rollout of the No Surprises Act. Our partnership with the American College of Radiology and the American College of Emergency Physicians provided a solid foundation for our joint amicus briefs, which were specifically cited in the court’s favorable rulings. And, while the long-term results of these four legal victories are still not fully known, it is certain that winning all four was far better than losing.
Although we worked tirelessly, any candid assessment of the past year needs to acknowledge the lack of substantial gains on Medicare payment. Given the history of the past 30 years, this is not wholly surprising. While we fought the proposed 10% fee schedule cut for 2023 down to about 4%, it’s hard to couch this as a significant victory for our members. However, the Administrative Council is exploring a full range of options that may be available to us to address unsustainable Medicare payments. And, reflecting the importance of collaboration within the health care ecosystem, we are also partnering with the Surgical Care Coalition and the American Medical Association to confront this problem.
The year was also a time of significant transition within ASA. Chief Executive Officer (CEO) Paul Pomerantz retired at the end of December and Brian Reilly, our chief operating officer for the past several years, took the reins as CEO on January 1, 2024. Mr. Pomerantz has been an extraordinary leader, making a lasting impact on ASA during his decade-long tenure at the helm.
In addition, we announced the appointment of James. P. Rathmell, MD, MBA, as Anesthesiology’s new editor-in-chief, effective as of the beginning of 2024, and I passed the presidential baton to Ronald L. Harter, MD, FASA, at the conclusion of our House of Delegates meeting in October.
One of the highlights of my term as president was hearing from our members. Whether your comments were supportive or instructive, I’m pleased by all that we accomplished together this year and the foundation we’ve laid for the future of the Society. As with any foundation, there is, of necessity, more work to be done, but ASA is in good hands with the incoming leadership of Dr. Harter, Mr. Reilly, and our outstanding Executive Committee, Administrative Council, Board of Directors, House of Delegates, and ASA staff.
It has been a privilege and an honor serving as your president.
Membership Trends 2019-2023
Diversity, Equity, and Inclusion (DEI) officers are leading efforts for their member cohorts, including development of scholarships for underrepresented in medicine medical students.
New digital offerings included the fellowship guide to support residents in their search for specialty training opportunities and the Roadmap to Become an Anesthesiologist with guidance from student to anesthesiologist.
Robust ANESTHESIOLOGY® annual meeting education and networking saw more than 1,900 anesthesiology residents and 1,600 medical students attend the meeting in San Francisco, making up a third of conference attendees.
Diversity, Equity, and Inclusion has become a term with widely varying meanings and interpretations. Under the guidance of the DEI Strategic Advisory Group, we have set out to ensure there is clarity for what it means and what we will uphold and strive for within the context of ASA.
Key definitions intended to focus on community building and acceptance, in addition to acknowledging merit, knowledge, and skill:
ASA will strive to:
Strategies to deliver on the DEI goals:
Our advocacy efforts resulted in numerous successful outcomes in 2023 in partnership with state component societies, other medical associations, Veterans, and the active involvement of so many members.
2023 stood out for the continued success of enduring products like SimSTAT, ACE, and SEE, and impressive growth in newer online offerings like POCUS, Anesthesia Toolbox, and PeRLS. Here are just a few highlights from among our many educational resources:
Anesthesia Toolbox was migrated to ASA’s digital learning ecosystem. This learning platform and community helps anesthesiology departments and residency programs develop, peer review, and share learning resources. 120 residency programs from four continents (North America, Africa, Asia, and Europe) are subscribed to the Toolbox for a total of 10,608 users. Anesthesia Toolbox has a growing library of more than 1,500 content items and 2,500 questions.
More than 12,000 unique users were enrolled in ACE: Anesthesiology Continuing Education courses. ACE evaluations received in 2023 have averaged a recommendation rating of 99.5%.
Summaries of Emerging Evidence (SEE) remains a highly regarded educational offering, garnering an average recommendation rating of 99.2% for the 2023 editions. The program had nearly 5,000 subscribers during the year.
In 2023, ASA hosted more than 50 in-person, virtual and hybrid meetings, and partnered on more than 40 revenue-generating events at the ASA Conference Center, the third highest grossing revenue year since the Center opened in 2014.
Our proactive media outreach to reporters nationwide and in response to timely issues, including ASA’s guidance on when GLP-1 agonists should be stopped prior to elective surgery, preserving physician-led anesthesia care for Veterans, the U.S. Food and Drug Administration’s approval of over-the-counter naloxone, and research presented at ANESTHESIOLOGY 2023, showcased our members’ thought leadership in anesthesiology as well as the broader health care community.
In 2023, we secured 5,831 placements in top-tier national, local consumer, and trade media, an increase of 39% over 2022. Top placements included ABC News, Good Morning America, CNN, TIME Magazine, Associated Press, Yahoo! News, Washington Post, U.S. News & World Report, Rolling Stone, and People Magazine.
Our social media properties posted content across X/Twitter, Facebook, Instagram, and LinkedIn, earning:
In 2023, the Made for This Moment (MFTM) digital ad campaign earned more than 10.8 million impressions, nearly 3.4 million video ad views, and 14,000 website visits.
A new suite of vertical-format, short-form video ads launched, engaging the three priority audiences of health care executives, policymakers, and members – on topics such as workforce shortages, cost of care, equity, and access to care, and the unique value and role of anesthesiologists.
Collaboration continued with our 53 component societies, 12 affiliated subspecialty societies, and 13 international societies.
After a global search, the ASA Board of Directors approved the appointment of James P. Rathmell, MD, MBA, as the next editor-in-chief of Anesthesiology. Dr. Rathmell began his term on January 1, 2024. 
The Anesthesia Foundation provides loans to anesthesiology residents of up to $7,500 at no interest if repaid within six months of completing training. In 2023, 44 residents received $330,000 in loans; 25 former loan recipients completed repaying their loans, 14 of which were repaid before maturity without incurring any interest charges. The Anesthesia Foundation received many notes of gratitude for the assistance provided and continues to make new loans as the need increases, with many residents struggling with big city rents, inflation, family pressures, and program restrictions on moonlighting.
APSF, in collaboration with ASA, the Japanese Society of Anesthesiologists, and the Japan Federation of Anesthesiologists, planned the first international conference on anesthesia safety to be held in Tokyo, Japan, February 9-11, 2024. The APSF Stoelting Conference was held in September 2023 and had a combined 150 in-person and virtual attendees discussing “Emerging Medical Technologies - A Patient Safety Perspective on Wearables, Big Data, and Remote Care,” an event that critically examined a group of emerging technologies from the perspective of patient safety. In addition, APSF developed three videos, moderated by Della Lin, MS, MD, FASA, on workplace violence. The APSF awarded more than $14 million in grants and will fund two Investigator Initiated Research Grants for 2024.
FAER awarded funding to 16 anesthesiologists totaling $3,225,000 - including the first-ever SOAP-FAER Mentored Research Training Grant (MRTG), co-sponsored by the Society for Obstetric Anesthesia and Perinatology (SOAP). FAER matched 67 medical students to 42 host institutions for the 2023 Medical Student Anesthesia Research Fellowship (MSARF) program - the greatest number of sponsored students in a single year in the history of the program. The second annual Academic Giving Competition saw 28 academic anesthesiology departments compete for most funds raised and most donors. $309,069 was raised during the 12-day competition, almost double the funds raised in 2022’s inaugural competition, enough to fund an entire MRTG plus sponsor roughly 10 MSARF participants.
In 2023, the ASACF Global Scholars Program provided support for 11 young leaders in the specialty from low- and middle-lower income countries to participate in the ANESTHESIOLOGY 2023 annual meeting. Prior to the ANESTHESIOLOGY annual meeting, the scholars participated in four-day observerships at one of five hospitals: University of California, Davis, University of California, San Francisco, Stanford University, VA Palo Alto, and University of Washington.
In 2023, work began on the renovation of a $5.5 million collections facility and WLM started moving the collection into the new facility and out of leased space. The WLM also completed a Museum Assessment Program assessment by the American Alliance of Museums.
Focused on Quality and Safety
ASA’s Quality Division, which includes Analytics and Research Services, the Center for Perioperative Medicine, Payment and Practice Management, Practice Guidelines, and Quality and Regulatory Affairs, is addressing many of the most pressing issues impacting the specialty today.
Workforce:
We held our second Anesthesia Workforce Summit in November 2023, which included leader executives from a wide range of anesthesiology practices, representatives of non-physician anesthesia providers, and hospital executives. Summit attendees discussed the supply of anesthesiologists and its need to increase and train more residents—either by expanding residency program size and/or creating new anesthesiology residency programs.
Center for Perioperative Medicine:
The Center for Perioperative Medicine was formally launched as an organizational strategy for the long-term development of ASA’s initiative and goal setting in perioperative medicine. The Center’s goals focus on education, stakeholder engagement, and residency and fellowship training.
Center for Anesthesia Perioperative Economics (CAPE):
The Center for Anesthesia and Perioperative Economics was officially launched in October 2023. CAPE is designed as a future-thinking body that will address economic issues related to anesthesia services and payment.
Diagnostic Excellence Grant and Education Learning Products:
Funded by the John A. Hartford Foundation and the Gordon and Betty Moore Foundation, the ASA project, Perioperative Diagnostic Excellence for the Older Adult: An Educational Initiative, resulted in free educational virtual learning products with CME for anesthesiologists. After 14 months, the learning module has 1,673 learners enrolled.
Leaders in Quality Measurement:
We successfully nominated four representatives to the Centers for Medicare and Medicaid Services consensus-based entity, Battelle’s Partnership for Quality Measurement committees. With their expertise and insight on these committees, it ensures the voice of anesthesiologists is at the table for measure implementation in federal payment and quality programs.
GLP-1 Agonists:
We published guidance on glucagon-like peptide-1 (GLP-1) receptor agonists and preoperative fasting. Our recommendations suggest withholding the medication before elective surgery to reduce the risk of complications associated with anesthesia in adults and children.
Total = $50.3M
■ Membership Dues - $24.7M
■ Continuing Education Products - $9.2M
■ Annual Meeting - $7.2M
■ Grants and Contributions - $2.9M
■ Other Income - $2.6M
■ Publications and Journals - $2.5M
■ Other Meetings - $1.2M
Total = $81.0M
■ Investments - $73.1M
■ Cash - $6.1M
■ Receivables - $1.8M
Restricted and Unrestricted Reserves 2014-2023
($ in millions)
It is imperative that we grow and diversify our revenue streams so we can continue to deliver on our strategic goals now and in the future. Additionally, it is important that ASA is aligned with key segments of the health care ecosystem to uncover value while advancing our mission within those segments.
$1.9 million
Unrestricted Support and Sponsorship Revenue
$3.5 million
Annual Meeting Exhibits and Advertising
$325,000
ADVANCE 2023 Exhibits and Advertising
$300,000
Restricted and CME Education Funding
Despite the number of challenges confronting ASA, it is heartening to see the many achievements from the past year outlined in our 2023 annual report. Much of the credit for our success is attributable to Dr. Champeau; I thank him for his visionary guidance and leadership, leaving ASA in a strong and resilient position.
I am honored to lead ASA in the year ahead. I am filled with confidence in our ability to meet the challenges facing our specialty because of the astounding depth and breadth of talent, knowledge, and commitment to our patients embodied by our members, who are supported by our dedicated and skilled ASA staff.
There are plenty of threats facing us: VA National Standards of Practice; threats of still further Medicare payment cuts; ongoing issues with the No Surprises Act; egregious title misappropriation by students equating themselves to residents, and nurses equating themselves to doctors; annual scope battles in many of our statehouses around the nation; and workforce challenges—to name a few of the most concerning. My pledge to all ASA members is that I will work tirelessly to address these threats to maintaining anesthesiologist-delivered and anesthesiologist-led care of our patients.
In addition to this long and troubling list, I know that these issues, as well as numerous other pressures facing anesthesiologists today, are producing an alarming level of burnout among our colleagues. The pandemic only worsened the plague of burnout that had pervaded all of us in the health care sphere. I am proud of the work that ASA has done on this front, providing important resources for our members to better equip them to address the stresses they face. For all that we have done to date, however, I am certain there is more to do.
We must focus greater attention upon this critically important subject. I will maintain my focus and priority on recognizing, preventing, and treating burnout, and will pursue further opportunities to assist our members as they face these daunting challenges.
It is an honor to lead this amazing society; I look forward to working with all of you as we navigate the year ahead.
This marks my last annual report message, and during my decade as ASA’s CEO, one of the things I’m most proud of is how the American Society of Anesthesiologists has emerged as a leader in the broader health care ecosystem. Dr. Champeau highlighted several areas this year where our partnerships, particularly in our advocacy initiatives, secured significant victories.
In addition to our advocacy collaborations, ASA has strengthened its relationships with medical specialties, the American Hospital Association, patient organizations, pharmaceutical and medical device associations, and with other health care interests. A positive aspect of this influence is our ability to convene multiple stakeholders to solve common problems. A great example from 2023 was our Workforce Summit II held in November, which assembled ASA physician leader executives from a wide range of anesthesiology practices, representatives of non-physician anesthesia providers, and hospital executives who were joined by representatives from the American College of Surgeons, American Hospital Association, International Anesthesia Research Society, Accreditation Council for Graduate Medical Education, and the American Board of Anesthesiology.
Throughout this report, you’ll see numerous areas in which ASA led the way in creating partnerships to bring value to our members, advance the specialty and, most importantly, improve patient care.
The last 10 years have been the most professionally satisfying of my career. I have appreciated the opportunity to work with the most dynamic of medical specialties, the most dedicated of members and physician leaders, and committed professional staff. Together we have grown our membership (to nearly 58,000 members) and society programs, strengthened our advocacy and influence, and prepared ASA for the future. And, a special point of pride I take, is for the seventh consecutive year, ASA was selected as a Best and Brightest Companies to Work For® in the Nation.
Thank you for your support and partnership, your hard work on behalf of the Society and the specialty, and especially what you do for your patients every day. I wish you all the best for continued success, and with Brian Reilly as your new CEO, ASA has a very bright future.
The 2023 ASA Administrative Council took office on October 26, 2022, with their one-year terms concluding on October 18, 2023.
Seated, from left to right: Ronald L. Harter, MD, FASA, President-Elect; Michael W. Champeau, MD, FAAP, FASA, President; Donald E. Arnold, MD, FACHE, FASA, First Vice President.
Standing, left to right: Kenneth Elmassian, DO, FASA, Secretary; Crystal C. Wright, MD, FASA, Assistant Treasurer; Kraig S. de Lanzac, MD, FASA, Assistant Secretary; Lois A. Connolly, MD, FACHE, FASA, Vice President for Professional Affairs; Jeffrey S. Jacobs, MD, MBA, FASA, Vice Speaker of the House of Delegates; James “Jay” R. Mesrobian, MD, MBA, FACHE, FASA, Treasurer; Patrick Giam, MD, FASA, Speaker of the House of Delegates; David Martin, MD, PhD, FASA, Vice President for Scientific Affairs; and Randall M. Clark, MD, FASA, Immediate Past President.
