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Summer 2008


Ebb and Flow

Tony Mira
President and CEO, ABC

August is here. For most of us this is the time of year when we strive to enjoy family, the weather, and hopefully a little extra time away from the rat race. Ever since I was a kid, the big event of the season was the family vacation. Some, of course, were more memorable than others. There was always a certain sense of adventure about the entire enterprise. It was not uncommon for us to have as much fun planning the trip as executing it. I always liked the contemplation of options and the exploration of possibilities in my mind. Somehow just the idea of a change in routine seemed to have a very restorative effect on all of us.

The other thing I have noticed about this time of year is that you hope you can sneak away without anything going wrong or unraveling while you are on vacation. I must confess I was rather nervous that Congress would not act in time to avoid a cut in the Medicare rate. Having given anesthesiologists a most favorable increase in the conversion factor in January it seemed like we were slipping into an all too familiar pattern. Now I know I can relax a little, not that there aren’t other reimbursement issues looming on the horizon, but they can wait till fall as far as I am concerned.

Whatever your plans for the next couple of months, I hope you find a comfortable retreat far from the madding crowds to read and ponder the various perspectives we have compiled in this issue of Communiqué. As always, we have striven to find authors who will help you explore and better understand the ever-changing face of anesthesia practice management. You will note we cover the spectrum with some insightful pieces on basic business issues such as the importance of managing the cost of anesthesia care and your role in O.R. management. We thought you might be interested in one physician’s opinion on Aquavan. There is also a most relevant and practical discussion of the Roth 401(k). Whether you agree with our authors or not does not matter. Our goal is to bring you new perspectives on topics of the day so that you can gain some perspective on your own practice situation.

If there is one thing I have learned over the nearly 30 years I have been in this business, it is that healthcare is subject to incredible ebb and flow. This year’s threat of a Medicare rate cut only reminds us that anesthesia practice management is a lot like financial planning; you can never really celebrate your successes nor feel too bad about your setbacks, because sometimes they are two sides of the same coin. You just have to hope that you have a reasonable and appropriate long-term strategy so that you continue to have some degree of control of your own destiny versus having it imposed on you by others.

Let us hope that your practice situation is secure and that you have the luxury of contemplating some of the ideas presented in the following pages. May your time with family and friends be pleasant and a source of happy memories. We always welcome and appreciate feedback and comments on our authors’s ideas. Maybe you will even be sufficiently inspired to share some of your own. After all, if it weren’t for you and this challenging business we wouldn’t be here.