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Spring 2009


The Constancy of Change

Tony Mira President and CEO

I am very happy to provide you with another carefully researched and thought-provoking issue of our Communiqué. Our staff and contributors have provided a significant body of material related to the ongoing challenges managing an anesthesia practice effectively in these ever-changing times and particularly challenging economy. Our goal is to give you fresh perspectives on topics of the day and practical suggestions you can implement to enhance the strategic position of your practice.

While our many authors touch on a range of topics, there is a common theme to their perspectives. Change is not only inevitable but coming at us with increasing intensity. Successful practices cannot afford to be caught off guard. The calibration of our environmental scanning must be fine-tuned. No aspect of practice management is exempt from the tinkering of legislators, regulators, payors and hospital administrators. Gone are the days of happy oblivion when strong collections and consistent cash flow made for a stable practice. It is no longer enough to simply have good outcomes. The market is always pushing us all to do more for less and to be all things to all customers.

I hope you will study each of these articles as they have all been chosen to give you a balanced perspective. I am especially proud of our core series of pieces on the Anesthesia Care Team. We have had so many questions about our view of anesthesia staffing issues we wanted to make sure we included a variety of perspectives. Our main article, The Future of the Care Team, was written jointly by our own Jody Locke and Frank Rosinia, MD of New Orleans. For balance we have also included contributions from three clients: Trevor Myers, MD of Arlington, Virginia who is president of a care team practice; Richard Bindseil, DO and Steve Weddel, MD from Longmont, Colorado, who are part of an all physician practice; and Robert Hague, CRNA who is the president of a practice of physicians and CRNAs in Idaho Falls, Idaho. Jackie Popiela, one of our vice presidents of client management also shares her experiences working with practices as the work through the issues of modifying their staffing model. This is probably one of the most timely and challenging topics of the day. I can only hope we have done it justice.

Do not shortchange yourselves, though, each of the other pieces is sure to stimulate reflection and possibly inspire some internal discussion within your organization about opportunities to either refine your governance, manage your expenses or prepare for any of the other regulatory changes being considered. Our writers are all recognized experts in their respective fields. Just as they advise us, let them advise you.

This is why we produce the Communiqué: to stimulate debate and flush out best practices. We gets lots of useful feedback on all of our issues. Please let us hear from you. If something interests you and ultimately leads to a refinement of your practice, let us know. By the same token, if we have missed or mis-stated a topic that is near and dear to your heart let us know this as well. We are committed to providing a forum for the sharing of ideas and the cultivation of successful strategies for success.

Many thanks for your continued support. All the best in this season of rebirth and recovery.