Dr. Modell and Mrs. Estes’s History Paper (October, 1993)

Jerome H. Modell, M.D., and Mrs. Kay Estes
In 1964, an organization known as the Southeastern University Department of Anesthesia Chairmen (SUDAC) held its first meeting. The host was Dr. John Steinhaus at Emory University. The participants included the chairmen of university departments of anesthesiology that were located south of the Mason-Dixon line and east of the Mississippi River. At that time, even though some of the department chairs, such as Dr. Perry Volpitto of the Medical College of Georgia and Dr. John Adriani of Louisiana State University, had been in place for many years, academic anesthesiology in the southeastern part of the United States was in its infancy. Of paramount concern to all the participants at the first meeting was the poor recruitment for the field of anesthesiology compared with that for many other specialties. Because of this concern, the American Society of Anesthesiologists (ASA) established a study to determine the reasons that caused medical students to have a negative image of anesthesiology. Dr. Louis Orkin, then Chairman of the Department of Anesthesiology at Albert Einstein College of Medicine and a key participant in the ASA study, was the featured guest at this first SUDAC meeting. Medical students and recruitment consumed the majority of the agenda.
A unique feature of the annual SUDAC meetings was that they were hosted by one university at a time on its campus, or at the primary hospital that served the medical school. The annual meetings were informal. There were no officers elected, no dues paid, and no minutes taken. This permitted the ideas to be shared by “show and tell.” The immediate cooperation between the members of SUDAC proved unique, to the point that they rapidly began to share information regarding clinical care, education, research, and fiscal matters. Due to the symbiotic relationship of the chairmen in SUDAC, their sharing of data, their unwritten pact to assist each other, and their refusal to recruit from each other’s department secretly, the foundation was laid for the rise of academic anesthesiology in the southeast.
This proved to be an excellent format for new chairmen to learn rapidly from their peers. Currently the meetings are still hosted by one university at a time but they are no longer exclusively located on .
As the organization grew in size, it began to address other issues such as the political forces applicable to anesthesiology, the effect of legislation and regulation, and the financial impact of governmental decisions. Although meetings are frequently more structured than in the past, this is one organization that has retained much of its original style and mission.
In 1967, the leadership of SUDAC approached several chairmen of academic departments of anesthesiology in other parts of the country, and the Society of Academic Anesthesia Chairmen (SAAC) was formed. SAAC, because it would be approximately four times the size of SUDAC, required considerably more formality, including the formation of articles of incorporation and by-laws. Officers were elected and formal programs were designed for its annual meetings. Over the years, the agenda of the meetings has shifted more from education and research to the clinical needs of society and how to meet them within the framework of institutions primarily structured for education and research. Because of the changes in reimbursement for professional services, and the growing dependence on those monies to finance academic departments of anesthesiology, in the late 1970s, SAAC became very proactive in this arena. In 1976, at a meeting held in October during the annual meeting of the American Society of Anesthesiologists (ASA), the leadership of SAAC, of the Association of University Anesthesiologists (AUA), and of ASA met and agreed that one representative from each society would meet jointly with representatives of the Health Care Financing Administration (HCFA) to discuss reimbursement methods and their effect on patients who were served both in private practice and in the academic arena.
The concerns shown in the annual programs of SAAC have evolved more and more toward the economic aspects of the specialty and the effect of change on the survival of academic anesthesia. The primary mission of education and research, however, remains and is a very important emphasis of SAAC. SAAC has also recognized that new chairmen of academic departments of anesthesiology frequently are appointed on the basis of their academic achievements rather than on any experience or formal training in business. For this reason, SAAC has recently sponsored, in combination with its annual meeting, special sessions for new chairmen to assist them in meeting the challenges of their newfound position.
Unlike SUDAC, SAAC does not meet at university departments of anesthesia. The meeting is usually held in conjunction with the annual meeting of the Association of American Medical Colleges (AAMC) and is frequently held in Washington, D.C. This permits the members of SAAC to inform their senators and representatives (and their staffs) of unique problems in anesthesiology and how legislation might either favorably or adversely affect the quality and quantity of anesthesiologists for the future. The link to the AAMC is important because it is the organization that nationally represents all colleges of medicine. The strong support of the AAMC in the initiatives of academic anesthesiology is crucial, as is its link to important bodies such as Congress and the National Institutes of Health. In 1992, SAAC, in recognition of the fact that leadership in anesthesiology is not gender related, changed its name to the “Society of Academic Anesthesiology Chairs.
Finally, another group of anesthesiology departments was recognized – those that fell somewhere between academic medicine and private practice – that is, departments with approved residency programs in hospitals not closely integrated with a college of medicine. The educational issues of fellows and residents in anesthesiology are similar between the members of SAAC and their counterparts in the approved programs in nonuniversity hospitals. Therefore, in October 1985, the organization known as the Association of Anesthesiology Program Directors (AAPD) was formed. It holds its annual meetings jointly with SAAC. Much of the program is shared between the two organizations. The balance of the program is directed to other issues of SAAC that may not be relevant to members of AAPD.
(The original paper appended lists of the Officers in both Societies and a sample annual program.)

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