SAAC/AAPD History

Formation: The Society of Academic Anesthesiology Chairman (SAAC) grew out of meetings and discussions of the earlier society, the South Eastern Anesthesia Chairmen (SEAC) later to become the Southeastern University Departments of Anesthesiology Chairs (SUDAC). The Association of Anesthesiology Program Directors (AAPD) was created much later to include the Directors of those departments not affiliated with medical schools. I have been fortunate to obtain help from anesthesiologists who were involved in these early discussions and who have provided much of the material which follows.

Sources: The following Anesthesiologists have provided me with documents or recollections;

I would particularly like to thank the above four for providing so many details and recollections about the formation of SAAC. I also appeal to other members of SAAC and AAPD. If you have records, correspondence, photographs, or other items of interest to the Societies' members, please let me know.

Alan W. Grogono, M.D.
November 19, 2003


Letter from John Steinhaus, October 4, 1999:

SAAC History

The organization of SAAC was initiated at the meeting of "University Anesthesia Chairmen" on December 10, 1967. This meeting was chaired by Douglas Eastwood which followed an earlier meeting of an organizing committee consisting of J.F. Artusio, Jr., J.B. Dillon, D.W. Eastwood, B.E. Etsen, N.W. Greene, M.T. Jenkins, B.D. King, Frank Moya, and J.E. Steinhaus. The impetus for an interest in the formation of SAAC came from the favorable and enthusiastic expressions from members of SEAC later SUDAC, a regional organization of anesthesia chairmen from the southeastern area of our country.

The initial meeting of SEAC (SUDAC) was organized by J.E. Steinhaus and held in Atlanta in March, 1964, on the general topic of teaching anesthesiology in medical school centers. It was part of the program of the Training and Recruiting Committee which was initiated by the Anesthesia Survey due to the decreasing numbers of young physicians starting residencies in Anesthesiology. In earlier correspondence, J.S. Gravenstein had suggested the value of such a meeting to J.E. Steinhaus. The immediate, enthusiastic and vigorous response by the attendees led to a second meeting in Gainesville at the invitation of J.S. Gravenstein, the following March, 1965. This group had no formal bylaws and the only officer was the chairman of the given meeting. Membership numbered between 15 and 20 and was limited to chairmen. It quickly expanded its agenda to all problems facing the Chairmen of a Department or Division of Anesthesiology. One of the early subjects of great interest was sharing information on faculty salaries which very successfully countered the unrealistic low salaries gathered by the AAMC that was supplied to the Deans.

A constitution for SAAC was written, revised, and adopted at the 1967 meeting. The minutes of that meeting report favorable comments from many of its members including John Bonica, John Jones, Harry Beecher, John Dillon, Arthur Keats, Nick Greene, Bob Dodd, Ray Parley, and Brian Craythorne.

The following officers were nominated and elected:

President

James Eckenhoff
President Elect E. M. Papper
One Year Councilman Frank Moya
Two Year Councilman M.T. Jenkins
Three Year Councilman J.E. Steinhaus
Advisor to the Council H.K. Beech
Secretary-Treasurer D.W. Eastwood

John E. Steinhaus, October 4, 1999.


Organizational Meeting:

Dr Steinhaus also sent a copy of the minutes from the Organizational Meeting. The minutes are somewhat faded and, for this reason, have not been re-typed here. Accompanying the minutes, however, was the following completely legible list.

Individuals Attending the Oganizational Meeting of The Society of Academic Anesthesia Chairmen (Dec 10, 1967)

John Abajian, Jr. Martin Helrich
John Adriani Evelyn E. Henley
Charles R. Allen Ernest O. Henschel
Joseph F. Artusio, Jr. Duncan A. Holaday
Carter M. Ballinger Thomas H. Irving
H.K. Beecher J.J. Jacoby
Donald W. Benson M.T. Jenkins
John J. Bonica John R. Jones
John P. Bunker Arthur S. Keats
A.J. Cantenacci Kenneth S. Keown
Eugene H. Conner Benton D. King
N.W.B. Craythorne Charles M. Landmesser
James A. Cutter T.E. Macnamara
Gianfranco Dal Santo Valentino D.B. Mazzia
Hamilton S. Davis Frank Moya
Judson S. Denson Jack Moyers
John B. Dillon William C. North
Allen B. Dobkin Louis R. Orkin
Robert B. Dodd E.M. Papper
D.W. Eastwood Ray T. Parmley
James E. Eckenhoff Charles B. Pittinger
James C. Erickson, III Max S. Sadove
Benjamin E. Etsten Peter Safar
Leonard W. Fabian John F. Schweiss
Alastair J. Gillies K.L. Siebecker
J.S. Gravenstein John E. Steinhaus
Nicholas M. Greene Kenneth Sugioka
William Hamelberg Robert B. Sweet
Frederick P. Haugen F.H. Van Bergen
Henri S. Havdala Howard L. Zauder.

Dr. Jerome H. Modell replied with a copy of the paper which he prepared in conjunction with Mrs. Kay Estes (University of Florida College of Medicine) in 1993 for the Wood Library Museum of Anesthesiology. The text is reproduced below:Dr. Modell and Mrs. Estes's History Paper (October, 1993)

HISTORY OF THE SOCIETY OF ACADEMIC ANESTHESIOLOGY CHAIRS

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.)


Dr. Frank Moya (801 Arthur Godfrey Road, Suite 400, Miami Beach, Florida 33140) was also kind enough to look out his own collection of papers. He came across the following correspondence: a request to him from Douglas W. Eastwood and a copy of Dr. Moya's reply:

Dr. Eastwood's Request (Nov 17, 1988)

Medical Center

10701 East Boulevard
Cleveland OH 44106

Veteran's
Administration

In Reply Refer To:112(W)

November 17, 1988

Frank Moya, M.D.
1620 S. Bayshore Drive PH 6
Miami, FL 33131

Dear Frank:

Twenty-five years ago the first "organizational" meeting of the Southern University Department of Anesthesiologty Chairman (SUDAC) was held at the invitation of John Steinhaus in Atlanta. The theme of theis year's meeting is "SUDAC - yesterday, Today & Tomorrow". Ed Ernst who is developing the program aasked me (since John Steinhaus will not be available) to talk about the charter meeting and I need your help.

How did "yesterday's meeting (Wednesday, march 24, 1964) affect you? Could you take a few minuites to indicate your thoughts concerning that meeting (perhaps on audio tape), a portion of which I may be able to present to those present at the April 19, 1989 meeting.

To help you remember the first meeting I am enclosing the invitational letter, program, and minutes of the first meeting made available to me by John Steinhaus. If you have questions concerning my request or want additional infortmation, I can be reached at the Cleveland vetranns Administration Medical Center address as indicated on this letter. The phone number is (216) 791-3800 Ext. 51666.

Sincerely,

DOUGLAS W. EASTWOOD, M.D.

Enclosure

Frank: you sent Jerry to the first meeting but attended many others. - How did they help you?

Regards
Doug


Dr. Moya's Reply (Nov 28, 1988)

November 28, 1988

Douglas W. Eastwood, M.D.
Department of Anesthesiology
VETERANS ADMINISTRATION MEDICAL CENTER
10701 East Boulevard
Cleveland, Ohio 44106

Dear Doug:

I was delighted to hear from you after all these years. Apart from working at the V.A. hospital how are you doing?

The Southern Chaiman's meetings were always useful and informative for me. Probably the most useful aspect of those meetings was the opportunity to chat and commiserate leisurely with the other young struggling chairmen. It was great learning how to be a chairman by exchanging stories of success and failure. Curiously enough, we always seem to learn the most from the worse horror stories.

A specific part of the annual program that I would always look forward to was the Faculty Salary presentations. This was extrtemely useful in my annual discussion and negotiation with the Dean.

Finally, there was the benefit that all academic anesthesiology has enjoyed in the spawning of the Society of Academic Anesthesia Chairmen. I'm sure you'll recall that it was your idea to explore the formation of a national organization modelled after our southern organization. I still remember driving with you through the Shenandoah Valley mulling over the basic principles on which SAAC was later organized.

Doug, many thanks for seeking my thoughts on our Southern Chairman's meetings. It forced me to dredge up many fond memories of you and our southern colleagues.

With personal regards,

Sincerely,

Frank Moya, M.D.

Chairman

Department of Anesthesiology

4300 Alton Road * Miami Beach, Florida 33140 * Telephone (305) 674-2121


Douglas W. Eastwood was also kind enough to respond to my enquiries with the following e-mail:

Dr. Eastwood's E-Mail (Aug 12, 1999)

Dear Alan:

John Steinhaus and I finally got together by phone and shared memories regarding the start of SAAC as best we could. There are some points which neither of us are certain about, and they are, very likely, of little importance to you.

My interest in developing an organization in which all Chairmen of academic departments could share information began when I was on the AUA Council. At that time I was also the representative from the AUA to the Council of Medical Specialty Societies of the Association of American Medical Colleges. Since the AUA membership did not include a number of academic department chairmen I felt that an organization in which all would be represented should be developed.

At the first meeting of the Southeastern Anesthesia Department Chairmen which was held in Atlanta and in subsequent meetings it became obvious that there was a need for open discussion of subjects of common interest like resident and staff recruitment, department status, salaries and medical student and resident teaching. These subjects were available only in hallway discussion at AUA meetings.

Discussion with others on the AUA Council including Moya, Steinhaus, Papper, indicated an interest so I reserved a room in the hotel on the Friday preceding an AUA meeting in New York City. I do not remember the year for certain but it was 1964 or 1965. The exact date could be obtained from the ASA or AUA files. All academic anesthesia chairmen we could identify were invited. An organizing group was established and SAAC was incorporated in Charlottesville. A lawyer friend on the faculty of UVa, Joseph Gibson, did the paper work and expenses for the meeting and the registration came from our department funds.

The list of officers as you have indicated on your web site seems correct to me. I resigned from SAAC when I left UVa to go to the Library of Medicine and the home office moved from Charlottesville to the ASA office subsequently.

I am going to send this e-mail now though it may be that you would like to ask specific questions. I am not certain that I can be specific because I have no files and a memory which is occasionally oblique.

Sincerely,

Doug Eastwood