Collaboration between Specialty Societies and AAOS Is the Key to Advancing Orthopaedics

Editor’s note: This interview is a companion piece to the article “Orthopaedic Practice and Research Are Team Efforts.”

Joseph D. Zuckerman, MD, FAAOS, professor and chair of the Department of Orthopaedics at NYU Langone Medical Center and past president of AAOS, spoke with Robert M. Orfaly, MD, MBA, FAAOS, AAOS Now editor-in-chief, to offer his perspectives on the history of individual and organizational collaboration between AAOS and orthopaedic subspecialty societies.

Dr. Orfaly: Andy, thank you for taking the time to sit down with us and talk to the members about what is new in education. As long as I can remember, there’s been an ongoing conversation about how orthopaedic surgeons can all have our own subspecialty, but we want to work together for common causes for the betterment of our profession and patient care. As someone who’s been a leader sitting at the table for many of these conversations, can you give us a rundown of the history of how we got to where we are today?

Dr. Zuckerman: It’s an important conversation because sometimes the history gets lost. Under the heading of a longitudinal view, my first experience with the concept of orthopaedic unity was probably in the early 1990s, when I was an at-large member of the AAOS Board of Directors (BoD). That was a time when specialty societies were expanding, new societies were being formed, and their membership was increasing.

Back in 1992–1993, the big topic was the fact that the Arthroscopy Association of North America developed this terrific plan for an orthopaedic learning center to teach orthopaedic surgeons arthroscopy, and they did a phenomenal job of fundraising. When it came to the attention of AAOS, their first response was, “Well, we should participate in this.” That led to a number of discussions about how AAOS and specialty societies could partner on a major project like this. There is no playbook for this. What developed afterward was the state-of-the-art Orthopaedic Learning Center (OLC), which has probably educated thousands of orthopaedic surgeons through the years and gave way to the next iteration of the OLC, which is in the new building.

But that was the first sense that as specialty societies got bigger and their membership expanded, their role in the world of orthopaedic surgery was going to change. Now, my view was always that in an ideal situation, AAOS is the umbrella organization. It’s the big tent with everybody included. It was that way for years, but again, societies get larger in terms of membership. Their needs change, and the ability of AAOS to continue to be the big tent changes because AAOS has its own priorities to function well as an organization.

When I was on the BoD as chair of the Council of Education back in 2004, we developed unity summits, where we would spend a day or two with every special society represented for discussions about what the needs are, what can we do, how can we foster unity within the world of orthopaedic surgery in the United States. I thought the goal was always to have AAOS remain the umbrella organization, recognizing that the specialty societies were evolving, and to figure out how these relationships were going to change. You want it to function in a way that works for them and for AAOS, and that’s always been the challenge because, over time, the needs change, situations change, and you have to respond to that. The development of the Board of Specialty Societies with positions on the BoD was a direct response to the fact that specialty societies needed, wanted, and should have a role in how the BoD functions, because the specialty societies are such a big part of it.

I would say virtually every member of a specialty society is a member of AAOS, certainly eligible for membership, other than corresponding members from other countries. You have to have leadership that recognizes that and keeps that relationship going.

Dr. Orfaly: What do you think are the key elements of how that relationship has to continue to evolve in the coming years?

Dr. Zuckerman: Now there’s a whole other issue. Think about what’s happening with our residents as they graduate: 80 or 90 percent are probably doing fellowships, right? They’re coming out of residency with a fellowship designation that they want to subspecialize in. Some of them come into residency with an idea of what they want to specialize in. We want them to recognize the value of being a member of AAOS and whatever special society is appropriate.

But we have to make sure that for the orthopaedic surgeon in this country, the value of being a member of the Academy is clear. That will not only help AAOS but also build unity because then people are members of both AAOS and specialty societies. It keeps them intertwined in a positive way. They recognize both as their homes in orthopaedic surgery.

Dr. Orfaly: When you speak to a resident, how do you counsel them as far as representing both their profession as an orthopaedic surgeon and also as a hip or spine or shoulder surgeon?

Dr. Zuckerman: At NYU, because the department emphasizes the AAOS Annual Meeting and presentations, posters, and the value of going, our residents come out of our program knowing that AAOS is an important organization. That should be everybody’s goal: finish your residency or your training, get board certified, and become a member of AAOS.

At the same time, in a parallel way, for whatever specialty is going to be your focus, you can also be a member of that specialty society. We encourage them to do that, but the point you made is an important one. We are orthopaedic surgeons. I haven’t nailed a femur in decades, but I feel good about the fact that I did and that’s part of my DNA with respect to my profession. We want everybody to view it that way, and sometimes it’s a challenge. We hire faculty, and when the issue of taking a general call comes up, they say, “Well, I did a hand fellowship, so I’m most comfortable there.” I get that, but it’s become more of a challenge for residents to look at themselves as orthopaedic surgeons first and specialists second.

We need to just keep focused on that, which will help the whole concept of unity within the world of orthopaedic surgery. There are a lot of orthopaedic organizations throughout the world. I don’t think this is self-serving because we’re involved with AAOS, but to me AAOS is the preeminent orthopaedic society in the world. All the things they do, whether education and advocacy, I think are unsurpassed. Our goal has to be to have all of our trainees recognize that. At the same time, we must look for ways that the specialty societies can benefit from their association with AAOS and how AAOS can continue to benefit from maintaining a strong and vibrant relationship with the specialty societies.

Robert M. Orfaly, MD, MBA, FAAOS, is a professor in the Department of Orthopaedics and Rehabilitation at Oregon Health and Science University. He is also the editor-in-chief of AAOS Now and chair of the AAOS Now Editorial Board.