There Is No Room for Partisanship in Orthopaedics

Academy engages in year-long, in-depth conversations about partnerships

Given the recent midterm elections and the upcoming presidential election in 2020, it is difficult to avoid political rhetoric and ignore the general population’s growing displeasure, regardless of your party affiliation. Mass media are zeroed in on topics calling for bipartisanship and challenging one-sided policies and divisiveness in general.

Don’t worry; I’m not going to weigh in on the current state of U.S. politics, but I do see some similarities—both good and bad—with orthopaedics.


David A. Halsey, MD

Dominance is not necessary, nor logical

Thirty years ago, the orthopaedics landscape was relatively narrow, with few professional societies serving the orthopaedic community. Today, however, it is much more diverse with many subspecialty and state societies, each with their own missions, striving to further expand their niches. Where it gets interesting, though, is when the societies overlap, creating competition for resources, members, market share, and so on, as well as potentially redundant products and services.

Like some, I support both a competitive and collaborative orthopaedic environment. If done correctly, it can bring out the best in all stakeholders and provide additional value to constituents. Let me be clear, there is no reason to strive for dominance in this incredibly complex marketplace. Instead, I believe we are stronger together than we are alone, especially when addressing universal topics such as advocacy, continuing medical education (CME), research, and training issues. The following is a list of products and services for which the Academy currently partners with other organizations:

  • advocacy
  • communications
  • clinical practice guidelines, appropriate use criteria, performance measures
  • governance
  • in-person educational meetings
  • joint CME sponsorship
  • management/consulting
  • online/digital learning

These offerings thrive with collaboration and shared resources, whether it be financial, infrastructure, or subject matter expertise. Without collaboration, they cannot achieve maximum impact.

With that said, I am happy to provide an update to the Academy’s year-long, multiphase partnerships initiative, which focused on the Academy’s current partnerships, mainly with the Board of Specialty Societies (BOS), which includes 23 professional societies.

But before I get into the specifics, I absolutely must personally thank each society within the BOS for participating in this process. It was such a positive, collaborative, and eye-opening experience.

Such reflection is rarely easy. It almost always requires difficult conversations, and that was the case with this initiative. Fortunately, each society’s representatives, including board members, executive directors, and staff, were nothing short of exceptionally professional, thoughtful, and genuine. They provided profound feedback that we could not have produced in any other way.


Representatives from the American Shoulder and Elbow Surgeons discuss during a breakout session at a Partnership Summit.

Academy’s initial assessment identified need for improvements

In 2017, the AAOS Board of Directors reflected on its partnerships with the subspecialty societies. Our initial assessment was that there was room for improvement, and it was greatly needed. We identified wide-randing inconsistencies in agreements, communications, support, and expectations.

In response, the Board dedicated resources in 2018 to thoroughly assess its partnerships in hopes of redefining them in a way that is mutually beneficial and well managed. It’s our vision to create a partnership culture that accomplishes the following:

  • promotes alignment, not rivalry
  • defines direction
  • allocates resources
  • clarifies roles
  • provides mutual benefits
  • creates shared value
  • holds people and organizations accountable
  • ensures agility and innovation

Framework for a better future state

It’s no surprise that such meaningful goals cannot be accomplished with a few sporadic conference calls and a handful of in-person meetings. We leaned on a well-defined, multiphase process, which required full buy-in and participation from all stakeholders. And I’m pleased to report that we met our requirements.

The partnership initiative included three primary components:

  1. Discovery – provide a historical view of what has and has not worked, as well as what needs improvements
  2. Principles – identify universal governing principles for representation, governance, products, and services
  3. Frameworks – outline detailed business models and frameworks for partnerships across products and services

In the early stages, the Academy commissioned a third-party vendor to conduct quantitative research to measure subspecialty society satisfaction with AAOS activities and services in which the societies partnered with AAOS. In March, during the Partnership Summit I held at the AAOS 2018 Annual Meeting, the data were synthesized, and best practices were identified. In the following month, we leveraged a Board workshop to evaluate principles. Shortly thereafter, AAOS drafted sustainable frameworks. The Board approved the Partnership Principles and presented them to the BOS at the National Orthopaedic Leadership Conference in June. From there, we solidified goals, strategies, and frameworks.


The American Spinal Injury Association and the Scoliosis Research Society were two of 23 organizations that provided feedback to the Academy throughout the various data collection opportunities.


The American Orthopaedic Society for Sports Medicine representatives brainstorm ideas during a Partnership Summit earlier this year.

Results

It took a village, one consisting of the Academy and every BOS partner, and it was well worth it. The strictly defined principles and frameworks will lead to a much more harmonious orthopaedic community where the Academy and the subspecialty societies can increase their value propositions to their members by providing more relevant products and services.

The Partnership Guiding Principles include:

  • Provide AAOS member value – All partnerships deliver value to AAOS members.
  • Align with the AAOS Strategic Plan – All partnerships support the AAOS Strategic Plan and enhance partner value.
  • Reinforce effective communication – All partners establish and maintain clear, effective, and accountable two-way communication.
  • Thrive on professionalism and mutual value – Interactions are focused on professionalism, respect, collegiality, trust, and appreciation of the relationship’s mutual value.
  • Negotiate equitable, clear, and consistent agreements – Partnership agreements are equitable and comprehensive.
  • Establish effective processes with assigned accountabilities – Partnership processes and roles are clear and utilized to increase efficiency and mutual accountability.
  • Review and track progress – Every partnership creates and tracks metrics that are reviewed, communicated, and revised as necessary; lessons learned are documented and shared.

It must be fate that our guiding principles spell PARTNER!

Moving forward, we then developed four frameworks:

  1. Service provider – AAOS provides specific services to partner for a fee.
  2. Copromotion (name only) – Two organizations leverage separate promotion capabilities within a single marketing strategy. No revenue or expenses are exchanged or logo usage fees.
  3. Subject matter expert collaboration – One partner leads the development effort and utilizes select content experts from the other partner, along with branding, to strengthen the offering and its reach.
  4. Joint collaboration – This is an expanded form of partnership where two or more organizations partner and share in the risks and rewards of the partnership. Frameworks vary from utilizing significant member contributions from the partner to having joint member-leadership collaboration and sharing financial and operational responsibilities.

Looking to the future, the principles and frameworks will not end with the subspecialty societies. We plan to apply what we’ve learned through this initiative when creating partnerships with other orthopaedic stakeholders, such as commercial entities, healthcare systems, and other industry partners.

Again, I want to stress that this initiative was not easy. Taking the time to reflect on your organization and listening to others provide feedback about their perceptions of your organization are difficult. Our Board learned a lot, as did I. But reflection is only the first step.

Now, it’s time to move forward and self-manage. I believe that by working together, in solidarity, we can change the paradigm.

David A. Halsey, MD, a general orthopaedic surgeon with subspecialty interest in hip and knee arthroplasty, is president of the Academy 2018–2019. He is also the chief of orthopaedic surgery at Martha’s Vineyard Hospital.

BOS promotes unity and collaboration
The Board of Specialty Societies (BOS), originally created in 1984 as the Council of Orthopaedic Musculoskeletal Specialty Societies, brings together the leaders of musculoskeletal societies to address issues of mutual concern, such as advocacy, continuing medical education, research, and residency and fellowship issues. The BOS serves as a resource and advisory entity to the AAOS Board of Directors and the American Association of Orthopaedic Surgeons. In addition, the BOS promotes unity and collaboration between the specialty societies and AAOS. The 23 BOS member organizations include:

  • American Association for Hand Surgery
  • American Association of Hip and Knee Surgeons
  • American Orthopaedic Foot & Ankle Society
  • American Orthopaedic Society for Sports Medicine
  • American Shoulder and Elbow Surgeons
  • American Society for Surgery of the Hand
  • American Spinal Injury Association
  • Arthroscopy Association of North America
  • Cervical Spine Research Society
  • J. Robert Gladden Orthopaedic Society
  • Limb Lengthening and Reconstruction Society
  • Musculoskeletal Infection Society
  • Musculoskeletal Tumor Society
  • North American Spine Society
  • Orthopaedic Rehabilitation Association
  • Orthopaedic Research Society
  • Orthopaedic Trauma Association
  • Pediatric Orthopaedic Society of North America
  • Ruth Jackson Orthopaedic Society
  • Scoliosis Research Society
  • Society of Military Orthopaedic Surgeons
  • The Hip Society
  • The Knee Society

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