One of the Academy’s primary goals must be to increase orthopaedic unity to effect change, improve efficiencies and meet surgeons’ needs

A year ago, at the AAOS Annual Meeting, you heard me say, “Together, we are one.” It may not have meant much then, but during the past year, unity efforts have taken center stage and the results are increasingly visible. I believed then—and I remain convinced today—that one of the Academy’s primary goals must be to increase orthopaedic unity to effect change, improve efficiencies and meet the needs of orthopaedic surgeons in an era of increasing orthopaedic specialization.

Already, more than 75 percent of AAOS members consider themselves specialists in one or two areas. To respond to their concerns and meet their needs, the AAOS must work with specialty societies, coordinating efforts to achieve maximum success.

Initial efforts

The unity efforts began with an Orthopaedic Summit, held in October 2004, and involving leaders from both specialty societies and the AAOS. Together, we developed a set of recommendations to ensure orthopaedic unity. These recommendations included reorganizing the Council of Musculoskeletal Specialty Societies (COMSS), integrating specialty society and Academy educational programs, increasing specialty society involvement in the AAOS Annual Meeting, and meeting one-on-one with specialty leadership on a regular basis.

In acknowledging the importance of subspecialty care, the AAOS initiated a massive change in organizational culture. The Academy recognized that it shares the same concerns that specialty societies have. COMSS—now a reorganized, action-oriented Board of Specialty Societies (BOS)—is working with the Board of Councilors (BOC) to address combined organizational issues that affect not only the grass roots orthopaedist but also the specialist. Under a newly established structure, the executive directors of each of the specialty societies are meeting with the Academy’s executive director to address common issues.

Over the past year, these actions have blazed a pathway to major advancements that will ensure continued orthopaedic unity in the future. The BOS and the BOC have held combined meetings during the spring National Orthopaedic Leadership Conference and the fall educational meeting. Together, they are addressing common issues of reimbursement, scope of practice, tort reform, and medical education—including maintenance of certification. There is now a process for the BOC and BOS to bring resolutions forward on common issues, effectively providing the fellowship with a way to change the course of the Academy.

Educational efforts

Major advances have been made in combining and cobranding the Academy’s continuing medical education (CME) courses with specialty societies. When we started, only 38 percent of courses were jointly sponsored. Today, 70 percent of courses are cobranded.

This effort has several benefits for both the Academy and the specialty societies. It eliminates duplication of efforts while it helps reduce competition for increasingly scarce education dollars. It attracts the best instructors and enables the best use of resources for CME events.

Specialty societies are now high-level participants in planning the AAOS Annual Meeting program. Symposia submitted by specialty societies have a high priority for acceptance. To ensure that scientific papers and posters reflect the “hot topics” and latest thinking on a subject, the subcommittees that review submitted abstracts are composed primarily of specialists in that area of expertise.

Working together

Throughout the year, the AAOS leadership meets one-on-one with specialty society leadership. Together, we identify beneficial areas of common interest and make action plans. The Unity Review Group, recently approved by the AAOS Board of Directors, monitors these efforts to ensure that goals are met and that the unity effort is moving forward.

The effects within the Academy of this culture change to encourage unity have been substantial. There are major initiatives on education, Web site linkage, and advocacy issues that will benefit both specialists and general ortho-paedists. Bob Jasak, an AAOS staff member in the Washington, D.C., office, is specifically assigned to and supported by multiple specialty societies to address reimbursement and specialty interests in Washington.

Working together in Washington can have powerful results, as we have already seen. The partnership between the AAOS and the American Association of Hip and Knee Surgeons (AAHKS) in response to proposed cuts in reimbursement for total hip and total knee replacements is just one example. Representatives from the AAOS and the AAHKS met with representatives from the Centers for Medicare and Medicaid Services (CMS) to petition CMS to maintain current reimbursement levels. This successful effort saved orthopaedic surgeons between $58 million and $100 million a year in reimbursement for these procedures, but it depended on a combined effort. (See related story beginning on page 1.) The AAOS will continue to work with other specialty societies on advocacy issues that affect specific areas of orthopaedics.

Expanding our efforts

The unity effort has expanded beyond specialty societies to reach and involve regional and state orthopaedic societies. The AAOS is developing a structure for regional societies and increasing our links to state societies to address common issues in education, advocacy, and research.

In addition, the AAOS has reached out to sister organizations, such as the American Orthopaedic Association (AOA), the American Board of Orthopaedic Surgery (ABOS), and the Orthopaedic Research and Education Foundation (OREF), to ensure that we work together in an effective manner. AOA and AAOS leaders are meeting on a regular basis to identify areas of collaboration. We are partnering with ABOS on issues surrounding Maintenance of Certification to ensure a user-friendly process. We are working with OREF to expand patient and public awareness of the value of orthopaedic surgery and orthopaedic surgeons, and the need for further research on musculoskeletal conditions.

I am so proud of how far this unity effort has come in just one year and what a difference it has made for our members and our profession. The AAOS and specialty societies are looking for partnership opportunities to address member needs. The relationships between the AAOS and specialty societies, regional societies, state societies and other orthopaedic societies have never been stronger. The BOC and BOS are beginning to work effectively and efficiently with each other. These efforts are turning orthopaedic unity into a reality, enabling us to speak with one voice on major issues that challenge our profession. Unity is mission-critical. Together we are one.

Richard F. Kyle, MD

President