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Published 1/1/2007
Andrew N. Pollak, MD

BOS applauds steps to ensure unity

More than 98 percent of the board-certified orthopaedic surgeons in the United States belong to the AAOS, even though as many as three out of four AAOS members identify themselves as subspecialists. In part, this is due to steps taken by the AAOS to avoid the fate of similar organizations, such as the American College of Surgeons and the American Medical Association, that have fragmented into distinct subspecialty groups.

The Board of Specialty Societies (BOS) grew out of the Council of Musculoskeletal Specialist Societies (COMSS) and serves as a vehicle for communications between the specialty societies as a group and the AAOS. It represents specialty society interests on the AAOS Board of Directors, reflecting the critical importance of the relationship between the AAOS and the subspecialties.

An orthopaedic summit

At an AAOS Board workshop in 2004, a set of principles were developed to guide the AAOS relationships with specialty societies, reinforcing the belief that collaboration with the specialty societies was not only in the best interests of the Academy, its members, and their patients, but also critical to the future of orthopaedics. Those principles included recognition that the relationships between organizations must be based on equality in partnerships, mutual trust and fairness, shared control of joint ventures, open and transparent communication, and proportional risk-reward relationships.

Later that year, at a summit of specialty societies, the AAOS outlined these principles. One-on-one meetings between AAOS and specialty society leaders helped further define the steps necessary to realize the AAOS’ unity efforts. The Academy had been viewed by many organizations as an 800-pound gorilla that could dictate terms of joint ventures without making the effort to meet the distinct needs of individual societies. Larger societies had begun to offer competing and duplicative educational opportunities and products to their members, resulting in a potential waste of volunteer faculty resources, poor geographic distribution of society resources, and inconvenient scheduling of educational opportunities for the orthopaedic surgeon who belonged to both the Academy and the specialty society.

The first orthopaedic specialty society summit also clarified the need to reorganize and refocus COMSS as an organization within the Academy and to develop a mechanism for addressing individual specialty society needs separate from those of the group of specialty societies. The name change from COMSS to the Board of Specialty Societies recognizes the significant changes in the organization.

Integration efforts

Both bottom-up and top-down approaches were taken to integrate AAOS and specialty society structures. BOS committees match the Academy’s Council structure and send representatives to those Councils. This enables more direct communication between the specialty societies and the Academy workgroups responsible for defining the Academy’s portfolio of activities.

Regular one-on-one meetings are held between the Academy presidential line, the specialty society organizational leadership, and the presidential lines and boards of the individual specialty societies. These meetings facilitate communication, address individual challenges as they arise and ensure that the presidential lines, which vary from year to year, remain focused on the importance of ongoing transparency and dialog with one on other.

During this past year, a mechanism was created to include the representatives of the specialty societies in the Academy processes for changing bylaws, proposing resolutions, and developing standards of professionalism. These activities are critical to the Academy and the effectiveness of its advocacy, educational and research efforts, making participation in the processes by the BOS extremely important.

Adding value

The AAOS Board of Directors also recognized the need to add value to the specialty societies’ relationships with the Academy. Academy staff are working with individual societies to identify ways that societies can utilize staff services and abilities. A three-year meeting cycle has been established, in which executive directors will meet annual twice and a specialty society summit will be held in the third year. The first executive directors’ meeting, held in August 2006, was attended by approximately 70 percent of the BOS executive directors. Of those attending, 85 percent reported that the meeting was valuable and expressed interest in continuing their participation.

Internal changes have also helped improve the relationship between the specialty societies and the AAOS. Those include cobranding of instructional course lectures and symposia at the Annual Meeting, joint sponsorship of educational activities using a variety of shared risk/shared reward models, joint publication of monographs and other enduring materials, and integration of several societies into the Rosemont office, additional opportunities for others.

The integration between the BOS and the Board of Councilors (BOC) has been particularly rewarding. The critical process of developing resolutions, bylaws, and standards of professionalism—once the sole province of the BOC—has been shared with the BOS in an effective and collegial manner. The leadership’s vision—in both the AAOS and the BOC—was crucial to this process.

Future Academy leaders will be challenged to maintain the focus on unity and ensure that the Academy maintains its relevance to the board-certified orthopedic surgeons in this country.

Andrew N. Pollak, MD, is chair of the Board of Specialty Societies. He can be reached at apollak@umoa.umm.edu.