Fellows and members may file formal grievances based on alleged violations of the Standards of Professionalism (SOPs) that have been adopted by the fellowship. Currently, the AAOS has four SOPs establishing mandatory standards for all fellows and members in the following areas:
- Providing Musculoskeletal Services to Patients
- Professional Relationships
- Orthopaedic Expert Witness Testimony
- Research and Academic Responsibilities
Two additional SOPs—Advertising and Orthopaedist-Industry Conflicts of Interest—will be presented for consideration at the 2007 Annual Meeting and voted on by the fellowship following the meeting.
Only fellows and members may file grievances against other fellows and members. A signed and dated Grievance Report that identifies the alleged violations of SOPs is required to begin the grievance process. A Grievant (the person who files a grievance) may seek advice from counsel to prepare the Grievance.
The Grievant bears the burden of proof. All material relevant to the accusations should be sent with the Grievance Report. The AAOS office of general counsel then conducts an administrative review prior to submitting the grievance materials to the Respondent (the person alleged to have violated the SOPs) and members of the Committee on Professionalism (COP).
Responding to a Grievance
AAOS provides the Respondent with copies of the Grievance Report and all supporting documents submitted for consideration. The Respondent then has 60 days in which to respond to the allegations and submit his or her own set of supporting documents for the COP’s consideration. A Respondent may seek the assistance of outside counsel.
All communications regarding grievances must be made through the AAOS office of general counsel. Information about grievances is confidential and should not be shared with others until the AAOS Board of Directors has taken final action.
Prima facie determination
The COP reviews grievances to determine whether a prima facie matter exists. If so, there is sufficient merit in the information the AAOS has received from the Grievant and the Respondent to support the allegations and allow the matter to proceed to a hearing. This hearing permits both the Grievant and the Respondent to present evidence, including witnesses if necessary, and to be represented by counsel if desired. Final recommendations regarding a grievance are determined in executive session only after a formal grievance hearing.
The Board of Directors adopted revisions to the Professional Compliance Program Grievance Procedures for all grievances filed on or after Dec. 2, 2006. The following revisions were adopted:
- Move the Definition section to the beginning of the procedures
- Clarify that the AAOS Professional Compliance Program is an ethics compliance program, not a peer review program under the federal Health Care Quality Improvement Act
- Clarify that there is an obligation for Fellows to participate in the AAOS grievance process in good faith
- Clarify that each party to the grievance is responsible for obtaining and providing all information to AAOS
- Clarify that the burden of proof rests with the Grievant
- State that the COP will meet at least three times during the year, at the Annual Meeting and at two or more other times, and that COP meetings outside of the Annual Meeting will be held in Rosemont, Ill., unless the COP determines otherwise due to “extenuating circumstances.” In 2007, the COP will meet Feb. 16-17 (in San Diego during the Annual Meeting), June 1-2 (in Rosemont, Ill.), and Oct. 5-6 (in Rosemont, Ill.).
- Establish an expectation that there will be regularly set meetings of the Judiciary Committee
- Clarify how the recommendations on the grievance will be heard by the AAOS Board of Directors
Grievances submitted to AAOS prior to Dec. 2, 2006, follow the Professional Compliance Program Grievance Procedures dated Sept. 24, 2005.
Professional Compliance Program Grievance Procedures can be accessed online at: www.aaos.org/ProComp.