Published 11/1/2007
Kathleen Delaney

What does it take?

Professional Compliance Program gives all a chance to be heard

Since its inception in 2005, 23 grievances have been filed with the AAOS Professional Compliance Program. To date, four cases have been brought before the AAOS Board of Directors for final adjudication. The status of other cases is shown in the box that accompanies this article. In most cases, the grievances allege violations of the Standards of Professionalism (SOPs) on Orthopaedic Expert Witness Testimony, although alleged violations of the SOPs on Professional Relationships have been cited in two cases.

Only fellows and members may file grievances against other fellows and members. Information about grievances is confidential and not shared until the AAOS Board of Directors has made its final decision.

The Grievant (person who files the grievance) bears the burden of proof. The AAOS office of general counsel conducts an administrative review before submitting the grievance materials to the Respondent (person accused in the grievance) and members of the Committee on Professionalism (COP).

Two opportunities to be heard
AAOS procedures ensure that each party to a grievance has at least two opportunities to be heard. The COP determines whether a prima facie case exists, eg, whether the grievance merits a formal hearing. During the hearing, both the Grievant and the Respondent present their positions and have the opportunity to question the other party. They may have counsel present and witnesses to support their positions.

The hearing panel is composed of members of the COP, and the session is officially transcribed by a court reporter. The COP then meets in executive session to determine its final recommendation. The hearing panel’s report and recommendations are sent to both the Grievant and the Respondent.

Either party may appeal to the Judiciary Committee based on a belief that the COP erred in its recommendations for professional compliance actions or lack of due process. Appealing to the Judiciary Committee is required if either party wishes to make a direct appeal to the AAOS Board of Directors.

The Judiciary Committee’s report and recommendations are sent to both the Grievant and the Respondent and are presented to the AAOS Board of Directors at its next scheduled meeting.

The results of all official professional compliance actions are made public. They are published in AAOS Now, and notice of the action is sent to the American Board of Orthopaedic Surgery, the appropriate state orthopaedic society, state medical board, state licensing board, and, as appropriate, other medical associations. The AAOS also notifies the National Practitioner Data Bank of suspensions or expulsions relating to patient health or welfare, including expert witness testimony.

Professional Compliance Program Grievance Procedures, as well as all approved Standards of Professionalism, are available online at: www.aaos.org/profcomp

Kathleen Delaney is professional compliance program coordinator. She can be reached at delaney@aaos.org

What’s the status of the cases?
Of the 23 grievances filed with the AAOS Professional Compliance Program to date, four cases have been brought before the AAOS Board of Directors for final adjudication; three cases have been dismissed because the COP determined that a prima facie case of a violation of the SOPs was not present (in one of these matters, the Grievant demanded a hearing before a COP Hearing Panel); two cases have been returned to the Grievants because the underlying legal matter was not yet fully resolved, and one case was dismissed because the alleged violation occurred prior to the effective date of the Professional Compliance Program. COP Hearing Panels have conducted 11 grievance hearings, including the demanded hearing.

At present, five cases are at various stages of review.