In my view, a good leader is able to identify and respond to the timely, tough issues facing an organization. The “hot” issues during the past year—and there were many—did not just suddenly appear. But they did, for several reasons, take center stage and need to be addressed.

As an organization, the AAOS often assumes a leadership role and addresses the tough topics—in developing innovative educational experiences, in building coalitions, and in engaging patients and physicians for change. But the AAOS also serves its members—responding to your needs, advocating for public policy changes to ensure patient access to orthopaedic care, and providing reliable information on a range of topics to members, patients, and the wider public.

The three areas of education, research, and advocacy are the strengths of the Academy. They are supported by a culture of quality and service, which is embodied in the volunteers and staff who carry out the AAOS mission to “serve the profession, champion the interests of patients, and advance the highest quality musculoskeletal health.”

Education
In 2007, the hot topic in education was the Maintenance of Certification™ (MOC) process. The AAOS responded by developing new products and services that can help you meet the requirements for continuing medical education (CME), improve your knowledge base, and strengthen your patient care. As part of the MOC process, the educational focus shifted from didactic delivery of predetermined content to a customized response to your individual personal self-assessment of your strengths and weaknesses.

Both the December 2006 Board workshop and the November 2007 CME Summit concentrated on how the AAOS could make that shift. As a result, under the leadership of Council on Education Chair Alan M. Levine, MD, you will soon see more opportunities for customized learning in the future—using the Internet, virtual reality simulators, and focused learning modules.

Research
In the research arena, technology assessment was the hot topic of the year. The Council on Research, Quality Assessment, and Technology, led by Council Chair Joshua J. Jacobs, MD, took on that task. Based on their recommendations, and in response to member requests, the AAOS is moving forward—slowly and deliberately—not as an evaluator of new technologies but as a clearinghouse of information.

Another research “hot topic” was the development of clinical practice guidelines, particularly for the prevention of symptomatic pulmonary embolism after total joint replacement. In response to your requests for guidelines that address bleeding risks in orthopaedic patients, the Guidelines Oversight Committee developed an evidence-based alternative to previous protocols.

Both these activities reinforce the Academy’s commitment to putting the best interests of the patient first. They underscore the AAOS role as a credible, reliable source of information for surgeons, patients, and the public.

Advocacy
The American Association of Orthopaedic Surgeons continues to work with legislators and policymakers on hot topics such as Medicare reimbursement levels, medical liability premiums, the uninsured, on-call coverage, and physician-owned ancillary services. Although these topics have remained “top-tier” for several years, orthopaedic surgeons are taking the lead in refocusing the debate on the threat such issues present to patient choice and access to care.

Public policy issues take time to develop and address, and the AAOS Council on Advocacy, chaired by David A. Halsey, MD, is moving forward with an agenda for change. With a national presidential election this year, we all have the opportunity to effect change. As Past President Stuart L. Weinstein, MD, points out, participation in the Orthopaedic Political Action Committee (PAC) as well as in the political process itself, is important. (See “Election Year 2008 and the Orthopaedic PAC” on page 41.)

My personal interest in the emergency/on-call issue goes back to my participation on the task force established two years ago. Orthopaedic surgeons in communities across the nation are addressing this issue, and the Orthopaedic Trauma Association is laying the groundwork for change.

Appropriate disclosure
One of the toughest issues the AAOS faced in 2007 was the public announcement by the U.S. Department of Justice (DOJ) of the results of its investigation on the relationships between orthopaedic surgeons and implant manufacturers. Although the AAOS disagreed with the manner in which the DOJ directed the companies to release information under the terms of the settlement, we continue to encourage disclosure of relationships in an educational context that enables our patients and the public to understand the importance of collaboration.

A working relationship between physicians and industry is needed to advance technology and improve patients’ lives. But physician participation in research, product development, and clinical testing must be ethical and appropriate; any activity with a company must be conducted in a transparent manner. “Patients come first” is not just a phrase; it is what drives our profession.

Quality and service
Keeping you informed on the issues is a priority for our Communications Cabinet, under Frank B. Kelly, MD. Your AAOS Now editor, S. Terry Canale, MD, is also passionate about ensuring that you get the news—now!—and has turned our staid Bulletin into a vibrant new publication.

I’ve named just a few of the many hundreds of volunteers who ensure that the products and services developed by the AAOS are timely, accurate, and patient-centered. During my years in leadership, I have seen how AAOS members, volunteers, and staff are creating a culture of quality, doing the right thing, and doing it well. My heartfelt thanks to the AAOS staff, our Board of Director, and the many physician volunteers who serve us all so well.

The French philosopher Victor Cousin once said, “You can only govern men by serving them.” That’s how I hope you see my year as president, as a selfless servant and a consensus builder. Thank you for giving me that opportunity.