Published 9/1/2008
Frank B. Kelly, MD

Step up the advocacy ladder

AAOS advocacy depends on you

During the past decade, AAOS advocacy efforts—addressing the concerns of orthopaedic patients, improving the quality of health care, and strengthening our profession—have become increasingly important to AAOS members. Recognizing this, the American Association of Orthopaedic Surgeons (the other AAOS we belong to) was formed in 1999 to enhance advocacy activities at both the federal and state levels.

In the 2005 and 2007 AAOS Member Needs Assessment surveys, the fellowship clearly stated that advocacy for issues such as achieving reasonable Medicare reimbursement and enacting meaningful medical liability reform is of great importance. Despite the sincerity of those opinions and concerns, most members are reluctant to become personally involved in advocacy activities.

AAOS leadership has listened to member priorities and seen the gap in activity to match the need. As part of the efforts to help more of our fellows increase their effectiveness in the advocacy process, the volunteer leadership structure was revised 2 years ago and a Council on Advocacy was created. In addition, two recent board workshops were devoted to advocacy.

From benchwarmers to all-stars
Determining how to best encourage members to be more involved is a difficult and complex problem; very few of us pursued a medical career to be engaged in the political process! Most of us have taken the “default” option, preferring not to be involved and yielding this responsibility to the handful of our colleagues who have embraced advocacy efforts and who expend their personal time and resources to develop expertise and effectiveness in this area.

With some colleagues willing to do the “heavy lifting,” is it appropriate that the rest of us fail to support their efforts while continuing to complain in the doctors’ lounge? Although we cannot all be advocacy “all-stars,” we can all be patient advocates and we all have the ability to make a difference! To be most successful, everyone must do their part while we “build the bench” with those willing to play a leading role.

Are you ready for advocacy “basic training,” willing to “build the bench,” and energized to climb the “advocacy ladder” to All-Star status? If so, the following steps will take you to the top.

Support your PAC and candidates for office
Without taking time from your practice and patients, you can take the first and most essential step by annually contributing to the Orthopaedic Political Action Committee (PAC). Like it or not, political campaigns are run on financial contributions. Though contributions to candidates and PACs do not directly influence a vote, these contributions do help gain access to elected officials, thereby affording an opportunity for our more engaged colleagues to educate these individuals about our issues.

The recent growth of the Orthopaedic PAC is now giving the AAOS unprecedented access to members of Congress, improving the odds that good public policy will result for your practice and patients. But don’t stop there; making contributions to your state medical and state orthopaedic PACs—as well as directly to individual campaigns—is part of a culture of regular giving and advocacy citizenship. Financial contributions do make a difference; just ask the trial lawyers!

Establish relationships
Sometimes, it is who you know. Form personal relationships with your local, state, and national elected officials. Although contributions to campaigns are an essential component of this step, perseverance is the key. It may take some time before elected officials recognize and call you by name, even longer before they look to you for education and advice on issues. You can start establishing relationships at any time…but sooner is better than later.

Perhaps the most expedient and effective method to establish this relationship is to actually host a fundraiser in your home. Candidates greatly appreciate and remember those who host a reception for them. The process is not complex; often, the candidate’s staff will help make most of the arrangements. Hosting a fundraiser is one of the best ways to form a lasting relationship with elected officials.

Meet with your elected officials
Once these relationships are established, take the next step and call or meet personally with elected officials on a regular basis to discuss pertinent issues. Sign up for and respond promptly to AAOS legislative alerts asking that you contact your state or federal representative. Be willing to schedule meetings to discuss your concerns.

This “one-on-one” advocacy enables one message to be delivered by many voices. As the relationship develops and trust is established, you will become a valuable resource on medical issues.

Coalitions, regulatory agencies, judicial elections, political parties
Successful advocacy includes other essential, behind-the-scenes activities, such as coalition building, testifying before or serving on regulatory agency panels, working on judicial elections and litigation that affects our patients, or becoming active in a political party at the local, state, or national level. While often overlooked, this involvement is an important aspect of the advocacy process.

Media spokesperson
Top rungs of the “advocacy ladder” require experience and expertise that enable you to serve as a “go-to” media person. We can’t all be “media stars,” but with AAOS media training, we can become effective spokespersons for our local or statewide organization. Other opportunities include writing articles for your local newspaper or appearing as a regular local TV or radio guest.

Everyone can be an advocate
The opportunities for involvement in the advocacy arena are endless, and every fellow should be an advocate at the basic level. Although most of us will not become stars and only a few will ever consider running for elected office, we all can make a difference. Building close, lasting relationships with elected officials takes time and commitment. As you gain expertise and feel more comfortable with the advocacy process, you can serve as a spokesperson at the local, state, or national level.

Remember, successful advocacy is all about you. If you decide to participate in the advocacy process, there is certainly no guarantee you will win…but if you don’t participate, you are guaranteed to lose!

Frank B. Kelly, MD, chairs the AAOS Communications Cabinet. He can be reached at fkelly@forsythstreetortho.com

Advocacy Basics

  • Register and vote
  • Join the Orthopaedic PAC
  • Sign up for AAOS Action Alerts
  • Make the calls when asked
  • Go to an event for your Congressional representatives

What orthopaedic advocacy all-stars do

  • Serve in the U.S. Congress
  • Contribute $1,000 annually to the Orthopaedic PAC
  • Serve as fund raising leaders
  • Host federal candidate fundraisers
  • Have close personal relationship(s) with members of Congress
  • Are leaders in coalition, regulatory, and judicial arenas
  • Serve as officials in the political party of their choice
  • Are successful workers in the legislative process
  • Are skilled media spokespeople