During the Town Hall meeting, AAOS leadership (left to right) Tony Rankin, MD; Joseph D. Zuckerman, MD; and John J. Callaghan, MD, responded to concerns expressed by fellows.


Published 4/1/2009

Advocacy was “Talk of the Town Hall”

Intersection between medicine, politics was key

Advocacy was the “talk of the Town Hall” held during the 2009 Annual Meeting. Most of the questions focused on patient advocacy, quality care, the different types of quality measures, the on-call issue, and AAOS efforts to effect change in these areas. Many of the members’ questions and comments reflected a shift in attitude toward the need for advocacy on the grassroots level.

Robert H. Haralson III, MD, MBA, moderated the meeting, with members of the presidential line, the AAOS Board of Directors, and other staff on hand to answer questions.

Wanted: Members with Obama connections
In response to a question about the change in Washington, D.C., with the election of Barack Obama as president, David Lovett, head of the AAOS office of government relations, pointed out that Democrats focus on primary care rather than procedures. “He [President Obama] needs to be educated on these issues,” said Mr. Lovett.

Although the AAOS has established several working relationships with members of the Senate and House, it doesn’t have strong ties to the Obama administration.

“If you’ve got a connection to President Obama, we need to know about it,” he implored members. “We need to develop a personal relationship with him.”

Any members who have access to the president should contact the AAOS office of government relations, or e-mail or call the Orthopaedic Political Action Committee (PAC) Chair, Stuart L. Weinstein, MD; David A. Halsey, MD; or the Council on Advocacy Chair, Peter J. Mandell, MD.

Keys to advocacy: PAC money, patient advocates
When one member asked whether the PAC should take a stance in presidential elections, Dr. Weinstein responded “We are a pragmatic PAC. We support members of Congress who support our issues.

“When it comes to advocacy, there are so many issues on the table right now,” Dr. Weinstein said, “and our access to Congress has never been better.” He pointed out, however, that if more members would step up to the plate financially, the PAC would be better able to take advantage of the situation.

Although the Orthopaedic PAC is the second largest medical specialty PAC, only 25 percent of AAOS fellows contribute.

Dr. Haralson pointed out that the AAOS Board contributes at the 100 percent level and that the Board of Councilors contributes at the 98 percent level. He urged those in the audience to get involved.

During the Town Hall meeting, AAOS leadership (left to right) Tony Rankin, MD; Joseph D. Zuckerman, MD; and John J. Callaghan, MD, responded to concerns expressed by fellows.
Michael Marks, MD, of Norwalk, Conn., was among the fellows who raised issues at the Town Hall Meeting.

Another source of assistance would be patient stories, sharing difficulties they have faced in obtaining access to quality care.

“Finding patients to assist in these efforts is a problem,” said Jeffrey M. Smith, MD, of San Diego. “As surgeons, we have a moral ethic. We step in and take care of the patient. We go out of our way to provide quality care no matter what we get paid for it. That leaves us as the only people who can explain the situation. With the public perception of doctors being highly paid, we’re just a notch below the CEOs on the negative list.”

Daniel W. Green, MD, of New York, took the issue a step further. “When we do encounter a patient who had a problem with access, what mechanism is there to refer those patients?” he asked.

Dr. Halsey encouraged members to contact Dr. Haralson, as the AAOS medical director, with the information.

Quality is also an issue
Questions on the Physician Quality Reporting Initiative (PQRI) focused on possible improvements to the program and the AAOS stance on the issue.

“We’re really interested in quality and making sure—whether it’s an insurance company, a government agency, or some other body—that what they perceive as quality measures are real quality,” said Second Vice President John J. Callaghan, MD. He pledged to hold workshops on quality measures to determine whether the ones currently being used are appropriate. “Then we’ll advocate for the ones that are appropriate, and advocate against those we think are inappropriate.”

Dr. Haralson noted that the PQRI program was not the disaster it appeared to be. He encouraged members to participate in the 2009 PQRI program.

“It’s not too late to start because there are two reporting periods,” he said. He referred members to the AAOS Web site (www.aaos.org/pqri) for step-by-step directions on how to participate.

He also encouraged members to participate in the new e-prescribing initiative. “E-prescribing is very easy for orthopaedic surgeons because we don’t use a lot of medications. And that is another 2 percent incentive payment.”

“We are trying to change the culture of medicine,” noted Tony Rankin, MD, AAOS past president. “We need to get residents involved early in their careers.”

Advocacy, according to one audience member, is made up of a lot of little points. With increased involvement by patients and fellows, the AAOS will be able to address many of them.