I write this in January, the month named for the Roman god Janus, the god of beginnings and transitions, who had two faces…one looking back and the other looking forward. As this will be my last column as your president, I’m going to follow the example of Janus, and share my thoughts on both the past year and the future.


Published 2/1/2012
Daniel J. Berry, MD

Looking back, facing forward

Daniel J. Berry, MD

Building on the past
My predecessor, John J. Callaghan, MD, made “quality” the byword of his year in office. I’m proud that initiatives begun under his leadership became realities during my term of office. In May 2011, the AAOS and the Orthopaedic Research Society cosponsored a Comparative Effectiveness Research Symposium, focusing on the value of musculoskeletal procedures not only to our patients, but to society as well. In October 2011, the AAOS hosted the first Orthopaedic Quality Institute. This unique venture brought together payers, purchasers, government officials, representatives from industry, and other healthcare stakeholders to help find workable solutions that improve the quality of patient care.

Other investments the AAOS has made in “quality” during the past several years also began to bear fruit during the past year. One example is the American Joint Replacement Registry (AJRR), which will provide the data we need to help us, our hospitals, and our patients make the best decisions about joint replacement surgery. Thanks to David G. Lewallen, MD, and many other AAOS members and industry partners, the AJRR is now a reality and poised for rapid expansion.

Quality education is a hallmark of the AAOS, and this is an arena where many transitions are underway. New technologies present both challenges and opportunities—they are frequently expensive, so we invest carefully in those that provide the best opportunities for outreach, education, and integration. From webinars to the OrthoPortal, and from mobile applications to surgical simulation, the AAOS will continue to explore and exploit new technologies that benefit our members and their patients. Our technology project team, led by Mininder S. Kocher, MD, MPH, will help provide guidance in this arena.

Advocacy is an arena that demands cooperation, collaboration, and commitment. The American Association of Orthopaedic Surgeons, through our office of government relations in Washington, D.C., is always looking for ways to establish coalitions and find partners who support our message of quality care, supported by appropriate reimbursement. We must get beyond the short-term fixes to the sustainable growth rate formula and the piecemeal approaches to medical liability reform to achieve fiscal stability and comprehensive tort reform.

With 2012 as an election year, advocacy—particularly through the Orthopaedic Political Action Committee (Orthopaedic PAC), under the leadership of Stuart L. Weinstein, MD—should be on all of our minds. If you have not yet made a donation to the Orthopaedic PAC, I urge you to visit the website (www.aaos.org/pac)to find out how the Orthopaedic PAC works on your behalf and how you can contribute to these efforts.

Speaking of financial support, I also urge you to generously support the Orthopaedic Research and Education Foundation (OREF). Through OREF, you can help support innovations in orthopaedic education by donating to the AAOS Education Enhancement Fund. I also encourage you to support the foundation and lifeblood of our profession—orthopaedic research—by contributing to the OREF Annual Campaign gift-sharing plan, which supports OREF and specialty societies.

Keeping lines of communication open and collaborating with orthopaedic specialty societies to deliver a consistent message—while respecting the individuality of each of the subspecialties—helps ensure that the orthopaedic community remains strong. This is an aspect of the president’s job that I consider key to the future of our profession. Throughout the year, I’ve had the opportunity to work along side members of the Board of Councilors and the Board of Specialty Societies, have attended meetings of specialty societies, state societies, and regional societies, and have had the privilege of working with them in synergistic, constructive ways.

Facing the future
Many of these challenges and initiatives will continue into the future, potentially gaining momentum. New technologies and media are challenging the position of enduring materials—textbooks, journals, even the AAOS Now you hold in your hands. The Internet has transformed educational practices; to maintain its position as the leader in orthopaedic education, the AAOS will need to re-examine how we transfer information. The importance of this initiative is underscored by our decision to add a chief technology officer to our staff executive team.

The emphasis on providing quality care while controlling healthcare costs will also continue. It will be increasingly important for AAOS members to be able to support medical decisions with cost-effectiveness data, such as that being developed by the Social and Economic Value of Orthopaedic Surgery Project Team under the direction of John R. Tongue, MD.

Scrutiny of the ties between orthopaedic surgeons and device makers will intensify as the provisions of the “Sunshine Act” are implemented. And government watchdogs will be paying greater attention to orthopaedists who own or provide ancillary services, to ensure that these arrangements do not create conflicts of interest in providing patient care. For those reasons, the Academy’s disclosure program and the activities of the Committee on Outside Interests, under Kenneth DeHaven, MD, will continue to be important initiatives.

The AAOS Professional Compliance Program is also under scrutiny. I am confident that it will be sustained, but challenges may continue. Defending this program is costly, but I believe is money well-spent.

If you read the Treasurer’s Report by Frederick M. Azar, MD, (December 2011, AAOS Now), you know that the AAOS, like all big organizations, will face fiscal challenges and will require continued prudent financial management in the years ahead. It is perhaps appropriate that Dr. Azar is the nominee for the office of incoming second vice-president; he has the financial background and knowledge to balance revenues and expenditures, enabling the AAOS to continue delivering the great value our members enjoy.

Last words
In closing, I say—as every AAOS president before me has said—“Thank you.” Thank you for the opportunity to serve and to lead this exemplary organization. It has been a privilege to work with such a dedicated Board of Directors and with staff, such as Chief Executive Officer Karen L. Hackett, CAE, FACHE; Chief Operating Officer/Chief Financial Officer Rich Stewart; and Chief Education Officer Mark Wieting, who are so committed to our organization.