Published 7/1/2013
Roshan P. Shah, MD, JD; John M. Froelich, MD; Kristin Leighty; Samir Mehta, MD; the Washington Health Policy Fellows

PAC Challenge Grants Work

Matching or challenge grants increase resident involvement

It is no longer enough for today’s physicians simply to read the literature, have excellent technical skills, and provide compassionate patient care. Increasingly, the ability of orthopaedic surgeons to deliver quality musculoskeletal care is shaped by political forces and the public eye.

The healthcare sector has grown into such a behemoth, with so many stakeholders, that, unfortunately, the central focus in the delivery of health care is no longer the physician–patient relationship. It is critical—today more than ever—that orthopaedic surgeons participate in health policy decisions. That is exactly what the American Association of Orthopaedic Surgeons (AAOS) and many key leaders in the orthopaedic field are doing.

The AAOS Political Action Committee (Orthopaedic PAC) is the engine of that advocacy. Resident participation in the Orthopaedic PAC augurs a bright future for the orthopaedic profession. Sadly, however, an internal review in 2012 found that less than 1 percent of orthopaedic residents are members of the Orthopaedic PAC.

Enticing orthopaedic residents to contribute to the PAC can be done. AAOS Now has previously reported on the success of William N. Levine, MD, at Columbia University in challenging his residents to achieve 100 percent participation in the PAC (“The 100 Percent Challenge,” July 2009). Similarly, several attending physicians at the University of Pennsylvania were also successful in achieving 100 percent participation by residents through use of a matching challenge grant.

Residents usually say they want to join the Orthopaedic PAC, but are too busy. Interestingly, they cited the faculty-matching program as motivation for elevating the priority given to joining the Orthopaedic PAC. These results and other findings were recently published in the journal Orthopedics.

The faculty-matching model is easily replicable at other residency programs and ought to be given serious consideration. It takes one individual—a resident or a faculty member—to organize matching donations. The first step is to solicit faculty members to find those willing to match donations. Then an email to residents encourages them to join the Orthopaedic PAC. Persistence is paramount. The contact person tallies all the resident donations and conveys that information to the faculty members willing to match.

An additional benefit of this approach is that it can be used to recruit new faculty members who never previously supported the Orthopaedic PAC. The key is for residents to learn from faculty members who model their professional responsibility, personal duty, and support of advocacy. This is no small accomplishment.

As of July 2012, only 39 of 153 program directors in residency programs were active in the Orthopaedic PAC. That’s only about 25 percent of program directors—a lower proportion than the roughly 30 percent of overall participation in the Orthopaedic PAC among AAOS members.

Advocacy for the delivery of quality musculoskeletal care is an important part of the practice of orthopaedic surgery and ought to be incorporated in residency training. The first step in professional advocacy—joining the Orthopaedic PAC—is easy to do and is a natural starting point for engaging residents. Faculty members with insight into advocacy issues and the importance of the Orthopaedic PAC can influence trainees and have an even greater influence on the future of the profession.

Roshan P. Shah, MD, JD; John M. Froelich, MD; and Samir Mehta, MD, have all been Washington Health Policy Fellows. Kristin Leighty is the PAC manager in the AAOS office of government relations. She can be reached at leighty@aaos.org