Add to these challenges the tectonic plates of healthcare reform shifting at an unprecedented pace. We should not have to wait years to look back at this time to realize the significance of this moment. Health care is changing for good, but likely not for the good of our patients and our profession. This unprecedented government intrusion into our practices constitutes a threat to patient access and calls for a unified approach and a sustained call to action.


Published 5/1/2013
Frederick M. Azar, MD

A Standing Call to Action

Today our country is struggling with a poor economy, natural disasters, and a protracted war. But the mountains that we must climb are not fundamentally different from those that prior generations of Americans have encountered and have conquered.

Frederick M. Azar, MD

We all know that orthopaedic care will be in even greater demand in the future. Thus, we must see the challenges that await us as opportunities for advancement and enhancement for the sake of our patients and our profession.

In the midst of this seismic paradigm shift in healthcare, the question we must ask ourselves is not “why?” but “what?” I would pose the following for your consideration: “Ask what our Academy can do for us, and ask what we can do for our Academy.”

Lifelong learning is a fundamental tenet of our profession and thus our Academy. We continue to work very hard to provide timely, unbiased education through various types of media and courses.

However, the publishing world is rapidly changing, as is the delivery of our CME courses. Two thirds of learning is currently accomplished online, which has led us to expand our electronic media, including ebooks, mobile apps, webinars, and webcasts.

The need for skills instruction will always exist. To address this need, plans for the new building include a state-of-the-art Orthopaedic Learning Center that will have the capability for distance learning. We continue to look for ways to innovate and integrate publication and education activities. This integration will help us to determine how best to incorporate future product development methodologies and delivery of educational programs and publications.

Advocacy, practice management
Physicians are increasingly looking for ways to control practice costs, but many of the greatest cost drivers are only marginally controllable.

This volatility has led to an increase in the numbers of physicians seeking hospital employment model. According to Academy census data, these numbers are rising. As our practice needs continue to evolve, our Academy will accommodate them, regardless of where we practice.

Many of us are familiar with the advocacy phrase: “If you don’t have a seat at the table, you’re probably on the menu.” Through our office of government relations, we have been able to leverage our reputation into many seats at many tables. We have also proactively sought to sponsor our own events in an effort to engage other stakeholders in musculoskeletal health.

In addition, the Orthopaedic PAC remains #1 among health professional PACs, and that’s with only 28 percent membership participation. The opportunity here for us lies in the 72 percent who do not routinely contribute. Just imagine how much more we could do to advance orthopaedic issues if they joined!

This statistic demonstrates the need for greater unity, which is critical to the house of orthopaedics. We only represent 2.7 percent of all physicians, and a fragmented 2.7 percent is not going to advocate effectively. So we must collectively advocate for what is best for our patients and our profession.

Research, quality, communication
Why did we become orthopaedic surgeons? Many of us chose orthopaedics as a profession because of the ability to restore function and improve quality of life.

We believe that orthopaedic surgery has the greatest social and economic value in all of medicine. But, with the upcoming disruptive shift in healthcare delivery, we need to guarantee access to orthopaedic care. The AAOS has invested substantial resources in quality initiatives, including patient safety.

Quality is intimately associated with our advocacy efforts. These quality initiatives need to be done, we need to be the ones doing them, and we need to develop them with valid methodologies because they will be directly linked to both delivery and to payment reforms.

The light is about to shine on our performance and quality. Let’s be prepared!

Our patients are our best advocates, just as we orthopaedic surgeons are their best advocates. In 2012, our Academy launched A Nation in Motion® to raise awareness of what we do and to highlight the value we provide to musculoskeletal health in America. This campaign is our commitment to tell the story of the value of orthopaedic medicine and the positive impact orthopaedic surgeons have on patients’ lives.

It’s up to you
What can you do? We need your support. Each of us has been gifted with certain strengths, and each of us has certain interests that we can offer to our Academy. These include volunteerism, financial support, and feedback. We need a more consistent and sustained effort from the three quarters of our members who are currently not engaged in these activities.

I may be preaching to the choir today, so go home and engage your colleagues. This is a standing call to action. There is much at stake here, and it is worth fighting for. Get involved, whether at the local, state, regional, or national level, in the areas of advocacy, education, research, quality, or communication. In return, your Academy will do its best to support these mission-critical efforts on all fronts.

It is easy to succeed in times of calm, but we will be judged—individually and collectively—by how we respond to these unprecedented times of uncertainty. If we begin every deliberation with “what is best for our patients,” we will arrive at what is best for our profession.

In the words of Mark Twain, “Always do right. This will gratify some people and astonish the rest.” Let us look to gratify and astonish.

Frederick M. Azar, MD, is the AAOS first vice president. He can be reached at

Editor’s Note: During the Ceremonial Meeting at the 2013 AAOS Annual Meeting, incoming First Vice President Frederick M. Azar, MD, addressed the fellowship. These following are excerpts from his remarks.