Some years ago, before there was an AAOS Communications Council or even a Communications Cabinet, we orthopaedic surgeons had an image problem. It wasn’t that we had a bad image, rather that we had no image at all.

Back in 1998, the AAOS conducted a survey to see how aware members of the public were about orthopaedic surgeons and the conditions we treat. When people were asked about who treated spine problems, they answered chiropractors or neurosurgeons. When they were asked who treated foot problems, they answered podiatrists. Sports injuries? Family practitioners. Ask them about what orthopaedists did, and some thought we straightened teeth! The survey also revealed that we had a problem communicating with our patients, even though we, as orthopaedists, thought we did quite well.

The survey detailed just how bad our image problem was, but we really didn’t know what to do about it. Even though the Council on Communications had recently been established, many AAOS members thought that investing in public relations (PR) was like throwing money in a black hole. About the same time, we heard about this woman at the American Academy of Dermatology (AAD) who had declared war against the effects of the sun.

Turning the tans around
Let me explain. Before this time, the sun was like a god, with magical powers to make people look bronze and to heal all sorts of ailments. I personally was a “sun worshipper.” I spent countless hours in my youth “working on my tan.” I made George Hamilton look pale in comparison. Then it was discovered that skin cancers—basal cells, squamous cells, and malignant melanoma—were caused by the sun.

Almost single-handedly, this woman named Sandy Gordon brought the message to the world to “beware of the sun,” and the tanning bed industry was basically sunset. What a campaign! So the AAOS hired Sandy to put orthopaedic surgeons on the map and to give us not only an image but a positive image at that. Sandy created quite a stir; many members who saw her asked, “Who is that woman with the big hair who, when she talks to you, looks as if she’s jumping out of her skin?”

Her energy and enthusiasm got both the Communications Council and the AAOS PR department started, and in 14 short years, she has made orthopaedic surgery the darling of all medicine. Our specialty is glamorous and glitzy and the envy of almost all medical and surgical specialties.

Oh, sure, we have had great advances along the way—total joints, advances in spine surgery, as well as new sophisticated foot and hand surgeries, new interventions in trauma surgery, and revolutionary sports medicine procedures—all of which get our patients in motion and back to their activities. But I think it was more than just new operations that improved our image. Plenty of specialties have new procedures, but don’t share our popularity.

I think it was the PR that Sandy Gordon brought with her and put into place, and I have proof. Remember that survey I mentioned? Well, 10 years later (in 2008), we repeated it—same questions, same number of responders—and the image of orthopaedists (who we are and what we do) had improved by 10 percentage points. Anyone who knows anything about surveys knows that 10 percent in a large survey is a huge leap.

The end of an era?
Well, the bad news is that Sandy is retiring. (Sandy, say it ain’t so!) What a great 14-year career she’s had at the AAOS. Think of all that has happened because the AAOS leadership allowed her to put into place innovative PR communications and campaigns that pushed orthopaedic surgeons and the AAOS brand into the limelight. Take a look at this list of intiatives and accomplishments, and these are just off the top of my head. I’m sure there are many more—maybe even some confidential ones!

• Playground builds in underprivileged neighborhoods (15 sites in 10 cities)
• “Patient Safety Is Not an Accident” campaign/Sign Your Site program
• E-motion—art by orthopaedists and orthopaedic patients, two national touring exhibits
• A Nation in Motion campaign/“Get Up, Get Out, Get Moving”
• End Distracted Driving campaign—a national program with the Alliance of Automobile Manufacturers
• MORE Awards—recognizing excellence in accurate reporting on musculoskeletal health issues, healthy behaviors, and high-quality care of bones and joints by national, local, and Internet media
• Humanitarian Award—recognizing AAOS members who have distinguished themselves through outstanding musculoskeletal-related humanitarian activities
• The AAOS 75th Anniversary celebration, including an online timeline, art display, and website
• Press and media releases on clinical, research, and scientific breakthroughs presented at the AAOS Annual Meetings and in Academy publications
• Legacy of Heroes—the stories of World War II veterans who became orthopaedic surgeons, an online museum, book, and traveling exhibit
• Social media—Facebook, Twitter, and YouTube
• Media training for AAOS leadership
• Damage control

For the above programs, Sandy has won more than 200 awards for the AAOS, including the prestigious CLIO Healthcare award for outstanding PR programs. Many times, as I watched her put these programs together, about halfway through the process I would say to myself, “No way that’s going to work,” only to be wrong. It’s as though she puts little pieces of stone in just the right positions to make a beautiful mosaic and a meaningful creation.

I once asked Sandy, “Of all the programs you’ve worked on, which is your favorite?” I thought she might pick the 15 playgrounds in different cities or a national program like the distracted driving campaign or the “Safety is No Accident” program because of the impact on the public. But she picked Legacy of Heroes and the AAOS 75th anniversary programs.

I asked her why those two and she replied, “Because I got to meet and work with all those orthopaedists from World War II and all the orthopaedists involved in 75 years of the AAOS.” That says it all about Sandy—it’s the people involved who are more important to her than any exposure or accolades she receives. Congratulations, Sandy. You deserve all the accolades you will receive at the Annual Meeting.

Crisis management
Notice that in the above list, I saved “damage control” until the end. Perhaps in this era, it should be put first. In this day and age, nothing appears to be sacred, finding balanced media coverage is difficult, and liability and class action claims and lawsuits are rampant. The AAOS Communications Cabinet protects our best interests and image with a fantastic damage control program. Damage control isn’t mentioned above a whisper except internally, but it is an important aspect of PR and helps orthopaedics maintain its positive image.

What brought this to mind were several recently published articles reporting poor results from orthopaedic devices or procedures, which could potentially throw a “bad light” on orthopaedics. For example, an article in the New England Journal of Medicine compared outcomes for treating patients with degenerative meniscal tears without arthritis with either a partial arthroscopic meniscectomy or a sham surgery. The study found no differences in outcomes. It wasn’t long before a Fox News “expert” and a news commentator concluded that 700,000 needless surgeries were being performed by greedy doctors, costing patients $4 billion a year.

Well, I didn’t even wait for the commercial to come on before I was on the phone with AAOS and Sandy: “Hey, we got an image problem, and we need some damage control quick!” The AAOS was already on it. Orthopaedic spokespersons from the Academy and Academy leadership were briefed and handled the media to a point that little harm was done—that’s damage control.

So, besides honoring Sandy, what is this editorial all about? It’s obviously about more than just building playgrounds or winning awards. It’s about more than big hair, big ideas, and big creativity (you betcha!)—although ideas and creativity are really important. It’s about maintaining the positive image of orthopaedics that Sandy has helped build for the AAOS. Although budgetary restraints are necessary, we mustn’t let finances get in the way of maintaining a strong PR department and Communications Cabinet.

I call on our AAOS leadership to make this a high priority, regardless of the cost. Don’t let Sandy down, don’t let me down, and don’t let the AAOS membership down.

S. Terry Canale, MD, is editor-in-chief of AAOS Now. He can be reached at aaoscomm@aaos.org