When Joshua J. Jacobs, MD, began his term as AAOS president at the 2013 Annual Meeting in his hometown of Chicago, he had clear goals in mind for the year ahead. Under his leadership, some of the Academy’s many objectives would include leveraging and growing the Academy’s educational programs throughout the world, as well as ensuring that patients are well represented and continue to have access to high-quality musculoskeletal health care.

AAOS Now spoke with Dr. Jacobs about the Academy’s many accomplishments under his leadership, the challenges and rewards of serving as president, and the advice he would give his soon-to-be successor, Frederick M. Azar, MD.

AAOS Now: What did you enjoy most about being Academy president?

Dr. Jacobs: The Academy is one of the most highly regarded professional organizations in all of medicine. It has been gratifying to represent and to interact with our talented and dedicated volunteers and staff. I’ve found that other stakeholders—other medical professional organizations, industry, government, and the payer community—have a great deal of respect for what the AAOS and its members do to improve the musculoskeletal health of our society.

AAOS Now: What were some of the more challenging aspects of being AAOS president?

Dr. Jacobs: Perhaps the most challenging aspect of the AAOS presidency is responding to periodic reports in the media that distort and misrepresent our profession. Staff members in the Academy’s public relations department work with trained volunteer spokespersons to present an accurate picture of the many issues related to orthopaedic care.

AAOS Now: When you assumed the presidency, you noted that you would focus on helping the AAOS collaborate with international orthopaedic associations, as well as on improving healthcare quality. What did the Academy accomplish in those areas?

Dr. Jacobs: The international demand for our educational content is increasing. To help meet that demand, the AAOS has embarked on a strategic program to enhance and expand our international educational outreach. The Academy’s collaborations with international orthopaedic associations continue to develop and will be an important source of growth in the future. This growth is key to enabling the AAOS to fulfill its missions related to promoting and fostering professionalism, quality, and advocacy in orthopaedics.

In the quality arena, we continue to provide tools to help our members adapt to the changing healthcare landscape, where reimbursement based on value (defined as quality per unit cost) is being implemented to supplant volume-based reimbursement. For example, the pending Congressional fix to the sustainable growth rate (SGR) involves reimbursement based in part on as yet unspecified quality metrics. In response to such payer initiatives, the AAOS Board of Directors approved a performance measure program to develop the needed quality metrics based on the best available evidence.

AAOS Now: What other important work was accomplished during your tenure?

Dr. Jacobs: Orthopaedic unity continues to be a top priority for the AAOS. Orthopaedic surgeons represent only 2.7 percent of practicing physicians in the United States. A fragmented 2.7 percent would not be effective in advocating for our patients. We must speak with one voice to be heard. The leadership of the AAOS works closely with our specialty society partners to keep the “house of orthopaedics” unified and strong.

One way we are demonstrating orthopaedic unity is through the new orthopaedics headquarters building being constructed just south of the Academy’s current headquarters in Rosemont, Ill. The new building will be home to more than 25 orthopaedic organizations, including our equity partners—the Arthroscopy Association of North America, the American Orthopaedic Society for Sports Medicine, the American Association of Hip and Knee Surgeons (AAHKS), and the Orthopaedic Learning Center.

AAOS Now: How does the AAOS continue to respond to the changing healthcare landscape, including the implementation of the Patient Protection and Affordable Care Act (PPACA)?

Dr. Jacobs: Over the last year, the AAOS has fought hard to preserve access to coordinated, high-quality orthopaedic care. We have thus far been successful in preserving the in-office ancillary services exemption to the Stark Law, which enables private practices to offer advanced imaging and physical therapy services. With our partners at AAHKS, we have helped to significantly reduce proposed cuts to total hip and knee replacement reimbursement recommended by the Relative Value Unit Update Committee of the American Medical Association.

In addition, we have worked extensively with the House of Representatives Energy and Commerce Committee and the House Ways and Means Committee, as well as the Senate Committee on Finance to develop a proposed SGR fix that will benefit our members and their patients. The AAOS Political Action Committee (PAC) and the AAOS Council on Advocacy, as well as staff members in the AAOS office of government relations, have been instrumental in the many advocacy successes over the past year.

AAOS Now: Why would you encourage younger members to get involved in the Academy?

Dr. Jacobs: One reason is that the AAOS has extensive offerings and programs designed specifically to benefit young orthopaedic surgeons. These include continuing medical education courses, the OrthoPortal (http://orthoportal.aaos.org), webinars, and various practice management products and programs.

In addition to taking advantage of these education resources, young orthopaedic surgeons should also get involved in advocacy at both the local and national levels to control the future of our profession. Younger members should contribute to these efforts and support the AAOS PAC to maintain the strong voice of orthopaedic surgeons on Capitol Hill.

AAOS Now: What advice might you offer to your successor, Dr. Azar?

Dr. Jacobs: Dr. Azar will be a great president. He has been on the Board of Directors for the past 6 years, first as treasurer, then as second vice president followed by first vice president. He has extensive knowledge of all the Academy’s activities and has demonstrated effective leadership skills as well as a strong commitment to advance the Academy’s mission. My advice to him is this: You will work very hard and will deal with a number of challenges, but take the time to enjoy the tremendous honor of being AAOS president.

AAOS Now: Is there anything else you would like to add, as you reflect back on your year as president of AAOS?

Dr. Jacobs: The medical profession is at a crossroads and is in the midst of unprecedented changes regarding how we deliver health care. It is critical that orthopaedic surgeons are part of the solution to the current healthcare crisis and lead the efforts to provide high value musculoskeletal care. To lead, we must be engaged in local, regional, and national reform initiatives. As the saying goes, “We must be at the table, or we will be on the menu.”

Jennie McKee is a senior science writer for AAOS Now. She can be reached at mckee@aaos.org