Political, social, and economic changes continue to have significant effects on health policy in the United States, including how orthopaedic surgeons provide musculoskeletal care. The legislative and regulatory policies established in Washington, D.C., will continue to have an impact on the orthopaedic profession and, more importantly, orthopaedic patients, for years to come. For resident members of the American Association of Orthopaedic Surgeons (AAOS), understanding the legislative issues that affect orthopaedic surgeons is a critical first step in becoming more active in advocacy.

Political advocacy covers a wide range of activities, including voting in elections, educating a member of Congress, or contributing to the AAOS Political Action Committee (Orthopaedic PAC). The AAOS works hard to dialogue with many key members of Congress and uses these relationships to educate legislators and their staff on issues that are important to the orthopaedic community. What better source for information on orthopaedic issues than an orthopaedic surgeon?

PACs play a significant role within the political discourse and are a way for organizations to voice their policy concerns. The Orthopaedic PAC helps keep these effective avenues of communication with lawmakers open. Without these various advocacy efforts, orthopaedic surgeons and their patients would have little impact on health policy decisions made in Washington.

Getting involved: The PAC
One of the reasons that more U.S. orthopeadic residents and fellows do not donate to the Orthopaedic PAC may be that they are not aware of how to get involved. Making an online donation to the PAC is simple and easy, using the following steps:

First, login and go to the PAC website (www.aaos.org/pac). Click on the “donate to the PAC” button.

At the donation screen, indicate whether payment will be through a credit card or a check. If a credit card is used, indicate whether this is a one-time or recurrent (monthly, quarterly, or annually) contribution.

Residents are asked to provide their residency program information so that the program can be recognized.

Note that a recurring donation of just $84 per month qualifies the resident or fellow as a member of the AAOS Capitol Club ($1,000 annual donation), entitling him or her to extra benefits, such as an invitation to a special Capitol Club event during the AAOS Annual Meeting.

Residents can join the PAC with a donation of as little as $10 annually, although contributions at all levels are appreciated. There is power in numbers and the more residents who become active within the PAC, the louder the collective voice of orthopaedic surgeons will be in Washington, D.C.

In 2014, six residency programs achieved 100 percent participation in the PAC by residents and another dozen programs had one or more resident contributors. Residency programs with 100 percent participation will be recognized within the AAOS, at the Annual Meeting, during the National Orthopaedic Leadership Conference (NOLC), and online.

The PAC has also launched a key contact network with residents who have contributed. This program recognizes residents who understand the importance of being involved in the PAC and works with them to help increase the participation of their peers. Many residents do not understand the role of the PAC or the importance of getting involved as a resident member. Reaching out to residents on a personal level and educating them on these issues can help increase resident support of the PAC.

Of course, many residents are already involved in the PAC. This year, more than 90 residents from 31 different residency programs joined the PAC. Resident support for the PAC has increased three-fold during the past 5 years. This participation shows that efforts by the PAC Executive Committee and other AAOS fellows to educate residents on political advocacy is working.

Still, more can be done to help residents understand the value of joining the PAC. Resources are available online that provide additional information about the PAC and how to get involved, including an Orthopaedic PAC Resident Toolkit that provides a variety of educational material. Residents who desire more information can use these resources and pass on the information to other residents in their programs. Residents can also see what programs are actively involved already by going to the website.

General information about both federal and state advocacy issues can also be found online (www.aaos.org/dc). Links in the left navigation bar lead to issue pages, NOLC topics, and state resources to help residents and fellows effectively communicate with elected officials, along with general information about the legislative process. Residents who want to participate in next year’s NOLC should contact their state orthopaedic society.

Getting involved: The RA
In 2011, the AAOS Candidate, Resident, and Fellow Committee created a resident workgroup to address the issue of resident engagement in the AAOS. It became very clear that residents were both interested and eager to become more involved in the AAOS. Workgroup Chair Nathan Skelley, MD, under the direction of Todd Milbrandt, MD, and Young-Jo Kim, MD, investigated several other successful organizations and patterned the AAOS Resident Assembly (RA) as a resident-run venue that educates, engages, and represents the future members and leaders of the AAOS.

The RA has five committees: Technology, Education, Practice Management, Research, and Health Policy. Residents with an interest in health policy or political advocacy have the opportunity to participate in the Health Policy Committee and should contact residentassembly@aaos.org to share ideas and contribute information. The more residents who get involved, the more effective will be efforts to improve the care provided to patients.

Last year, the AAOS Board of Directors approved the RA’s policies and procedures, making it the first democratic group of residents in the Academy’s history. The inaugural RA meeting was held at this year’s Annual Meeting.

With more opportunity comes more responsibility. This unprecedented access by residents means that residents need to take these opportunities seriously and do their best to exceed expectations.

Getting involved: Other advocacy tools
To stay informed on health policy and advocacy issues that pertain to orthopaedics, residents and fellows can take the following steps:

• Subscribe to the electronic newsletter Advocacy Now.
• Prefer social media to email? Head to advocacy.aaos.org or follow AAOS Advocacy (@AAOSAdvocacy) on Twitter. These resources contain up-to-date information about the key issues the AAOS is working on for the orthopaedic community.
• For more information on the legislative impact on health care, check out Politico (www.politico.com/ehealth) or Kaiser Health News (www.kaiserhealthnews.org).

Making it easy
In summary, here are three easy steps that U.S. orthopaedic residents (and fellows) can take to get involved:

1. Consider donating to the PAC (www.aaos.org/pac). Residents can donate as little as $10.
2. Participate in the Resident Assembly, which can provide an understanding of the issues that concern residents and enable them to work together to find solutions.
3. Keep informed on political issues shaping health care by becoming involved in your state orthopaedic society and reading Advocacy Now and other trustworthy resources.

Residents represent the future of the orthopaedic profession. In that sense, it is important for residents to understand the issues and policies that will affect their professional lives. The policies and legislation put into action today determine orthpaedists’ ability to care for patients in the future. For more information or answers to questions on how to best contribute, contact the authors of this article.

Chad A. Krueger, MD, is the Orthopaedic PAC Resident Fellow and is a resident in San Antonio, Texas; he can be reached at cak0705@gmail.com

Jared L. Harwood, MD, was the 2014–2015 Washington Health Policy Fellow. Kristin Brackemyre is the political affairs manager in the AAOS office of government relations; she can be reached at brackemyre@aaos.org

Additional Information
National Orthopaedic Leadership Conference resources
Orthopaedic PAC Resident Toolkit
State Advocacy Tools