A few weeks before her retirement, Karen L. Hackett, FACHE, CAE, had but one request for how AAOS Now would describe her nearly 14-year tenure as chief executive officer (CEO) of the AAOS: “Focus on the leadership of the Academy—the volunteers and the staff,” she entreated. “Anything 'I have done' has been accomplished with them.”

One of the milestones of Ms. Hackett's tenure as CEO was the groundbreaking for the new AAOS headquarters in 2013. From left: Chief operating officer/chief financial officer Rich Stewart; 2013-2014 AAOS President Joshua J. Jacobs, MD; Rosemont Mayor Bradley A. Stevens; Ms. Hackett; 2014-2015 AAOS President Frederick A. Azar, MD; and 2015-2016 AAOS President David D. Teuscher, MD.
Courtesy of Erin L. Ransford Ms. Hackett receives a Tree of Andry statue from 2016-2017 AAOS President Gerald R. Williams Jr, MD, during the recent Board of Directors meeting in San Diego in recognition of her service to the Academy.

However much credit she chooses or declines to take for it, Ms. Hackett leaves a strong, vibrant Academy that serves as an influential advocate for patients and AAOS members alike, working to advance the quality of orthopaedic care and uphold the specialty's standards of professionalism. With a membership of approximately 36,000—96 percent of the orthopaedic surgeon universe, renewing at a rate of 98 percent—a staff of 250, and a budget of $60 million, the Academy is recognized as a force within the healthcare ecosystem.

During Ms. Hackett's time as CEO, the Academy achieved major milestones, including the 2015 completion and opening of the new Orthopaedic Headquarters building in Rosemont, Ill., a $50 million building housing the Academy's central offices and those of partner organizations, along with the state-of-the-art OLC (Orthopaedic Learning Center) Education and Conference Center. A wide range of quality initiatives also occurred during her tenure, including the development of Clinical Practice Guidelines (CPGs), Appropriate Use Criteria (AUC), and performance measures. In addition, the Academy held landmark events, such as the National Surgical Patient Safety Summit in 2016.

On the advocacy front, the American Association of Orthopaedic Surgeons, supported by member contributions, garnered respect on Capitol Hill on both sides of the aisle with its formidable political action committee (PAC). In addition, the Academy began converting its educational offerings into digital formats to meet the needs of today's members. The AAOS continued its public service advertising and outreach through efforts such as the Distracted Driving/Walking multimedia campaign. Yet another important initiative was the expansion of the Journal of the AAOS to include the well-received Green Research Section and JAAOS Global Research and Reviews, an open access journal that will offer a wealth of new information and opportunities for authors.

Speaking in her window-lined office atop the AAOS headquarters building as the morning sun streamed in, Ms. Hackett said the new building “is something you can touch and feel and see. When I drive to work and see it on the corner, it looks pretty darned good. I have to credit everyone who worked on it, including Rich Stewart, without whom we would not have gotten it done. It is something our members are very proud of. The Orthopaedic Learning Center is state of the art. We did the building on time and on budget.” She spoke with pride about the other achievements as well, once again deflecting credit (“These weren't my accomplishments.”). “We can be proud of all of our quality initiatives—CPGs, AUCs, performance measures—all of them designed to help our orthopaedic surgeon members take better care of their patients. From the advocacy standpoint, I am proud of the work we do on Capitol Hill and how respected the Association is, the commitment and dedication of our volunteers who go up to the Hill and how well they understand the issues, and our staff who help support them. “Linked to that is our PAC, one of the largest medical PACs in the country,” she continued. “We have educated our members on the value of the PAC, and they have responded. When we advocate, we always lead with what is best for the patients. It's not always about reimbursement. It is about the patients and access to care, and sometimes [the interests of our members] play into the access to care issue. We support members of Congress, who are either running for office or are in Congress, who support our issues. It doesn't matter what side of the aisle they are on. Some of them don't support all of our issues.” The best they can be
The Academy's commitment to education remains a foundational principle, Ms. Hackett said, however the delivery methods may evolve. “Our members want to do the best they can do for their patients. I tell people my 'elevator speech' is, 'We help orthopaedic surgeons be the best that they can be so that they can take the best care of their patients.' That is what we do. In the education area, we are going through governance changes to help us have a more efficient structure to serve the changing needs and make the transition to digital, but our roots are in education. Our members come to courses, they do self-assessment, they read our journals, they buy our books, in print or digitally. They are committed to lifelong learning, and we partner with them on that.” Asked about her leadership style, she responded, “I'll leave that to somebody else.” She continued, “You can learn a lot by listening. Obviously, as the CEO, the buck stops with me, and I have to make decisions, and sometimes hard decisions. We have a terrific staff, many of whom have been here a long time, and I have learned a lot from them. I've tried to be approachable—some will say more so than others. I've tried to learn and listen.” Ask “somebody else,” such as member volunteers who have served in leadership positions during Ms. Hackett's time at the Academy, or staff members who have worked for and with her, about her leadership traits, and you will hear words such as dedication, commitment, and professionalism. They note her reverence for the Academy and ability to execute by engaging people to put forth their best effort to achieve common goals. Gerald R. Williams Jr, MD, who just completed his term as 2016–2017 president, was on the Board of Directors when Ms. Hackett joined the Academy. “It was a difficult time in some ways because it was a transition,” he recalled. “From one governance structure to another. From one culture to another. From primarily an educational organization to a multifaceted one. In addition, Karen was entering a predominantly male-dominated profession at a time when there was a closely knit leadership group. I remember well the grace, confidence, and enthusiasm with which she tackled her new position.” He continued, “In addition to her innate talents, management skills, and strategic vision, Karen is one of those rare leaders who has the drive to be personally successful but the humility to always put the needs of the organization in front of hers. Her personal characteristics are exemplary: confident, consistent, respectful, deliberative, loyal, and resolute. The truest test of a leader is the number of people that voluntarily follow them. I am sure every one of Karen's staff would follow her lead anywhere. The Academy owes Karen a tremendous debt of gratitude for a job spectacularly done.” “Karen has been a tireless worker for the AAOS over the past 14 years as CEO,” said Frederick M. Azar, MD, 2014–2015 Academy president. “From day one she has had a keen understanding of the culture of our profession. She is a gifted and bright leader whose institutional memory has been an incredible asset for our organization. Her leadership style is to listen and understand other perspectives before voicing her own opinion. Her preparation and organizational skills are unsurpassed. Our patients and members have all benefited from her dedication to our profession during her tenure.” William J. Best, former lay member of the Board of Directors, said, “In my experience covering 35 years in management consulting, Karen's capabilities greatly exceed many of today's corporate leaders, in her ability to understand the nuances of complicated issues, work toward a compromise solution, and lead an effective organization. AAOS has been fortunate to have such a capable and devoted leader.” Longtime Academy staff members also speak in admiration. “Karen's broad association experience and leadership background make her a role model for the AAOS, both as a collaborative colleague and staff leader,” said Donna Malert, who has worked alongside Ms. Hackett and the leadership for 11 years, currently as governance manager. “Karen realizes the importance of communication, and as such, her door is always open to staff. She is very receptive to feedback from others, and she willingly offers her own expertise and experience to others for enhancing their personal and professional development.” “Karen is a selfless leader; she constantly puts the needs of AAOS ahead of her own,” said Monica Kropp, a manager in Human Resources. “She manages with a conscience by building trust, integrity, and commitment. Her boundless energy will be missed.” Graham Newson, associate director, Office of Government Relations, says Karen leads by example. “A hard worker absolutely dedicated to the mission of the Academy, Karen effectively led the Academy through the many challenges of the day. During this time of tremendous change for our nation's healthcare system, she kept a steady hand on the wheel, ensuring that the Academy's voice was heard, advocating proactively throughout for our members and their patients,” he said. “Karen also has a wonderful sense of humor. She was a great CEO and will always remain a great friend.” A woman's place … is in charge
A woman serving as CEO of a large organization may no longer draw a second glance, but when Ms. Hackett took the helm at the Academy, she knew she would be engaging with a decidedly male-majority membership. “When the search firm called me, I kind of laughed,” she recalled. “I had worked in hospitals, and I knew there weren't many women orthopaedic surgeons. I asked, 'Why would they ever hire a woman to run their association?' The recruiter said, 'Oh they're very open-minded; you should meet with them.' Fourteen years later, I'm now retiring. They have treated me very fairly. Maybe it's my background—having only brothers, I kind of grew up as one of the guys. My best friend played pro football. So I'm comfortable around macho guys. Maybe that helped.” Ms. Hackett considers association management a calling, which she came to after a start on the business side in hospitals. Prior to her time at the Academy, she was chief operating officer of the American College of Healthcare Executives and in 2010–2011, during her tenure at the Academy, she served as the board chair of the American Society of Association Executives. “Association management is something I love, but like many others, I stumbled into it,” she said. “I found it is my passion. I really like helping the members. Working with orthopaedic surgeons and seeing what they do to help people just makes it all the better.” Upon her April 14 retirement, Ms. Hackett's plan is to relocate from Chicago with her husband, Robert Carlisle, to homes in Amelia Island, Fla., and on Lake Winnipesaukee in New Hampshire. She has her immediate sights on a retreat to a spa and a cruise, and then to the task of remodeling the lake house. She joked that her husband, having gotten a 10-year head start on her in retirement, is “scared to death” of her joining in that status, because “he's got his life.” In seriousness, she added, “No, he's been very supportive. This job is great, but it does entail a lot of evening conference calls and a lot of weekends. I could not have done it without him.” Asked if she had words of wisdom for her successor, Thomas E. Arend Jr, CAE, Ms. Hackett said, “My only advice is to look and listen and see what you can learn. I will tell him he will learn a lot from the staff. There is a lot of institutional memory here. I wish him the best. It's a great job; he's going to love it.                                 Terry Stanton is senior science writer for AAOS Now. He can be reached at tstanton@aaos.org

The New CEO: Thomas E. Arend
Thomas E. Arend Jr, CAE, assumed the position of AAOS chief executive on April 1. 

Thomas E. Arend

“The Academy is very pleased that Tom Arend, an experienced and proven healthcare leader, will serve as our next CEO,” said 2016–2017 AAOS President Gerald R. Williams Jr, MD. “Tom is a strong strategic thinker and visionary leader who understands the complexities of the changing healthcare arena. He will serve our members and staff well.”

Mr. Arend most recently was executive vice president, chief operating officer, and general counsel at the American College of Cardiology (ACC), a 52,000-member organization in Washington, D.C. In that role, he was responsible for ensuring the ACC's overall financial health, operational effectiveness, and strategic direction. In addition, he was responsible for all aspects of the College's legal, risk management, and compliance activities. Since joining the ACC in 2004, Mr. Arend played critical roles in the development of a comprehensive relationship with industry standards and code of ethics, as well as the College's 5-year strategic plan and more recent governance restructuring. He also spearheaded several successful collaborations with other medical societies and stakeholders that directly benefit the ACC's mission to transform cardiovascular care and improve heart health. “I am excited to join the AAOS, and I am honored and humbled to be leading this strong and vibrant organization,” said Mr. Arend. “I look forward to advancing the mission of the Academy and working closely with the volunteer leaders, members, and staff.”