Residents grapple with health policy issues
The Resident Assembly's (RA) Health Policy Committee (HPC) hit the ground running. Committee Chair Patrick Marinello, MD, set goals and maintained committee momentum through a successful, active year.

The HPC submitted three action items at the 2016 AAOS Annual Meeting in Orlando, Fla. The action items covered resident representation within orthopaedic state societies, the creation of health policy milestones for orthopaedic surgery residents, and resident physician prescribing of narcotics.

Taking action
The HPC recognizes that resident involvement within state orthopaedic societies varies greatly. Low participation in some states may indicate a missed opportunity to educate tomorrow's leaders. After the action item was approved, it went to the AAOS Board of Councilors (BOC). At the 2016 Fall Meeting, the BOC updated its model state orthopaedic society guidelines to encourage state societies to add a resident member to their leadership structure. This position will provide a direct avenue for resident involvement in advocacy on the state level.

Health policy is often glossed over in resident education, but it is an essential part of successful orthopaedic practice. The HPC is working to create and implement a curriculum of health policy milestones for orthopaedic residents. A task force has been developing these milestones with the ultimate goal of providing an optional curriculum to orthopaedic residents who are interested in health policy and advocacy.

Perhaps the HPC's most successful program was the fall webinar, "Payment, Politics, and PACs: A Primer to Resident Advocacy." The webinar was well attended by residents from across the country. The keynote speaker, John T. Gill, MD, chairman of the Orthopaedic Political Action Committee (PAC), and Chad Krueger, MD, the PAC resident fellow, emphasized the importance of physicians, specifically resident physicians, as health policy advocates. The webinar also provided information on topics such as graduate medical education funding, the Medicare Access and CHIP Reauthorization Act, the Children's Health Insurance Program, the Orthopaedic PAC, and the health policy platforms of the 2016 presidential candidates. Feedback was overwhelmingly positive; the webinar will be used as a springboard of issues for the year to come.

The HPC also published a number of articles in AAOS Now to update residents on important advocacy issues. The topics covered included physician-compare websites, the Futures Capitol Club, the Orthopaedic PAC, and talking politics with your patients.

At the 2017 AAOS Annual Meeting, the RA elected Nicholas Bonazza, MD, as the new chair of the HPC. During the RA business meeting, the HPC also raised the following three new action items:

• support for the new Accreditation Council on Graduate Medical Education Common Program Requirements
• exempting resident physicians from the Centers for Medicare & Medicaid Services' Open Payments database
• developing an AAOS position statement regarding residents and physician-compare websites

All three items passed with overwhelming support.

The year ahead
The changing political climate will keep the HPC busy. The committee is seeking new ways to keep residents informed of policies that affect them and to involve residents in advocacy efforts that support orthopaedic surgeons and patients.

Policy decisions can—and will—have a dramatic impact on the practice of orthopaedics for years to come. Passivity will not achieve policy goals. The HPC will continue to communicate this message through webinars and articles that draw the connections between policy and practice from the resident's perspective. It will also strive to find new ways to convey up-to-date information on policy changes, to empower residents to seek more information, and to enlist the aid of the AAOS office of government relations and the Orthopaedic PAC.

Orthopaedic residents have shown their interest in advocacy by attending webinars, participating in developing articles and advisory opinions, and increasing contributions to the PAC. Building on the success of resident outreach, the HPC will strive to engage residents in actual advocacy by connecting residents and AAOS fellows who model the type of initiative and relationship-building that supports successful advocacy.

The health policy milestones program will combine elements of education with opportunities for direct advocacy. Over the next year, the HPC will finalize these educational modules on health policy and advocacy for orthopaedic residents. With documented completion of the modules, residents will have opportunities to work with the AAOS office of government relations, to attend functions with the AAOS or appropriate state societies, and to actually advocate for issues with local government officials. Thus, the program should give residents a solid foundation in health policy and advocacy that can be used throughout their careers.

Ultimately, the HPC hopes to provide residents with the tools necessary to be lifelong advocates for themselves, as orthopaedic surgeons, and for their patients.

Kevin J. Cronin, MD, is a member of the AAOS Resident Assembly Executive and Health Policy Committees and is a resident member of the Emerging Professionals Committee. He can be reached at kevincronin88@gmail.com

Nicholas Bonazza, MD, is a member of the AAOS Resident Assembly Executive Committee and is chair of the Resident Assembly Health Policy Committee. He can be reached at nbonazza@pennstatehealth.psu.edu

Calling all residents!
The Resident Assembly Health Policy Committee needs your energy, your ideas, and your enthusiasm! The committee's charges include addressing issues affecting the field of orthopaedic surgery, developing health policy action items, and educating residents and promoting resident involvement in political issues impacting orthopaedics both locally and nationally. If health policy interests you, sign up today at www.aaos.org/residents