As the AAOS Office of Government Relations’ (OGR) inaugural Resident Advocacy Fellowship winds down, 2018 fellows Chris Anthony, MD, and Ryan Eggers, MD, MA, share their experiences. The one-year program, which is directed by Stuart L. Weinstein, MD, is designed to enable AAOS to work more directly with resident members, and to give residents the opportunity to learn more about the Academy’s legislative and regulatory advocacy work in Washington, D.C.

Chris Anthony, MD

In the coming years, orthopaedic surgeons will be increasingly required to exhibit leadership and skill on multiple fronts. Beyond our traditional skills in surgery and the need for competency in patient communication, the rapid changes in health care will require ongoing innovation in care and a more complete understanding of the environment in which that care is delivered.

Understanding the different layers of our healthcare system will also be key to success. The AAOS OGR Resident Advocacy Fellowship has enabled me to further my knowledge of how orthopaedic practice is influenced by legislative and regulatory decisions, as well as the important role we can each play in determining the future of our profession.

As part of the fellowship, I have been exploring the availability of tests and interventions commonly performed by orthopaedic surgeons, variability in their prices, and quality of related data. Simply providing patients with pricing information, without understanding the quality of care, likely falls short in helping them fully understand the healthcare products they are purchasing.

With several collaborators, we are obtaining price and quality data across various surgical procedures and diagnostic tests that we offer as surgeons. We will report our findings to help surgeons and healthcare systems further understand the value we currently offer patients.

It has been a great honor to serve as one of the AAOS Resident Advocacy fellows for 2018. The experience has involved several weeklong trips to Washington, D.C., multiple meetings and conference calls with AAOS OGR staff, and the always-present mentorship of Dr. Weinstein. I highly recommend this experience to residents who want to gain an additional perspective and tools for ensuring our patients receive optimal musculoskeletal care in the coming years.

Chris Anthony, MD, is a graduate of the University of Iowa, Carver College of Medicine, and currently serves as a postgraduate year (PGY)-5 in the Department of Orthopaedics and Rehabilitation at the University of Iowa.

Ryan Eggers, MD, MA

It’s easy to get overly focused in residency, but a career in orthopaedic surgery is more than research and surgical skills. Ideally, a residency program will prepare us for all aspects of clinical practice. However, more often and in every area of orthopaedics, our ability to practice is affected by the legislative and regulatory environment.

Throughout my career, I have recognized the importance of understanding and navigating this environment to improve my ability to care for patients. I have been honored to serve in multiple capacities for the AAOS Resident Assembly and on several AAOS committees. The AAOS OGR Resident Advocacy Fellowship is one of the best opportunities I have encountered thus far for learning the governmental and advocacy aspects of orthopaedic practice.

As a 2018 fellow, I have worked on three projects this year. The first, which I recently completed, included contributing to comments on Stark Law reform. The Centers for Medicare & Medicaid Services (CMS) requested comments from various stakeholders on ways to modernize the physician self-referral laws so that they do not interfere with advanced payment models required by the Medicare Access and CHIP Reauthorization Act. AAOS delivered, and I was a part of the process. In its comment letter, AAOS stated, “It is urgent that CMS create new exceptions so that physicians may more easily comply with both the new payment models and existing safeguards against fraud and abuse.”

The second project is a long-standing effort by the Health Policy Committee of the Resident Assembly to create a resident-focused curriculum known as Health Policy Milestones. It involves organizing a series of readings and informative webinars on topics relevant to advocacy and health policy for residents. Those who complete the readings and attend the webinars will earn a certificate in advocacy and hopefully pursue additional opportunities for involvement within AAOS. We have an excellent team of residents working on this project, which is nearing completion.

The third project is an initiative to increase resident involvement in the National Orthopaedic Leadership Conference (NOLC) in Washington, D.C. Because support from the state societies is crucial to increasing attendance at NOLC, this project is a joint effort between the OGR and the state orthopaedic societies.

During my time with OGR staff in Washington, D.C., I participated in conference calls with regulatory authorities at CMS, attended a House subcommittee hearing on Stark Law reform, and met with representatives from Georgia to thank them for their support of AAOS and to forge further productive relationships for advocating for our patients. It was a fantastic opportunity to learn the inner workings of the OGR, which does so much for our profession.

I was honored to be selected for the 2018 Resident Advocacy Fellowship. To me, the position represents the prioritization of resident involvement by AAOS leadership. I have learned much more than I anticipated, and I have dramatically enhanced my understanding of the importance of advocacy in orthopaedic surgery. I encourage residents who wish to increase their knowledge base and add an important supplementary skill to their clinical practice to apply for the fellowship.

Ryan Eggers, MD, MA, is a graduate of the Loma Linda University School of Medicine and currently serves as a PGY-5 at WellStar Atlanta Medical Center.