Thomas Muzzonigro, MD, (left) said that effective advocacy is key to maintaining the quality of our practice lives and control over the quality of care we provide our patients.
Courtesy of Thomas Muzzonigro, MD

AAOS Now

Published 8/1/2019

NOLC Participants Share First-hand Experiences on ‘The Hill’

In June, approximately 350 orthopaedic surgeons from across the country participated in the AAOS 2019 National Orthopaedic Leadership Conference (NOLC). The purpose of the annual event is to advance AAOS’ Unified Advocacy Agenda by providing legislative and regulatory education, building support for orthopaedic-related legislation and regulation, and strengthening relationships with key decision makers within the U.S. government. This article comprises the unique experiences of three different members with varying levels of advocacy involvement.

Claudette Lajam, MD
Chair, Advocacy Resources Committee

Capitol Hill visits

There is nothing more important than an informed, engaged membership in our advocacy efforts to ensure that we have a seat at the table. That’s why the Capitol Hill visits have always been my favorite part of NOLC. This year, we brought more technical issues to our members of Congress, including controlling insurance company monopolies, increasing competition with hospital mega-mergers, and bringing our voice to the surprise billing debate. My colleagues, as usual, impressed me with how quickly they embraced and could explain these complex issues during our meetings with lawmakers. For future visits, I propose discussing at least one nontechnical legislative issue and providing more opportunities to study the issues before our visits.

It also was an honor to present Richard F. Bruch, MD, the Distinguished Congressional Ambassador Award at the Advocacy Resources Committee meeting. Dr. Bruch is an outstanding example of the difference we can make when we actively participate in advocacy.

Congressional, resident member engagement

Engagement with members of Congress at social events is fundamental to our advocacy, and NOLC gives us incredible access. We met with female leaders on both the House Energy and Commerce and Ways and Means Committees on Tuesday evening. On Wednesday, our awesome Capitol Club event gave us access to almost 20 members of Congress. Even more impressive was the number of AAOS residents in attendance. At each event, members of Congress and staffers were overwhelmingly positive about meeting and speaking with our residents.

Resident engagement and involvement at NOLC should be enhanced going forward, possibly by including poster sessions.

Symposia

This year’s symposia were well done. The review of the Academy’s core values was informative, and the symposia on advocacy, leadership, and quality were eye-opening. What’s more, the breakout sessions allowed members to include their voices and shape the conversation. I’d like to see more breakout sessions included in the future, when appropriate, and for symposia presenters to be more representative of our membership.

Regardless of the topics and activities, NOLC was an opportunity to connect and socialize with my amazing colleagues—those who dedicate their time and talent to work toward furthering our profession. I am humbled to be in your company.

Thomas Muzzonigro, MD
Chair-elect, Board of Councilors (BOC)

The modern practice of orthopaedic surgery has become increasingly challenging. I believe that effective advocacy is key to maintaining the quality of our practice lives and control over the quality of care we provide our patients. Fortunately, I have had the opportunity to visit Capitol Hill during NOLC as part of an extremely talented team of Philadelphian orthopaedic surgeons, including Alan Hilibrand, MD; Josh Port, MD; Angela Rowe, DO; Antonia Chen, MD; and Chip Hummer, MD. Congressional representatives closely lean in when we explain the importance and value of physician-hospital partnerships and working with patients and insurers to deliver outstanding, safe, and cost-effective care.

Thomas Muzzonigro, MD, (left) said that effective advocacy is key to maintaining the quality of our practice lives and control over the quality of care we provide our patients.
Courtesy of Thomas Muzzonigro, MD
Claudette Lajam, MD, presented Richard Bruch, MD, with an AAOS 2020 Distinguished Congressional Ambassador Award, saying that he is an outstanding example of the difference we can make when we actively participate in advocacy.
Courtesy of Claudette Lajam, MD
Scott Cooper, MD, participated in a breakout session on healthcare payment reform during the advocacy symposium.

Power of stories and relationships

Legislators are particularly moved by our engagement with patients, families, and young residents. These stories help them better understand challenges surrounding graduate medical education, healthcare delivery, and malpractice/insurance reform. One of my most memorable experiences is from a congressional meeting I attended with Kurt Weiss, MD. Representatives sat transfixed in rapt attention as he explained the importance of funding for osteosarcoma research and surgery. They became teary-eyed when he shared the story and a picture of his first pediatric cancer survivor with her first newborn child—she is now expecting another baby! I still get chills when I recall that day.

Building relationships that last a lifetime is the cornerstone of effective advocacy, and patient stories help clarify difficult issues. Your AAOS Office of Government Relations helps legislators understand the challenges orthopaedic surgeons face in today’s medicolegal climate. We all want to deliver first-class orthopaedic care, but barriers persist to implementing our plan of action. We need help at the federal and state levels to make sure insurers and health systems play fairly.

Importance of political engagement

Your elected representatives want to know that you are truly engaged constituents in addition to practicing orthopaedists. Active participation at NOLC and in the Orthopaedic Political Action Committee (OrthoPAC) is a great place start. Meet your legislators, know their names, and help them enough so that they know your name. If you support them even when there isn’t an active issue, they can be your champion when crises arise. Additionally, you should donate to the PAC and encourage your partners to do so. My group, for example, is trying to become a Premier Practice with 100 percent participation through easy payroll deductions and text donations.

Remember that civil litigation attorneys typically boast of a greater than 90 percent PAC participation, and insurance and hospital PACs are extremely well-funded. Orthopaedic surgeons need to work as a team to level the playing field. I strongly encourage you and your colleagues to join the PAC today and help us reach our goal of 40 percent AAOS member participation.

Learn more about recent orthopaedic wins at bit.ly/2LQnOpM. Donate to the PAC today at bit.ly/2Ocq2T3. Reach out to me directly at muzzy@tririversortho.com or 412-780-9961.

Scott Snow Cooper, MD
New member, BOC

The recent NOLC was the first I’ve attended and my first meeting as a new member of the BOC. I thought I had a pretty good idea of what to expect going into the experience, but I never expected to enjoy the event as much as I did. There were meetings and receptions, of course, and I got to reintroduce myself to both AAOS President Kristy L. Weber, MD—whom I met on the residency interview trail—and Council on Advocacy Chair Wilford K. Gibson, MD—whom I met at an Arkansas Orthopaedic Society event. But by far the most important thing we did was visit the offices of our Congress members.

Due to the House of Representatives being out of session, most of us met with legislative aides, but some got to meet their members of Congress. Regardless, I found their willingness to meet with us remarkable and evidence of the influence that AAOS and the OrthoPAC have on our lawmakers.

Making a difference for our patients, profession

We advocated specifically for three things: the Hospital Competition Act, which seeks to address the ongoing mergers of hospitals and physician groups; the Competitive Health Insurance Reform Act, which would remove ridiculous antitrust protections from the health insurance industry; and specific potential legislation that we favor to address out-of-network “surprise billing.” Though the aides were largely noncommittal, because the buck doesn’t stop with them, I found them to be interested, attentive, and even actively curious to hear our positions.

I’ve always been a politics guy, but if you’re like me, you may have become jaded through the years—especially lately. But I’m here to tell you that, aside from our direct care, there isn’t anything more important that we can do for our patients and profession. When it comes to public policy, we either get involved and have a seat at the table, or we will be “on the menu.”

Future advocacy engagement

By attending NOLC, I learned about the issues we can influence to improve the practice of orthopaedics. I also learned that our association has a voice that is respected and heeded in the halls of power, but it is only because of us—the AAOS fellowship. I cannot stress enough the critical importance of funding the OrthoPAC, which all of us should be doing. Just as important is being involved by getting to know our state and national legislators, helping their campaigns, and being active in advocacy through our state societies and AAOS. I’m truly looking forward to being more closely involved with our advocacy efforts going forward.