Felix H. (“Buddy”) Savoie III, MD, FAAOS, the incoming AAOS president, opened his 2022 presidential address by discussing the big picture of the memberships’ common goal: patient care.

“I understand how easy it is to get lost in minutiae and forget the big picture of what we all are about: the care of patients and how to do it better,” Dr. Savoie said during the Your Academy event on Thursday, where he was accompanied onto the stage by his wife, Amy, and nine of their ten grandchildren. “Each and every one of us is—or should be—united in this common goal. Let’s take care of our patients to the best of our ability, and let’s get better together as we do it.”

Dr. Savoie enumerated the major ways AAOS helps surgeons provide safe, optimal care to patients, including education, support of evidence- based medicine, advocacy, and communication.

Education

One of the principal reasons for AAOS’ creation was to foster continuous learning and the exchange of knowledge among physicians. That commitment to education remains a core mission of the organization.

Dr. Savoie pointed to a recent AAOS initiative that addresses the educational needs of surgeons from the starting point of orthopaedic specialization: residency. Recently elected Second Vice President Paul Tornetta III, MD, FAAOS, and a team of volunteers and staff have constructed the Resident Orthopaedic Core Knowledge (ROCK) program, which is scheduled to roll out later in 2022. This undertaking will tie in to the annual Orthopaedic In-Training Examination and, with the support of the American Board of Orthopaedic Surgery, will form a more comprehensive correlation to the written Board exam taken upon completion of residency.

Dr. Savoie emphasized that education does not stop when residency ends. It continues with coursework and training throughout one’s career and with education-focused events, such as the gathering of thousands of orthopaedic surgeons in Chicago.

“There is nothing like the AAOS Annual Meeting and being able to share information and learn from and with each other,” he said. He added that the tradition of sharing knowledge and exchanging ideas should not be misconstrued as a desire by AAOS to appropriate the intellectual property of individual members or of specialty societies.

Noting that the practice of orthopaedics has become highly specialized (and that he himself has focused his practice on shoulder and elbow), Dr. Savoie observed that viewing orthopaedic surgery and patient care through only one’s specialty can narrow one’s education. At the AAOS Annual Meeting, however, attendees are exposed to the full range of specialties and knowledge from many different perspectives.

What unites the profession is a dedication to the health and safety of the patient, Dr. Savoie said. “At the end of the day, we are all friends, physicians, and surgeons with a common purpose.”

Evidence first

AAOS helps members provide the best possible patient care through its ongoing commitment and extensive involvement in evidence-based research and quality initiatives, but Dr. Savoie acknowledged that in orthopaedics, evidence may be fragile, elusive, or even overlooked. Sometimes, he noted, the surgeon says he or she knows what is best for their patient, “evidence be damned.”

“Diversity and variety are what make medicine an art, but there are significant pressures on us to justify what we do,” Dr. Savoie said. “As a surgeon, I would agree that an assembly-line, cookie-cutter approach to disease treatment is not the way to go, but general guidelines are useful. We all want to be current in our care, and guidelines can help to make this happen.”

One of the best ways to ensure that patients receive the best care possible is to establish an evidence-backed body of knowledge in support of surgeons’ actions that can forestall payers’ attempts to reject treatment plans or deny payments for procedures and optimal care. One essential bulwark in the effort to build an evidence base is the AAOS Registry Program.

AAOS registries, beginning with the cornerstone American Joint Replacement Registry, have evolved and expanded with the addition of entities collecting data for shoulder and elbow, tumor, fracture and trauma, and spine (with the American Spine Registry, a collaboration with the American Association of Neurological Surgeons). According to Dr. Savoie, there are also plans for ankle arthroplasty and other practice foci.

“This undertaking (for the registries) is tremendous, and the process is continually being upgraded and modified,” he said. “These registries provide direct evidence of how effective we surgeons are at getting patients back to an active lifestyle.”

Advocacy

Advocacy is central to AAOS’ effectiveness in supporting its members and their effort to provide the highest-quality care to patients. Dr. Savoie acknowledged that advocacy within the U.S. healthcare system, with many interests competing for resources and influence on policy, is a great challenge, but AAOS and its volunteers and staff—backed by a level of member support that stands out in medicine—are up to the task.

He noted that Douglas W. Lundy, MD, MBA, FAAOS, chair of the AAOS Advocacy Council, “has led an incredible effort to preserve our way of practice.”

For example, in the past year, AAOS worked to help delay proposed Medicare cuts for another year and continued to seek equitable treatment of orthopaedic surgeons by government and private payers. The hard work of advocacy is most successful when everyone is involved, Dr. Savoie said, and he encouraged all members to be united and get involved— and not just by writing a check. Insurance companies will always be able to donate more and speak more, he said. AAOS members need to get involved locally and personally.

“We have to do more,” Dr. Savoie said. “Our president, Danny Guy, has given us a road map: in-district advocacy events.”

Communication

AAOS is constantly working to improve communication, Dr. Savoie said. Along with the many ways the organization provides information—through publications, focused messaging, and digital and social media—AAOS is launching a new mobile app, coming soon, that promises to be user-friendly and provide members with quick and easy access to the products and services they need and use most.

Communication is an essential tool for addressing the issues of diversity, equity, and inclusion. “I think we can acknowledge that orthopaedic surgery is not the most diverse specialty,” Dr. Savoie said.

By way of example, he noted that Title IX has increased the number of female athletes in the orthopaedic patient population. A similar increase has occurred in the number of female medical students, but a correlating increase has not occurred in the number of female physicians choosing orthopaedics, and the numbers remain stubbornly dismal for underrepresented minorities.

“Under the leadership of 2020–2021 President Joseph A. Bosco III, MD, FAAOS, the AAOS Presidential Line met with various organizations to try to find the root of the problem and solve it, but unfortunately found everyone grappling with the same questions without answers,” Dr. Savoie said. Among the most vexing issues is equipping young people with the opportunities and resources to pursue careers in medicine and orthopaedic surgery—to build the pipeline that ultimately will expand the ranks of minority surgeons. “Thankfully, there are pipeline organizations like Nth Dimensions and the Perry Initiative teaching us how to improve,” Dr. Savoie said.

Through the recently announced IDEA (Inspiring Diversity Equity and Access) Grant Program, AAOS has committed more than $1 million over five years to help increase the pipeline. “But it is not enough,” and much desired progress remains unattained, Dr. Savoie said. “A recent Journal of the AAOS ® article found that 97 percent of responding African American orthopaedic surgeons felt discriminated against in the workplace,” Dr. Savoie said. “That is unacceptable. We are all in this world together, and while I may not be able to walk in your shoes, I should walk with you.”

In addition to committing to inclusion within the profession, members need to work on the patient side to address the problem of healthcare disparities and access to quality care. Dr. Savoie said he and the Board of Directors want AAOS to be part of the solution.

The new president closed his speech by thanking the Board of Directors and outgoing President Daniel K. Guy, MD, FAAOS, for his leadership.

“Success doesn’t come in a vacuum,” Dr. Savoie said. “We are all a team, and a really, really good one. We can always be better, but we are better together than apart. I hope that we can all work together for the greater good of our patients.”

Leah Lawrence is a freelance writer for AAOS Now.