Cassim M. Igram, MD, FAAOS


Published 3/11/2024
Cassim M. Igram, MD, FAAOS

The Top 10 Excuses for Not Contributing to the OrthoPAC

For many years on his Late Show, David Letterman would have a daily top 10 list, submitted from the home office in Sioux City, Iowa. It usually dealt with issues in the news or pop culture.

Oddly, for many years, AAOS Fellows have come up with many different excuses for not contributing to the Political Action Committee of the American Association of Orthopaedic Surgeons (OrthoPAC). Keeping that in mind, below is a top 10 list of Fellows’ all-time excuses for not actively participating in the OrthoPAC, submitted from the AAOS headquarters in Rosemont, Illinois, followed by responses submitted from the AAOS Office of Government Relations in Washington, D.C.

10. I have no idea what the OrthoPAC does for me.
The OrthoPAC is the only national political action committee in Washington, D.C., dedicated solely to representing the Association before Congress. The OrthoPAC is our voice in our nation’s capital. We have the second-highest-funded medical political action committee in the country, second only to that of the American Society of Anesthesiologists.

9. The OrthoPAC is just not that important.
AAOS must have an advocacy presence in Washington, D.C. How we practice and how we care for our patients are issues that never go away.

8. The OrthoPAC is just too political.
Not so. The OrthoPAC is strictly nonpartisan. We cannot pick sides. That said, it is impossible to agree with each politician on every issue. However, the OrthoPAC must not wear a partisan hat and instead wears a surgical cap when choosing to support candidates that support causes and issues that are important to AAOS.

7. I will not give money to the OrthoPAC because they gave money to Democrats.
In the last election cycle, 52 percent of donations went to Republican candidates.

6. I will not give money to the OrthoPAC because they gave money to Republicans.
In the last election cycle, 48 percent of donations went to Democratic candidates.

5. I just do not want to be politically active.
Being politically active is directly tied to preserving high-quality patient care, and it is not difficult to achieve. Building relationships is important. Get to know your member of Congress or one of your Senators. Go to town hall meetings in your district. Sponsor a fundraiser. It is not that hard to make connections, which is the key to opening doors and protecting our ability to care for our patients.

4. Plenty of other AAOS Fellows donate to the OrthoPAC.
It would be nice if that was the case. Only about 20 to 25 percent of active Fellows donate to the OrthoPAC. By way of comparison, nearly 90 percent of trial lawyers donate to their political action committee.

3. I just do not have the money to donate.
You cannot afford to not donate. Think of it as an investment in our ability to practice. Call it “practice insurance.” No donation is too small. Naturally, we would like to raise as much money as possible to support our efforts.

2. Elections are just not that important to me.
It was President Barack Obama who said, “Elections have consequences.” Whether we like it or not, Congress has great sway over how we practice and how we care for our patients. As a result of the OrthoPAC’s advocacy efforts in Washington, D.C., we have had accomplishments ranging from COVID-19 relief, legislation to curb surprise billing, research funding, value-based care, and lifting restrictions on orthopaedic devices.

1. I just do not know how to donate.
The answer is in the palm of your hand. Simply text “AAOS” to 41444, which is the easiest way to donate. You can also donate online at

The OrthoPAC recently celebrated its 25th anniversary. We continue to have a strong presence in Washington, D.C., thanks to donations from a minority of Academy Fellows and the tireless efforts from our staff in the Office of Government Relations.

To the Fellows who are already regular contributors, we thank you. However, there is so much room for improvement. Politics is a messy business. However, we must have a seat at the table in order to have our voices heard and to protect the House of Orthopaedics.

Cassim M. Igram, MD, FAAOS, is a clinical professor in the Departments of Orthopedic Surgery and Neurosurgery at the University of Iowa. He is a member of the AAOS Now Editorial Board, treasurer of the OrthoPAC, and a member of the AAOS Committee on Professionalism.