OrthoPAC Celebrates Its 25th Anniversary of Advocating for Patients and the Orthopaedic Profession

This year, the Political Action Committee of the American Association of Orthopaedic Surgeons (OrthoPAC) celebrates 25 years of supporting AAOS’ advocacy efforts on behalf of orthopaedic surgeons and their patients.

Although 1999 marked OrthoPAC’s founding year, AAOS has been involved in advocacy since the founding of its Washington, D.C., office in 1979. As the federal government became more involved in healthcare, the Board of Councilors formed a non-connected political action committee (PAC), the Committee for Quality Orthopaedic Healthcare, in 1986.

As advocacy became more important to AAOS members, in 1997, the Academy formed the American Association of Orthopaedic Surgeons, a 501(c)(6) organization, to increase its overall advocacy efforts. Between 1998 and 1999, the non-connected PAC began spending down its assets, and in 1999, it transferred its last $5,000 to the new, separate, segregated fund of the American Association of Orthopaedic Surgeons, the current OrthoPAC.

OrthoPAC raises funds to elect candidates who support issues facing orthopaedic surgeons and their patients. All of the issues, from OrthoPAC’s inception until today, are related to two fundamental goals: improving orthopaedic surgeons’ ability to care for their patients and protecting patients’ access to musculoskeletal care. OrthoPAC is committed to preserving the physician-patient relationship.

AAOS has always had a superb Office of Government Relations (OGR), with dedicated staff in the legislative and regulatory arenas. Regardless of how outstanding the OGR is, a vibrant PAC is necessary to support legislative goals in the current environment. Elections in the United States are prohibitively expensive (Table 1), and only the ultra-wealthy can support their own campaigns. Hence, OrthoPAC’s role has become increasingly important in the U.S. political cycle. OrthoPAC’s sole aim in aiding candidates or members of Congress is to help support the advancement of the legislative agenda of AAOS and the Specialty Societies who have advocacy in their missions.

OrthoPAC is non-partisan, meaning it is issue-driven and has no allegiance to any political party, and this fact is critically important in the current polarized state of politics. OrthoPAC is a pragmatic, not ideological, PAC. There are multiple issues on OrthoPAC’s agenda at any time, and it supports candidates from all parties who support these healthcare policy priorities. Candidates’ positions on social issues, foreign affairs, etc., outside the realm of orthopaedics have no bearing on OrthoPAC support.

Through OrthoPAC, AAOS and its members build relationships with members of Congress, getting the opportunity to frame debates on important issues and, in many cases, serve as resources on musculoskeletal issues for key legislators. Being “at the table” gives orthopaedic surgeons a chance to contextualize healthcare-related issues around the key points of care access and quality. It would be irresponsible of AAOS not to be at the table on every single issue that relates to orthopaedic care. There are always opposing forces who feel that they know what is best for orthopaedic patients. The OGR maintains constant vigilance on the legislative and regulatory front, and OrthoPAC helps to mobilize AAOS’ advocacy outreach to specific members of Congress who can weigh in on legislation or impact the regulatory process.

When the AAOS healthcare agenda dovetails with other medical specialty societies and associations, these organizations often combine resources to work in coalitions to be even more effective advocates for their members and patients. Examples include the Practice Expense Coalition, the National Institute of Arthritis and Musculoskeletal and Skin Diseases Coalition, and Doctors for Medical Liability Reform.

Over the past 25 years, OrthoPAC has developed an impeccable brand on Capitol Hill. Because of this, when an issue is purely an orthopaedic issue, OrthoPAC can work alone. The OGR and the AAOS members who advocate to members of Congress always have unquestioned credibility, and they never go in without a clearly defined “ask” or facts supporting their viewpoints. Every issue is always framed in the context of how legislation may help or hurt patients’ ability to access orthopaedic care or the quality of that care.

OrthoPAC has been led by chairs (Paul Collins, MD, FAAOS, from 1999–2006; Stuart Weinstein, MD, FAAOS, from 2006–2015; John Gill, MD, FAAOS, from 2015–2023; and current Chair Wayne Johnson, MD, FAAOS, FACS) and Boards of Directors who were committed to enhancing communication with current and future members and expanding fundraising efforts via the Capitol Club, the Rainmakers Program, and the Advisor’s Circle. OrthoPAC facilitates fundraisers for candidates and sitting members of Congress who support orthopaedic issues, along with supporting individual members and advocacy-focused Specialty Societies in hosting fundraisers as well.

Advocacy requires different expectations than daily practice. Orthopaedic surgeons are used to getting things done expeditiously. An injured patient comes to the emergency department; the surgeon makes the diagnosis, develops a treatment plan, and gets the patient to the OR and on to recovery. Advocacy, on the other hand, is the antithesis of this timeline; it requires patience and persistence. Success in health policy and advocacy is usually incremental and achieved over time. Starting and end points are very hard to define. For example, it took more than a decade of sustained advocacy efforts to get rid of the sustainable growth rate as a formula for physician reimbursement and have it replaced by a value-based care system.

While celebrating OrthoPAC’s 25-year history of fighting for patients and the profession, AAOS members cannot rest on their laurels. OrthoPAC works for all orthopaedic surgeons regardless of practice model, because they all share common issues that will become more complex over time. The year 2014 was OrthoPAC’s highwater mark, with 31 percent of members contributing to the PAC, ranking first among all medical PACs and in the top 10 of all U.S. PACs. In 2024, it must be an immediate goal to surpass that benchmark, and that makes it incumbent on each AAOS member to contribute, with the exception of foreign nationals. There is not a single member of this community who cannot afford to contribute to the PAC, regardless of political affiliation or lack thereof. The AAOS membership needs to make OrthoPAC the strongest medical PAC in the United States and advocate together as a profession. Fragmentation of advocacy efforts (by anatomic regions or procedures) is not a winning strategy because it gives policymakers an excuse to “tread water.” Unity in advocacy is the only formula for success, hence OrthoPAC’s new tagline: “Unity in Orthopaedics.”

AAOS members should look back with great pride on what OrthoPAC has accomplished on behalf of patients and the profession over the past 25 years. Regardless of one’s practice type (e.g., employed, academic, private practice, multispecialty clinic, solo practitioner), the legislative and regulatory hurdles facing the entire profession are considerable. Every single U.S. member, as well as future members, must step up and join OrthoPAC and maintain annual PAC membership.

For those wishing to be more active in advocacy, OrthoPAC can provide opportunities to be engaged in the political process. Participation in OrthoPAC has never been more critical. For more information about OrthoPAC, please visit aaos.org/advocacy/pac.

The Political Action Committee of the American Association of Orthopaedic Surgeons (OrthoPAC) is affiliated with and connected to the 501(c)(6) Association. OrthoPAC is not connected to or affiliated with the American Academy of Orthopaedic Surgeons, which is a 501(c)(3) organization.

Stuart L. Weinstein, MD, FAAOS, is past chair of the OrthoPAC Executive Committee and a past president of AAOS.