Published 9/10/2025
|
Bradley Lezak, MD, MPH; Joseph Bosco III, MD, FAAOS
Editor’s note: This article is part of a series on the importance of healthcare advocacy for orthopaedic surgery residents. Part one, which provided an overview of key healthcare advocacy topics relevant to musculoskeletal care, is available here. The next article in this series, which focuses on Medicare payment reform, will be published in an upcoming issue of AAOS Now.
Physicians are primarily dedicated to patient care, placing patient interests above all else and adhering to a strict ethical code that fosters trust. Historically, some physicians have expanded their responsibilities to influence broader health policies. Although individual physician involvement in politics has existed for centuries, organized advocacy by physician groups has become increasingly prominent. This article explores the history and impact of medical and orthopaedic advocacy and the benefits that orthopaedic surgery residents can gain through involvement in healthcare advocacy.
A history of medical advocacy
Advocacy in medicine dates back to Hippocrates, who encouraged physicians to advocate for patients and strive for justice in care. In the 19th century, physician and writer Rudolph Virchow, MD, penned essays highlighting the connection between medicine and politics, emphasizing that societal health impacts individual health. Significant political involvement in U.S. healthcare began with the introduction of Medicare and Medicaid in the 1960s, necessitating greater physician engagement in the political process to ensure accessible and optimal healthcare delivery.
In orthopaedics specifically, AAOS represents orthopaedic physicians and advocates for musculoskeletal patient care. In the late 1990s, AAOS established the Political Action Committee of the American Association of Orthopaedic Surgeons (OrthoPAC) to promote legislative issues important to orthopaedic surgeons. OrthoPAC is guided by representatives from AAOS and managed by professionals in Washington, D.C.
AAOS-led advocacy has led to significant accomplishments at the federal level, including passage of the Sports Medicine Licensure Clarity Act, changes in the 2018 Bipartisan Budget Act, provisions in the SUPPORT Patients and Community Act for opioid control, and Centers for Medicare & Medicaid Services rule changes for total knee arthroplasty.
State-level successes include protections for the integration of physicians with physical therapy programs and the expansion of ambulatory surgery centers.
AAOS continues to advocate for additional policies that will positively impact orthopaedic surgeons, such as long-term Medicare payment reform to include inflationary updates tied to the Medicare Economic Index, administrative burden relief, a repeal of the ban on physician-led hospitals, and more.
The benefits of resident engagement
Orthopaedic surgeons can engage in political advocacy at both federal and state levels, with involvement ranging from voting to donating, actively campaigning, or building relationships with representatives. For orthopaedic surgery residents, advocacy is crucial for several compelling reasons, extending beyond the immediate benefits to training and the practice environment.
First, advocacy provides the opportunity to influence healthcare policies that directly affect one’s education and future career. Engaging in advocacy furthers one’s understanding of the intricacies of healthcare legislation, reimbursement systems, and regulatory requirements, enabling more effective navigation of these systems.
Developing leadership and communication skills is another significant advantage of political advocacy. By participating in advocacy activities, residents learn to articulate their needs and concerns clearly and persuasively, skills that are essential for professional success. These experiences also foster critical thinking and problem-solving abilities, as they require analysis of complex policy issues and develop strategic approaches to address them.
Moreover, advocacy efforts by residents can lead to tangible improvements in their working conditions. For example, resident involvement in policy discussions can influence regulations regarding funding for residency programs and access to educational resources. These improvements not only enhance the training experience but also contribute to better patient care by ensuring that residents are well supported and well educated.
Furthermore, advocacy prepares residents to be future leaders in their field. Residents are the next generation of orthopaedic surgeons; early involvement in advocacy ensures they are ready to take on leadership roles within professional organizations and healthcare institutions, helping the profession evolve and improve.
Engaging in advocacy also provides residents with a sense of empowerment and professional fulfillment. It can be highly motivating to know that one can influence policies and practices that impact the profession and patient care. It fosters a sense of responsibility and commitment to the broader medical community.
Finally, through organizations like AAOS, residents have the opportunity to network with experienced professionals and mentors who can guide their advocacy efforts and career development. These connections are invaluable for professional growth and for creating a collaborative community of orthopaedic surgeons dedicated to advancing their field.
In summary, advocacy is indispensable for orthopaedic surgery residents as it equips them with the knowledge, skills, and networks necessary to influence healthcare policies, improve their training and practice environments, and prepare for leadership roles.
By actively participating in advocacy, residents contribute to the betterment of their profession and the healthcare system, ultimately leading to enhanced patient care and professional satisfaction.
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.
Bradley Lezak, MD, MPH, is an orthopaedic surgery resident at NYU Langone Orthopedics in New York and a member of the AAOS Now Editorial Board as well as the AAOS Health Policy Committee.
Joseph Bosco III, MD, FAAOS, is a professor of orthopaedic surgery, vice chair of clinical affairs, and director of quality and patient safety at NYU Langone Orthopedics. Dr. Bosco is also a former AAOS president (2020-2021).