July 2004 AAOS Report

Board takes action on Expert Witness Program, ethics opinion, guidelines

The AAOS Board of Directors (BOD) took several actions at its June 11-12 meeting in Rosemont, Ill.

The Board unanimously approved the business and implementation plans for an AAOS Expert Witness Professional Compliance program. Under this program, AAOS fellows and members would be permitted to file complaints against other fellows or members regarding all ethical issues for which the AAOS Board has adopted Professional Principles. Among the first of these minimum-standard principles will be expert witness testimony. The new professional compliance program will give substantial due process to those charged with violating Professional Principles. David A. Halsey, MD, chair of the Expert Witness Program Project Team, presented the recommendations to the BOD. Much work remains to be done, including the development and approval of AAOS bylaw amendments, before any disciplinary process begins operation, at the earliest in spring 2005.

The Board voted to revise the current AAOS "Opinion on Ethics and Professionalism on Gifts and the Orthopaedic Surgeon’s Relationship with Industry," to make it consistent with voluntary guidelines adopted by the Pharmaceutical Research and Manufacturers Association (PhRMA) and the Advanced Medical Technology (Alva Med) Association regarding interactions between industry representatives and health care professionals. The revised code is posted on the AAOS Web site.

As recommended by the Evidence-Based Practice Committee and the Council on Research, the BOD approved the revised AAOS Clinical Guidelines on Hip Pain (Phase I), Low Back Pain (Phases I and II), and Wrist Pain (Phase I)

The AAOS Hip, Spine, and Hand/Wrist Evidence Analysis Work Groups have completed the evidence-based clinical guidelines addressing treatment of hip pain and wrist pain by first contact physicians, and low back pain by first contact physicians and musculoskeletal specialists.

Also as recommended by the Professional Conduct Board Project Team, the BOD approved an AAOS "Code of Ethics for Governance and Management." While not legally mandated, the adoption of such a code of ethics is viewed as a "best practice" by many not-for-profit organizations.

The Board participated in a comprehensive strategic discussion on the topic of evidence-based practice (EBP). Michael J. Goldberg, MD, chair of the Evidence-Based Practice Committee, moderated the session.

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