Today's News

Thursday, March 16, 2000

Dr. Tipton: AAOS must match resources to mission, objectives to create balance

(Ed. Note: The following is an interview with William W. Tipton Jr., MD, AAOS executive vice president.)

The Academy seems to be doing more and more and getting bigger and bigger every year. This year the Academy had to raise dues and dip into reserves. Is that a warning sign that the Academy's resources are being stretched too thin?

There was a significant deficit in the operating budget this year. We're initiating a number of new member services this year. We need to provide programs that are relevant to the membership and their patients and to the primary mission of the Academy to provide high quality education

This year, we are initiating a major public education program, we're offering members free web site templates so they can reach the public and their patients through the Internet and we're expanding the public education content of our home page. You're going to hear a lot about "just-in-time" education which will provide new knowledge and existing knowledge to the physician when and where it is needed. We're also interested in providing education to our international members. We have the knowledge and we have the ability and obligation to provide that education.

Then there is the increasing advocacy role that we have had to play, given the federal and state legislative and regulatory activities and the changes in how health care is delivered today. I call it that great "sucking sound," it's all costs -money going out. Add to that the impact of inflation-the erosion of the purchasing power of the dues since the last dues increase in 1994.

When it came to overcoming the deficit, the Board of Directors considered various options, and in the end made the correct decision to dip into reserves for about half of the deficit, but ask members to assume the other half. No one likes to raise dues, but our dues still leave us in the middle of the pack of other medical societies.

Is there any thinking or planning to restrict or limit growth to stay in balance with AAOS's financial and human resources?

Every year, we have to look at our resources and match them to our mission and objectives and take appropriate steps to create a balance. We can't do everything, but we can do what is relevant to the mission of the Academy and our membership. We should not be afraid to put the knife to outdated programs. It's easy to add new and exciting hot topic programs, but we have an obligation to establish the relevance of both these new programs and projects as well as those that have been around for a long time and determine if they are still relevant or should be modified or eliminated. Some of these decisions are made through the budget process that has undergone change in the last few years. We've put more responsibility on the staff to be as accurate as possible on costs and revenues. In their presentations on the budgets they oversee, staff can provide input on the relevance and critical benefits of programs. And they can recommend what projects to cut back. We've drawn into the budget process, the AAOS leadership, chairman of the Board of Councilors and COMSS. Therefore, we have taken the team approach of staff and volunteers working together to make recommendations to the Board of Directors which makes the final decision.

How does the AAOS keep in tune with the needs of the membership?

A primary means is through our marketing department and the focus surveys it conducts with the members. Prior to 1994, marketing was part of each project and product, but there was no science to it. I recall one individual in leadership who said, a year after we established our marketing department, that it was not needed because, "after all we have a captive audience." It assumes that we don't care about what the members say, because they will buy what we produce. That shows a lack of understanding about how to maintain relevance to our membership. To "stay in tune with the membership," we are using all methods of communications. But frankly, the weak link is communications from the membership. Most of the calls I get are from concerned members are about health care delivery and financing, but not a lot about other matters. I hear much more about membership concerns through visits to state orthopaedic societies.

What are some of the major challenges facing the Academy?

A major challenge is how to incorporate the Internet with our education, health policy and research projects. Another challenge is volunteerism. How can the AAOS compete for membership partici-pation in projects when other organizations are offering monetary compensation? The members' willingness to be active in educational projects and courses is a drag on their resources. How do we compete with the outside world that puts a price on their time?

A third challenge is advocacy. The American Association of Orthopaedic Surgeons, the C6 organization, is working to help our members help their patients receive quality care in an era of apparently limited resources.

We also have an international challenge. Orthopaedists in other countries have a thirst for knowledge and training that we can provide. We are willing, but it is a resource problem in terms of money, volunteers and time. We need to provide education-knowledge and technical training. If we don't, it will force some to reassess membership in the Academy and to look to their specialty society to get their education.

The problem is that specialty societies are smaller and therefore the education op-portunities are less than what the Academy offers. And, because of their size, the specialty society is even less likely to have a role in advocacy. Instead, the AAOS should meet the needs of the members and be an umbrella organization working in close alliance with all the specialty societies to help them where possible to meet their goals and objectives.

You have been active in establishing close relations with industry. What is the status of that activity?

The Corporate Advisory Council (CAC) is moving into its third year. It is structured so AAOS leadership and CEOs of industry can meet to discuss issues of mutual interest. I am chairman and there is a rotating chairman from industry. We have more than 30 members.

In the last two years, we've had constructive discussions about the Annual Meeting, including the possibility of holding a Health Fair at the end of the meeting. We've also discussed the need for edu-cating orthopaedic surgeons to conduct clinical trials, and the ethics of industry support for Academy programs. We've added an industry represen-tative on the Ethics Committee to help us update that portion of the Opinion on Ethics, and we've added an industry representative on the Public Education Committee.

There are plans to include industry participation, through the CAC, in the National Action Committee for the Bone and Joint Decade. The result of this activity is that I get calls from CEOs, I haven't heard from previously. Some calls are on issues of concern with the Annual Meeting; others are on financial support for Academy education events, following the guidelines of the Accreditation Council for Graduate Medical Education.

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Last modified 16/March/2000 by IS