In a recent editorial in the New England Journal of Medicine, the first few phrases of Dickensí A Tale of Two Cities were used effectively to describe the ambiguous state of todayís health care ". . . it was an age of wisdom and it was an age of foolishness, it was a spring of hope and it was a winter of despair."
If the condition of medicine in general is ambiguous, the state of orthopaedics is even more uncertain and, as a result, this Academy is feeling the winds of change more profoundly than it has in the past several decades.
I am worried. Iím worried about this Academyís ability to respond effectively to the challenges that confront us.
To determine what the Academy must do to establish new levels of leadership in orthopaedic surgery, a task force, called The AAOS in 2005, met in Chicago last fall. It predicted that orthopaedic surgeons, in as soon as two to three years, would question their memberships in organizations and would require greater value for continued membership.
In response, a research program was undertaken which revealed that a significant percentage of the membership, consisting of our youngest fellows, do not consider the Academy a primary source of musculoskeletal education, particularly with regard to the provision of timely on-line information.
Several pilot studies were initiated - studies that focused on the Academyís development of innovative technological methods for accruing and for disseminating information on a wholly new level.
One pilot study is developing just-in-time education online, with a program called Indications Conference. This program uses the new technology to allow you to access immediate information on operative procedures anywhere, anytime.
The procedures - complete with video and referenced articles - will be updated every few months. Another pilot program, called the Burden of Disease, promises to establish the Academy as The Source of verifiable information on the incidence, impact, cost and outcomes of musculoskeletal care.
Initial efforts to mine available data revealed that musculoskeletal conditions ranked number 1 in reported chronic impairments in the United States, more than all vision, hearing, and speech impairments combined.
Musculoskeletal injuries alone account for 65 million impairments a year. So the magnitude of the problem is enormous. And what about the cost - a staggering $215 billion.
If the dollar costs of musculoskeletal conditions were spread evenly over all the roadways in America, you would accumulate $55,000 for every mile you drove.
Our plan calls for our Research Council to gather data annually on the three musculoskeletal conditions that, based on the evidence, are most important with regard to their impact on society
From those data we will develop coordinated annual programs in research and in health policy, to increase our impact with the NIH and with the other governmental agencies. And, in member education and public education, we'll increase our own base of knowledge and increase our patients' awareness of these conditions.
Now we are in a massive struggle, a fight for survival, a fight to advance orthopaedic clinical care and research in the most difficult of times.
The way you and I will win this battle is to have the Academy become the knowledge core of orthopaedics.
With the accumulation of data, such as that seen with the Burden of Disease, and knowledge dissemination, such as that seen with just-in-time and public education, we'll have the ammunition we need to significantly improve musculoskeletal care in this country and worldwide.
I pledge to provide my fullest effort to work with President Canale in enabling the Academy to meet the challenges that confront us and to emerge, by 2005, as THE organization that provides the most remarkable levels of sustained value and effectiveness anywhere to orthopaedic surgeons worldwide.