Today's News

Thursday, March 1, 2001

Dr. Tipton tells AAOS challenges

Following is an interview with William W. Tipton Jr., MD, AAOS executive vice president.

What are some of the challenges facing the AAOS?
One of the biggest challenges faced by the AAOS is the decline in attendance at CME courses in last few years. Our members tell us that they are attending fewer courses because they have a limited amount of time available to be away from their practice. Time is an even more precious resource than money. A close second to "time" is the cost factor. I'm not so sure it is the cost of the courses, but rather the fact that as reimbursements have declined, our mem-bers have a heightened awareness of costs of everything, including CME and therefore they're more discerning about what courses they will attend. While location is still important, content has become a much more important factor.

What has been the response by the AAOS?
We are prepared to meet this challenge. We've been gearing up to move more CME programs to an electronic mode-specifically, the Internet. We have one course on the Internet and plans are in the works to put more on in the coming years. There hasn't been a mad rush to sign-up for the online ACL course, but the members are a transition stage-learning to use the Internet. We also are attempting to determine educational needs so as to create meaningful and desirable content.

There are some financial implications for the Academy, but it goes to the heart of the organization, doesn't it?

Yes. Our primary mission is education. If we lose education, we lose the reason for members to belong. That's why we are working so aggressively to meet this challenge. Education is the glue that maintains our superb membership numbers and it must be maintained both in flexibility of delivery as well as relevance to the needs and desires of our members.

What other challenges to you see?

There is an increased demand on our members by patients and payers to maintain quality care, despite declining reimbursements. There are few disciplines that can maintain quality in the face of declining cost. Much of this squeeze can be blamed on managed care, but we're seeing cracks in managed care. Their premiums are rising and their ability to cope with the cost of delivery of health care is declining. We most likely are in the last stages of managed care. We must continue our role as advocates for our patients and members for cost effective care-high quality, reasonable costs.
There also are other increasing demands on the AAOS, but the AAOS can't be all things to all people. That has been very evident in the last two years. You can see it in our budgets. We had a dues increase in 2000 and had to dip into reserves, and for fiscal 2001, we once again have to go into our reserves. We've begun to really sharpen our pencils to maintain involvement and to control costs. But we have to face the fact that we can't continue to go into reserves to carry out everything that might be expected of the AAOS.

We hear more discussion about involvement with industry these days, why is that?
For years, industry was involved with our educational efforts mainly through the Annual Meeting. With some of the challenges that I mentioned earlier, there has been increased pressure to determine alternative support for our mission without compromising our ethical standards. Three years ago we created a Corporate Advisory Council, which is made up of CEOs of industry as well as the leadership of the Academy and staff. This has lead to a series of discussions surrounding the ethics of industry and orthopaedic surgeons as we explore the possibility of joint AAOS-industry courses. Industry has educational needs as well and how exactly to meet those needs and yet keep it separate from promotional needs remains a challenge. How do you maintain elbow length distance and engender support, while main-taining high ethical standards? That's what we're exploring.

You mentioned meeting membership needs, would you comment on the AAOS communication program?
We're into the third year of developing an effective communications program, which also raises another challenge. That is where to best put the emphasis, how much money to spend and how do you judge the effectiveness. Our membership has voiced support for such a program to raise public awareness of who we are and what we do as orthopaedic surgeons. It remains to be seen how effective this program will prove to be. Certainly some of the humanitarian efforts that have resulted from the program such as the playground projects and the Special Olympics have produced a unique interaction of orthopaedic surgeons and the public.
I think the effort to raise awareness that musculoskeletal disease has a major impact on society has been helped by our involvement with the Bone and Joint Decade. The effort not only increases the public's awareness of the enormity of demand placed on society because of diseases of the musculoskeletal system, but also increases the awareness of the need for more research, and for the funds to support that research.

What's the AAOS posture on advocacy in the coming years?

We will continue our role as advocates for patients and members to be played-out at the local and federal levels of government. This increased emphasis is required because of what I perceive as an ever-increasing involvement of government at all levels to influence the direction of health care delivery in this country. This increased involvement of government interest, in my opinion, is due to an ever-increasing cost of health care, not the lack of health care quality.
Amidst all of these challenges in the past few years and this year to come, I would be remiss if I did not comment on the positive accomplishments of AAOS. These include a viable Orthopaedic Learn-ing Center for teaching surgical skills both at the OLC and by satellite abroad; our positive role in Washington, D.C. as an effective leader; continued progress in moving the AAOS education programs towards the Internet; and the early positive returns of our massive public relations and media program evident in the response to our playground program. AAOS remains focused on its mission in its Strategic Plan to promote the highest quality musculoskeletal health, the interests of all patients, and the orthopaedic profession through education, health services research, advocacy and communication.

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