Today's News

Saturday, March 13, 2004

"Knowledge is our business" says new AAOS President

by Susan Nowicki, APR

Robert W. Bucholz, MD, became the 72nd president of the American Academy of Orthopaedic Surgeons on Friday. Stuart L. Weinstein, MD, assumed the position of first vice president, and Richard F. Kyle, MD, was elected second vice president.

In his address to the fellowship, Dr. Bucholz described his first volunteer involvement with the Academy: working on a trauma task force to help the Food and Drug Administration (FDA) define the difference between a delayed union and a nonunion.

"The governmental agencies consulted the Academy since we were viewed as the source of expert opinion and musculoskeletal knowledge…The task force of orthopaedic surgeons unselfishly volunteered their experience, time and analytical skills to further our knowledge and understanding of an important subject. Then and there, I was hooked," he said.

"Indeed, the continued relevance of the Academy to its fellowship and its preeminence as a professional association demand continued leadership in this primary business of orthopaedic knowledge," he said.

"Knowledge is more than information…It is not the 'who, what, when or where,' but rather, the 'how and the why' of a subject," he said. The Academy functions as both a filter and generator of knowledge. "Our most valuable asset is our aggregate intellectual capital. This capital is derived from dedicated, creative volunteers and staff. The information provided by the AAOS is indispensable to a knowledgeable practice of orthopaedic surgery."

In describing his plans for the future, Dr. Bucholz said that the foundation of the Academy's mission has always been scientific and clinical education. But competition from the orthopaedic industry, specialty societies, regional societies and academic institutions is challenging its position as the leader in orthopaedic education and forcing the development of new strategies.

"Our traditional CME courses must refocus on cutting-edge, timely subjects," he asserted. "Collaboration with specialty societies and orthopaedic industry on both didactic and surgical skills courses will ensure high quality programs and eliminate illogical competition. Easily accessible electronic courses and regional courses will fill an educational void and make life easier for the orthopaedist to demonstrate the six competencies identified by the American Board of Orthopaedic Surgery for maintenance of certification.

"Practice management courses on coding and reimbursement, compliance, clinical trials, ambulatory surgical centers, patient privacy, and professional liability must be constantly modified to satisfy the ever-changing regulatory landscape.

"Our Fellows have less time and money for their education. Focused, high intensity, and inexpensive courses will thus be mandatory in the future."

Internet-based education
A major component of the "AAOS in 2005" initiative was a commitment to Internet-based education, Dr. Bucholz noted. That commitment has now been translated into a number of projects, such as the Orthopaedic Knowledge Online (OKO) Web site. With its focused topics, graduated learning, videos of state-of-the-art procedures, current evidence-based reference sources, and links to other educational sites, OKO will likely evolve into the primary mode for information transfer for the next generation of orthopaedic surgeons, possibly becoming a single ortho-portal for electronic education and searches and a central electronic site for orthopaedic educational material.

Although the Web is a growing focus for education, noted Dr. Bucholz, "one medium does not fill all Fellowship needs." He pointed to the sustained vitality and popularity of Academy written publications and its unsurpassed track record of educational print materials.

A growing membership
He also looked to the future, specifically to orthopaedic residents and candidate members. "This next generation of orthopaedic surgeons possesses different aspirations and skill sets than you and I," he said. "I have had the privilege of training these young doctors during my professional life and firmly believe that our Academy's knowledge culture will thrive uninterrupted under the leadership of these future orthopaedic surgeons."

Dr. Bucholz also acknowledged the ways a shrinking world and a growing number of in-ternational members are affecting the Academy. "Our annual meeting serves as the international fair for exchange of ideas and technology. Our distributions and translations of educational material have increased 30 percent to 40 percent annually for the last five years. Interest in Academy-sponsored CME courses throughout the world has mushroomed. The Journal of the AAOS and OKO are now prized benefits of Academy international membership. Nevertheless, we have witnessed just the tip of the iceberg."

Not only can the world learn from the Academy, but the Academy can learn from the world, said Dr. Bucholz. "Many commonly performed orthopaedic procedures originated abroad. International advances are being made in arthroplasty registries, bone morphogenetic proteins, and cartilage transplantation…The acquisition of knowledge is a two-way street. It is imperative that we reach out to our international colleagues, benefit from their research and experience, and secure the position of the Academy as a forum for international exchange of knowledge."

Working with government
Noting that the government is also one of the Academy's "customers," Dr. Bucholz pointed to collaborations with the Centers for Disease Control and Prevention, the FDA, the Occupational Health and Safety Administration, the Centers for Medicare and Medicaid Services, and the Agency for Healthcare Research and Quality.

"The Academy is a trusted, respected resource for these powerful legislative and regulatory bodies which profoundly impact our practices and patients. What is truly noteworthy is that these agencies, not the Academy, have initiated these alliances, task forces, and contacts…The credibility that the Academy gains from these exchanges of knowledge is invaluable in our advocacy efforts.

"Research is the life-blood of our specialty," continued Dr. Bucholz. "The majority of the technologies and treatments that I can now offer my patients were not known or available when I was a resident in training. Some treatments have changed incrementally, some completely, through orthopaedic research. The Academy's role stretches from the support and encouragement of researchers to the identification of a research agenda to the assessment of evidence-based knowledge to its publication and dissemination."

A patient focus
The Academy also has a responsibility to the public, our patients. Because Americans often make unwise choices, Dr. Bucholz said, "It is our professional responsibility to educate the American public so they make better choices in their musculoskeletal health." He pointed to Your Orthopaedic Connection, the Academy's patient education Web site, and encouraged member to direct patients to the site.

He also recognized the Academy's public service announcements, which appear on television, radio, and billboards, reaching an estimated audience of 120 million, and reaffirmed the Academy's commitment to continue and expand these efforts, perhaps by partnering with corporate America.

Turning his attention to patient safety, Dr. Bucholz identified it as "one of the most important initiatives in the 72-year history of the Academy. Under the leadership of Drs. James Herndon and David Wong, a critical issue which barely appeared on the radar screen of our specialty has been propelled to the center stage that it deserves…The rapidity with which the Academy responded is commendable."

The need for advocacy
Noting that "the role of government, especially the federal government, has expanded in all areas," Dr. Bucholz called for long-term participation at all levels of the political process.

"Dollar for dollar, orthopaedic care improves the health and quality of life for Americans more than any other medical field. This fact is unfortunately not appreciated by the political power brokers. Our role must be to get the message out. Through the Association, the Orthopedic PAC, the Board of Councilors, specialty societies, state orthopaedic societies, and the Bone and Joint Decade coalition, hard, irrefutable data on the cost-effectiveness and value of orthopaedic care must be researched, packaged and distributed to our elected officials."

He decried the affects of rising liability premiums, frivolous lawsuits, and escalating jury verdicts and called for a sustained, continuing effort to educate and influence political leaders. "Physicians in general and orthopaedic surgeons specifically have been slow to grasp this concept. The AAOS thus has an additional responsibility to educate our fellowship on the political process."

In conclusion, Dr. Bucholz stated that he wanted the Academy to remain the "go-to" authority for knowledge, "the site where the patient goes to discover the risks of an upcoming surgery, an orthopaedist goes to learn how to safely perform a new surgical procedure, a government agency goes to partner on a musculoskeletal initiative, where the media goes for expert sources and information on a story, a resident goes to learn how and where to find a job, a candidate member goes to get precise practice management education, and even the senior orthopaedist goes to learn the challenges of retirement. In this way, the AAOS will remain the premier medical association that the fellowship and the staff have made it."

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Last modified 13/March/2004