Saturday, February 26, 2005
Spain: A close look at first Guest NationBy Carolyn Rogers
The Academy and the Spanish Society of Orthopaedics and Traumatology (SECOT) have a long-standing history of mutual esteem and cooperation, but Spain's selection as the Academy's first-ever "Guest Nation" is due primarily to a close working relationship that took root four years ago in Madrid.
At the time, the AAOS was seeking SECOT's assistance with a possible Madrid showing of the Academy's "e-Motion" art exhibition. Then-SECOT President Dr. Fernando Gomez-Castresana and Dr. Antonio Perez-Caballer met with Lynne Dowling and Marissa McCarren of the AAOS international department in Madrid to discuss the project.
In the end, the exhibition didn't come together, but the working relationship between the Academy and SECOT's board of directors blossomed as a result.
"We had the opportunity to show them some of our activities and publications," recalls Dr Gomez-Castresana.
Dowling and McCarren were "surprised" and impressed by the quality of their activities and products, he says. "Since then we've had the opportunity to cooperate with the AAOS on different courses in Spain, four jointly-produced monographs, other publications and some new projects."
Both Dr. Perez-Caballer and Dr. Gomez-Castresana currently serve on SECOT's board of directors.
"We've really worked as a team and have been pleased with the outcome," McCarren says of the SECOT-AAOS collaboration.
"We're a small country"
"We were very surprised and flattered to be the first country honored as Guest Nation," says Dr. Gomez-Castresana. "We're a small country, so it really is amazing."
So how does the health system of this relatively small country match up with the U.S. system?
"In the United States, it's a much more open system, more of a competitive activity than in Spain," says Dr. Perez-Caballer, MD.
"Here, 100 percent of the population has the opportunity to be treated by you-we don't have that," says Gomez-Castresana.
Spain actually has two different systems, explains Dr. Perez-Caballer.
"First, there is the National Security System, which pays you a salary," he says. "This system serves the entire population, including immigrants…We have a lot of immigrants in Spain from Latin American countries."
The second system is private, he says.
The vast majority of orthopaedic surgeons in Spain, however-more than 80 percent-work for the national system.
"Of the remaining 20 percent, many orthopaedic surgeons work for both the national and private systems, so only about 3 percent are truly working in private practice," says Dr. Gomez-Castresana.
Both Dr. Perez-Caballer and Dr. Gomez Castresana work solely in private practice.
This is a challenge, Dr. Gomez-Castresana says, because "you always have to fight against that monopoly."
To many Spanish orthopaedic surgeons, however, the most striking difference between the U.S. and Spanish systems lies in the doctors' own pocketbooks, Dr. Perez-Caballer says.
"Fees for orthopaedic services in the United States are much higher than in Spain," he says. "We think that's a very important difference, as you can understand!"
SECOT: A bridge to Latin America
"We are collaborating on many important publications with the Academy and we want to keep that in the future," he says. "We are fighting for that."
"From a scientific point of view, the Academy is a leader in the world, and we want to be a part of this leadership," explains Dr. Gomez-Castresana. "It's better to be with the first than the last!"
SECOT also sees itself playing an ongoing role as a "bridge" between Latin American orthopaedic societies and the AAOS.
"The Academy is interested in increasing its influence in South America," says Dr. Gomez Castresana. "We are a bridge for that, because of our language and our ties to Latin American countries. Dr. Miguel Cabanela, [chair of the AAOS International Committee] is doing an excellent job with South American countries, in giving courses and so on. And we are in a very good position in this country to help, so we can work together."
AAOS-SECOT monographs are being sold in Latin American countries as well as in Spain, Dr. Perez-Caballer points out.
"The Academy considers Latin America to be a permanent area of expansion, and these countries are very much involved with SECOT," he says. "Our meetings are combined with the Argentinean society, the Chilean society, the Columbian society, and even the Latin American society."
"So, we are helping the Academy to reach their goal," Dr. Perez-Caballer says. "That is very important to us because it means that they need us, also… We feel important!"
"We are looking forward to great interaction between Latin American countries and the United States," Dr. Gomez-Castresana says.