Boards decide strategic initiatives, create educational endowment
By Marilyn Fox, PhD, and G. Jake Jaquet
$5 million fund will support special education projects beginning in 2008
During their meeting on Monday, the Boards of Directors of the American Association of Orthopaedic Surgeons and the American Academy of Orthopaedic Surgeons (AAOS) held a strategic discussion in preparation for creation of a new three-year strategic plan, approved $5 million for an education endowment, and approved a request from the Extremity War Injuries Project Team for $375,000 to hire a consultant to help procure funds from the Department of Defense (DOD) for further research into extremity war injuries. The Board also approved a new lay member to replace retiring member Leslie Altick, and heard updates on the Orthopaedic Political Action Committee (PAC), specialty society issues, and various programmatic activities. It also recognized six individuals retiring from the Board for their service.
Richard F. Kyle, MD, AAOS president, thanked the Board and staff for a productive year marked by successful efforts to work with specialty societies in education and advocacy, implement the new governance structure, and avoid significant cuts in Medicare payments, and for the debut of AAOS Now, a monthly news magazine.
Board member and project team chair Norman Y. Otsuka, MD, and AAOS Medical Director Robert H. Haralson III, MD, presented strategic priorities for discussion in five major activity areas: governance; education; advocacy; research, quality assessment, and technology; and communications. The Board was asked to rank order priorities in preparation for the creation of the next three-year plan. The following priorities were named for special attention:
These priorities and others will be refined and tested against the next member needs assessment to be completed in 2008.
New lay Board member
The Lay Board Member Project Team, led by Dr. Kyle, James H. Beaty, MD; E. Anthony Rankin, MD, Miss Altick, and Karen L. Hackett, FACHE, CAE, recommended, and the Board approved, George Zachary (Zach) Wilhoit as the new AAOS lay Board member. One of 12 applicants, Mr. Wilhoit was selected because of his broad range of experience in areas relevant to AAOS activities. He is the chief executive officer of Ethnic Technologies (E-Tech), a global, multichannel marketing and information technology (IT) company. With an MBA from the Harvard Graduate School of Business and a background in government service, including exposure to the legislative and lobbying processes in Washington, D.C., Mr. Wilhoit understands the ways in which IT, advocacy, diversity of patient populations, and the business of health care intersect in contemporary medicine.
A project team led by William L. Healy, MD, treasurer, recommended, and the Board approved, the establishment of a $5 million education endowment from excess cash reserves. The endowment would be used to fund special education projects that meet the following criteria:
The endowment would be managed by an independent fund manager, and no more than 5 percent of the fund could be spent on an annual basis for educational activities. The fund would be augmented by investment returns and tax-deductible donations. An oversight subcommittee would be composed of the AAOS president, treasurer, and the chair of the council on education. The funds will be available for use beginning in 2008.
PAC reports and updates
Stuart L. Weinstein, MD, chair of the Orthopaedic PAC, reported that contributions to the PAC were at an all-time high, with $1.77 million being contributed in 2005-2006. The PAC had an 80 percent success rate in contributions to winning candidates in the 2005-2006 election cycle. Acknowledging the challenges of working with a new Congress and the national priority given to the war in Iraq, Dr. Weinstein pointed out the opportunities and noted the recent successful meetings held with congressional committees.
He also reported on the progress made by Doctors for Medical Liability Reform (DMLR) in enlisting grass roots support from patients, with a network numbering 620,000 individuals. DMLR has turned its attention to supporting states in their struggle for tort reform.
Other advocacy activities
Dr. Rankin, named by the Advocacy Council to chair the work group on AAOS Involvement in Medicare Part A Issues, presented a draft report and preliminary recommendations to the Board. Other members of the work group are Kevin J. Bozic, MD; Charles H. Classen Jr., MD; S. Glen Neale, MD; Thomas P. Sculco, MD, and Dr. Healy.
Although Part A is typically thought of as the “hospital” portion of the Medicare payment, Part A decisions include new technologies and their reimbursement, coding issues that impact overall resources available, and payments that affect resources available to physicians who own specialty hospitals and ambulatory surgery centers. Developments such as gainsharing and CMS reliance on physician professional associations for guidance on clinical assessments argue for more involvement in Part A.
The work group will report its formal recommendations in the future, but the Board agreed that AAOS should increase its involvement where AAOS input would add value to the decision-making process, impact patient access to and quality of care, and affect the direct and indirect resources available to orthopaedic surgeons as they deliver care to patients in an environment of increased costs and declining reimbursements.
Specialty society issues
Andrew N. Pollak, MD, Board of Specialty Societies (BOS) chair, reported several issues brought forward by orthopaedic specialty societies. The Orthopaedic Trauma Association requested that a U.S. Trauma Care Summit be convened to investigate the organization and delivery of trauma care in the future.
The American Society for Surgery of the Hand (ASSH) issues included linking AAOS Web page to subspecialty societies, creating a “universal” education page to promote all AAOS and subspecialty educational programs (organized by anatomic region), linking CME from all subspecialty societies, moving the BOS meeting at the Annual Meeting closer to Specialty Day, working to provide priority access to Annual Meeting housing for BOS members, and implementing a coordinated approach to completing CMS surveys on Relative Value Units with a Web site to upload the data.
The North American Spine Society (NASS) issues included addressing NASS’s overall involvement in the AAOS spine education program, as well as discussing the linking of spine registry participation to recertification.
Extremity War Injuries
Dr. Pollak also reported on the Extremity War Injury (EWI) Project Team’s work. The EWI II Symposium was held in late January, and Dr. Pollak stated that there is “a tremendous need for this type of program.” Current DOD funding for the Orthopaedic Trauma Research Program is $7.5 million for FY2007. He outlined a detailed strategy that could be used to facilitate an increase in this amount, and said a funding goal of $30 million to $50 million, “while a stretch, is achievable.” He asked, and the Board approved, hiring a consultant to pursue this strategy.
Orthopaedic Knowledge Online (OKO)
William A. Grana, MD, MPH, opened his presentation with a quote from Will Rogers who observed that the “world ain’t going to be saved by nobody’s schemes…. Plans get you into things, but you got to work your way out.” Dr. Grana noted that the significant strides made by OKO since its inception in 2001 were the result of plans made and a lot of hard work.
With over 100 surgical topics posted, more than 17,000 individual users, and more than 1.3 million pages accessed in 2006, OKO has matured into the Academy’s orthopaedic clinical portal, with individual sites for topics, orthopaedic review, continuing medical education, and a virtual bookstore. Work with orthopaedic specialty societies, as well as with the evidence-based practice and medical liability committees, has resulted in an ever-expanding array of online information. A member and resident benefit, OKO has received over $1.5 million in grants since 2001.
“Now rhymes with ‘wow’” was the summation of Editor-in-Chief S. Terry Canale, MD, about the premiere edition of the newest AAOS publication, AAOS Now. The monthly, tabloid-format magazine replaces both the AAOS Bulletin and the AAOS Report.
The three-year plan for the new publication, Dr. Canale reported, is to meet member needs, become financially self-sufficient, increase member involvement, and add more coverage of current issues. He said that “news and views” would be the thrust of AAOS Now.
An internal review and evaluation of AAOS Now will be conducted after publication of the second issue; at that time, any necessary adjustments would be made to format, content focus, and volume of material published. A critique of AAOS Now by the appropriate oversight bodies as to content quality and emphasis would also be sought.
Your Orthopaedic Connection
Thomas R. Johnson, MD, editor-in-chief of the AAOS patient education Web site Your Orthopaedic Connection (YOC), reported that in the past year, 95 million Americans searched the Web for healthcare information, but 70 percent did not find what they were looking for, highlighting the potentially significant role YOC can fulfill.
Since its inception in 2000, YOC has accumulated a library of 500 articles; each month the site receives more than 800,000 visits. He thinks, however, that YOC still is not robust or rich enough and that most Academy members are not aware of the site and thus are not directing patients to it.
Dr. Johnson also wants to expand the scope of YOC to include new types of articles and to expand the site’s mission to include patient-centered care. He suggested making YOC a “free-standing” unit more like the OKO Web site. A usability study and a review of the site’s content are planned for the future.
James D. Heckman, MD, editor-in-chief of the Journal of Bone and Joint Surgery-American (JBJS-A), provided an update on JBJS activities, describing the content aspects of the publication during 2006.
Dr. Heckman noted that 1,357 manuscripts were received during 2006, 79 more than were received during 2005. In addition, 97 solicited manuscripts were submitted for publication in five supplements published during the year.
The overall acceptance rate upon first submission was 14 percent (16 percent for clinical manuscripts, 11 percent for case reports and 14 percent for basic science manuscripts). “Orthopaedic Forum,” “Ethics in Practice,” “Topics in Training,” “What’s New,” and “Evidence-Based Orthopaedics” articles have an 80 percent overall acceptance rate.
In January 2007, as a service to orthopaedic surgeons and their patients, JBJS established a mechanism by which patients can obtain a free copy of any article published in the American volume of JBJS. Finally, Dr. Heckman noted that JBJS has a new five-year agreement with the Academy to provide a subscription to the American volume for all AAOS active fellows.
The Ethics Committee, chaired by Jeanne L. DelSignore, MD, recommended that the Board adopt a revised Advisory Statement on Domestic and Family Violence and Abuse: The Physician’s Responsibilities and a new policy for a Mandatory Disclosure Database for all AAOS volunteers. Both measures were passed by the Board (the disclosure database policy with minor modifications).
Maintenance of Certification
The American Board of Orthopaedic Surgery (ABOS) report given by Richard J. Haynes, MD, noted that Judith F. Baumhauer, MD, and Michelle A. James, MD, were elected as directors for 2007. Because the new Maintenance of Certification process still is generating many questions, ABOS staff and directors at the ABOS educational display (outside Ballroom 20) will be distributing MOC Computer Examination Pathway information documents to those diplomats whose certificates expire in 2010, 2011, and 2012. David G. Lewallen, MD, in his report on the ABOS/AAOS Combined Task Force on Maintenance of Certification, echoed the need for members to have access to more information.
Joshua J. Jacobs, MD, chair of the Council on Research, Quality Assessment and Technology, recommended, and the Board approved, support for collaboration with the NASS on preparing clinical practice guidelines.
Retiring Board members recognized
Six individuals retiring from the Board of Directors were recognized for their service: Kristy Weber, MD; Gordon M. Aamoth, MD; Leslie L. Altick; Dwight W. Burney III, MD; Dr. Pollak; and Dr. Weinstein. Dr. Kyle was also recognized for his service of the past year as president and presented with a framed collection of AAOS Bulletins published during his term.
Additional coverage of Monday’s Board meetings will appear in upcoming issues of AAOS Now Annual Meeting Daily Edition.