April 2000 Bulletin

AAOS—C3 and C6—alive and well

In 1996, the AAOS fellowship empowered the Academy Board of Directors to establish a C6 organization when and if the Board deemed it necessary. The term "C6" is an abbreviation for an Internal Revenue Service classification—501(c)(6)—for not-for-profit membership or professional organizations. C6 organizations have greater flexibility in advocacy issues than 501(c)(3) not-for-profit educational organizations, such as the Academy.

In 1998, with the aid of outside legal counsel, your Board determined it would be in the best interests of the Academy to establish a parallel C6 organization. The IRS had adopted a tougher stance and had stringently limited the level of permissible advocacy activities of C3 organizations. The formation of this C6 organization allowed the Academy to continue to function as a C3 tax-exempt not-for-profit educational organization. Additionally, the law allows a C6 organization to establish and operate a connected Political Action Committee (PAC). The Association created the new, affiliated Orthopaedic PAC in February 1999.

From the outset, the Academy leadership realized that internally two separate organizations would have to exist, but externally—to the membership—they would appear, to the extent possible, as seamless organizations working in tandem in complimentary arenas. They would be directed toward both the advocacy interests of the orthopaedic surgeon and to the historic education mission of the Academy.

We have been fortunate to be able to keep the same acronym, AAOS, for the C3 (American Academy of Orthopaedic Surgeons) and the C6 (American Association of Orthopaedic Surgeons) organizations. We owe a debt of gratitude to the American Orthopaedic Association, which, in the spirit of camaraderie, permitted us to use the word "Association" for our C6 organization. Internally, there are two sets of Bylaws. The AAOS membership and health policy functions are included in the C6 Association, while the AAOS education, research and communication activities remain in the C3 Academy. The Academy and the Association are governed by the same individuals who serve on the Board of Directors of each organization, and the two organizations use the same unified strategic plan.

A small but vocal minority argued early in the reorganization that the formation of a C6 organization would undermine and diminish the role of education (and research), which is the primary mission of the AAOS. I can tell you that this is not the case on my "watch," nor will it be on the "watch" of Richard Gelberman, MD, first vice president, and Vernon Tolo, MD, second vice president.

At this year’s Annual Meeting, a resolution was defeated that sought to make both the C3 and the C6 organizations have separate strategic plans. The resolution also would require a list and description of major C6 programs and a "white paper" of staff assignments and responsibilities dealing with the socioeconomic activities of the C6. At the Association’s Resolutions Committee meeting, the Board of Councilors reiterated that they considered that it was premature to restructure the C6 and that two of the provisions had been completed. The sponsors of the resolution said they no longer believed the resolution was necessary. The Resolutions Committee concurred.

While realizing this concept has worked for other organizations, the AAOS leadership was opposed to creation of separate strategic plans and Boards of Directors for the C3 and C6 organizations. Such a split might have the unintended consequence of splitting the largest orthopaedic organization in the United States and the world and diminishing our strength of unity and purpose.

It has remained the AAOS leadership’s goal to obtain the maximum benefits of having both the C3 and C6 organizations to continue to present the highest quality musculoskeletal education and insure that the interests of our patients and members are well represented. It has also been our goal to assure that AAOS members view the creation of the C6 organization and transfer of some C3 functions to the C6 organization as seamless and that we continue to function as efficiently as usual and as, in the past, in a united manner. The plan seems to be working exceptionally well. In fact, it is working so well that it necessitated this report to the membership that the AAOS —both C3 and C6 organizations— are alive and well.

S. Terry Canale, MD


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