April 2004 Bulletin

Boards approve Position Statement on ASC, make volunteer appointments, hear progress reports

The Boards of Directors of the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons met on March 8,9 and 12 in San Francisco. They approved a new position statement on ambulatory care surgical centers, gave the go-ahead to establish a new travel scholarship fund for Iraqi orthopaedic surgeons for 2005 and acted upon recommendations for responding to competitive threats to the AAOS.

In other actions, the Boards recognized several members retiring from volunteer leadership positions and approved council and committee appointments. They also heard progress reports on several key AAOS activities and projects.

Position statement approved
As recommended by the Council on Health Policy and Practice, the Association BOD approved a “Position Statement on Ambulatory Surgical Centers,” noting that there are currently more than 3,700 Medicare-certified ambulatory surgical centers (ASCs). In 2001, ASCs supported 3 million surgical procedures and received about $1.6 billion in Medicare payments. The number of ASCs has doubled in the past decade because of rapid advances in technology and medicine.

The AAOS, as one of the leading advocates for patient safety, believes that many procedures that were previously performed only in the inpatient setting can now be performed in ASCs because of advancements in arthroscopic equipment and techniques. The improvement of short-acting general anesthesia has reduced operative and recovery times and has made it possible to perform more procedures in ASCs.

ASCs have also grown because they offer numerous benefits to the patient and the orthopaedic surgeon. ASCs often have shorter wait times before and after surgery. Furthermore, coinsurance rates are often lower when compared to other outpatient health care settings. The Position Statement reads in part:

The AAOS believes that many surgical procedures can be safely performed in ASCs. ASCs provide a benefit to both patients and orthopaedic surgeons because many musculoskeletal surgical procedures can be provided in an efficient, cost-effective manner. ASCs can improve the quality of care received by the patient and delivered by the physician. The growth and development of ASC must not be hampered by restrictive payment or coverage policies from either Medicare or other private payers.

For the full text of the statement, visit the AAOS Web site.

BOD workshop recommendations approved
The AAOS Board of Directors held a workshop in December 2003 on “Competitive Threats to the AAOS” and “Planning for Future Corporate Resource Attraction.” Robert W. Bucholz, MD, current AAOS President and leader of the workshop, presented a series of recommendations for future action in response to the workshop findings, which were approved by the BOD. Selected actions include:

Governance best practices
Lawrence E. Rosenthal, PhD, AAOS chief operating officer, presented a report on AAOS Governance Best Practices. This project grew out of an RMS McGladrey survey of 95 associations from around the United States that covered best practice in association composition and structure; leadership; roles and accountability; management climate; committee structure; composition and operations; development and performance management; and compensation and perquisites.

AAOS was measured against the best practices identified in the survey. Marks were generally high, in the “A” and “B” range, but areas needing improvement were identified. Based upon the review, several recommendations were developed and approved by the Board. They include:

Specialty Society Day report
Richard H. Gelberman, MD, chair of the Specialty Society Day Project Team, provided an in-depth report on the group's review of current performance and future options for Specialty Society Day at the AAOS Annual Meeting.

The project team noted a strong trend toward specialization from general orthopaedic surgery and determined that the Academy and specialty societies have a changing membership base; moreover, there is increased competition in educating orthopaedic surgeons from industry, other specialties, universities and hospitals.

(Left to right) Current AAOS President Robert W. Bucholz, MD; AAOS CEO Karen L. Hackett, FACHE, CAE; 2003-2004 AAOS President James H. Herndon, MD, and Secretary E. Anthony Rankin, MD, listen to the Specialty Day Project Team Report during the March board meeting.

They conducted a survey of member organizations in the Council on Musculoskeletal Specialty Societies asking about the placement of Specialty Society Day on the Annual Meeting schedule and format options. Survey results showed that the specialty societies like having a full-day meeting on Saturday and being able to generate their own revenues. From their investigation, the team determined that additional research was needed to ascertain whether or not specialists and generalists with specialty interests obtain maximum value from the annual meeting. Task Force recommendations, which were approved by the BOD, included:

Educator recognized
Frederick G. Lippert III, MD, who led the Orthopaedic Educators Course for 32 years, was recognized for his work. This course provides valuable training for orthopaedic educators, residency program chairmen, instructional course chairmen, education committee members and others responsible for orthopaedic education.

Committee, Council appointments approved
Dr. Bucholz presented the recommendations of the Committee on Committees for various committee and Council appointments and the Board approved the following: James N. Weinstein, DO, MS, as chair of the Council on Academic Affairs; Vernon T. Tolo, MD, as the AAOS representative to the Journal of Bone and Joint Surgery Board of Trustees; George Shybut, MD, as a member of the Resolutions Committee; Shawn Patrick Granger, MD, as member of the Practice Management/Rehabilitation Subcommittee of the Council on Education; Rajendra Kumar Kadiyala, MD, as a member of the Trauma Evaluation Subcommittee; Thomas Grollman, MD, as Board of Councilors representative to the CPT and ICD Coding Committee; and William N. Levine, MD, to the Orthopaedic Basic Science Evaluation Subcommittee.

In a related action, Dr. Bucholz announced he was empanelling a project team to review the AAOS committee structure. The newly created project team — which will be chaired by Stuart L.Weinstein, MD, and include Joshua J. Jacobs, MD, Joseph D. Zuckerman, MD, Karen Hackett, FACHE, CAE, and Susan Serpico — will report to the Committee on Committees in September.

Also approved were the appointments of David G. Lewallen, MD, as chair of the American Joint Replacement Registry Oversight (AJRR) Board; William J. Maloney, MD, to chair the AJRR Hospital Recruitment and Relations Committee; and Richard D. Coutts, MD, as chair of the AJRR Data Validation Committee.

Scholarship fund for Iraqi surgeons
The AAOS has been instrumental in helping the U.S. Army and Iraqi physicians reestablish an Iraqi Medical Society and helped organize the first Iraqi Medical Forum which was held February 14-17, 2004. When the AAOS first committed to extending assistance to this embattled region, it identified several long-range objectives, including development of educational exchange opportunities both inside and outside of Iraq. To launch this program, the Board approved establishment of a scholarship fund that would support the travel of two Iraqi orthopaedic surgeons to the 2005 Annual Meeting in Washington, D.C. This project was referred to the Finance Committee to further develop the proposal.

Retiring board members and council chair recognized, new members welcomed
Seven individuals retiring from the Boards of Directors or Councils were recognized for their service, including Richard H. Gelberman, MD; E. Anthony Rankin, MD; Maureen Finnegan, MD; David G. Lellawen, MD; Stephen A. Albanese, MD; Gerald R. Williams Jr., MD; and Joseph P. Iannotti, MD, PHD, chair, council on academic affairs.

New members welcomed to the Board of Directors were Richard F. Kyle, MD, second vice president; Frances A. Farley, MD, member-at-large under age 45: Oheneba Boachi-Adjei, MD, member-at-large, no age designation; Dwight W. Burney III, MD, Board of Councilors secretary, and Andrew N. Pollak, MD, Council of Musculoskeletal Specialty Societies secretary.

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