August 2002 Bulletin

AAOS conducts academic practice survey

Greater challenges ahead for academic orthopaedists

By Steven Fisher, MBA

In today’s health care environment the practice of medicine is intertwined with the management of business issues that accompany the care of patients. These issues are considered by many to present even greater challenges for orthopaedic surgeons who practice in an academic setting.

According to the most recent AAOS membership census, nearly nine percent of orthopaedic surgeons practice in an academic setting, and more than 40 percent have medical school or university appointments. The Academic Business and Practice Management (ABPM) Committee recently conducted a survey of academic orthopaedists to identify their specific needs for practice management assistance and support.

Survey methodology and response information

The survey instrument was designed by the ABPM committee and on April 16, 2002 was posted on the AAOS Internet site. E-mail messages were sent to 463 members of the Academic Orthopaedic Society inviting them to respond on-line. A total of 114 individuals completed questionnaires by the cut-off date, yielding a response rate of 24.6 percent.

Nearly 80 percent of the respondents to the survey were based at a university-affiliated teaching hospitals while 12 percent were based at private hospitals. Almost one in four respondents indicated they serve as department chairs; one-third stated they serve as faculty; and 27 percent said they function as directors of residency, research or clinical programs. The remaining 17 percent hold multiple responsibilities.

Summary of results

The survey classified the problems that face academic physicians into three broad categories: acquisition of resources, oversight of resources and allocation of resources.

The first category relates to obtaining the resources needed to maintain/ expand the academic program, such as hiring staff, obtaining funding for various purposes and securing space. Oversight of resources covers day-to-day operational matters such as department design, contract negotiation, faculty productivity and performance. Allocation of resources encompasses such challenges as developing faculty compensation plans and allocating time among research, clinical and educational activities.

Key findings

A complete report of the ABPM survey, authored by Sylvia Watkins-Castillo, PhD, manager, survey and information analysis, research & scientific affairs department, is available on the AAOS Web site at wordhtml/research/surveys/reports.htm.

Work plan

Based on the results of the survey, the ABPM committee developed the following work plan to present to the Council on Academic Affairs at its July 2002 meeting:

Academic Business and Practice Management Committee

James J. Hamilton, MD, committee chair
University of Missouri, Kansas City, Mo.

Michele M. Zembo, MD
Children’s Hospital, New Orleans, La.

Frederick N. Meyer, MD
University of South Alabama, Mobil, Ala.

Jonathan L. Schaffer, MD
The Cleveland Clinic, Cleveland, Ohio

David L. Skaggs, MD
Children’s Hospital, Los Angeles, Calif.

Claude E. Nichols, III, MD
University of Vermont, Burlington, Vt.

B. Sonny Bal, MD
University of Missouri, Columbia, Mo.

Ronald Faulbaum, consultant
Washington University, St. Louis, Mo.

Steven Fisher, AAOS staff liaison
AAOS; Rosemont, Ill.

Steven Fisher, MBA, is the manager of practice management affairs, AAOS health policy department. He can be reached at (847) 384-4331 or

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