December 2002 Bulletin

From our readers

Write to The Editor, AAOS Bulletin, 6300 North River Road, Rosemont, Ill. 60018-4262


Thank you for the article "Profiles in Diversity" (August 2002 issue). It demonstrates that women and minorities with a strong work ethic and determination can become dedicated and contributing orthopaedic surgeons. Each individual profiled recalled a pleasant exposure to the specialty and a mentor who encouraged them.

The J. Robert Gladden Society (see Consider joining the Gladden Society) works along with the Ruth Jackson Society and the AAOS Diversity Committee in providing exposure and mentoring to individuals of different racial and ethnic backgrounds who have the potential for becoming orthopaedic surgeons. The take home message for AAOS members is that they, too, can provide that spark and encouragement to young individuals who may aspire to become orthopaedic surgeons.

Raymond O. Pierce, Jr., MD
Indianapolis, Ind.

The article "Profiles in Diversity" was an excellent presentation of the Academy’s effort to increase diversity within our specialty. As praiseworthy as this effort is, I believe it will yield little fruit simply because most minorities, except for females, now are shockingly underrepresented in this nation’s medical schools. The figures for entering medical students for 2001 show females comprise 48 percent of medical students, but underrepresented minorities made up only 13 percent of the entering medical student pool.

We have, and will continue to have, our greatest difficulty in trying to attract, for example, African-Americans to our specialty simply because there are relatively few of them now in medical school. The key to increasing diversity within orthopaedic surgery is to increase diversity within the total medical student pool in this country.

The total percentage of African-Americans in U.S. medical schools since 1975 has varied between 6 and 7 percent of the total medical school enrollment. The Journal of the American Medical Association’s Medical and Graduate Education issue of Sept. 9, 2002 reports that only 6.2 percent of residents now in accredited graduate medical education programs in this country are African-Americans. As a consequence of these continuing disparities, African-Americans, while comprising about 15 percent of the general population, now constitute only 3.7 percent of this country’s physician workforce, a percentage that has remained relatively frozen for the past 75 years. As a nation, we should strive to increase the percentage of minorities in our country’s physician workforce to a number commensurate with their percentage in the general population.

For the reasons cited here, and many more not cited, all of us need to become stakeholders in the goal of increasing diversity in our country’s physician workforce. Once the percentage of minority physicians approximates their percentage in the general population, chances become much greater that better health care will be available for all U.S. citizens in the coming decades.

John J. Gartland, MD
1979-80 AAOS President
Philadelphia, Penn.

Academy finances

The most recent edition of the Bulletin (October 2002 issue) has a few articles that are of concern to me and hopefully to other Academy members. In this issue, (AAOS President) Dr. Tolo reviewed the organization’s "sound financial future," and announced a $150 increase in annual dues. I understand that the last dues increase was in 1999 (only three years ago) and that costs have increased. I also appreciate that the Academy budget has been slashed for next year and cost-cutting efforts are continuing.

But throughout the issue, other articles report on multiple expensive special projects. I question whether we can afford all of them.

The membership currently supports a "free" subscription to JBJS, aggressive political action activity (lobbyists, HIPAA, physical therapy, EMTALA, and state issues as discussed in this edition), programs in support of cultural issues, sponsorship of playground construction, membership surveys on a myriad of topics, electronic media education, Legacy of Heroes, coding issues, Bone and Joint Decade, Clinical Scientist Traveling Fellowship, OrthoStar, OREF, the Bioskills lab, and OKO, just to name a few. I agree that all of these projects are worthy endeavors. But not all members are interested in these projects and many might not want our organization to pay for them. And our Academy bureaucracy seems to increase to the point that individual member input is drowned out by the numerous committees, boards, and administrators. I was amazed recently when I discovered that we have a Committee on Committees.

But what is worse is our dependence on the "contributions" from orthopaedic industry, as Dr. Bucholz (AAOS second vice president) pursues additional sources of revenue from these corporations. As we continue to accept expanded "unrestricted grants" from the medical-industrial complex, we run the risk of losing our independence and objectivity. Even the appearance of impropriety is improper.

I am a fiscal conservative and believe we should live within our means. One should not buy a new car unless one can afford the payments. It is my opinion that if our organization cannot afford to pay for its activities from contributions from the membership, then maybe the membership does not really want that activity that badly. I would suggest the Academy prioritize and re-think our long-term financial plan before embarking on other new and costly special interest programs, raising our dues, and accepting additional funds from industry.

Joel E. Cleary, MD
Helena, Mont.

Would you like to comment on something you read in the Bulletin? Let's hear from you. Send your letter to the Editor, Bulletin, AAOS, 6300 N. River Rd., Rosemont, Ill. 60018. Fax (847) 823-8026.

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