December 2004 Bulletin

Fall Leadership Meeting held: “Hot topics” discussed

By Susan A. Nowicki, APR

Orthopaedic leaders from across the country, including the AAOS Board of Directors (BOD), Board of Councilors (BOC) and Council of Musculoskeletal Specialty Societies (COMSS), gathered in San Francisco, Oct. 14-17, for the Fall Leadership Meeting.

Participants explored issues such as patient satisfaction surveys for the new Orthopaedic Maintenance of Certification (MOC) Program; Workers’ Compensation; physician stress; emergency room and trauma care; AdvaMed and PhRMA guidelines on relationships with health care providers; provision of imaging services by non-radiologists; and incorporating evidence-based medicine and patient safety practices into orthopaedic practice. In addition, COMSS and the BOC each met separately to discuss state-level issues and topics of interest to subspecialty practice. Also, a special concurrent “Specialties Summit” was held.


The BOC Resolutions Committee Open Hearing focused on two BOC Advisory Opinions and five AAOS Resolutions adopted in 2000 that are undergoing their five-year review.

Advisory Opinion #1 on “Medical Staff Self-Governance” recommended that the AAOS BOD “formally voice its support for the concept of medical staff self-governance as one of the primary protections for physician oversight of quality patient care in the hospital setting.” Further it recommended that AAOS communicate its support of this concept to the American Medical Association and other national specialty organizations and consider legal challenges supporting the issue on a case-by-case basis.

Advisory Opinion #2 on “Support for the Medical Military” recommended that the AAOS BOD affirm and applaud “the superlative efforts of military orthopaedists in rendering responsible orthopaedic care to wounded victims of the Iraqi conflict.” It also identified several specific actions AAOS should consider to support these orthopaedists.

Participants approved both Advisory Opinions and offered recommendations on the AAOS resolutions under review; BOC comments were forwarded to the AAOS BOD for consideration.

Patient satisfaction surveys

Frank B. Kelly, MD; James V. Luck Jr. MD; David G. Lewallen, MD; and John R. Tongue, MD, participated in a panel discussion on use of patient satisfaction surveys for MOC. Dr. Tongue noted that patient surveys address access to care, interpersonal aspects of practice and some aspects of patient outcomes. They can help orthopaedists understand their patients’ viewpoints, identify problem areas and improve practice management. Dr. Kelly noted that the AAOS could help members by reviewing various patient survey instruments.

AdvaMed and PhRMA Guidelines

Representatives of the Advanced Medical Technology Association (AdvaMed) and the Pharmaceutical Research and Manufacturers of America (PhRMA) presented overviews of these two programs regarding working relationships between health care professionals and industry representatives. Blair Childs, executive vice president, strategic planning and implementation, for AdvaMed, and Scott Lassman, JD, assistant general counsel for PhRMA, discussed their respective organizations’ guidelines.

This issue is of particular importance as the AAOS develops Standards of Professionalism for its Professional Compliance Program that will include minimum standards of acceptable conduct for orthopaedic surgeons in their professional relationships.

Imaging services by non-radiologists

One of the hottest controversies today is a federal legislative and regulatory effort promoted by the American College of Radiologists (ACR) to prevent non-radiologists from providing imaging services in their offices. James Borgstede, MD, chair of the ACR Board of Chancellors, was asked to provide radiology’s perspective on the issue. If this occurs, AAOS will bring the orthopaedic perspective to Congress.

The AAOS Position Statement on “In Office Diagnostic Imaging Studies by Orthopaedic Surgeons” states in part “orthopaedic surgeons are experienced in diagnostic radiologic methods and are fully competent to supervise the performance of and interpret imaging studies in the offices for the evaluation and management of musculoskeletal conditions.”

Evidence-based medicine and patient safety practices

David A. Wong, MD, chair of the AAOS Patient Safety Committee, led a panel on “Incorporating Evidence-Based Medicine and Patient Safety Practices into Orthopaedic Practice.” He specifically cited the AAOS “Sign Your Site” campaign and prophylactic antibiotics for infection prevention in total joint replacement as examples of patient safety initiatives supported by evidence-based medicine. Dr. Wong also previewed a new Patient Safety Committee-produced educational video on the prevention of medical errors.

Specialty summit

Concurrent with the leadership meeting, the AAOS hosted a summit with representatives of the various orthopaedic specialty societies. “We now have an environment in which more orthopaedic surgeons are focusing their practices in a specialty area,” said Academy President Robert W. Bucholz, MD. “This change affects orthopaedics in many areas including education, advocacy and public communications.” The summit’s goal was to create a frank and open dialogue on the many relationships between the AAOS and orthopaedic specialty societies.

“We want to create a fair, equitable relationship with each specialty society that recognizes the great value that the specialty societies bring to the Academy. We want to keep orthopaedics together as a strong voice for our specialty,” said Dr. Bucholz. Summit participants made several recommendations, which will be forwarded to the AAOS BOD for action.

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