February 2001 Bulletin

‘It’s been a very good year’

My presidential year started off on a high note receiving compliments about my address at the annual meeting on "Falling In Love Again" with our patients. However, I was quickly brought back to earth by several editorials that stated the Academy was naïve to focus on the physician-patient relationship and the problem of communication when huge issues in managed care needed to be confronted (and these health policy issues should be our focus). In answer to this, your Academy is a multifaceted organization capable of handling many issues in education, research, communication and health policy and I believe these critics are the naïve ones who think the Academy is unidimensional and can only focus on one issue.

Germane to that, some have argued that recently the Academy has moved too far toward health policy issues and away from research and education. I agree that there has been recently more emphasis in that direction than in the past. This has occurred because more issues in this field that directly affected our members have risen. Our members are who we represent and therefore the Academy has to respond. Hopefully, in the future, we will be further increasing our proactivity.

Furthermore, it is no longer academic issues vs. general orthopaedist issues because orthopaedic academic institutions are feeling the same ill effects of managed care as the generalist.

With the help of Jim Herndon’s task force, the patient-physician communication endeavor has really blossomed in 2000. By now, most of our members realize that interactive communication with the patient is important and some may have a problem. Work is underway, now that we have identified the problem, to find the solution. The solution appears to be in educating our members on proper and effective communication techniques. With the aid of the Council of Education and the Board of Councilors, soon specially trained orthopaedists will teach our members about proper communication techniques. If we continue our efforts, I am convinced we will be the leader in organized medicine in patient-physician communication.

Along the way, we also learned we could improve "office-patient" relationships (patient-friendly office) and improve practice management endeavors. We met with the leadership of the Bones Society (orthopaedic administrators) and solicited their input. So don’t worry, practice management help is on the way. David Halsey’s task force will, as a portion of Richard Gelberman’s AAOS in 2005 report, present recommendations on practice management endeavors that will benefit our members. David Wong’s task-force has recommended an office practice survey for patients that is patient- and physician- friendly and can give the orthopaedist statistics on how his office compares to other orthopaedic offices.

The year 2000 was a big initial year for the Bone and Joint Decade. Stuart Weinstein is to be congratulated for defining the U.S. and the Academy’s role in the decade and also for defining what the decade means and can do for the orthopaedist. Presently, proclamations from 44 states and a letter support from President Clinton for the decade have been received.

One of the things I am most proud of is our marketing and public relations efforts. I can still remember all too well the results of our Public Relations survey in which we were informed that the public, patients and providers could not differentiate the orthopaedist from a family practitioner, neurosurgeon, podiatrist or chiropractor. Sandy Gordon, Al Nagelberg, and the Council on Communication, headed by Stuart Hirsch, have done an amazing job in the last year telling the public the orthopaedic story–who we are and what we do.

A large part of this has been through public service efforts including announcements, building safe, accessible playgrounds and an art exhibit by orthopaedists and orthopaedic patients. I see the communication and public relations piece continuing on its own with more exciting activities, but also becoming a more integral part of the Academy and COMSS endeavors in education, research and health policy.

Our research efforts continue to grow, however, recently on the administrative side we have lost a number of high-level personnel, including our Director of Research. Ordinarily, this could be a devastating blow, but I think we can turn this to our advantage. In an effort to have more "horizontal integration" among the four Councils, we have been looking at a model of organizational structure called "Project Teams." These Teams could be made up of individuals from different Councils with expertise in that particular project (whatever it may be). With new personnel coming on board in the Research department, this seems to me to be a perfect time to introduce Project Teams for some of our research initiatives.

I mention education last because (1) I consider it the most important, (2) it is the mission of the AAOS, and (3) because there is considerable activity in the field.

It should be understood that the mechanism of delivery of the education message is rapidly changing. The printed textbook is quickly being replaced by online publications. The Council of Education, led by Joe Zuckerman, has realized this early and has responded quickly by moving to electronic publications. Two of these new electronic texts are works-in-progress entitled, "Online Reference and Review" and "Just-in-Time Surgery Online." New text, whether printed or electronic, will have editors who will be compensated so the AAOS Publications Department can remain competitive with commercial publishers. This is just one aspect of the electronic education endeavor. In the last year, the AAOS has placed on our web site an entire orthopaedic campus in which members can choose their topic and their mechanism (mode) of learning (text, courses, etc.)

The CME course experience is also changing rapidly. Travel has become costly and time consuming and some of our members no longer want to spend time away from their practice in order to attend CME courses. Our own and other medical specialty CME registration numbers for diadiatic courses reflect this. Our OLC courses continue to do well because of the "hands on experience," done quickly without frills, and with ease of travel. Conversely, the Summer Institute has fallen on hard times and possibly has outlived its usefulness. Because of falling attendance the last five years, it will be discontinued.

Again, responding quickly to change, the Council of Education has now put several CME courses online and plans several more. The Council continues to work on a virtual reality model that could, in the future, bring skills courses online.

As you can see, it has been a very good year and I believe 2001 will even be better as Richard Gelberman and Vern Tolo bring forth "recommendations" for what the Academy and our membership will look like in 2005.

Finally, as I sign off, I can say I’m proud to be a physician, more proud of being an orthopaedist and most proud of serving as your president.

S. Terry Canale, MD
President


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