January 1996 Bulletin

Resolutions

The Resolutions Committee will conduct an Open Hearing regarding the proposed resolutions on Friday, February 23 from 2 p.m. until everyone has had an opportunity to speak, in Room 310E of the Georgia World Congress Center. The Bylaws Committee will conduct an Open Hearing regarding the proposed Bylaws amendments to be voted on at this Annual Meeting on Saturday, February 24, from 2 p.m. until everyone has had an opportunity to speak, in Room 310E of the Georgia World Congress Center. The resolutions to be considered and voted on by the Fellowship at the 1996 Annual Meeting follow.

Resolution 1: Adoption of the 501(C)(6) tax status for the Academy

If adopted, the resolution would require the Academy to begin the timely and fiscally appropriate change from the present 501(c)(3) tax status to the 501(c)(6) tax status. In its current status of a 501(c)(3) organization, the Academy is considered an educational organization and may spend only a portion of its revenues on "lobbying" and nonclinical educational activities. It may not have an affiliated Political Action Committee (PAC). A 501(c)(6) organization would be a professional association which could continue its education activities, but does not have the same restraints on lobbying activities and may have an affiliated PAC.

Resolution 2: Enabling physicians to ethically practice medicine in a managed care system

If adopted, the resolution would require the Academy to use any and all efforts to seek the enactment of legislation which would provide every physician the right to apply for credentials with any managed care firm he or she chooses; the right to have his or her application evaluated on rational, reasonable and objective criteria developed by the managed care firm to assure its enrollees of quality care; and the right to be offered the chance to provide services to his or her patients in the plan, providing he or she agrees to the plan's reimbursement schedule and reasonable requirements concerning utilization review and other administrative policies. Further, the Academy would be required to use any and all efforts to seek the enactment of legislation which prohibits the dismissal of impaneled physicians without cause or due process. In addition, the Academy would be required to use any and all efforts to seek the enactment of legislation which would prohibit the use of "withholds," bonuses or inducements of any kind by managed care companies which may influence the medical decisions made by the physicians on their panels.

Resolution 3: Retention of a separate volume performance standard for surgery

If adopted, the resolution would require the Academy to continue to urge Congress to retain the existing multiple volume performance standards which feature a separate standard for surgery.

Resolution 4-9: Board review of previously adopted resolutions

The following resolutions were submitted in accordance with the Bylaws which requires the Board of Directors to review all resolutions adopted by the Fellowship within five years of their date of adoption unless the resolution specifically provides otherwise.

Resolution 4: Orthopaedic Fellowships; CAQ (Adopted February, 1990)

A. Resolved, that the American Academy of Orthopaedic Surgeons continue to strongly support the work of the Residency Review Committee on Orthopaedic Surgery in its role of accrediting Fellowship programs in an efficient and effective manner.

Board recommendation: Retain.

B. Resolved, that the Academy Fellowship reconfirm its action of 1989 to oppose the issuance of Additional Certificates of Added Qualification in the field of orthopaedic surgery.

Board recommendation: Given the resolution of the Fellowship at the 1995 Annual Meeting which provides that "it shall be the policy of the American Academy of Orthopaedic Surgeons to oppose the issuance of additional CAQs in orthopaedic surgery," rescind the 1990 resolution as redundant.

Resolution 5: Annual Meeting (Adopted February, 1990)

A. Resolved, that the Board of Directors and the appropriate Academy committees be charged with examining the structure of the Annual Meeting with the goal to increase attendance and participation at the annual business meeting.

Board recommendation: Given the resolution of the Fellowship at the 1995 Annual Meeting that the Academy "shall continue its efforts to insure the maximum attendance and participation of the Fellowship at business meetings of the Annual Meeting, including consideration of schedule changes, alternate voting mechanisms, and modifying the format of the business meeting(s)," rescind the 1990 resolution as redundant.

Resolution 6: FDA; Reclassification of Orthopaedic Devices (Adopted February, 1990)

A. Resolved, that the Academy encourage the timely and efficient exchange of scientific information between orthopaedic manufacturing companies and the FDA in order to facilitate the reclassification of orthopaedic surgical devices.

Board recommendation: Retain.

Resolution 7: Update of Orthopaedic Knowledge; Recertification; ABOS (Adopted February, 1990)

A. Resolved, that the Academy endorse the concept that a continuous update of a knowledge base in orthopaedics is essential to provide quality health care.

Board recommendation: Retain.

B. Resolved, that the recertification process of the ABOS be clearly defined as a method of determining the maintenance of adequate and appropriate current knowledge of orthopaedic surgery, rather than as an effort to determine continuing competence, and that the Academy urge the ABOS to adopt this position.

Board recommendation: Retain.

C. Resolved, that the Academy urge that ABOS adopt a position that a proctored written examination not be the sole pathway for this recertification process.

Board recommendation: As ABOS has already taken this action, rescind the 1990 resolution.

D. Resolved, that the Academy be a principle instrument to ensure opportunities for the maintenance of orthopaedic knowledge.

Board recommendation: Retain.

E. Resolved, that the Academy support the continuing dialogue between the Academy and the ABOS in which the most efficient and reliable mechanisms for this evaluation process can be identified.

Board recommendation: Retain.

Resolution 8: Recertification; ABOS; Fifth Pathway (Adopted February, 1991)

A. Resolved, that the Academy, recognizing that the American Board of Orthopaedic Surgery initiated time-limited certificates for orthopaedic surgeons in 1986 and is likely to continue issuing time-limited certificates for the foreseeable future, hereby reaffirms its action of 1990 regarding recertification and the importance of a continuous update of a knowledge base in orthopaedics.

Board recommendation: Retain.

B. Resolved, that the Academy encourage and assist the ABOS in the development of a fifth assessment pathway, to be based on appropriate continuing medical education and self-assessment at home.

Board recommendation: Retain.

C. Resolved, that the Academy rescind all resolutions on the issue of recertification adopted by the Fellowship prior to 1990.

Board recommendation: As this has already been done, rescind the 1991 resolution.

Resolution 9: Medicare Reimbursement; Friend of the Court briefs; Public Information (Adopted February, 1991)

A. Resolved, that the Academy take every available step to challenge reductions in Medicare reimbursement for orthopaedic procedures, including ongoing consideration of legal action when appropriate.

Board recommendation: Retain.

B. Resolved, that the Academy immediately and forcefully carry the concern[s expressed in this report ] that continued reductions in Medicare payments to physicians ultimately may jeopardize the availability of services to the elderly and cause major disruptions of services to Congressional leaders, government agencies, national medical associations, and others as appropriate.

Board recommendation: Retain and modify the 1991 resolution as indicated.

C. Resolved, that the Academy consider drafting "friend of the court" briefs or other participation in litigation affecting orthopaedic surgeons and their patients.

Board recommendation: Retain.

D. Resolved, that the Academy maintain [expand] its patient education programs that [to] inform the public that successive federal actions to limit physician reimbursement may jeopardize the availability of orthopaedic services to the elderly and others.

Board recommendation: Retain and modify the 1991 resolution as indicated.

Bylaw amendments

There also are three groups of Bylaws amendments to be considered and voted on by the Fellowship at the 1996 Annual Meeting.

Group 1: Proposed amendments to officially establish the position of executive vice president.

If adopted, the President of the Academy would continue to be chairman of the Board of Directors, but no longer would be principal executive officer of the Academy with duties including supervising and controlling all business affairs of the Academy. The Executive Director position on the Board of Directors would be replaced with Executive Vice President who would be the chief executive officer of the Academy with powers to act on behalf of the Academy.

Group 2: Composition and election of the Board of Directors.

If adopted, among other things, the position of Third Past President would be removed from the Board at the conclusion of the 1996 Annual Meeting and one additional Member-At-Large (of no age designation) would be added to the Board. The Members-At-Large would consist of two individuals who are under age 45 at time of election, one who is age 45 or older at the time of election, and one who is without age designation; all would serve for two-year terms. Effective only for those taking office at the conclusion of the 1996 Annual Meeting, one At-Large Member who is less than age 45 and one At-Large Member with no age limitation will be elected for a one-year term. For every election thereafter, the positions will have terms of two years.
In addition, the Board of Directors would have the option of holding one business meeting at the Annual Meeting instead of being required to hold two business sessions at the Annual Meeting.

Group 3: Resolutions of the fellowship not binding on the Board of Directors; Resolutions of the Board of Councilors binding on the Board of Directors.

If adopted, any resolution adopted by the Fellowship at the Annual Meeting would be submitted to the Board of Directors for its consideration. In addition, any resolution adopted by the Board of Councilors would be binding on the Board of Directors. The Board would be responsible for the reasonable and timely implementation of any resolution adopted by the Board of Councilors. The Secretary would report the implementation of the resolutions to the Fellows.

Other amendments to be "read" at the 1996 Annual Meeting.

There are five sets of proposed amendments to the Bylaws to be "read" at the 1996 Annual Meeting and to be voted on at the 1997 Annual Meeting. These include sets of amendments to clarify and modify the disciplinary process of Fellows and members; to create an International Affiliate membership category in the Academy; and to create a mandatory Fellowship polling process. Other amendments would affect the review of resolutions, require a mailed ballot on all resolutions, eliminate the requirement for 20 signatures if a resolution is submitted by a state orthopaedic society, and expand dissemination of information about resolutions to any individual who notifies the Academy in writing.


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