This report highlights actions taken by the Board of Directors during its meeting in Rosemont, Ill., May 17-18, 1996.
Possible legal action
The Board authorized the preparation of legal documents for a possible request for a court injunction to prevent the Health Care Finance Administration (HCFA) from using the term "centers of excellence" for hospitals participating in the proposed demonstration project on total joint replacement. The Academy does not object to HCFA seeking new payment methods to reduce health care costs. However, the Academy does object to HCFA using the term "centers of excellence" for the participating hospitals and to encouraging the hospitals to use the term as a marketing device.
The Academy's fiscal 1997 budget of $34.3 million in revenue and $33.5 million in expenses was approved by the Board. The Board also approved a motion that the Board of Councilors should budget its fall meeting expenses at the same amount that would be incurred if the Councilors met in the Chicago area. The Board approved a motion that future Academy budgets should focus on reallocation of existing resources before additional resources were authorized.
The Board heard a presentation from the Arthroscopy Association of North America (AANA) for expanding the Orthopaedic Learning Center in Rosemont to include an addition with a high-tech lecture room with seating for 150 to 200 people; redevelopment of existing space for a multipurpose conference-exhibit-lunch room, and computer lab; plus a new entrance to the OLC. The three-phase project would cost $2.15 million including technical equipment. An Academy staff report stated that the OLC space is too crowded for courses with more than 85 registrants; 56 percent of the Academy courses have exceeded that registration and the trend to larger enrollments is continuing.
The Board did not act on a proposal by the AANA Board that AANA would participate in development of Phase I of the expansion of the OLC at a cost not to exceed $500,000, contingent on the Academy and AANA participating in a joint fund-raising venture to finance the expansion and an endowment of the operation of the OLC. AANA's Board also stipulated that if the fund raising was unsuccessful, the Academy would reimburse AANA.
The Academy Board reaffirmed its action taken in February 1996 to develop a 100- to 110-seat multipurpose room and a multimedia room in vacated tenant space adjacent to the OLC; the cost is not to exceed $500,000. Academy President Kenneth E. DeHaven, MD, appointed a work group headed by James D. Heckman, MD, to develop options for further expansion of the center and to evaluate the fund-raising potential for further construction and/or maintenance, replacement and upgrading equipment, and endowment of the operations of the center. Other members of the work group are Richard D. Coutts, MD; Richard H. Gelberman, MD; George L. Lucas, MD; Robert A. Winquist, MD; Joseph D. Zuckerman, MD; and Mark W. Wieting, director, Academy educational programming.
A draft 1997-1998 Strategic Plan for the Academy was approved for circulation to the Board of Councilors, COMSS, and fellows for further review.
Back pain algorithms
The Board approved limited-use field testing of Phase I and Phase II Low Back Pain Algorithms, developed by the Academy and the North American Spine Society. The algorithms also will be published in Spine to obtain comments from a broader universe of experts. The Board asked that the published algorithms have an appropriate explanation that they are preliminary algorithms subject to revision, based on the results of the field testing and other comments.
The Board approved an Advisory Statement on Cell and Tissue-Engineered Products that advises orthopaedic surgeons that "sound experimental evidence of safety and efficacy combined with clinical studies of the new technologies be developed prior to their general use." The Advisory Statement advises that "orthopaedic surgeons should avoid promoting technologies until their scientific or clinical efficacy has been demonstrated."
The Board approved a Position Statement on Firearms Violence which states that the Academy "is committed to reducing death, injury and disability due to firearm violence through support of a comprehensive public health approach." The Academy's Position Statement on Commitment to Excellence, approved in March 1991, was reapproved without change.
The Board approved a plan to determine the outcomes and effectiveness of the Academy's public advocacy programs since 1992, determine what other medical specialty organizations have done and achieved on health policy issues, and to recommend changes in the Academy's programs and messages.
The Board approved renewal of a three-year contract, permitting The Journal of Bone and Joint Surgery to print the Academy's Instructional Course Lectures in the Journal. The Academy will receive a payment of $20,000 a year.