June 2003 Bulletin

Orthopaedists focus on health policy advocacy

Carolyn Clancy, MD, said that AHRQ is the
world's largest provider of funds for patient
safety research

More than 200 orthopaedic surgeons from throughout the country gathered in Washington, D.C. April 23-26 for the annual AAOS National Orthopaedic Leadership Conference (NOLC). Participants heard presentations by top-level speakers, mounted an intense advocacy strategy meeting, sponsored a lively and informative Board of Councilors (BOC) meeting and held a Council on Musculoskeletal Specialty Societies (COMSS) session on advocacy issues. The meeting concluded with an inspiring trip to Walter Reed Medical Center to visit military orthopaedists and soldiers injured in the Iraq war.

A broad cross-section of the orthopaedic community’s leadership attended this meeting, including the AAOS Board of Directors, BOC, COMSS, the AAOS Political Action Committee (PAC) Executive Committee and representatives of state orthopaedic societies. Their focus was on developing strategies for passing medical liability reform and Medicare payment increases.

During the conference, participants received special training on grassroots lobbying techniques, which will be especially important in the coming battles on medical liability reform. A number of orthopaedic surgeons also delivered letters urging support for professional liability reform to their senators and/or representatives.

Policymakers speak

Participants heard from several important policymakers on key health policy issues:

  • Thomas Grissom, director of the Center for Medicare Management of the Centers for Medicare and Medicaid Services (CMS), participated in a 90-minute discussion on the effect of Medicare payment decreases. The orthopaedic leaders in attendance made clear to Mr. Grissom that continued Medicare payment decreases would result in access problems for Medicare patients in the very near future, because payments, in many instances, now hardly cover practice costs, let alone provide income to physicians.

Thomas Grissom, director of the CMS Center for Medicine Management, spoke about the impact of Medicare reimbursement decreases

In addition, members of the AAOS Presidential Line—including James H. Herndon, MD, president; Robert W. Bucholz, MD, first vice president; and Stuart L. Weinstein, MD, second vice president—presented progress reports on the major Academy activities now underway, including an update on the new AAOS Professional Liability Reform Initiative. To date, donations have been received from 836 Fellows, totaling $601,365 (see related article beginning on page 64). Highlighting the meeting was a frank and lively dialogue with BOC members, who shared the concerns of grassroots orthopaedists.

The conference concluded with presentations from three physicians who have served in state legislatures, including Tom Scott, MD, (continued on p. 40) an orthopaedic surgeon who is a former member of the West Virginia State Senate. They discussed their careers and gave tips on how orthopaedists can become more involved in the political process. To learn more about medical liability, visit the special medical liability resource center created by the Washington Office on the AAOS Web site. The resource center can be found at: http://http://www3.aaos.org/washington/washing.cfm

COMSS on advocacy

The Council held an afternoon-long session, led by COMSS chair David G. Lewallen, MD, which addressed advocacy issues and the role of specialty societies. Discussions focused on AAOS issues versus specialty society issues; 501(C) (3) vs. 501 (C) (6) structures for advocacy activities; use of the Washington Office and other AAOS resources for specialty society advocacy activities; and the value and feasibility of having more than one orthopaedic PAC.

Advocacy strategic planning

Concurrent with the NOLC, a special two-day advocacy strategic planning meeting, chaired by David A. Halsey, MD, chair of the Council on Health Policy, was held. It brought together representatives from all areas of the AAOS to prioritize advocacy legislative and regulatory issues, to develop long- and short-term advocacy goals regarding each issue, to create specific measures of success for achieving each goal and to assess the current AAOS advocacy structure and determine what other segments of the staff and/or volunteer structure should be involved in these issues.

Robert Hartwig, Insurance Information Institute, told NOLC participants that trial lawyers have destroyed the professional liability insurance business.

The AAOS currently addresses a wide range of advocacy issues that affect orthopaedic surgeons, including medical liability insurance costs and tort reform; Medicare physician payment; patient safety; CPT and ICD coding; collective negotiation for physicians; Medicare regulatory burden; scope of practice; research funding and orthopaedic clinician scientists; emergency coverage and EMTALA; Workers’ Compensation; graduate medical education funding; volunteer physician immunity from liability; ergonomics and workplace injuries; patient information privacy/HIPAA; regulations of biologics, combination products, devices and drugs; prompt payment; Patient’s Bill of Rights; performance measures; CMS Joint Replacement Demonstration Project; and Medical Savings Accounts.

A report summarizing the recommendations from this meeting will be presented to the Board of Directors at their June meeting in Chicago.

Michael H. Gordon, MD, councilor from
New Jersey, pressed policymakers for answers
to several health policy questions.

Visit to Walter Reed Medical Center

After the NOLC concluded, a delegation of 17 orthopaedic surgeons representing AAOS and the Board of Councilors and including the president and president-elect of the National Association of Orthopaedic Nurses made a special visit to Walter Reed Army Medical Center for a briefing by military surgeons providing care to service men and women recovering from injuries sustained in Operation Iraqi Freedom. (See related article beginning on page 33)

Lt. Col. Dean Taylor, MD, Society of Military Orthopaedic Surgeons representative to the BOC, facilitated the visit, which was hosted by Col. David W. Polly, Jr., MD, Walter Reed Medical Center, Chief, Department of Orthopaedic Surgery and Rehabilitation.

The hospital has thus far treated a total of 183 patients, including 103 battle casualties. The patients had various orthopaedic injuries ranging from broken bones to amputations and gunshot wounds.

To learn more about the work being done at Walter Reed, visit its Web site at http://www.wramc.amedd.army.mil and look through the orthopaedic surgery section.

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