October 1996 Bulletin

Secretary's Notes

by D. Eugene Thompson, MD, Academy Board of Directors Secretary

This report highlights actions taken by the Board of Directors during its meeting in Rosemont, Ill. Sept. 20-21, 1996.

HCFA joint demonstration project

The Board approved a position statement urging that the Medicare joint replacement demonstration project be canceled. The Board also authorized $25,000 to pursue legal action, if necessary, to challenge the terms "Centers of Excellence" or "Participating Centers of Excellence" which the Health Care Financing Administration (HCFA) intends to use in the demonstration project.

Package pricing

An Advisory Statement approved by the Board states that orthopaedic surgeons, and all members of the provider team, should carefully consider certain payer and provider considerations and potential risks before entering into negotiations on package pricing contracts. Orthopaedic surgeons should avoid agreements which contain the potential for conflicts of interest, and consistently aim to achieve high quality care and outcomes.

Resolutions process

The Board approved for submission to the fellowship proposed amendments to the Bylaws regarding the resolutions process. The proposed amendment, to be "read" at the 1997 Annual Meeting, states that to be binding on the Academy, a resolution must be considered by the Board of Councilors and adopted by the fellowship. To be considered by the Board of Councilors, a resolution must be submitted by Sept. 1 or as a late resolution at the fall meeting of the Board of Councilors. Resolutions that are received at least 90 days prior to the first business meeting at the Annual Meeting (but which have not been considered by the Board of Councilors) and approved by the fellowship will be advisory and not binding on the Academy.

Council, committee changes

The Board approved changing the term of the Council chairs to a two-year term with possible two, two-year term reappointments. Currently, the chairs are appointed for two, three-year terms. Three members of the Committee on Graduate Education will be added to the Committee on Educational Programming, thus combining the committees. The Committee on International Education and Relations was renamed the International Committee.


The Board approved awarding the 1996 AAOS/OREF Health Services Research Fellowship to Richard Johnston, MD, and Mininder Kocher, MD. Dr. Johnston will take a fellowship at Dartmouth College and Dr. Kocher, at Harvard University.

OLC expansion

The Board discussed the development of Phase II and Phase III expansion of the Orthopaedic Learning Center (OLC). Phase I, which involves reconstructing space within the Academy building, had been authorized by the Board in May 1996. Phases II and III would include building an addition on the OLC for an auditorium and a commitment to seed a $5 million endowment fund. The Board discussed the implications of the proposed 200-room hotel on property adjacent the OLC and Academy building. The proposed hotel could be used for some of the training and educational activities planned for the expansion of the OLC. The Board determined not to go forward with Phase I at this time until clarification of the plans for the proposed hotel. The Board also approved proceeding with a feasibility study to determine if a capital campaign could be held for endowment of the OLC.

Spine algorithm

The Board approved publication of Phase I and II spine algorithm, developed by the Academy and North American Spine Society (NASS), in the appendix of Orthopaedic Knowledge Update: Spine. Publication of the algorithm, which has not been field-tested, will contain a disclaimer that they are not final or official policy of the Academy or NASS. The appendix also will include the acute low back pain guidelines developed by the Agency for Health Care Policy Research (AHCPR). An article by Stanley Bigos, MD, will discuss the AHCPR guidelines.

Positions, guidelines

The Board approved a Position Statement on Managed Care in Workers Compensation stating that the Academy believes that properly designed and efficiently run workers compensation managed care programs can provide high-quality health care to injured workers and minimize their disabilities. The statement lists characteristics of effective managed care workers compensation programs and supports changes in such programs that establish measures for safety and prevention and improve the timely delivery of high-quality, cost-effective medical care to workers who are injured on the job.

The Board approved a revised Position Statement on Containing the Cost of Orthopaedic Implants, and a Position Statement on Trampolines and Trampoline Safety. The Board also approved Guidelines for Grants to the Academy.

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