A Message from the President
By Jonathan E. Isaacs, MD
President, Virginia Orthopaedic Society
Dear Virginia Orthopaedic Society Members,
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Jonathan E. Isaacs, MD VOS President |
Let me start by saying how honored and excited I am to be the President of the Virginia Orthopaedic Society. These are tumultuous times to be an Orthopaedic Surgeon anywhere in America – Obamacare, workers comp reform, FDA crackdowns, and growing competition and threats from non-Orthopaedic specialists. Societies such as VOS are more important than ever. With less than 11 months left in my term, I have an ambitious list of goals emphasizing increasing political influence, removal of barriers to quality patient care and protection of our constantly threatened revenue streams.
Our lobbying efforts are the most important service we offer to all Orthopaedic Surgeons in Virginia, whether they are members or not. The AAOS focuses on protecting us on the national level and the Medical Society of Virginia (MSV) is a powerful voice for physicians in general, but the VOS is the only group focused on issues affecting the ability of Orthopaedic Surgeons to practice in the Commonwealth of Virginia. I admit that I never truly appreciated the complexities or the seriousness of this service until I became involved on the VOS Board.
Let me give you an example of what I’m talking about…keep in mind that basically every special interest group (i.e. the physical therapists, the radiologists, the podiatrists, the lawyers) all support their own lobbying efforts at levels, not just more than us, but magnitudes higher than us. The Radiation Technologists have their own organization and their own lobbying groups (yes, the people that roll the fluoroscan machines into the room and push a button that turns the machine on for a few milliseconds – the exact time and radiation emissions pre-programed and automated – in response to you saying “shoot”). This past year they pushed legislation through the State Senate and House that makes it so the only people other than doctors and a limited number of Physician Assistants (only those under the supervision of Radiologists…not surgeons) that can operate fluoroscans are Radiation Technologists. Many of us operate Xi-scanners (mini c-arms, still completely automated but putting out undetectable levels of radiation one foot away from the image generator) in our clinics and in the OR. Nurses and PAs, who are clearly well educated, use judgment and make decisions daily on par with the potential risk of using a mini c-arm, and are a critical component to our efficient and productive work flow, cannot operate the machine. No one would argue that radiation safety is important, but certainly with some additional training and education these “high end” physician extenders should be able to learn to safely operate this equipment, right? Nope – not with this new law.
You don’t have to think about this for long to see that the only people that benefit from this are the Radiation Technologists themselves. In fact, it is almost unbelievable that this could happen. The key to how things like this do happen is the relationships between special interest groups and the people that make the laws! It goes something like this: Lobbyist X (working for the radiation technologists) started forming a relationship with Delegate Y many years ago. Through campaign support, regular interactionsand persistence, a mutual respect, friendship, and trust forms. The Radiation Technologist group (similar to VOS) looks at emerging technologies as a threat to their job and salary security. Lobbyist X goes to Delegate Y (remember that they are friends now) and says that to protect patients and medical co-workers, that only Radiation Technologists should use fluoroscan equipment. Delegate Y is not a doctor, a physicist, or a scientist. He does not have the background to understand that if the concern is safety, there are many paths to achieve this goal and the law being pushed by Radiation Technologists is completely self-serving. An angry phone call or letter from an Orthopaedist who has no relationship to the Delegate however does sound “self-serving” and the Delegate sides with the person he knows and trusts…. Lobbyist X and the Radiation Technologists.
OK, most of you know that I am a hand surgeon (I was not the “angry Orthopaedist”) and this particular scenario affects me and other hand surgeons (and maybe foot/ankle surgeons) more than a lot of you. But, you can apply this same scenario to many topics that do affect you – the physical therapy society lobbying against physician-owned therapy groups, workers' comp groups lobbying for fee schedules, podiatrist lobbying to do tibial fractures, etc. You should be able to relate to why understanding the “rules of the game” and, more importantly, becoming an active participant in “the game ” This is crucial to protecting our own interests.
VOS lobbying efforts are led by Cal Whitehead and his colleagues. We are very fortunate to have him and his staff on our team. We need to be better at not only supporting Cal, but making our own efforts to be involved. By now, you will have received a letter from me encouraging you to donate to the ORTHO-PAC. This is the “war chest” that gives us the resources to develop these vital relationships with our state representatives. When the next big debate or conflict arises, it may not be who is right or wrong, but whose position makes the most sense for the citizens of Virginia or even what direction is best for society. It may (and often does) come down to who does that particular Delegate or Senator trust. Building trust takes time and, in our world, that means more money. I, and the rest of the VOS leadership, will do our part this upcoming year in getting to know the politicians making the decisions that affect us and to start forming the relationships that will give us a legitimate voice. Do your part too. If you have donated to the PAC, thank you. If you have not, please do so now. If you know someone who is not a member of VOS, convince them that their support is important. We will have our own “White Coats on Call” this year as we spend a day (January 31) showing our representatives that we care about public policy. Plan to come. Yes, it will be a day less of work and revenue but, I promise you, the alternatives will cost you more in money and frustration in the long run.
We have a lot of work cut out for us this year. I look forward to leading the charge and hope that I will convince some of you to shift our trend away from apathy (at least compared to many other special interest groups) to one of action, involvement, and a commitment to gaining some control over our own destinies.