Spring 2013


66th Annual Mtg

VOS 66th Annual Meeting
May 3-5, 2013
Mandarin Oriental Hotel
WashinGton, DC

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A Message from the President

Protecting Free Market Quality and
Access in Workers' Compensation System

By Jonathan E. Isaacs, MD
President, Virginia Orthopaedic Society

Dear Virginia Orthopaedic Society Members,

Jonathan Isaacs, MD
Jonathan E. Isaacs, MD
VOS President

As we head into the final few months of my presidency, I have tried to reflect on the past year’s events. I started off my term promising to work to remove barriers to quality patient care, to protect our constantly threatened revenue streams, and to strengthen the political influences of the Virginia Orthopaedic Society. Though I did not know the manner in which I would complete my promise, this turns out to be exactly what I and the VOS have accomplished over the past year. 

As many of you know, representatives of the workers' compensation industry forced us and other stake holders into a standoff over their efforts to control our treatment fees. I think we all accepted that the current workers' comp system in Virginia is not perfect and initially looked at this challenge as an opportunity to negotiate, to fix some of the problems on both sides, and to make it a better system for all stakeholders. Unfortunately, despite repeated good faith efforts (led on our part by Cal Whitehead and his team), the insurance industry was completely inflexible on their position that we accept a statutory, Medicare-based fee schedule.  For many reasons, we refused to yield this point. Worker’s comp patients are harder to take care of, take more time, and come with extra paperwork and bureaucracy.  Many orthopaedic surgeons would not continue to take care of these patients if fees were reduced. Additionally, how could any of us reasonably agree to have more government control of the way we run our practices!? 

It turns out that the data the workers' comp groups were pushing to support their challenge actually helped us more than hurt us. Although our medical fees are a little higher than many other states, the overall costs to Virginia businesses are actually quite low – in fact, the 4th lowest premiums in the country!  So how do you explain this discrepancy?  Most of the “expense” to businesses is the missed wages and the larger compensation settlements that come with poor medical treatment.  Though our care costs a little more, it is worth it.  We get the workers of Virginia back to work and do it faster and better than other states.  Additionally, if the cost of this service in Virginia is the fourth lowest in the country, how can the workers' comp groups explain why we need a fee schedule?  Well, they pushed hard enough that price-fixing legislation was introduced in the Virginia House of Delegates but through a coordinated effort with allies (MSV of course, hospitals, therapists, some chambers of commerce, even the trial lawyers were with us!), factual talking points, and strong grassroots advocacy the legislation was tabled – “dead” for this session.

In my last “presidential address,” I tried to rally the troops (so to speak).  It was time to dig deep…. donate some time and energy…. contact your General Assembly representatives… join VOS or recruit members…. participate in VOS “Day on the Hill”!  Many of you listened and responded.  The VOS PAC treasure chest grew substantially, many members offered their expertise in insurance reimbursement and workers' compensation practices, and many of you heeded our calls to contact your legislators.  It all paid off.  Beating this proposed fee schedule House Bill became the focus of our planned day on the hill.  In the days leading up to the “day on the hill,” we went over high impact talking points, practiced our logical arguments, and generally got pumped up to be energetic and (politely) assertive. The Bill was tabled the day before. I admit that it made the day on the hill a little anti-climatic, and it was hard to get the Senators and Delegates too excited about a dead bill. 

Still, it was a fascinating experience. The whole legislative building seemed to be full of high school students, church members, and lobbyists. We worked through these crowds and got some good face time. Between the reception the night before and the morning spent in meetings, I could see the beginnings of some political relationships forming. Relationships that might not have formed had we not been bound together in this common fight.

So, the workers' comp factions will be back and other fights will come our way. We won this round. But we also grew as an organization. We grew as a political force.  And we all saw how working together achieved something that we could not have done alone. I would like to thank the VOS leaders and members who responded to the call this year. I am also grateful to the Medical Society of Virginia and other physician societies who worked with us and will continue to collaborate on workers' comp and other issues impacting our patients and our practices.