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VOS 69th Annual Meeting
April 15-17, 2016



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AAOS Update

Virginia Represented at the National Orthopaedic Leadership Conference

By Wilford Gibson, MD

On Thursday April 30, 2015, over 400 orthopaedic surgeons from across the country descended on Capitol Hill to meet with their legislators as part of the National Orthopaedic Leadership Conference (NOLC). Virginia was represented by Councilors Doug Boardman and David Romness, Andrew Mann, our VOS Association Manager and myself, Wilford Gibson, Chair of the AAOS Advocacy Resource Committee among others. 

At the top of the list was a thank you for the passage of the Medicare Access and CHIP Reauthorization Act (MACRA). The SGR fix was introduced by Congressman Michael Burgess, MD (TX-R). After 13 years and 17 patches it was a cause for celebration.  Additional legislative issues discussed included repealing the Independent Payment Advisory Board (IPAB) through legislation introduced by Congressman Phil Roe (TN-R), H.R. 1190, which now has 232 cosponsors. Thanks to AAOS efforts it has passed the 220 cosponsorship threshold needed for House floor consideration.  Senator John Cornyn (TX-R) introduced the companion bill in the Senate, and it now has additional cosponsors as well. 

HR 921/S. 689, the Sports Medicine Licensure Clarity Act, introduced by Congressmen Brett Guthrie (KY-R) and Cedric Richmond (LA-D) was also discussed, and through these efforts the House bill has garnered an additional 25 cosponsors bringing the number to 54.  AAOS will continue to focus on these legislative initiatives in addition to others including ICD10, 21st Century Cures and Physician-Owned Hospitals.  Congressman Ted Poe (TX-R) has just introduced HR 2126 to delay the implementation of ICD10 this October. I believe ICD10 is the biggest crisis facing Orthopaedic surgeons today.  Get behind the movement to delay ICD10 and ask your Congressman to cosponsor HR 2126.

Social Media Big Impact at #NOLC2015
Some of you may already follow me on Twitter at @wilfordgibsom (that's an "m" at the end) and @AAOSAdvocacy. If not, Twitter is a powerful tool for following and influencing members of Congress. At #NOLC 2015, Orthopaedic surgeons and staff took pictures of meetings and tweeted messages of real time intelligence to facilitate and direct subsequent discussions on the Hill. The hashtag  tracked the phrase #NOLC2015 and as it became more popular it became what was trending on April 30th!

  • During the NOLC, more than 240 individual tweets were sent using #NOLC2015, including more than 50 photos from different congressional meetings.
  • #NOLC2015 tweet received over 110 retweets, reached over 220,000 unique accounts, and had nearly 410,000 views.
  • Congressional retweets included Rep. Palazzo, Sen. Alexander, Rep. Tipton, Rep. Roe, Rep. Harper and more, including Rep. David Brat (VA-R)
  • Since the NOLC, the @AAOSAdvocacy mentions have increased by 168% and we gained over 60 new followers.

The Virginia Delegation
Our Virginia delegation accomplished 11 Hill visits with Legislative Assistants or Members of Congress, including both Senators and Districts 2, 3, 4, 5, 6, 7, 8, 9 and 10. Do you know which one is your Congressman by name? Better yet, in the words of AAOS PAC Chair John Gill, "Does your Congressman know you?"  If you want to influence the legislative process and have a hand in the solutions to healthcare, get to know your Congressman and get him to know you!

#NOLC2015 was rounded out with six symposia on Friday and Saturday. Some of these topics, such as Symposium 1 Big Data, that I moderated have far reaching implications. I'm hopeful about influencing AAOS Leadership to open this meeting and the Fall Meeting to more AAOS Fellows. I believe what we learn regarding advocacy and quality measures will be as important as what we learn at our Annual Meeting.

I look forward to hearing from each of you!

Wilford K. Gibson, MD

Board of Councilors 2015 AAOS National Orthopaedic Leadership Conference (NOLC) Report


We are your representatives to the AAOS Board of Councilors (BOC).   The BOC serves as an advisory body to the AAOS Board of Directors and acts as a liaison between the practicing orthopaedic surgeons and our national organization.  The BOC meets three times per year:  1) at the AAOS Annual Meeting, 2) at the National Orthopaedic Leadership Conference (NOLC), and 3) at the Fall Meeting.   The following report summarizes the recent BOC business meeting at the AAOS NOLC that occurred between April 29-May 2, 2015.

The BOC heard updates from the AAOS presidential line including Fred Azar, MD (immediate past AAOS president from the Campbell Clinic), David Teuscher, MD (AAOS president, from private practice in Beaumont, Texas) and Gerald Williams, MD (second vice president, from the Rothman Institute).  The Committees of the BOC gave their respective reports:  Communications, Economics, State Legislative and Regulatory Issues, and State Orthopaedic Societies. 

Perhaps the major issue facing orthopedic surgeons in 2015 is the challenge of adapting to the rapidly changing healthcare environment which includes: the transition of fee–for-service to value-based reimbursement and bundled payments, implementation of the Affordable Care Act, increasing capital costs, lower reimbursements and increased data reporting requirements.  The AAOS is responding to these pressures by developing programs to enhance Advocacy, Communication, and Practice Management.

  1. We are our patients’ best advocates, but by the same token, they are our best advocates.  There is a major effort being made to educate patients concerning advocacy issues.

    a. AAOS TV was developed for Academy member use in waiting rooms as a vehicle to help educate patients about bone and joint health issues, and includes segments about the importance of becoming a patient advocate. Members interested in AAOS TV should email

    b. The AAOS has become more influential in the US Congress due to the generosity of those contributing to the Orthopaedic PAC.  However, patients and their stories still seem to resonate well.  If you have a patient who has a compelling story to tell, please contact me and I will pass the information on to Academy staff.

    c. Patients who visit your website need to know about a national campaign called A Nation in Motion. With more than 700 patient stories, studies that highlight the value of orthopaedic care and orthopaedic surgeon-authored blog posts, this multimedia campaign helps illustrate why orthopaedics is such a benefit to society. We get people back to work, back to life and back to doing the things they love. Please provide a link to A Nation in Motion ( from your practice website. Encourage visitors from your site to submit stories on A Nation in MotionYour website also should be linked to to provide your patients with accurate clinical information about their orthopedic conditions.

  2. The Political Action Committee of the American Association of Orthopaedic Surgeons (Orthopaedic PAC) is the only national political action committee in Washington, D.C., that solely represents orthopaedic surgeons before Congress.  While there is considerable diversity of expertise in orthopaedics, there is enough commonality to remain united in our advocacy efforts so that we can have enough clout to have an influence on the national and state legislative processes. The legislation to eliminate the Sustainable Growth Rate (SGR) was passed this year largely due to the efforts of the AAOS PAC.

    The Orthopaedic PAC held an evening fundraising event which raised a record $58,150. More than 130 AAOS Fellows gathered for the event. Members of the PAC’s donor level, the Capitol Club, joined other PAC donors who purchased tickets to attend the event or bundled contributions from colleagues back home. Representatives Ryan Costello (R-PA), Bill Flores (R-TX), Dutch Ruppersberger (D-MD), Mark Takano (D-CA), Mike Fitzpatrick (R-PA), Evan Jenkins (R-WV), Derek Kilmer (D-WA), Pete Sessions (R-TX), and Bill Johnson (R-OH) interacted with the PAC contributor attendees.

    Each of us needs to contribute to the AAOS PAC to continue to effect change. Visit to donate and learn more.

  3. There is a gradual shift to value-based reimbursement from traditional fee-for-service. Value is defined as a ratio between quality and cost.  In other words, the higher the quality and the lower the cost, the greater the value.

    a. It is crucial that orthopaedic surgeons retain a leadership position in defining quality of orthopaedic care. Orthopaedic surgeons are the professionals most qualified to develop and evaluate quality of care measures for patients with musculoskeletal conditions.  Though the Performance Measures Committee, the AAOS along with the appropriate specialty society is leading the development of orthopaedic quality measures.  These are the tools that will be used to judge your performance in the value-based reimbursement models of the not so distant future.  This is a link to the initial effort concerning osteoarthritis of the knee:

    b. Improving the quality of care is a key to success in the future market.  Clinical Practice Guidelines (CPGs) are valuable tools that allow you to advance the physician-patient communications process and enhance the diagnosis and treatment of musculoskeletal conditions.  These will be updated every five years and an app is being developed that will make CPGs searchable, interactive, and easy to use.  Go to to see an early web version of this app.

  4. Physician-Hospital alignment has become more common in recent years in an effort to increase value.  These alignments include employment models, co-management of orthopedic service lines such as orthopedic trauma or total joint arthroplasty, or other arrangements.  The Economics Committee of the BOC is investigating the possibility of producing a primer to enlighten membership concerning these options.
  5. The AAOS launched the Professional Compliance Program at the 2004 Annual Meeting in response to the membership's desire to address the issue of inappropriate or fraudulent expert witness testimony.  This program remains popular among the membership of the AAOS; more than $2 million has been spent to maintain this program.
  6. The State Legislative and Regulatory Issues Committee of the BOC continues to deal with issues including tort reform, scope of practice issues involving podiatrists and physical therapists,  restriction of ancillary services and advanced imaging.
  7. It can be argued that the most important committee of the AAOS is the Board of Councilors, but the BOC will only be strong if the state societies are strong.  The State Societies Committee continues to study and respond to grant requests by the individual state orthopedic societies.  

The BOC and the BOS conducted their business through nine (9) committee meetings, one (1) roundtable, and two (2) business meetings. In addition to topics specific to their groups, we collectively discussed and acted upon the following five (5) advisory opinions during an open hearing and a joint business meeting:

  1. Request to Change the Maintenance of Certification (MOC) Process for the American Board of Orthopaedic Surgery (ABOS);
  2. Use of an Evidence-Based Process to Assess the Recertification and MOC Process of the ABOS;
  3. Explore Alternate Accreditation for Orthopaedic Fellowships;
  4. Equity in Graduate Medical Education (GME) Funding; and
  5. AAOS Recommendation on Mandatory Radiation Safety Awareness Training for Orthopaedic Surgeons.

A sixth advisory opinion was submitted; however, the sponsor withdrew it from consideration. Members of the BOC/BOS Resolutions Committee heard testimony on each advisory opinion during the BOC/BOS Open Hearing. The Committee considered the testimony, along with the background information provided to them prior to the meeting, and made recommendations to the BOC and the BOS. During the BOC/BOS Business Meeting, the BOC and the BOS voted to adopt the recommendations within the Report of the BOC/BOS Resolutions Committee. The BOC and the BOS will forward the five (5) advisory opinions to the AAOS BOD for consideration and action for the BOD’s June 2015 meeting. 

If you have questions about any of these issues or programs, or if you would like an issue brought forward to the BOC, please contact me. The BOC will meet again in October 2015.

Respectfully submitted, 

David Romness, MD and Douglas Boardman, MD