David A. Halsey, MD, Begins His Presidency

By: Terry Stanton

During his address as incoming AAOS president at the Your Academy 2018 event yesterday, David A. Halsey, MD, invoked a biomechanical principle—Wolff’s law—to describe how he envisions an Academy under his leadership that continues to respond to the various disruptive changes affecting the practice of orthopaedic medicine.

The principle that a bone will adapt to the loads under which it is placed embodies the notion that “form follows function,” Dr. Halsey said. “That’s exactly what’s happening at your Academy today. We are purposefully adapting to those disruptive forces, in order to help you grow professionally and provide the best possible care for your patients.”

Among the dramatic changes that orthopaedic surgeons and other physicians have witnessed in the past two decades, he noted, are an explosion of technology, “the promise of personalized medicine,” the transformation of healthcare delivery and payment, and “an increasing encroachment on the autonomy of orthopaedic practice with the implementation of onerous regulation and unfunded mandates.” The opioid epidemic has only exacerbated the tumult.

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Dr. Halsey: “The orthopadeic society of today—and tomorrow—must respond to member demands more effectively and more efficiently.

In response to these formidable challenges, Dr. Halsey said, “Your Academy is evolving through four strategic initiatives in the coming year:

1.     building new, more effective models for governance and strategy,

2.     managing orthopaedic tribalism through partnership,

3.     enhancing the value of your Academy relationships, and

4.     supporting advocacy through research and quality.”

Challenges of governance arise from factors such as changing member expectations, disruptive technologies, competition within the orthopaedic community, and “the explosion of commercial CME and surgical skills training, Dr. Halsey said. “We need to rethink our approach to governance”—one that in current form was adopted in 1985 “and served us well in simpler times.

To this end, Dr. Halsey said he will lead the 2018 Governance Review Project Team “to examine the terms, composition, and required competencies of the Board of Directors and other governance structures.”

The “deep dive” review will ensure that Academy’s emerging strategic plan, which is being crafted under the leadership of First Vice-president Kristy L. Weber, MD, “will be successfully executed to meet the diverse needs of our membership and the organization,” Dr. Halsey said.

In regard to the trend of “tribalism” that has arisen with the mushrooming of subspecialization, Dr. Halsey said the orthopaedic profession “has both thrived and suffered.” Noting that the Academy has entered into a variety of agreements with “our specialty society tribes” that have been beneficial to both partners, he also observed, “Unfortunately some of these collaborations have been less successful, leading to a breakdown in credibility.” Summits with specialty societies will seek to establish a revamped culture grounded in a defined set of “principles of engagement.”

Addressing the goal of “enhancing the value of your Academy relationship,” Dr. Halsey noted that the proliferation of educational offerings from both other societies and commercial providers, has forced the Academy to reevaluate its own portfolio of member service. To this end, AAOS will focus on remaining the online hub where members can manage their education activities.

Members will value and benefit from the Academy’s ambitious plan to establish a complement of new registries, building on the success of the American Joint Replacement Registry and expanding into other specialties. “When you enroll your practice and patients in a centralized family of integrated registries,” Dr. Halsey said, “your data will serve many masters.” Participation will enable surgeons to sync with emerging reimbursement paradigms, benefit from streamlined credentialing, and fulfill maintenance of certification requirements.

Dr. Halsey implored surgeons to build relationships with policy makers, legislators, and regulators “to protect access for our patients to the full spectrum of orthopaedic care they need and deserve.”

Dr. Halsey said AAOS initiatives, including quality initiatives like Clinical Practice Guidelines and highly trusted communications to Congress and the Centers for Medicare & Medicaid Services, “have provided you, the practicing orthopaedic surgeon, access to the halls of public policy in your state capitols and in Washington, D.C.”

Dr. Halsey closed his remarks with words about his guiding principles, and he left his audience with the following three challenges:

1.     Remember to listen to your patients; really listen … for they are your most valuable educational resource.

2.     Take a risk and let your voice be heard, through service in various assemblies and boards, wherever you are in your career.

3.     Lean in and become engaged in your state orthopaedic society, for truly all politics is local!

“If we embrace these calls to action and seize the day,” Dr. Halsey said, “together we can build on the great accomplishments of our past leaders and mentors.”

A New England Physician

Dr.  Halsey is the chief of Orthopaedic Surgery Division at Martha’s Vineyard Hospital and a professor in the department of orthopaedics and rehabilitation at University of Vermont College of Medicine in Burlington, Vt. Prior to joining the full-time academic faculty there, he was in a private practice for 18 years in the Upper Valley region of Vermont and New Hampshire.

Dr. Halsey and his wife, Katie, have two adult children, Stephen and Kirsten, who are both pursuing careers in medicine.

Terry Stanton is the senior science writer for AAOS Now. He can be reached at tstanton@aaos.org

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