Charles Boustany Jr, MD, Speaks at Orthopaedic PAC Lunch

By: Elizabeth Fassbender, Esq.

At the annual luncheon honoring supporters of the Orthopaedic Political Action Committee (PAC), former congressman Charles Boustany Jr, MD, discussed how he went from practicing medicine to serving in Congress, and why it is critical that physicians stay involved in politics.

Before his time in Congress, Dr. Boustany was president and CEO of his own practice in the field of thoracic and cardiovascular surgery. However, after realizing that what happens in Washington, D.C., has a direct impact on practices back home, he decided to get involved in politics.

A native of New Orleans, Dr. Boustany served more than a decade in the U.S. House of Representatives, where he cofounded the influential House Doctors Caucus and coauthored legislation to repeal the sustainable growth rate formula. According to Dr. Boustany, the ability to have an impact didn’t immediately happen, but only after building credibility on a number of issues. Then, he noted, he was able to play a more active role in many of the healthcare fights that have occurred over the years.


Dr. Boustany (right), with Orthopaedic PAC chairman Dr. Gill, addresses PAC members at annual luncheon.

In addition to describing some of the past healthcare debates, Dr. Boustany discussed the state of health care today and possible pathways forward. Despite immense progress and innovation in medicine, he said, health care is not seeing the same innovation on the payment side. Furthermore, reimbursement and cost pressures, combined with the additional mandates and regulatory burden, are threatening the practice of medicine. He also noted the number of mergers and the monopolistic behavior that is tilted against physicians. So, what can be done?

“Forward-leaning physician leadership is essential in solving these problems,” Dr. Boustany said. Physicians have an inherent advantage in driving innovation in the payment and delivery system, but he emphasized that “you are going to have to take the lead in shaping” the reform, and “we’re not going to fix this without your involvement.”

Specifically, Dr. Boustany suggested that physicians find a unified consensus voice on core issues. For example, he recommended demanding hearings on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), exploring specialty-specific registries, and using the Center for Medicare & Medicaid Innovation and state waiver process to test new ideas. He also suggested that the physician community take the lead on using meaningful—not meaningless—data. Other needed changes he emphasized included streamlining the regulatory process, revisiting the Stark Law, and taking advantage of the momentum on the issue of physician-owned hospitals.

“Give it the full-court press now,” he urged. “Let Congress know that the independent practice of medicine is vital … As orthopaedic surgeons, you are the natural leaders to do it.”

In his presentation, it was clear that John T. Gill, MD, the current Orthopaedic PAC chair, is committed to following Dr. Boustany’s recommendations. In addition to thanking everyone for their support, he noted that the Orthopaedic PAC was having its best “off”—or, nonelection—year and best “soft dollar” year in its history. According to Dr. Gill, the Academy attended more than 600 events in 2017, which is a 30 percent increase from 2016. Orthopaedic PAC is also the largest health care PAC in terms of spending. Importantly, the PAC is issue-oriented and nonpartisan. To that point, Dr. Gill noted that you can’t spell “orthopaedic” without an R, D, or I.

Clearly, “you guys get it,” Dr. Gill stated.

Further, Dr. Gill explained that this is going to be a very interesting election cycle with a lot of activity. He highlighted a number of legislators who are stepping down and leaving Congress, which means important institutional knowledge is leaving, and “we are going to have our work cut out for us.” Already, more than 35 House Republicans announced their retirement, and there are more than 15 open House seats vacated by Democrats. This trend also includes a number of important committee positions.

In addition to supporting some of these campaigns, the work of the Orthopaedic PAC also includes efforts to get more doctors elected to Congress. To help in this regard, AAOS participates in a workshop for physicians who are interested in running for office. The workshop, now in its ninth year, offers education from how to develop a campaign plan to the importance of polling. Dr. Gill was also excited to highlight a former Board of Councilors member—Julio Gonzalez, MD, a practicing orthopaedic surgeon in Venice, Fla.—who is running for Congress. Dr. Gonazalez is a member of the Florida House of Representatives, serving South Sarasota County. He is a veteran of the U.S. Naval Reserves, an attorney, and an author of two books on the U.S. Constitution and federal healthcare policy.

“Congress is in our business,” Dr. Gill stated. “Let’s make it our business to be in theirs.” Only by participating in the process can orthopaedic surgeons ensure policies won’t hinder the ability to care for patients, he said. And as Dr. Boustany stated, orthopaedic surgeons “are in the best position to do it.”

Elizabeth Fassbender, Esq., is the communications manager in the AAOS office of government relations; she can be reached at