New Year’s Resolutions: AAOS Style

By: Wayne A. Johnson, MD

This year’s Annual Meeting will help me achieve my goals for 2018

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Wayne A. Johnson, MD

Every year, I look forward to attending another AAOS Annual Meeting, and this year’s meeting is no exception.

Looking back, some of my fondest Annual Meeting memories are from here in New Orleans 20 years ago in 1998. I was a fourth-year orthopaedic surgery resident at the University of Colorado. The scientific committee allowed me to present a scientific paper and three posters as well as publish a scientific article in the since-sunset AAOS Bulletin.

Fast forward 20 years to 2018 and the Annual Meeting is even more grand with a more comprehensive scientific program and diverse audience that now includes more international orthopaedic surgeons, allied health professionals, and medical students.

The educational, business, and social opportunities are incomparable to any other professional meeting I have experienced.

During the Annual Meetings, I utilize the time away from my practice to reflect on my career as an orthopaedic surgeon and to develop new strategies for patient care, practice management, and personal improvement.

More specifically, at this year’s Annual Meeting, I am seeking cutting-edge techniques and practice management tips from friends, colleagues, and product representatives, as well as educational experiences that will provide me with tools to better care for my patients.

During most Annual Meetings, it’s been easy for me to discover at least two or three practice-improvement opportunities. However, this year, due to the numerous and rapid transformations of medical practice the past decade, I have decided to focus on seven aspects that I would like to do better over the next year to improve my orthopaedic practice, including the following:

  1. I intend to emphasize to my older patients, their families, and the hospital nursing staff how critical fall prevention is to society. Crisis prevention is better than crisis intervention when it comes to osteoporotic fractures. As orthopaedic surgeons, we want to improve our patients musculoskeletal condition as much as possible. Osteoporotic fractures may result in the loss of independence, mobility, and survival. Osteoporosis prevention, education, and treatment by orthopaedic surgeons with assistance from primary care physicians can saves lives and maintain patient independence and function. As the U.S. population ages, coupled with the retirement of Baby Boomers, it will be incumbent of us to play a larger role in osteoporosis treatment before and after osteoporotic wrist and proximal humerus fractures with the goal of diminishing the number of osteoporotic hip and vertebral fractures.
  2. I want to increase my active management of my patients’ postoperative physical therapy to improve compliance and postop success. Rehabilitation can significantly improve a patient’s final outcome with nonsurgical and surgical management of many orthopaedic diseases. Unfortunately, increased insurance cost, decreased discretionary time, and lack of motivation make it challenging for patients to perform the prescribed therapy treatments. I plan to implement better patient education, regular physician communication with the physical/occupational therapist, and more frequent follow-up appointments to improve patient compliance with therapy.
  3. I intend to spend less time on a computer and increase my face-to-face time with patients. Unfortunately, there is only so much time in a day so I have to identify activities and processes that can be more efficient. To start, I am going to begin using a scribe and am currently working with my IT staff to improve the overall speed of the practice’s computer system, utilize dragon dictation, and consider templates for routine care. The combined outcomes should result in more in-person time with my patients.
  4. When patients present for evaluation, after I greet them, I want to allow the patient at least 60 seconds to tell their story before I ask any questions.
  5. I plan to continue to emphasize opioid education for my patients, utilize the prescription monitoring program, and utilize multimodal pain management techniques perioperatively.
  6. I want to use more online tools. Society is digitally connected, and I have to be, too. I’m going to increase my use of digital resources like Orthoinfo.org, Orthobullets.org, Medscape, and other trusted websites to educate my patients. I have found that these sites help accurately explain orthopaedic problems and feature photographs and videos that are easy for the layperson to understand.

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Dr. Johnson has attended many AAOS Annual Meetings over the years, including the 1998 event. He was impressed with the education content during that meeting and continues to be impressed many years later.

Courtesy of Wayne A. Johnson, MD

I want to completely cut the cord from textbooks and educational product technical guides. I am probably similar to many of you in that I enjoy reading an orthopaedic surgery article or chapter from the hard copy of a book. However, tablets, smartphones, computers, and other devices are making it easier to access and read books and articles on the go without the burden of carrying books and book bags. The Academy has made it easier to make the transition from paper textbooks with AAOS Learning Management System. The new online platform was introduced to members in 2017 at the Annual Meeting in San Diego, and it has made it easier to personalize your educational experience thru access to a broad range of educational tools in one convenient location.

I hope that my aspiration for self-improvement inspires and assists other colleagues who have similar challenges improving orthopaedic care for their patients despite today’s increasingly demanding practice environment. I believe that as I work through these process improvements, the implementation will have a dramatic impact on my patient care, practice management, and personal improvement.

At the same time, though, I realize that accomplishing my goals will not be easy. Fortunately, I have a near-endless supply of resources at the AAOS 2018 Annual Meeting to help me get started.

And by the time I see you at the AAOS 2019 Annual Meeting in Las Vegas, I hope to have implemented all seven of these process improvements.

Wayne A. Johnson, MD, is a member of the AAOS Now editorial board.

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