Advocacy president makes great strides

By Annie Hayashi

Successes realized on national and state levels, despite challenges

“A great leader needs a vision, integrity, and experience,” said Tony Rankin, MD, when he assumed the presidency of the AAOS a year ago. “It is critical for a leader to be in touch with the members, to truly understand their needs and the environment in which they function.”

Even though he faced significant challenges during his term in office, Dr. Rankin remained focused on the needs of the members—traveling extensively to state society meetings and universities to hear from the “grassroots.” It’s a practice he will continue as past-president—finishing the speaking engagements he couldn’t make this past year.

Under his leadership, the AAOS achieved several key national and state legislative victories and made substantial progress in other strategic areas.

Top of the agenda: Advocacy

“Our members rank a number of issues high in importance. But the number one and two issues are consistently medical liability and medical reimbursement,” said Dr. Rankin. “Our members’ greatest concerns are issues that can be best addressed through effective advocacy activities.”

To get members more engaged in advocacy efforts, Dr. Rankin oversaw the following initiatives:

  • A Board-appointed project team, led by David A. Halsey, MD, chair of the Council on Advocacy, to examine the impact of healthcare facility payments on patient access to orthopaedic care
  • Two Board workshops on advocacy (December 2007 and April 2008)
  • A survey of Academy membership conducted by a professional political pollster

“The survey generated an outstanding response of 40 percent—almost double our customary response rate,” said Dr. Rankin. “With the information we gathered, we believe we really have a road map for engaging more of our members in advocacy and for doing a better job for our members, our patients, and our profession.”

In addition to these efforts, the AAOS scored a key legislative success. Working with the Ortho¬≠paedic Trauma Association, the AAOS was instrumental in the passage of congressional legislation providing $66 million in support of peer-reviewed orthopaedic trauma research as part of the 2009 fiscal year budget. The AAOS (Access to America’s Orthopaedic Services) Act was also introduced in the House of Representatives during Dr. Rankin’s term.

Orthopaedic advocacy may get a boost in the 111th Congress, in part due to the significant role played by the Orthopaedic Political Action Committee (PAC) during the recent election. Not only did participation and contributions reach new highs, 92 percent of PAC-supported candidates won their races.

Dr. Rankin would like to see more AAOS members get involved in the PAC. Currently, about one in four members contribute to the PAC, compared to nearly universal participation among groups such as physical therapists and trial lawyers.

States get strong support

Recognizing that legislative change at the state level is as important as at the national level, the AAOS invested significant resources to support state societies during Dr. Rankin’s tenure.

“The Board voted to increase the funding for state action programs to $400,000 in 2009. That is an increase of $100,000 from 2008. With more money available for legislative initiatives, state societies can apply for grants to pursue their legislative goals while strengthening their advocacy programs,” said Dr. Rankin.

Another initiative to support state societies was the first Executive Directors’ Institute, held in November 2008. Participants gave the Institute high marks; 38 executive directors representing 41 states attended.

“The Institute is an effort to strengthen the state societies, to give them tools to improve their operations, to provide opportunities for them to share ideas, and to demonstrate our commitment to their missions,” Dr. Rankin said.

As a result of the Institute, four states (Wyoming, North Dakota, South Dakota, and Nevada) added executive directors. In addition, the “Advocacy Ambassador” program facilitates the exchange of knowledge and experience between state leaders by providing funds to enable leaders to attend other state orthopaedic society meetings as speakers or advisers.

The most recent initiative introduced Web templates that enable smaller state societies to build their own Web sites; sites are supported by the Academy information services department.

The power of one

“In 2009, roughly 75 percent of comprehensive and surgical skills programs will be jointly sponsored by the AAOS and an orthopaedic specialty society—a substantial increase since the first Unity summit in 2004,” noted Dr. Rankin at the 2008 Unity Summit. A reorganization plan proposed by the Board of Specialty Societies and approved by the AAOS Board of Directors will strengthen the voice of and participation by the 22 member societies.

Changes in the way that industry would fund continuing medical education (CME) following the Department of Justice investigations underscored the need for clear, ongoing communication among the AAOS and specialty societies.

“The AAOS Board of Directors recognized the uncertainty of how industry would fund future CME,” explained Dr. Rankin. “To ensure a mechanism was available to support quality education, the AAOS formed a separate entity, the Center for Orthopaedic Advancement.

“The Center, with its independent, non-conflicted board, could receive funds and review orthopaedic grant requests. Under the unity banner, we continue to have on-going dialogue on this issue with the Orthopaedic Research and Education Foundation, American Orthopaedic Association, and the specialty societies,” he said.

The strength of many

Dr. Rankin is particularly proud of the Academy’s position—and the progress it continues to make—as a leader in advancing diversity and culturally competent care.

Recently, the Board approved distribution of the on-line version of the culturally competent care materials to nonorthopaedic surgeons and other health professionals. The curriculum will be adapted to meet the needs of those outside of orthopaedics. The need for such materials is high, given that three states now require culturally competent care education for healthcare professionals.

“The Academy’s material is high quality, will benefit those who learn from it, and will be a source of revenue for us,” said Dr. Rankin.

A great year

“It’s been a great year and AAOS is a tremendous organization. We have great volunteers and staff. It’s been a real privilege, honor, and pleasure to serve the organization. I’d like to thank all the members of the Board, the volunteers, and the staff for the support I have received during the year,” Dr. Rankin concluded.

Annie Hayashi is the senior science writer for AAOS Now. She can be reached at