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Resolutions Committee holds Open Hearing

The AAOS Resolutions Committee will conduct an Open Hearing regarding the proposed resolutions of the American Academy of Orthopaedic Surgeons (Academy) and the American Association of Orthopaedic Surgeons (Association) today at 1 p.m. in Room 349 of the Morial Convention Center.

A newly proposed Association resolution on streamlining and simplifying the current Evaluation/Management (E/M) codes and guidelines for documentation, submitted by the Georgia Orthopaedic Society, will be considered. As part of the 5-year review process, three Academy resolutions and two Association resolutions will also be considered.

Copies of all resolutions and the recommendations of the Board of Councilors (BOC), the Board of Specialty Societies (BOS), and the AAOS Board of Directors were included in the official meeting notice sent to each fellow in January.

The Resolutions Committee encourages all fellows to attend the Open Hearing and express their opinions before the committee makes its recommendations on the resolutions. All fellows will have the opportunity to vote on the recommendations of the Resolutions Committee on each of the proposed resolutions shortly after the 2010 Annual Meeting.

Academy Resolutions
Three Academy resolutions will be considered under the 5-year review process.

Resolution 1—Orthopaedic Learning Center (OLC): The BOC, BOS, and AAOS Board of Directors recommend continuing to support the current OLC policy of using tiered scheduling categories for groups that desire to use the OLC for courses or other events.

Resolution 2—Process of Academy Approval of Evidence-Based Clinical Practice Guidelines: The BOC, BOS, and AAOS Board of Directors recommend retaining the Academy’s approval process for evidence-based clinical practice guidelines (CPGs) as modified. The modified resolution states that the AAOS Board of Directors would ensure that evidence-based CPGs include a formal review process that incorporates both a period of targeted peer review by topic experts and a period of public commentary by interested parties, including members of the BOC and the BOS, prior to presentation for formal approval by the Council on Research, Quality Assessment, and Technology and the AAOS Board of Directors.

Resolution 3—Additional Subspecialty Certificates in Orthopaedic Surgery: The BOC, BOS, and AAOS Board of Directors recommend that the Academy retain its policy opposing the issuance of additional subspecialty certifications (formerly known as Certificates of Added Qualifications [CAQs]) in orthopaedic surgery.

Association Resolutions
One new, duly submitted Association resolution will be discussed, and two resolutions will be considered under the 5-year process.

Resolution 4—Streamline and Simplify the Current E/M Codes and Guidelines for Documentation as Part of any Healthcare Reform: According to the Georgia Orthopaedic Society, which sponsored this proposed resolution, current E/M codes and guidelines for documentation must be streamlined and simplified. The sponsor notes that current codes and guidelines do not apply easily to the evaluation and treatment of surgical patients (especially those who have sustained musculoskeletal injuries), and certain elements of the documentation process, such as “timing” and “context,” have yet to be clearly defined. The sponsor also contends that complying with current guidelines “has become an industry unto itself,” thus increasing the cost of practicing medicine, and that the complexity of the system encourages manipulation by payers to reduce reimbursement for the provision of valid services. Ultimately, the proposed resolution would require the AAOS to support “the streamlining and simplification of the current E/M codes and guidelines for documentation as a part of any healthcare reform.”

The BOC supports an amended version of the resolution that provides that the Association would assess the streamlining and simplification of the current E/M codes and guidelines for documentation. The BOS voted to oppose the proposed resolution or the resolution as amended by the BOC. The AAOS Board of Directors voted to support the resolution as it was recommended by the BOC.

Resolution 5—American Association of Orthopaedic Surgeons (AAOS) Policy on Medical Care in the United States and Health Care Reform: This resolution would retain the AAOS policy on medical care in the United States and healthcare reform. The AAOS Board of Directors supports retaining this resolution, modified to include that the Association shall support and advocate for the Principles of Health Care Reform and Specialty Care, adopted in February 2009. The BOC and BOS support modifying and retaining the resolution.

Resolution 6—Supply of Orthopaedic Surgeons: This resolution would continue AAOS support monitoring the size and composition of the orthopaedic workforce and the number of orthopaedic residency and fellowship positions. It would also continue to allow the AAOS to take all appropriate and legal actions to address serious fellowship concerns about these issues. The BOC, BOS, and AAOS Board of Directors support retaining this resolution.

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