Stronger Together: Symposium Explores How AAOS Is Enhancing Collaboration with Advisory Bodies

Collaboration is a key enabler in the new AAOS 2024–2028 Strategic Plan, across the entire spectrum of musculoskeletal partners. A symposium at the 2024 Combined National Orthopaedic Leadership Conference (NOLC)/Fall Meeting explored recent ways AAOS has collaborated for success. Moderators Joel Mayerson, MD, FAAOS, chair of the AAOS Board of Councilors (BOC), and Julie Samora, MD, PhD, MPH, FAAOS, secretary of the AAOS Board of Specialty Societies (BOS) joined AAOS Now for an interview to discuss the highlights of the symposium. Dr. Mayerson noted that the symposium was designed to highlight how AAOS and its advisory bodies, both the BOC and BOS, symbiotically help each other improve, embracing the adage, “We can be stronger together.”

Bidirectional communication
Dr. Mayerson focused on the BOC communication campaign. As part of the new Strategic Plan, this summer, the BOC held virtual meetings with its constituents across five regions: Southeast, Northeast, Northwest, Mid-America, and Southwest. The regions included 10 states as well as Canada, Puerto Rico, and the military, creating more intimate groups for BOC leaders to really hear concerns from practicing orthopaedic surgeons. Attendees included current BOC members and state and regional orthopaedic society executive directors and leadership.

Questions and concerns posed during those grassroots efforts were then brought to the AAOS Board of Directors. AAOS leadership offered answers, sharing responses among all BOC participants via an online forum. Dr. Mayerson explained, “When one state is having an issue, [they may find] four states have that same issue, and they can find out if [the other states] addressed it, and they can work toward trying to fix [the problem].”

Across the five meetings, 250 BOC members and state society leaders met with BOC leadership and AAOS presidential leadership. Dr. Mayerson reported that participants “were grateful to be able to have a voice for their concerns.” Feedback from the BOC about AAOS’ efforts on Medicare payment reform and prior authorization spurred a webinar led by Adam Bruggeman, MD, FAAOS, Advocacy Council chair, to educate BOC and BOS members on the issues and explain how to advocate for patients and the specialty on Capitol Hill during the Combined NOLC/Fall Meeting.

AAOS and rural orthopaedics
BOC Secretary James Barber, MD, FAAOS, practices in rural Georgia, and his presentation reviewed some challenges faced by rural surgeons and their patients. He noted that there are 22 orthopaedic surgeons per 100,000 people in metro areas, compared with 0.1 per 100,000 in rural areas. Furthermore, rural patients are older and sicker, he added. Rural surgeons must be true generalists, making it an increasing challenge to recruit in an era when orthopaedic surgeons tend to specialize.

Dr. Barber noted a lack of regional collaboration and coordination for complex cases (particularly trauma) in rural areas across the country, suggesting that the BOC would be an ideal convener for initiatives to address challenges of rural orthopaedics. During the interview, Dr. Mayerson explained how the BOC is developing initiatives and partnering with AAOS on solutions, which could include legislative efforts or support for surgeon recruitment in rural communities.

BOS collaborations
Dr. Samora elaborated on how collaboration between AAOS and specialty societies has been effective. “We’re focused on working together to be better,” Dr. Samora shared. “Collaborations with all the specialty societies through didactics, resident education, patient advocacy, and research [are] the key as we move forward [and] work together.”

She noted that the symposium included presentations by Douglas Lundy, MD, MBA, FAAOS, from the Orthopaedic Trauma Association (OTA), and Dean Taylor, MD, FAAOS, from the American Orthopaedic Society for Sports Medicine (AOSSM). Each speaker elaborated on how successful collaborative ventures with AAOS advanced their society’s work.

OTA collaboration
Dr. Lundy focused on three ways OTA collaborates with AAOS. The OTA Evidence-Based Value, Quality, and Safety Committee participates in the development of Clinical Practice Guidelines (CPGs) originated by AAOS. Because this collaboration reflects joint evidence-based recommendations, OTA encourages its members to use the CPGs, including linking to the guidelines on its webpage. OTA is planning to collaborate with AAOS on developing CPGs for distal femoral fractures and deep vein thrombosis prophylaxis after injury.

Secondly, Dr. Lundy described how OTA applied for and received a research grant from the BOS Research Support Fund for a study titled “The Prediction of Fracture-Related Infection following Open Fractures.” OTA has submitted another application for the BOS Research Support Fund this year.

Finally, Dr. Lundy noted that OTA has had strong participation in the development and proliferation of the AAOS Fracture & Trauma Registry (FTR). OTA promotes FTR on its website and at the OTA Annual Meeting, as well as actively considering pathways to collaborate in research endeavors with AAOS using FTR.

AOSSM collaboration
Regular communication between not only the presidential leadership of AOSSM and AAOS but also their broader organizational teams through calls, virtual meetings, and even in-person meetings has facilitated strategic opportunities. Research, particularly multicenter trials, was also identified by Dr. Taylor as a way AOSSM aligns with AAOS. Like OTA, AOSSM expertise enhances the relevant AAOS CPGs and extends to joint educational programs.

Recently, AAOS advocated with AOSSM to address team physician liability, elevating it to a tier 1 issue. Dr. Taylor noted the power of working together to create a large, unified voice for advocacy. He recommended that the other specialty societies consider this opportunity to influence policy.

The examples of collaboration from OTA and AOSSM provide a framework which other BOS organizations can use when considering how to partner with AAOS. Dr. Samora thought the symposium provided “enlightening talks [on] how specialty societies can work with the Academy to really advance the field of musculoskeletal health.”

Drs. Mayerson and Samora both shared their enthusiasm for the new Strategic Plan. Dr. Mayerson commented, “I’m excited about Patients as a pillar [of the plan],” noting that patients are the real advocates for quality musculoskeletal care. He believes that the BOC provides a vital way to “take it down to the states as a grassroots effort [and] find patients who can elevate [orthopaedics] with stories showing how important our care is.” Summarizing, Dr. Mayerson offered, “The symposium highlighted [the advisory] bodies and their function within AAOS, … how [AAOS] is keeping the house of orthopaedics together, and that we’re all stronger together.”

Alexandra E. Page, MD, FAAOS, is a foot and ankle specialist in private practice in San Diego, California, and the deputy editor of AAOS Now.