Residents Share Their Experiences at NOLC

Checking in at the registration desk for the National Orthopaedic Leadership Conference (NOLC), there was a mix of excitement and nerves. NOLC is a chance for orthopaedic surgeons—with the support of AAOS—to voice policy concerns with senators and representatives. How can we as residents have enough experience to comment on policy to change surgeon practices? Where do you even learn how policy is currently affecting our practice and how we can participate in productive changes at the national level?

Over the course of the preceding year, we had become more interested in health policy and how it affects orthopaedic practice. AAOS releases the conference agenda with talking points for each policy focus and additional links to familiarize oneself with the material further. Before the meeting, we familiarized ourselves with key talking points on each of the advocacy topics and prepared to answer questions accordingly. Nonetheless, there was the uncertainty of an experience for which we had no formal educational or professional training. Thankfully, NOLC turned out to be one of the highlights of our residency training and an experience we highly recommend to all residents.

The first day of NOLC consists of general symposia sessions regarding some of the most important orthopaedic health policy topics as identified by AAOS. Some of the topics from this past year included: Medicare, prior authorization, medical liability, and practice as a team physician. Each session included a presentation followed by a question-and-answer component from the audience. The presentation provided in-depth information about the history of each topic and how policy in each of these areas could affect our practices as orthopaedic surgeons going forward.

There is no formal education in most residency programs that discusses current policy and the effects it has on orthopaedic practices. If it wasn’t for NOLC, we would not have known how these policy issues are affecting patient care at other centers across the country and ways we may unify to positively influence change going forward. The question-and-answer session provided reassurance that others in the audience had similar questions as we did, especially given the complexity of the topics.

After the completion of the general symposia, the Capitol Hill training session prepared new and returning attendees for their in-person meetings on the Hill the next day. Groups were divided by state and provided with folders containing information on policy topics to discuss with legislators. The four bills we advocated for related to safety from violence in healthcare, Medicare reimbursement, preauthorization exemptions to streamline workflow, and advancement of physician-owned hospital systems. Following the Hill training session, there was a dinner reception for all attendees, which was an opportunity to further discuss the general symposia topics and form a strategy for the Hill visits.

The second day of NOLC was filled with in-person meetings with politicians and their assistants on Capitol Hill. Although there were some nerves in the first several meetings, those feelings faded as the day progressed. The meetings were a mix of conversational and informative, depending on the political staffer’s previous knowledge of the topic. Some of the staff had previous healthcare knowledge, whereas others needed more background information. We focused on how each of the health policies could help positively affect the lives of our patients and our practices alike. Staffers were interested in personal anecdotes regarding how different policies have affected us and our patients. Many were also eager to hear from residents specifically to understand our view on the proposed bills as the newest members in the field. At the end of the day, we returned for a debrief.

“If you’re not at the table, you’re on the menu.” This was a phrase heard throughout our time at NOLC. In addition to deepening our understanding of policy issues affecting our profession moving forward, NOLC helped us understand how influencing policy for the future is accomplished. As residents, we are the future of orthopaedic surgery and should be informed on policy that will shape our future practice environment. Over the four proposed bills supported, we gained more than 60 new cosponsors. Seeing this success on the Hill is extremely rewarding and puts into perspective how advocacy can enact change over time.

For residents who are interested in advocacy and would like to get involved, there are several different ways to get started. Time and financial constraints during training can make travel difficult, and this is often where state societies can be helpful. State societies are a great way to get involved in advocacy efforts specific to your state while reducing travel distance. It is also beneficial to gain knowledge regarding potential orthopaedic and healthcare policy in your home state, as legislation may vary. Finally, some state societies sponsor residents to attend NOLC, so residents can meet other residents and faculty involved in orthopaedic advocacy from their state. Lastly, AAOS.org/advocacy is a great starting place to learn more about current issues and policies, receive updates on bills brought up at NOLC this year, and find ways to get involved.

Donating to the Political Action Committee of the American Association of Orthopaedic Surgeons (OrthoPAC) is another avenue to support orthopaedic advocacy efforts while under time constraints during residency. Large contributions are not necessary to help make a big difference. The more residents and practicing orthopaedic surgeons supporting the OrthoPAC, the larger a voice we have with legislators. The OrthoPAC helps further legislation affecting the agenda of AAOS and other subspecialty groups. For more information and to donate, visit aaos.org/pac. At the bottom of the webpage is a tab specifically designed for residents. There you can find more information, including a resident advocacy toolkit.

Kevin M. Weisz, MD, is a fifth-year orthopaedic surgery resident at Beaumont Health and future adult reconstruction fellow at Cleveland Clinic. He is the OrthoPAC resident fellow and a member of the AAOS Resident Assembly Health Policy Committee.

Alexandra Ernst, MD, MPH, is a fourth-year orthopaedic surgery resident at Virginia Commonwealth University. She is a member of the AAOS Resident Assembly Health Policy Committee.