Joshua Jacobs, MD, an orthopedic surgeon with Midwest Orthopaedics at Rush in Chicago, was recently inducted as the 2013 President of the American Academy of Orthopaedic Surgeons (AAOS) at the organization’s annual meeting last month. Here, Dr. Jacobs talks about the organization’s goals for next year and how orthopedic surgeons can meet the growing challenges from healthcare reform.Q: What goals and initiatives do you plan to continue or begin over the next year for AAOS?
Dr. Joshua Jacobs: One of the strengths of the academy has traditionally been our role in educating orthopedic surgeons. This continues to be a very high priority for the organization. The AAOS is updating its educational portfolio using state-of-the-art electronic media platforms in order to provide technology-savvy orthopedic surgeons the information they need in a timely and efficient fashion. We are also focused on public education initiatives at orthoinfo.org, which is an important source of unbiased information for patients as they contemplate the diagnostic and treatment options for musculoskeletal disorders.
Additionally, the AAOS is pursuing programs to enhance our international education efforts, which include the annual meeting, publications as well as sponsored courses for orthopedic surgeons around the world. There are many opportunities to expand and enhance our programs that will provide value to the international orthopedic community.
Q: The healthcare system in the United States has undergone significant changes over the past few years. How is AAOS helping its members meet these challenges?
JJ: As the Patient Protection and Affordable Care Act (PPACA) is implemented and the rules are written, it is very important that our organization is at the table to represent the interests of orthopedic surgeons and our patients. We want to make sure that the laws are implemented in ways that allow patients access to the essential services that orthopedic surgeons provide. We are going to continue to monitor healthcare policy issues on the horizon to make sure that we know what rules are coming up for consideration, and how we can participate in the crafting of those rules to protect the interests of our patients.
Q: What issues are at the top-of-mind for AAOS and orthopedic surgeons today?
JJ: Currently, there are two issues we are focusing on in the advocacy arena: the sustainable growth rate fix and retaining the Stark exemption allowing surgeons to perform in-office ancillary services. The CBO rescored the SGR fix, making it far less expensive than when it was initially recorded. There is now an opportunity for a real SGR fix that has eluded the Congress up until now.
The second issue is allowing ancillary services, such as advanced imaging and physical therapy, in physician offices as they are now. It is our understanding that elimination of this exemption to the Stark Laws is on the docket for the CBO to score. We view the provision of such in-office ancillary services as an important issue for patients to facilitate coordinated and convenient care. The AAOS' Office of Government Relations is closely monitoring this situation and, with the assistance of numerous AAOS fellows, actively working with policy makers on this issue.
Q: There has been a trend of decreasing reimbursements and hospital employment among orthopedic surgeons. How is AAOS responding to these changes and supporting its members going through them?
JJ: We are working closely with the RVS Update Committee (RUC) of the American Medical Association, which has a role in setting reimbursements for medical services. We are active in providing information regarding the orthopaedic surgeon's work effort in the various procedures we perform, as these procedures come up for review by the committee.
We are closely monitoring the trend of orthopedic surgeons becoming employed by hospitals with our periodic orthopedic surgeon census. We continually track these trends to make sure the AAOS' services and programs will continue to meet the needs of all of our fellows, regardless of their practice environment.
Q: What tools and programs from AAOS will be most helpful for orthopedic surgeons trying to navigate the changing healthcare environment in the future?
JJ: Going forward, it’s clear that our services are going to be evaluated and measured more than in the past. Our profession needs to work with various agencies and government groups so that the measurement and valuation systems are appropriate. We want to make sure that AAOS' fellows are aware of these initiatives and provide them with the tools they need to respond.
There are a number of ongoing programs we will continue to pursue to prepare our profession for healthcare reform. We will also produce appropriate use criteria (AUCs) for orthopedic procedures; we released the first one during this past annual meeting. AUCs will be helpful for our members to meet the quality demands required by payors.
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