For four straight years, orthopedic surgeons have topped the Modern Healthcare/Modern Physician annual physician compensation survey
, and the incoming president of the American Academy of Orthopaedic Surgeons says this has helped make the specialty a target of scrutiny.
Speaking at the AAOS annual meeting being held March 19-23 at Chicago's McCormick Place, Dr. Joshua Jacobs cited several articles—including a September 2011 report in Health Affairs
—that identify orthopedic surgery as a main driver in increased healthcare spending.
Jacobs, chairman of the orthopedic surgery department at Rush University in Chicago, said these reports have “fostered a distorted image of who we are and what we do.”
“Although those in policy circles may believe that inappropriate orthopedic surgeries are widespread, we in the trenches know that the procedures we perform bring mobility, independence, and a return to work, play, family and life to our patients,” Jacobs said. “We know that the procedures we do are effective and have value.”
Jacobs also mentioned orthopedic surgeons' history of innovation, but noted how this led to “relationships with manufacturers” and that these relationships have now “attracted the attention of the Department of Justice.”
To counter these negative images, Jacobs said the AAOS and its members have to engage both lawmakers in Congress and rule makers in the regulatory agencies. He added that orthopedic surgeons must also “clearly demonstrate how we are part of the solution to our nation's healthcare crisis.”
Jacobs referred to this as “quality as advocacy,” and said to address claims of overuse the AAOS can point to its efforts in developing clinical practice guidelines and appropriate use criteria. He added that these efforts need to be maintained.
“If AUCs will be developed—and they surely will be, and if orthopedic surgeons will be held accountable to them, and we surely will be—then I want orthopedic surgeons, not members of the payer community, to be the developers,” Jacobs said.
In addition to promoting best practices, Jacobs said the specialty also needs to back away from practices that may not have value.
“We need to have the commitment and tenacity to identify, based on the best available evidence, what works,” he said. “We also need to have the courage to identify what does not work and be prepared to change our practices accordingly.”
Both Jacobs and incoming first vice president, Dr. Frederick Azar noted how only 28% of AAOS members contribute to the organization's political action committee.
“Keep in mind that we only represent 2.7% of all physicians and let's face it; a fragmented 2.7% is not going to advocate effectively,” said Azar, chief of staff at the Campbell Clinic in Germantown, Tenn. “So we must collectively advocate doing what is best for our patients and our profession.”
He cited the Patient Protection and Affordable Care Act as a reason for strong advocacy by the AAOS.
“Healthcare is changing for good, but likely not for the good of our patients and our profession,” Azar said. “This unprecedented government intrusion into our practices constitutes a threat to patient access to our expertise and calls for a unified approach and a sustained call to action from our Academy.”
Azar noted that he was probably “preaching to choir,” and so urged the audience to “go home and engage your colleagues.”
As of March 21, the third day of the conference, 33,000 attendees had registered for the event. At the same time last year, registered attendance for the annual meeting in San Francisco was 31,000.