Posted November 9, 2015

AOAO PRESIDENTIAL WELCOME SPEECH

George Zimmerman, DO, FAOAO on Thursday, October 15, 2015

It is truly a great honor and my sincere pleasure to serve as your 74th President of the American Osteopathic Academy of Orthopedics. I have been a member of this academy since the early 1990’s and have been part of the AOAO Leadership for nearly a decade. I have participated as a Director, served as your Secretary and Treasurer, and I have climbed up the Vice-President’s ladder to this position today, and I thank you for allowing me this great opportunity. Over the last ten years, we have all seen and experienced first-hand the many alterations and modifications made in the world of medicine and surgery. For example, Healthcare Reform, the Affordable Care Act Obama Care it has become a painful fact of life. Hell, who knows, maybe within the very near future, further reform may bring us “Donald Care.” We are all thrilled and enlightened to finally see a repeal to the flawed Medicare Sustainable Growth Rate Formula. Unfortunately, this is not the end to payment reform, but only the beginning of a merit-based incentive system with bundle payments. Over the years, we have all been compelled to use the PACS System for x-rays, and we have all been involved in the implementation of some form of EMR. We have all been coerced to learn the ICD-9 coding system and now that we have all become quite comfortable with it, as of October first of this year, we are now required to learn ICD-10. All so our government can follow and track the quality and value of our surgical practice. We have seen a strong surge towards evidence-based Medicine, the development of treatment protocols and standardized order sets, all to assist us in the improvement of patient care, obtaining better surgical outcomes, and assuring patient safety while attempted to reduce cost. We have all experienced the change in the status quo of our Board Certification. Over the years we have come from a life-long certification, to certification every ten years and now, OCC (Osteopathic Continuous Certification), has been introduced, all in the name of professional accountability and the ability to assess our professional performance and improve our direct patient care. Over the last decade, our Academy has changed, developed, transitioned and grown, all for the better. Our Board and the AOAO Leadership has overseen and supported this transformation and evolution. The AOAO has grown to nearly 1800 members today, compared to less than a 1000 members ten years ago. The number of resident members has expanded from 308 in 2010, to 508, presently and the number of training programs has peaked at 42, compared to 30, only five years ago. Over the last decade, we have had significant and notable milestones within our Academy. In May, 2008, our Academy suffered an enormous loss with the sudden death of Dr. Morton J. Morris. Dr. Morris was our devoted and dedicated Executive Director of the AOAO since 1991. Just prior to Dr. Morris’ passing, he helped to spearhead and organize our break from the ACOS and participation in the Annual Clinical Assembly of Osteopathic Specialists. This was a very bold, but positive movement that allowed us more independence and autonomy. It allowed our Academy the ability to travel to more variable venues for our meetings, as well as to provide our organization improved benefits and structured educational programs, that solely focuses on Orthopedics and the needs of our AOAO members. This revolutionary transformation was the start to our Academy becoming a First Class, stand alone, Professional Association. It was in Boston, October 2009 that we held our first Annual Meeting of the AOAO without our non- orthopedic brethren. It was also the same time that Dr. Lee Vander Lugt officially assumed the helm of the AOAO as our fifth Executive Director. The Executive Office of our Academy handles all issues related to membership, the students and residents, the AOA, the AOAO committees and the Board of Directors. With our steady and perpetual growth, Dr. Vander Lugt suggested to the leadership Board that we consider employing a professional management company to help us become better structured and organized. Dr. Vander Lugt was instrumental in seeking out a company with a wealth of knowledge, vast experience and strong talents to aid us in managing our thriving association. It was the “Ruggles Service Corporation” that has successfully helped to foster us, over the last six years, from a small developing group to the more mature organization of which we are today. With this definitive and well-defined change to working with Ruggles, the Board of Trustees unanimously agreed to relocate the AOAO Executive Office from South Florida, where it existed for years, to the Richmond, Virginia location, at which it stands today. Over the years that I have been affiliated with the AOAO Leadership, I believe that we too have matured, become more educated, and have become more structured and better organized. The entire Board is involved and engaged in the operations and functions of our Academy. We are all extremely dedicated and devoted to the advancement and forward progress of the AOAO. Your present Board of Directors and Officers consist of the men seated to my right and left; however, over the last decade, there have been numerous others who have significantly influenced and provided many positive contributions to our organization. As Board members, we have all participated board development in educational seminars to teach us our roles and responsibilities. We have had to learn what is the purpose of a Board of Directors; what are we accountable for, and who are we accountable to; and what are our restrictions, limitations and boundaries. All so that we may better serve you, our members, in the most productive way possible. In the recent past, the Board has employed an agency to help us collaborate and draft our new and improved Official Mission Statement, as well as develop our sound and sensible strategic plan. It is an ambitious plan. A plan that we continue to follow, but revise, alter, massage and refine as we succeed and accomplish each of our goals. This Board works closely with all our committee, subcommittee and other associations, to promote improvement, enrich change, and encourage growth and reform. We have worked with our Treasurer and the Financial Committee, to reevaluate our Academy’s Investment Portfolio. We met with different financial consultants and performed our due diligence to find the best firm to manage our investments. The firm we chose has a slightly more aggressive philosophy from which we have had in the past, but they have been successful in their ways and it has paid off positively for our Academy. We have diligently worked with the By-Laws Committee, to review, revise and rejuvenate our old and somewhat outdated Rules and Regulations. We have worked with the Awards Committee to amend the criteria for “Fellow” within our Academy, of which has allowed us to grant many more honors to our accomplished and deserving members. As a Board of Directors, we realized that we were falling behind the times in regards to Social Media. We created a Committee to help us redesign and construct our new website, a much more member-friendly site, of which Ruggles now maintains and manages. We have successfully moved into the modern era of electronic media with computer-friendly syllabi, annual meeting mobile guides, digital poster presentations, and even a Facebook page. We continuously work with the CME Committee to provide our educational meetings and programs. Each of our meetings has improved in content and quality, as well as increasing the number of attendees and the number of impressive influential speakers and educators. Our CME Committee, under new leadership, has recently revised its policies and procedures, and revamped the ways we develop and structure the lectures for our meetings, as well as the means of obtaining speakers for our programs. The CME Committee is always looking at new processes to provide education for our membership. One new means they are evaluating is to provide webinar type lectures for our members with the possibility of earning CME credits. We have created a new committee to specifically accommodate the residents and fellows. We have set aside time in our Annual Meeting to provide our younger surgeons with an opportunity at the podium to share their papers and research with our membership. We, as a Board, continue to promote a healthy relationship with the residents and the students and strongly encourage their involvement within our Academy. We have a resident surgeon as an associate member of our Board and we have assigned an active board member, to function as a direct liaison to the student organizations, to field their questions and concerns about Osteopathic Orthopedics and to act as a mentor for their group. The Board has helped to organize and aide in managing the individual Specialty sections, within our Academy. We have worked, with their leadership, to provide educational lectures, seminars and labs, as well as help foster their growth and advance their development. We have worked with the Sections and the AOBOS to help create CAQ certifications. Currently, one for hand surgery, with 64 members earning the certificate; and in the very near future, we will have a CAQ for Sports Medicine. Over the last year, this Board of Directors has had the extraordinary opportunity to assist our past President, Gary Ulrich, DO, to bring into existence, the AOAO Foundation, a “not-for-profit” organization with the mission statement being: “To promote the uniqueness of the osteopathic profession by providing financial support to osteopathic orthopedic endeavors for the advancement of our profession.” I wholeheartedly believe that this will truly be a worthwhile venture, one that will infinitely aid and assist our profession in the future. So with all these accomplishments and all this activity, what could be next for our Academy? What will the future hold for your AOAO? To quote the legendary New York Yankees catcher, Yogi Berra, “the future just ain’t what is used to be.” I am an optimist and I believe our future is encouraging and bright. There will be numerous new issues that we will encounter, but I suspect that our Academy will grow, with every new experience and advance with every new opportunity. One of the biggest new issues which we have encountered, is the historic conversion to the single graduate medical education accreditation system. I embrace this issue as a monumentous opportunity and a remarkable chance for the AOAO to advance forward, obtain recognition from our M.D. brethren, and continue to prosper and flourish within the realm of Orthopedics and Surgery. In February, 2014, the American Osteopathic Association (AOA), the Accreditation Counsel for Graduate Medical Education (ACGME) and the American Association of Colleges of Osteopathic Medicine, reached an agreement to work together and allow allopathic and osteopathic medical school graduates, to come together and complete their residency training and fellowship education, equally, all within ACGME Accredited Program. The ACGME initiated this five-year transition to a single GME system on July first of this year, and already our osteopathic orthopedic training programs are in full swing preparing for the site visits and completing all of the documentation and paperwork necessary to meet the requirements and standards of the ACGME. However, not all of our Osteopathic colleagues are happy and content with this promising situation. Some are concerned that the conversion and melting together of the two medical professions, will dilute our osteopathic education and philosophy and weaken our profession, as it did in the turbulent California calamity in 1961. For decades, or at least as long as I have been part of the osteopathic profession, we have continued to claim that our education and training is equivalent to our allopathic counter-parts. We continue to strive to be acknowledged as equals and peers by the MD profession. So now that we have been given this opportunity to be accepted and recognized by the allopathic community, what do we do? This question was the topic of the Andrew Taylor Still Memorial Lecture, presented at the AOA Annual House of Delegates Meeting this summer. I had the pleasure of attending and hearing the esteemed Annual Lecture be presented by one of our own, Peter Ajluni, DO, past AOAO President and past AOA President. Dr. Ajluni remarked that we have fought for years and have suffered through multiple trials and tribulations to get to where we are today. So what do we do now? So how do we respond and react to this opportunity? Do we assimilate into the allopathic world and become part of the masses, as occurred in California, in the early 1960’s or do we become even more inspiring and influential. Dr. Ajluni made a strong point by comparing this opportunity that we have today to that of A. T. Still’s opportunity 140 years ago. Dr. Ajluni passionately suggests that we accept the challenge and use this occasion to show what we are made of and then with strong determination, champion our distinction. Maintaining our Osteopathic distinctive approach to orthopedic surgery will be vital to our existence. We will flourish in the future, by eagerly embracing this chance and allowing our Osteopathic Philosophy to carry on, as we merge with the Allopathic training programs. But for us to exist, we must champion our osteopathic distinction. Some of the other topics and issues we, as a Board, plan to explore over the next year include: Education for our memberships, both CME and GME. We want to provide this learning in a relevant and worthwhile manner. We are considering alternative pathways, such as online webinar, and hands-on regional skill labs, a kind of “DO version” of the AAOS Learning Center. As a Board, we have discussed the need for professional development for ALL our members. We are considering means and ways of providing professional development for our residents, the future surgeons, for the young surgeons–newly in practice, as well as the experienced, well-established surgeons and the mature surgeons, looking at retirement. This AOAO Board wants to pursue and develop better advocacy. We must strengthen our relationship and affiliation with other like-organizations, such as the AAOS, ACOS, the AOA and the ACGME, to name a few. We also need to collaborate with Local, State and Federal groups, to promote community outreach and the awareness of DO orthopedics and osteopathic medicine in general. In summary, I would like to thank you, the members of the AOAO, for your involvement and your commitment to our Academy. I believe our membership views the AOAO as an organization of which they can be proud of. An organization that they have faith in to support their needs, wants and requirements. An organization that is maturing and evolving into a first-rate, high- quality association. Our future is hopeful and bright, and only with your membership support and devotion, can we aim to accomplish our goals and target our ambitions. I thank you, for allowing me this extreme opportunity to serve in the capacity of your President for the next year. Posted September 15, 2015 AOAO Partners with CORD The conversion to the Single Accreditation System is in full swing and the osteopathic orthopedic residency programs are spending many hours preparing for their first ACGME site visits after completing all the pre-accreditation documents. Although the accreditation system will change, both the MD and DO programs have had the same mission in mind, training competent and caring orthopedic surgeons for the current population. For DOs this mission has always been met by training in mostly community based settings using non-academically credentialed faculty. In the end, both schools have produced excellent physicians. The DO program directors are delighted that the Council of Orthopaedic Residency Directors (CORD) has included our profession in their strategic plan. Not only that, but Thomas E. Baker, DO, program director in Columbus, OH, has been appointed to the CORD program planning committee and has already been included in the planning process. Elizabeth Ames, MD, will be attending the American Osteopathic Academy of Orthopedics (AOAO) Annual Meeting in Colorado Springs this October to become more familiar with the osteopathic orthopedic family. This spirit of cooperation can only enhance all of our training programs. At the recent CORD meeting in Providence, I listened intently to the discussions on curriculum building and subspecialty tracking in residency training. Osteopathic orthopedic training programs have always emphasized training competent “general” orthopedic surgeons during their residency, then sending our graduates off for subspecialty training during a fellowship. In the future the osteopathic community looks forward to sharing our thoughts in this regard with CORD members. As Executive Director, I wish to thank Kristin Olds Glavin, JD for reaching out to the AOAO in a spirit of cooperation and collaboration. We both represent relatively small organizations but we share many common goals and issues. The osteopathic program directors look forward with anticipation to this new era in training orthopedic surgeons for the future. Lee Vander Lugt, DO, FAOAO Executive Director