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A Day at the Office

A Day at the Office: State Orthopaedic Societies: The “ARM” of the Private-Practicing Orthopaedic Surgeon

Lundy, Douglas W. MD, MBA1,2,a

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Clinical Orthopaedics and Related Research: May 2017 - Volume 475 - Issue 5 - p 1341-1343
doi: 10.1007/s11999-016-5186-4
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The Georgia Orthopaedic Society gathers every autumn at a beautiful resort on the seacoast, but this annual meeting is far from where most of its surgeons practice. Many members—including some in my Atlanta-based practice, even when I served as the group's president—don't make the trip, and don't bother with membership. I suspect that this pattern replicates among state orthopaedic societies across the country, and I believe this is a problem.

Douglas W. Lundy MD, MBA

A friend of mine in rural private practice, Jim W. Barber MD, explains why. Jim says a state society is the “ARM” of its members; by that, he means a good state society provides: Advocacy, Relationships, and a productive, worthwhile Meeting. If you question your state society's value, you might try to help its focus on those three points.


The state orthopaedic society is the main vehicle that carries the local political agenda to the lawmakers at the state capitol. The American Academy of Orthopaedic Surgeons (AAOS) does not have the staff nor the bandwidth to advocate effectively for the many state and local issues that affect orthopaedic surgeons and the patients we serve. Your state society should monitor the real and potential legislation the state legislature is considering. Important scope-of-practice issues usually are handled at the state level. Physician ownership of ancillary services, rules, and regulations affecting ambulatory surgery centers and medical liability laws all are handled there. The status quo is under constant attack; many nonphysician groups want to change the current system to better suit their agendas. Your state society should watch these issues carefully, and mobilize its members to contact their legislators.

In Georgia, our state society helped pass effective medical liability legislation in 2005. Unfortunately, Georgia's state Supreme Court overturned the noneconomic caps instituted by this law several years later, but we still managed to convince the legislature to propose a Constitutional Amendment for trauma funding on the statewide ballot. These activities and many others have improved the care of patients in Georgia with musculoskeletal problems. The hospital-employed orthopaedic surgeon will often be represented by the hospital's lobbyist, and their agenda may well differ from that of the private practitioner. The private-practicing orthopaedic surgeon usually cannot afford to employ a lobbyist, nor can (s)he devote the time and attention necessary to monitor this legislation. The state society is the private-practicing surgeon's mouthpiece at the state capitol.


As I visit state-society meetings around the country, I am always impressed by the close relationships that many in those societies enjoy. Some of these friendships go all the way back to residency, but many more are developed at those meetings themselves, and are sustained by the shared circumstances and challenges the surgeons face, which come up for discussion at those very meetings.

The importance of these relationships cannot be overstated. I have made many friends through interactions in the Georgia Orthopaedic Society. Several potentially inflammatory local issues have been cured through backdoor communication with these colleagues in competing orthopaedic groups. The trust generated through these relationships quickly supersedes any potentially divisive issues that come between competitors. The common goals and mission of the state orthopaedic society is fertile ground for these physicians to develop the relationships required to smoothly mitigate future conflicts.

Physicians in small private groups can gain considerable benefit from these relationships. There is no substitute for personally knowing the orthopaedic surgeon who will call for guidance or for a referral or consult. Knowing who is around you and what commonalities you share helps the small-practice orthopaedic surgeon feel like (s)he is part of a community, rather than on an island surrounded by large groups and hospital systems. These relationships empower the private-practicing physician who can't depend on the might of a large-hospital system. By combining their efforts, they can effect positive change, and prevent damaging trends from occurring.


Lastly, the value of our state society is the annual meeting itself, which nurtures these relationships. In addition to the social gatherings that the state society facilitates at these venues, the meeting provides space and time for discussions on the state-level issues that matter, as well as high-quality continuing medical education offerings. Residents often compete to present their research papers at the state meeting, and we find—and recruit—talented, young orthopaedic surgeons there. This venue is especially important for the private practitioner in general practice who may not align with any specialty society. At the state meeting, (s)he instead can align with like-minded physicians who share the same challenges.

Remember, the state orthopaedic society is a volunteer organization that needs your help. Offer to attend Capitol Hill days, give a talk at the state society meeting, or become an elected member of the society Board of Directors. The state society is responsible for appointing the AAOS Board of Councilors, which is the Academy's body that voices the concerns of the Fellows. I believe you will agree that the state orthopaedic society is an especially effective forum to connect private practitioners with colleagues and advocates, in a world that offers few other means to make such connections.

© 2017 Lippincott Williams & Wilkins LWW