Before passing the gavel to his successor, David D. Teuscher, M.D., Azar spoke with Orthopedic Design & Technology about the challenges and victories of his 12-month term.
ODT: Upon your election as president last year, you said you wanted to focus on education—the learning needs of AAOS members (expanding the electronic media platform of mobile apps, ebooks, webinars, webcasts, etc.). Did you fulfill that goal?
Frederick M. Azar, M.D.: It’s been a good year. People look to the Academy as being the gold standard for information because they feel it’s accurate, it’s reliable and it’s peer-reviewed. But that’s not enough—people are looking for the ways they get the information, not just the fact that they feel like it’s the gold standard, but how are you going to get it to us? We worked very hard on trying to appeal not only to digital immigrants like myself but digital natives. We recognize that after about three clicks people become disinterested and go somewhere else so we have made the transfer from developing products to developing content. That’s really the big message we have for our members: We’re not trying to push out products—we realize it’s the content parts of products that they’re really looking for, so we worked hard to develop robust search engines, easy navigation and to have targeted information based on the results of a member needs assessment about what members want and need. What we’re trying to get to is a learning portfolio that’s individualized for our members but also is compatible with their wants and their needs.
We’ve expanded our electronic media platform of mobile apps. A good example is AAOS Access, which has more e-books, webinars and webcasts that can be accessed. We have also conducted a usability study on our website, and soon our members will see a reformatted aaos.org website. We’ve revamped www.orthoinfo.org too—soon it will look very different.
We also have a brand new Orthopaedic Learning Center that has state-of-the-art technology to push out courses for distance learning. We recognize that a lot of our members don’t want to fly to a meeting sometimes, they’d rather receive their instruction at home. [The Center] also has a state-of-the-art skills lab that can accommodate more than one course because it’s modular. We recognize that skills learning is not going to go away and now we have a better venue available to our members. A lot of things have happened; it’s been an exciting year in education.
ODT: One of your other goals as president was to improve the organization’s commun-ication with patients about the services orthopedic surgeons provide and the value they bring to society. How did you accomplish this?
Dr. Azar: We had a workshop immediately after the annual meeting to talk about this. We had all stakeholders present, and had a discussion about the path we could take to make that happen. We wanted to augment what was going on with our ‘Nation in Motion’ (www.anationinmotion.org) public awareness campaign and also our PSAs [public service announcements], so we formed a project team to look at this and we’ve done a few things that we’re going to report on at the board meeting. One of the big things we’re going to do to educate and engage our patients is to form something called AAOS-TV. We recognize that we have a captive audience in our offices every day and we also recognize that orthoinfo.org is a place we want to drive our patients to in order to get information about their orthopedic conditions, injury prevention, treatment alternatives, and also advocacy-related issues to help preserve their access to our services. We have developed this concept of AAOS-TV that will be unveiled for our members’ use in their waiting rooms, showing patient-focused video features that are educational, informative, and inspirational, and they can see other patients that are going through what they might be going through. But it also gives us some information on the advocacy side to help preserve their access. We think as physicians we are our patients’ best advocates, but we also think that an opportunity exists for patients to help advocate for the preservation of access to our care—they are more credible because they are the ones receiving the treatment. We also have a number of brochures that we developed that we can put out in physicians’ offices with the same topics. We have expanded our social network—Twitter, podcasting, Facebook, Youtube, things that we do. We recognize that we have a lot of people out there that would prefer to read a 1,400-page commentary regulatory agency letter but we also recognize that there are some that prefer the 140-character tweet. We plan to be adaptable in getting that information out to our members.
The burden of disease in the United States for musculoskeletal care is about $1 trillion a year. Everybody knows somebody who’s had orthopedic care at some point in their lives. A year ago, we had a project value team that looked at conditions and we developed a methodology paper that looked at the burden of disease to society, the cost benefit ratio to society and the lost work dollars for specific orthopedic procedures. We chose five condition areas and we published these in the core journals and the paper basically outlines that if you don’t have the surgery, you’re more a burden to society than if you do. Orthopedic surgery can be expensive but it’s also very, very expensive if a patient does not have access to that procedure. That’s something that we’ve pushed out to our stakeholders.
It’s aspirational to engage patients on all levels of our academy in areas like injury prevention, treatment, and things like that, but also to educate them on advocacy side. We’re excited with what we’ve been working on in that space.
ODT: Please characterize the past year (2014) for the orthopedic industry.
Dr. Azar: The orthopedic industry remains a central partner to us as far as harnessing innovation. We need each other to help develop new products for our patients. The one thing that you can see that’s happened is there’s been some consolidation, and it’s probably not the end of the consolidation. That’s something that happens in every industry and it’s one of the directions the orthopedic industry might be going. From our standpoint, whether it’s a number of companies or a few big companies, we need to be able to maintain a relationship with industry because we need to collaboration to help develop products for our patients. And we need each other to do that. This is not something that’s unique to 2014, it’s really something that is ongoing
ODT: What was the most difficult challenge of your presidency?
Dr. Azar: When we deal with issues that come up inside the beltway in Washington, [D.C.], it’s all about preserving access to orthopedic care and that’s always an ongoing challenge. That’s the top of the list for us—trying to preserve that access. We’re trying to navigate through the mandates out there, many of which are unfunded under the Affordable Care Act. Coverage decisions are a challenge, insurers are making it harder to get tests and surgeries done for different reasons, we don’t know why because there is plenty of evidence out there to demonstrate there is value to what we do in preserving function to our patients. Of course, the legal threats are always there for every physician. Those are the external threats. We constitute 2.7 percent of all physicians but internally we have a number of specialists and it’s great for our patients but it can trigger a little bit of fragmentation. So, there’s always a concern that for the house of orthopedics to be united, we have to be united. We’re constantly working on keeping the house of orthopedics united. But the big challenge for us is trying to preserve access to our care and trying to deal with some of these unfunded mandates that continue to be a burden on us getting care to our patients. We want to be able to continue to spend time with our patients and not spend time with a computer screen, and that’s a threat we all have as physicians, not just as orthopedic surgeons.
ODT: What advice would you give to your successor, (incoming) President David D. Teuscher, M.D.?
Dr. Azar: Have you met David? He’s a very charismatic individual. What is most important—and David gets all this—is to think strategic, be flexible, and embrace the concept of innovation. Those are some of the things that are important. Always put the patient first when making strategic decisions, and David already knows and believes this. Our board has embraced this as well. Always put the patients first. If we put our patients first, I believe we’re always going to arrive at the best answer for our members and our profession. I think that’s the overarching recommendation I would give to him—to continue to uphold that. It’s something I’m very proud to say the Academy has always done.