For most of her professional life, Weber has—for better or worse—been defined by her gender. She’s been the lone woman at countless industry events, and has distinguished herself amongst her male peers by preaching the merits of equality and inclusion in orthopedics.
Despite all the recognition it has brought her, though, Weber is fighting to be defined by more than her gender. As the first female president of the American Academy of Orthopaedic Surgeons (AAOS), Weber is hoping to use her position—and her perspective as a “6 percenter”—to inflict a cultural change upon the orthopedic industry.
“I, like others...am used to being one of the 6 percent—often, the only woman in an orthopedic meeting or on a particular committee,” Weber said during her inaugural speech at this year’s AAOS Annual Meeting in Las Vegas, Nev. “Have any of the men in this room experienced that? Even temporarily, other than maybe at a baby shower? Think about being that much of a minority in your work, every day of your career. I am not solely defined by being a woman, although that may be all that some people see as we continue to typecast what orthopedic surgeons are supposed to look like and be.”
In her speech, Weber pledged to execute on the strategic plan the Academy approved in December 2018. One of the plan’s three strategic goals involves helping evolve AAOS culture and governance so the organization can become more strategic, innovative, and diverse.
Before officially assuming the reigns of AAOS, Weber spoke with Orthopedic Design & Technology about the Academy’s strategic plan, her blueprint for her presidential term, and the challenges in changing the culture in both the 39,000-plus-member organization and the broader orthopedic industry.
Michael Barbella: What do you hope to accomplish during your term as AAOS president?
Dr. Kristy Weber: That’s a good question and allows me to talk about a paradigm shift. In the past, AAOS presidents have had their pet project and idea. It’s not always well thought out as a one-year idea and it disappears in a few years because the initiative was never really inculcated into the organization. We’re trying to change that—I led a group that developed a five-year AAOS strategic plan that we approved in December. It’s bold and specific in focus. We worked with a consultant team. My goal for this year is to execute on that plan. I think that’s the way organizations move forward—if you have a line of leaders that each do his/her part to execute the plan as outlined for the organization, and not really stray too far or get off-focus. We have three goals with metrics and specific objectives for each goal. If we can accomplish these three goals over the next five years, the AAOS will be a very different organization than it is today. These goals are outlined on the [AAOS] website, under Strategic Plan. The mission is the same as it was, the vision is new, and there are three new goals. They seem straightforward but, for the Academy based on where we are now, we have some work to do. There are external threats and challenges that make it impossible to continue the status quo in education, quality and other areas. We’re going to try and execute on each of the three goals this year and then just keep moving it forward. One of the goals I am most interested in involves the culture of the organization and diversity.
Barbella: Why did you think there was a need for a strategic plan for AAOS?
Weber: When we looked at the current state of AAOS and heard what members were looking for, we weren’t providing what they needed at a level we felt was appropriate. We were concerned that we haven’t kept pace with the Digital Age—people don’t read textbooks as much anymore. They’re on their phones and want information the way they want it, when they want it, how they want it based on what’s important to them. That’s just not where the AAOS has been in terms of technology, education, information, and in practice management. Our first goal requires delivering a personalized and seamless member experience and that means a major investment in technology, an overhaul of our learning platform, and moving our products to digital format. We’ve launched our Ortho Video Theater (OVT) in October, 2018, and it has been well received by members. The peer-reviewed CME-credit videos are high level, and there are video channels for industry and academic institutions as well. We’re hoping that we can be the hub for each member’s orthopedic needs and be able to deliver the information that people need in the way they need it. Some people want their information by text, some people want it on email or on their phone, and we want to be able to personalize the experience. I’m a tumor surgeon at Penn, so I don’t want to get an email about a hand surgery technique. That’s what the Academy does now, we just shower people with too many emails, many of which are not particularly relevant to someone’s specific practice or interests. So once we have the robust member data, we can then personalize how we communicate with each member based on what they want. Members can update their profile at aaos.org/myprofile. We want to be able to deliver value to the private practice surgeon in Missouri as well as somebody who has an academic practice in Pittsburgh. In different settings, orthopaedic surgeons will need different products and information related to practice or the regulatory environment we’re in. The second goal is all about quality and value. We’re living in a value-based healthcare system now, or moving that way, and that’s a shift for our members. Most of us grew up in a fee-for-service environment and do what we think works for patients based on our own experience. We’ve moved into a place now where we need to show value, and I think we have to use the best evidence available to show the value of musculoskeletal care. We need to prioritize the treatments that work and de-prioritize those that don’t. That’s a bit of a paradigm shift for our membership. But the Academy is going to move into that space in a big way and try to help people thrive in that new environment. One of our major new initiatives is a national registry, building off of our previous hip and knee registry. We’ve now added a registry for shoulder arthroplasty and rotator cuff, and we’ve got a couple of other registries in the pipeline. We’re connected into the CMS database, so we’ve got really powerful access to big data around the country. We will be able to address safety concerns about implants quickly and will provide individual member data for practice improvement, and to qualify for MIPS—the government’s Medicare system for quality. Participation in the registry will also eventually help them with ABOS maintenance of certification. The registry piece is going to be a real value add for members, and it’s a big investment for the Academy.
The last goal is related to culture—we’re going to evolve the culture and the governance of our board and volunteer structure to be more strategic, innovative and diverse. I would say we have to stretch to get from where we are now. We aren’t that innovative and we certainly are not diverse.
Barbella: How has your time on the presidential line prepared you for your role as president?
Weber: I know the organization. I’ve been at the board table in various roles as member at large or chair of the Council on Research and Quality previously for six years. This is my ninth year serving in the leadership of the AAOS in some capacity. The president role is different—there’s a lot more information to be aware of, and I have the responsibility of setting agendas and shaping board meetings. The board makes all of the strategic decisions, not the president or the leadership line I’ve gained knowledge and experience by watching leaders over time to hone my own listening and leadership skills, so I plan to lead the board well this year in a direction to successfully execute on our new strategic plan.
Barbella: Are you surprised that in 2019 you are the first female president of AAOS? Did you think a woman would have served as president before this?
Weber: After 87 years, I think it’s about time. Yes, I think there were women before me that were well qualified to lead the Academy the culture of the organization and the field (94 percent male) has not been one that always empowers or supports women leaders. Women have not previously been in leadership roles in large enough numbers to have more rise to the upper levels. Now there are and have recently been women leading organizations in orthopedics, including sub-specialty societies, regional societies, and the American Board of Orthopedic Surgery, so we’re starting to get there. I’m very proud to be the first woman president of AAOS. However, it’s not enough to check the box and say ‘We got one.’ I think we have to make this a sustainable path so there are no barriers to anyone who is qualified to be in the role no matter what they look like. I’m happy to represent women in addition to everyone else. I’m appreciative of the shoulders I’ve stood on to be in this role and hope I will serve as a role model and an example of what’s possible for women coming after me in the leadership.
Barbella: What will be the most challenging aspect of your presidency?
Weber: This is an interesting question, because the biggest challenge to the Academy may be different than the biggest challenge to the field of orthopedics. I think pulling the AAOS Board of Directors together to really work as a team will be a fun challenge. That involves being able to robustly debate important issues where people have differing opinions. I want to be able to create a safe space in the board room where people can express alternative views and it’s okay – we don’t have to be unanimous in our decision-making. This will require us to really dig in and think about where the Academy is going. I think it will be an exciting challenge to execute on the new strategic plan—as I’ve mentioned, we’re not where we need to be in the digital space or in the value and quality space, and we have some cultural issues to overcome. We surveyed about 5,600 Academy members last year about work culture. That included all the women and members of underrepresented racial/ethnic groups along with a matched group of men. Over 50 percent of respondents—men and women—experienced discrimination in their work as orthopedic surgeons. That’s a problem. Over 50 percent of the women experienced sexual harassment, and that’s a growing concern that we’re hearing about much more in the lay press right now. As we re-define and commit to new core values of the organization, I want to model those at the board level and hope that they percolate through the organization. We will use the new core values to differentiate AAOS from other organizations and help us not only to make decisions, but also guide how we behave. Culture is critical.
Barbella: What impact do you think your presidency may have on improving gender parity in orthopedics?
Weber: You can’t be what you can’t see. I hope it shows that women can lead in this field despite being a substantial minority. However, I’ve heard people say after my second vice president year, ‘What’s she doing? Why aren’t there more women in the field?’ Me being president doesn’t quickly translate into raising the percentage of women in orthopaedics from 6 to 10 percent! The organization has more than 39,000 members. For the percentiles to change, it’s going to take a while—we have to get more diverse people in the pipeline and wait for some of the traditional members to retire out of the pipeline. The Academy doesn’t really have reach into the medical student space, or into the high schools to get diverse students interested in orthopedics. However, there are established, effective orthopaedic pipeline programs in that space. The Perry Initiative and Nth Dimensions are two pipeline programs that work to encourage and facilitate women and minority students into the field. But what the Academy can do is change the way the board and volunteer structure look. Right now you can look at the Academy’s board and volunteer structure and see it’s decidedly white and male. Goal No. 3 of our strategic plan requires us to develop a strategy so the Academy Board and volunteer structure looks different in 5 years—more like the patients we take care of in terms of its leadership. That will be an outward-facing example of prioritizing and encouraging more diversity in the field and being more inclusive. But the overall numbers of women in the field are going to take a while to change. It can change more rapidly in the percentage of women orthopaedic residents. Currently, 14-15 percent of orthopedic residents are women. There are more women in the pipeline coming, and the women are excited. I have heard increased enthusiasm about women in orthopedics over the past several years. I feel like women are developing their skill sets and are primed to lead. The Ruth Jackson Orthopaedic Society (RJOS) has a professional development program that is focused in this area. I believe we will see many more women leaders in the future.
Barbella: What advice would you give to women and minorities seeking to improve diversity in both the Academy and the field of orthopedics?
Weber: What I say to women and minority potential and actual orthopaedic surgeons on a regular basis is not different from what I say to anyone in the field. I think you have to be excellent and super competent. You have to be so good that no one can say they don’t want you for a specific reason related to race or gender. Be so good that others have to see you, have to put you on that committee, they have to have you lead that committee because you’re an excellent doctor, you’re an excellent surgeon, you’re an excellent leader. First, be a great doctor and a great surgeon because that’s what we do—we’re here to take care of patients. I’m proud to lead the AAOS, but I never forget that my true purpose in this field is to care for patients. As you’re becoming a really good doctor and surgeon, develop those additional skill sets that you will need—conflict management skills, negotiation skills, leadership skills—so you have the ability to lead practices, disease teams, service lines or organizations. If we want to lead those teams as a surgeon, then we better step it up.