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Beaty's background in education will be a benefit for the academy's 2007 goals
New AAOS president comes from an institution with a long history of giving back to orthopedics.
The American Academy of Orthopaedic Surgeons is facing a year with many proposed changes and goals for itself and its membership. Education, advocacy and increased communication with its members top its agenda for 2007.
James H. Beaty, MD, the new president of the organization, is ready to direct the next step in its evolution.
Beaty is an orthopedic surgeon and the chief of staff at the Campbell Clinic in Memphis, Tenn. He is also a professor of orthopedics at the University of Tennessee — Campbell Clinic. He specializes in pediatric orthopedics and pediatric trauma.
Beaty has been very active in orthopedic organizations. He has served as president of the American Board of Orthopaedic Surgery, the Pediatric Orthopaedic Society of North America (POSNA), the Mid-America Orthopaedic Association and the Tennessee Orthopaedic Society. Also, he has held many leadership positions in the American Academy of Orthopaedic Surgeons (AAOS), including the immediate past chairman of the Committee on Continuing Medical Education, and former president of the Orthopaedic Learning Center, a joint venture between the AAOS and the Arthroscopy Association of North America.
He has been an associate editor for the Instructional Course Lecture Series of the Journal of Bone and Joint Surgery, and now is reviewer for the publication.
He is on the editorial board for The Journal of Pediatric Orthopaedics, the American Journal of Orthopaedic Surgery and the Journal of the Southern Orthopaedic Association.
He has edited and/or co-edited five textbooks, authored 52 book chapters and published more than 34 peer-reviewed scientific articles. He has given more than 100 scientific lectures and presentations worldwide, most of which focus on injuries and fractures among children and adolescents.
Lee Beadling
Orthopedics Today Managing Editor
Orthopedics Today: Dr. Beaty, what is your educational background?
James H. Beaty, MD: I am actually a Georgia native. I went to Washington and Lee University in Lexington, Va., and then medical school at the University of Tennessee College of Medicine in Memphis. I did my orthopedic residency at the Campbell Clinic and then a fellowship in pediatric orthopedics at the DuPont Institute in Wilmington, Del.
OT: How did you come to the practice orthopedics and your subspecialty?
Beaty: When I was a medical student I was attracted to orthopedics early on for a couple of interesting reasons. One is that I very much liked the idea of the almost immediate gratification you get from taking care of patients.
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I saw that what we did caused immediate results and improvement in patients’ function and their lives. I was attracted to such a tangible result in seeing the positive changes and influences in health we could provide to our patients.
Secondly, I actually had an interest in pediatrics as well as orthopedics, so becoming involved with pediatric orthopedics was a way to combine the two.
Fortunately, I had several mentors and role models who also had an interest in pediatric orthopedics. They really influenced me and were a strong push in getting me involved in orthopedics and pediatric orthopedics in particular.
OT: Who were your mentors?
Beaty: When I was a medical student, I had a few mentors. Dr. Alvin Ingram was here at the Campbell Clinic, and Dr. Harold Boyd really influenced me. Coincidentally, Dr. Boyd was a president of the AAOS in the 1950s. One of my later mentors, Dean MacEwen, MD, who was the chief at the DuPont Institute and my fellowship director, has been a good career mentor for me.
OT: How did you become active in the academy and what other positions have you held there?
Beaty: First of all, our program at the Campbell Clinic has a long tradition of having relationships with many medical organizations. We have a strong belief that part of getting involved with organizations is a way of giving back to the community of orthopedics. We believe in not just providing care for our patients here, but also in giving back to the community and to the orthopedic organizations.
Also, when I first started practicing, my senior faculty wanted me to get involved in areas of interest that I had in orthopedics, which includes education and research, and in the organizations with which you are involved.
They said they wanted me to get involved and give something back to them by volunteering. That is kind of how it started for me.
I was able to get involved with the academy primarily on the education side. I got involved in instructional courses with the academy and CME courses that were offered in pediatric orthopedics. I cut my teeth through the educational arm of the academy. I then began my involvement with the orthopedic learning center.
As far as positions in the academy, I’ve had an interesting pathway. I was initially involved with the Committee on Pediatric Orthopaedics back in the ’80s and then in the ’90s I really had a strong interest in education and was on the Committee on Surgical Skills, which I eventually became a member of and then went on to chair for a few years.
This was during the time when the Orthopaedic Learning Center was gaining a foothold and was on the upward move of involvement with physician education.
In the late ’90s the academy merged the Committee on Surgical Skills with the Committee on Educational Programming and I assumed the chairmanship of that committee. There, I was able to work with the academy staff and all the volunteers in overseeing the CME efforts, including the CME courses, the review courses, the comprehensive courses and the orthopedic learning center activities. That was a great experience, and I really learned what goes on behind the scenes at the academy.
I also got to know the great group of volunteer physicians we have who are involved in teaching, and also how great the academy staff is putting all of this together.
I have been a very fortunate guy. It has been a blessing to have the chance to be involved in leadership positions with a lot of organizations, and I really enjoy doing it.
OT: What do you feel are some of the greatest challenges facing orthopedists today?
Beaty: I think it is easier to divide the challenges that we face into the areas that the academy uses to addresses them. The first area is in education itself. There are a lot of changes going on in the education environment. The academy is in a position to continue as a leader in education for physicians, but we recognize that partnering with our subspecialty societies may benefit members of both our organizations. So that is one challenge.
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The entire face of physician education is changing the way that it is done and the way that it will be done in the next 5 to 7 years. We have to look ahead to see how the academy will maintain the good things that we are doing, but also learn to change to get ready for the next wave of physician education.
The second area the academy is addressing is advocacy. We obviously have a number of ongoing issues that are going to stay on the front burner for advocacy probably for the next few years.
They include the medical liability crisis that is going on in the country right now and the challenges of physician reimbursement through the activities of the CMS and other organizations. We are fortunate that, although there is going to be a new Congress, we will have involvement in both the national and the state levels. Over a long period of time, we have developed relationships with a number of congressmen in Washington.
So, there is recognition of trust to be able to work with them on issues that are of the best interest of not only orthopedic surgeons, but of our patients as well.
The third area is in research. The academy has undergone a major reorganization in the last 18 months and the research arm of the academy now supports all of the efforts that happen within the other parts of the academy. One of the biggest issues that we will tackle in the research arm of the academy will be the whole concept of new technology — how new technology and new procedures are introduced to the public and physicians in the future.
Right now, most of that comes through the orthopedic industry. The question for the academy is, do we want to have a voice in that process? We are addressing that this year. When new technology or new products are introduced, they have already gone through FDA approval for use.
We have to decide as an organization if the information about the new products is going to come exclusively from orthopedic industry or from either the academy or a group of physicians that are working with the academy, or even if that is a reasonable pathway to go down.
Now the academy is silent on most of the introduction of new technology and new procedures. As an organization, we certainly have physicians who are involved in meetings and research, but as an organization we remain for the most part silent on new things. That is something that we are questioning. The membership has an interest on the academy’s position on new technology and new procedures and we are trying to decide, as an organization, if that is the path that we want to go down.
Another advocacy issue relating to the medical liability crisis is the on-call crisis that is occurring throughout the country. I think that we have recognized over the past few years that there are fewer orthopedic surgeons who want to participate on-call because of various problems.
We started tackling that about 18 months ago and published in the October issue of the AAOS Bulletin some of the proposed solutions to improve that situation. But all of that is closely intertwined with the medical liability crisis, so we are going to continue to work on both of them.
Another challenge will be the communication effort of the academy. We are working very hard to streamline the information going from the academy to our members, so they will be able to see the topics that are of interest to them as well as to be able to customize what is coming across their desks in a way that they can see the pertinent information from the academy that we want them to see and that they need to see.
We are looking at all options to see that our communication is improved we want to do that online and through paper publications. That is a focus that we began working on last year and we will continue to work on this year.
OT: You mentioned the changing face of medical education, how is physician education changing?
Beaty: It is a combination of how physicians utilize self-assessment, the maintenance of the certification program that has come through the board of orthopedic surgery, which is a new certification activity for physicians for the past couple of years. Also, how do we fit in physician education combining what we are currently doing with those things and what will need to be done in the future. We need to show that by enhancing our education as physicians, it has a positive impact on our practice, a positive impact on our patients and really makes a difference in our clinical practice.
Those are some things that I think are on the horizon for us to address as an academy and to maintain the position on, as a real leader in the education of orthopedic surgeons. If I had to think of one of the biggest challenges for us as an organization, that is probably it.
OT: What are your goals for this coming year?
Beaty: We are very fortunate that we have a great group of people in the leadership line of the academy. It has been a real pleasure working with Stuart Weinstein, Dick Kyle and Tony Rankin. The academy staff is a first-class group of people who, when they have something on their desk or in their lap, take it and run with it and to make sure that it works out to the best interest of orthopedic surgeons and to our patients.
In the past it seemed like those with leadership roles within the academy had one central theme that they wanted to focus on. But what has really changed at the academy in the past few years has been that we are trying to tackle the issues that are important to the academy, to our members and their patients at this moment, and not just what is someone’s major or minor area of interest. That is a great thing for the organization and for our members as well.
The three things that I would say that have to come to fruition for my watch would be the orthopedic on-call issue, new technology issues and education. For the on-call issue, we have partnered with the Orthopaedic Trauma Association and POSNA to begin to give information to orthopedic surgeons that will improve their issues at the local, regional and national levels.
As for new technology and the assessment of new technology and procedures, we are going to dedicate a 3-day workshop of the academy board in April to deal with the issue. After the workshop we hope to have information that we can provide to our membership and to the public.
The last issue as far as a specific goal for me is the issue of education provided by the academy and where we will go with that in the near future. We dedicated some of the academy board’s time this past year to specifically deal with where we are and where we are going with our education activities.
In our last meeting in December, the Board of Directors spent a significant amount of time on this subject and we are now finalizing our effort from the board’s actions and we will make that available to our members and all others after we completed that evaluation. The efforts of the past 2 to 3 years, in particular Stu Weinstein’s efforts on the medical liability crisis and Dick Kyle’s efforts on the unity between the academy and the subspecialty societies and other organizations, those things are going to continue over the next few foreseeable years.
OT: What are the advantages for young orthopedic surgeons today that were not available 20 years ago?
Beaty: If you think about the changes over the last 20 years, so many things have happened that really changed the specialty. One in particular is that specialization within orthopedics has increased dramatically. The number of orthopedic residents who have fellowship training now is greater than 50%, and it seems like it is increasing. Yet, we have a great number of colleagues around the country who continue to practice general orthopedics. I think one of the advantages now is that young physicians going into orthopedics can really pick and choose whether they have an interest in being a general orthopedic surgeon or if they really want to specialize in a certain area.
A second advantage would be that it is a great time to be an orthopedic surgeon. By that I mean, despite all of the issues that I mentioned, with medical liability reform and orthopedic on-call and other issues that are tough tackle, the gratification that you receive from patient care is a wonderful thing. If you look at where the young orthopedists are today compared to where we were 20 years ago, the baby boomer generation is about to come into full force, and the amount of orthopedic care that they are going to need and acquire is just going to take a giant leap and bound. We baby boomers want to remain pretty active and we are going to be wanting and needing orthopedic care to retain that function and lifestyle well into our 60s, 70s and 80s.
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From an education standpoint, they have so many opportunities and so many different venues to receive their education and information about medicine right now. We can spend a lot of time talking about what the Internet has done, both good and bad, for medicine, though one thing is for sure: it is changing how the public receives information about medicine. It also has changed how we can access medical and scientific information.
Young orthopedists today join established groups that have developed systems or practices that are modern and up-to-date, including digital imaging and electronic medical records — all of the things that make life a little easier for the practicing physician and are great for the patients as well. Systems-based activities have been a real advance for the practicing orthopedic surgeon in the last 20 years.
Finally another advantage is our advocacy effort that we have built up over the past 20 years. The academy wants to be the voice for the practicing orthopedic surgeon in these areas. We have built up a great program and we should be proud of what our colleagues are doing in Washington and on the state level on our behalf in advocacy for physicians and for our patients. If you think back 20 years ago, what different technology and different procedures were available in 1987 vs. 2007 — the advances have been exponential. We all hope that those advances will continue over the next 20 years to better patient care.
OT: Dr. Kyle had set unity as the agenda during his presidency and followed through with that as the academy came together with the subspecialty societies to address and amend such issues as proposed Medicare changes by the CMS. Do you propose to continue that course?
Beaty: There are certain issues that will come up and affect various parts of the specialty societies that are unique and different to each one. In those situations we look forward to partnering with the specialty society to work on trying to solve the issues that may face them in a unique way.
OT: Any other comments?
Beaty: From a personal standpoint, our program in Memphis has had a long tradition of partnership with the academy. It is interesting to me … you know, timing in life is sometimes a funny thing, but it struck me as very interesting that as we come closer to the 75th anniversary of the academy and the fact that Dr. Campbell was one of the founding members, that this is happening now. I am very proud of the relationship and the involvement that our group has had with the academy over the years.
My personal thanks to all the volunteer physicians and all you do on behalf of orthopedics.