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EFORT remains focused on standardizing musculoskeletal care in Europe
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Editor’s note:This is the first installment of our new series, Pioneer Associations, on the formation of societies that have helped educate and organize orthopaedic surgeons.
Before the European Federation of National Associations of Orthopaedics and Traumatology was established, European orthopaedics was fractured, with the standards for care and education as varied as the languages spoken on the continent. The society’s founding fathers sought to create an organization that would help improve the education of Europe’s orthopaedic surgeons and standardize care.
Michael A.R. Freeman, FRCS, a past president of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT), conceived the idea for a combined meeting of the European orthopaedic societies while attending the 1989 International Hip Society meeting in New York.
Freeman told Orthopaedics Today Europe he started calling his friends, beginning with French surgeon Jacques Duparc, MD, who at that time was professor of orthopaedic surgery at Hôpital Bichat in Paris.
“You cannot organize anything of this kind unless it includes the French,” Freeman said. “They are a key part of the orthopaedic world. It would be like a doughnut with no jam in the middle if the French were not on board.”
Duparc convinced the Société Francaise de Chirurgie Orthopédique et Traumatologique (SOFCOT) to support the new organization. SOFCOT underwrote the costs of the first meeting of EFORT, held in 1993.
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Images: European Federation of National Associations of Orthopaedics and Traumatology |
Connection with other organizations
During the 1990 German Society for Orthopaedics and Traumatology (DGOT) meeting, Freeman chatted about his idea with Wolfhart Puhl, MD, of University Ulm in Germany, who is now a member of the Orthopaedics Today Europe Editorial Board. The DGOT agreed to fund the second congress, which was held in 1995 in Munich.
Freeman then contacted Paolo Gallinaro, MD, FRCS(Hon), who at the time was president of the Comité des Coordination Orthopédique du Marché Commun (COCOMAC), a group of 12 countries that were part of the former European Common Market. This group is considered EFORT’s forerunner, as it focused on providing musculoskeletal educational opportunities to its members.
Gallinaro hosted a meeting of the presidents of the European national orthopaedic associations in Marentino, a small town near Torino, Italy. That meeting yielded several resolutions: the new society would include musculoskeletal trauma. All members would be represented by two national delegates, with two votes per country and the annual membership fee would be 4 ECUs (now euros) per member of each involved national society.
Early challenges encountered
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Early on, the leaders of the new federation faced several obstacles. The multiplicity of languages in Europe was a problem, which led the steering committee to declare English as the official language.
“I asked for English because of the distribution worldwide,” Puhl, an EFORT past-president, said.
Money was an issue for the fledgling federation, according to Gallinaro, the first treasurer.
“I would always say ‘I am the treasurer of nothing. Treasurer of what? We have no money,’” Gallinaro told Orthopaedics Today Europe.
The newborn society got a boost, however, when COCOMAC disbanded and offered the money left in its treasury to EFORT. As EFORT grew it became obvious that a bigger, centralized office would be needed.
“We decided to bring all things together in one place,” said Puhl, editor in chief of the EFORT journal European Orthopaedics and Traumatology. The federation established a central office in Zurich, Switzerland, where it remains based today.
Biennial vs. annual congresses
In the beginning, the founders chose to offer biennial meetings because they were unsure if there would be enough interest, Freeman said. In addition, there was a fear their annual meetings might conflict with the annual meetings of the national societies.
“We did not want to do that,” Freeman said. “We are a confederation of the national societies.”
The 2007 EFORT Congress, held in Florence, Italy, proved that annual meetings were necessary. According to Puhl, the chair of that congress, EFORT received more than 4,000 abstract submissions for the meeting. EFORT has staged an annual congress since then, starting in Nice, France, in 2008.
The Florence congress was notable for another reason: The location of the opening ceremony. With the permission of the Vatican, the opening ceremonies were held in the Duomo di Firenze – Cattedrale Santa Maria del Fiore, the first secular event held there.
Federation to expand influence
To remain viable, the society must continue to grow. One effort has been to establish a political presence in the European Union. Musculoskeletal surgeons, both orthopaedic and trauma surgeons, represent 3% of the medical body in Europe, according to Orthopaedics Today Europe Editorial Board member Pierre Hoffmeyer, MD, EFORT president. However, orthopaedic and trauma surgeons perform about 25% of all surgeries done in Europe, he said.
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“So, there is a bit of a disparity between what we actually do for the public and how our voice is heard,” Hoffmeyer said.
With the help of a consultant, EFORT has been participating in meetings and raising its political voice. The organization is also interested in working with the World Health Organization.
“Trauma kills more than HIV, malaria and tuberculosis together worldwide,” said Hoffmeyer, professor and chairman of the orthopaedic service at the University Hospital of Geneva, Switzerland. “Who takes care of trauma? Orthopaedics. This is also a place where we want our voice to be heard,” he noted.
Ultimately, EFORT hopes to play a role in standardizing musculoskeletal training across Europe, Hoffmeyer said. Therefore, the organization will continue its financial support of the European Board of Orthopaedics and Traumatology (EBOT) exam. They will also support young orthopaedic surgeons who take the EBOT exam by conducting review courses.
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“Our main target right now is building up a system whereby young orthopaedic surgeons in Europe can get the same education everywhere, at least theoretically, so they can face this examination,” Hoffmeyer said.
Standardizing care is critical, too. “The future is that we should have a unified approach to musculoskeletal diseases, infections and trauma throughout Europe,” Hoffmeyer said. “I think EFORT can play a role in achieving this standardization of orthopaedics.” – by Colleen Owens
Reference:
- Michael A.R. Freeman, FRCS, can be reached at 79 Albert St., London NW1 7LX, UK; +44-207 387 0817; email: drfree@freenetname.co.uk.
- Paolo Gallinaro, MD, FRCS(Hon), can be reached at Via Governolo 28, 10128 Torino, Italy; +39-011-501524; email: paolo.gallinaro@unito.it.
- Pierre Hoffmeyer, MD, can be reached at pierre.hoffmeyer@efort.org.
- Wolfhart Puhl, MD, can be reached at Klinik Oberstdorf, Trettachstraße 16, 87561 Oberstdorf, Germany; +49 160-97292036; email: wolfhart.puhl@efort.org.
- Disclosures: Freeman, Gallinaro, Hoffmeyer and Puhl have no relevant financial disclosures.