This past weekend, I had the privilege of keynoting the annual meeting of the American Association of Hip and Knee Surgeons (AAHKS) in Dallas. Established in 1991, the AAHKS is the leading organization for knee and hip reconstructive surgeons (total-joint replacement).
The conference focused on a broad array of scientific topics, including implant design, clinical outcomes and surgical techniques while also zeroing in on the biggest socioeconomic issues in healthcare today. In front of 4,000+ attendees, I participated in a fireside chat with AAHKS President Dr. Bryan Springer.
We spoke about the future of American medicine and the role members of the association can play. Here are some of the topics we discussed, along with my impressions of the organization and its leadership:
Surgeons who stand apart
The AAHKS leadership and the majority of its members understand the need to improve our nation’s problematic healthcare system. Many of them have joined the movement toward better quality, greater access and lower costs.
Unlike many other surgical and medical specialties, I observed that most AAHKS members prioritize efficiency and total-patient care (rather than simply maximizing revenue from operations and treatments). I was particularly impressed that many of the presentations included information on non-surgical treatments. While these hip and knee surgeons are capable of replacing worn out, arthritic joints with consistently excellent results, that’s not the only solution they give patients. Often, they’ll initially recommend other approaches to address pain, including physical therapy, with the hope of improving a patient’s range of motion and muscle strength.
A comprehensive treatment program—one that includes early intervention, pain management and steady monitoring—has been proven to increase quality of life for patients. And that’s what AAHKS members strive to deliver in the most effective and affordable ways possible. This holistic philosophy isn’t traditional in most surgical residencies, which makes the association’s perspective on care refreshing.
Several speakers at the meeting talked about the importance of wellness and lifestyle change, including exercise, diet and better management of pre-existing conditions (chronic diseases). Many emphasized the importance of data analytics, and the potential that technology-based solutions such as telemedicine and artificial intelligence offer.
Adapting and leading
Pursuing transformational change in healthcare is challenging for many reasons, but the members of the association are forging ahead.
During the Covid-19 pandemic, for example, many surgeons had to shift medical care from in-person to virtual. They also moved the majority of their procedures from a traditional three-day hospital stay to an outpatient venue. Many took the difficult and risky step of shifting from fee-for-service reimbursements to bundled payments, including capitated contracts. This alternative method of payment involves a group of doctors taking full accountability for all of the medical needs of a population of patients and redesigning medical care delivery in ways that increase quality (thus weeding out approaches that add little value but drive costs sky high).
To reach that end, surgical specialists work closely with colleagues in order to maximize success. They collaborate with physicians from other specialties, including primary care, physical medicine, rehabilitation (PM&R) and various surgical disciplines and coordinate care to maximize clinical outcomes.
Dr. Springer and I ended our portion of the fireside chat by discussing the work the association is doing to increase diversity and inclusion in the subspecialty and the powerful role that global volunteerism can have in restoring the mission and purpose of medicine. It was clear to me that Dr. Springer, as president, will advance the practice of hip and knee surgery rapidly for the betterment of both the patients who receive the care and the physicians who provide it.
On retail giants and Medicare cuts
In the Q&A portion of the annual meeting, I was asked about the entry of retail giants like Amazon, CVS and Walmart into healthcare and whether these companies would be competitors or allies. My view is that we don’t yet know but that the opportunity for a synergistic relationship remains possible. These companies are coming into healthcare to generate the types of profits they currently earn in the retail world. If they can obtain the services needed at an appropriate price, I expect they’d be open to partnerships that prove mutually beneficial for the retailer, their consumers and healthcare providers.
I also was questioned on the upcoming cuts Medicare is planning for next year, which will impact both doctors and hospitals. I noted the federal government will lower payments one way or another, although possibly slower than currently planned. Ultimately, a shift in healthcare funding from pay for volume to pay for value is inevitable. Specialties that make moves to lower costs and deliver more efficient care now will be best positioned for long-term success.
I want to commend both Dr. Springer and Michael J. Zarski, the executive director of the association, for creating an agenda that tackled difficult issues and for encouraging honest debate. I also want to thank Renalin Malvar-Ledda, the senior director of events and operations, who made certain every detail of the program was flawless. The leadership team of AAHKS is one of the very best I have encountered.
I look forward to learning from the success of the group and hope to see it leading the transformation of American healthcare that is so sorely needed. How physicians can accomplish this task is a topic I am addressing in my Forbes and LinkedIn columns, which can be accessed via the links below.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Pearl’s newest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” is available now. All profits from the book go to Doctors Without Borders.
Article image courtesy of Dr. Jeff Stambough, MD, FAAOS via Twitter (link)
