by Elizabeth Hofheinz, M.P.H., M.Ed., April 7, 2020
In late February, The American Academy of Orthopaedic Surgeons (AAOS) was in discussions over whether or not to hold its annual meeting. As president, Kristy Weber, M.D., had the unenviable job of leading the Board of Directors to a final decision in the cancelation of this much-anticipated event.
Dr. Weber, chief of orthopaedic oncology at Penn Medicine in Philadelphia, had to break the news to the organization’s 230 staff members and thousands of participants and exhibitors after the Board’s decision. But that’s what leaders do…make the tough calls. 
And now we can see that Dr. Weber and the Board were right on target.
Dr. Weber: “I would like to recognize the CEO of AAOS, Tom Arend, who has been nothing short of phenomenal in handling this crisis. He has put our staff first and asked all of them to work from home early on during the COVID-19 crisis. The initial thought was to do a practice work from home day, but given the speed of this crisis, that turned into enacting work from home right away. Fortunately, his team had already been putting the necessary systems in place.”
And more good news?
“Absolutely no one at AAOS has been laid off due to COVID-19. In addition, the organization is in a stable financial position. Yes, the annual meeting is a major part of our revenue, so in that way it is a significant hit…but we are working through insurance issues and contracts. Mr. Arend’s team had the foresight to purchase communicable disease insurance coverage, so that is incredibly helpful (and a good lesson for the future). And his team has been relentless in documenting all of the reasons that it was necessary to cancel the event.”
Reflecting on another unusual event that called for an all hands on deck approach, Dr. Weber stated, “Hurricane Katrina upended the annual meeting planning in 2005, but we had many months of lead time for the 2006 meeting. The event was moved to Chicago and the educational program was able to occur exactly as scheduled. This pushed us to refine our methods of planning, communication, and execution.”
“With COVID-19, in contrast, we only had a few weeks before the meeting and were in intense contingency planning mode, looking at how to modify things according to CDC guidelines, etc. But once we made the decision to cancel this year, we went into high gear to ‘unwind’ the meeting. We immediately communicated our decision to all stakeholders and let them know that everything that could be done virtually, would be. As for refunds, they are on the way to companies and registered attendees. Those in the industry have the option of keeping the money in the AAOS ‘pot’ for next year, i.e., paying in advance.”
There are a multitude of questions that AAOS will be tackling as far as looking to future annual meetings and running the organization in general. Dr. Weber stated, “We must determine how to provide education and still be financially solvent. And what is the best way to run committee mtgs? How do we repurpose information? The learn.aaos.org platform has been and will continue to be vital for delivering free, digital, up-to-date information for members. This platform has become increasingly personalized such that, for example, a solo practice orthopedic surgeon in Nebraska gets what he or she needs as opposed to the type of information needed by an academic surgeon. Mass emails are ‘out’; personalized messages tailored to each doctor’s specialty are ‘in.’ For example, I no longer receive AAOS emails that direct me to a general orthopedic topic. Now I receive videos that are focused on oncology that say, ‘Dear Kristy, we have a new osteosarcoma video for you to view.’”
Emphasizing the importance of communication around the 2020 Orlando meeting, Dr. Weber noted, “We were updating stakeholders all along—before, when we canceled, and after the cancelation. We have sent thorough information to our members about how to get CME credits, as well as up to date information on the virus. And on March 20 I sent a letter to AAOS members addressing COVID-19 issues, in part reminding them that it is our social responsibility to avoid elective surgery during a time of scarce resources. AAOS has provided links with information from multiple sources regarding elective surgery (including a new AAOS statement) and is keeping everyone up to speed via our main website.”
The fate of all patients weighs heavily on Dr. Weber. “Systemically, we have, for example, numerous people who need outpatient care for mammograms or preventive care. Many of them can wait two months, but if an outpatient clinic goes under financially, then they will have to find other options and that could drag on into four or five months or longer.”
And the psychological effects of what some orthopedic patients are enduring are yet to be fully registered. “I have a patient who was diagnosed with cancer that spread from the liver to the femur—and he hadn’t known he had liver cancer. He was in a rehab facility and, due to COVID-19, his wife could not be with him in person when he received the news.”
Asked how orthopedic surgeons can help with the COVID-19 crisis, Dr. Weber stated, “Some ASCs are open and are managing overflow emergency patients so as to free up ER space for COVID patients. Philadelphia is preparing for a surge; Boston is on the verge of its surge. The biggest adjustment may be for residents and practicing orthopedic surgeons who are not accustomed to handling non-orthopedic emergencies. Fifth year residents are likely more accustomed to ER or ICU work because it wasn’t so long ago that they were in medical school. It’s different for the attendings, however. Penn has a number of modules to get orthopedic surgeons up to speed on the basic techniques around respiratory care.”
Asked to muse about how COVID-19 will remain in the ‘marrow’ of the orthopedic surgery community, Dr. Weber said, “This will be with us for a long time. From a business standpoint it is pushing us to learn to manage the ‘what ifs.’ For example, if a small practice is not operating with good financial stability then they need contingency plans. How can you turn this into a good opportunity for the AAOS to virtually provide education and get members what they need? My hope is that doctors think more about why they went into medicine as many centers may require all hands on deck.”
“I have no idea when we will see ‘normal’ orthopedic care, but as things come back online, we will be extremely busy due to postponed surgeries. My colleagues and I are preparing to work harder, work longer hours, and operate on Saturdays.”
For additional information on how you can experience the benefits of the virtual 2020 meeting, please visit: https://www.aaos.org/annual/