AAOS 2021 key topics

Key takeaways from the American Association of Orthopaedic Surgeons (AAOS) conference in September 2021

Karen Bush, MSN, FNP, BC, NCRPThe Annual Meeting of AAOS provided insight into many of the current topics in orthopaedic surgery.

AAOS looks at DEI

One such issue was how to improve diversity, equity and inclusion (DEI) within the profession. Orthopaedic surgery has the third-largest wage gap between males and females among specialists, and they land in the bottom three of specialties for underrepresented minorities (URM). AAOS is taking a hard look at the current state of DEI and offered sessions with real examples and solutions to address this growing concern.

One session suggested that the orthopaedic industry has moved past the understanding of what DEI is and why it’s important. Now, the focus is on what we should do to adjust. The panel of speakers provided some of the following recommendations to assist in closing the gaps:

  • Get to know the current state of your organization through personnel inventory
  • Conduct pulse surveys
  • Review human resource complaints
  • Educate leaders, particularly in implicit bias, with a focus on physician leaders and chiefs of practice
  • Make concerted efforts to recruit, retain, promote and increase the visibility of underrepresented minorities.
  • Seek URM talent in known web communities or professional groups
  • Require a diverse pool for interviews and track offers, hires, annual reviews and compensation
  • Use these key performance metrics to drive accountability and sustain efforts

The opioid epidemic

Impactful statistics, research and recommendations on the opioid epidemic and pain management were also presented at the AAOS Annual Meeting. One presenter reported that 12 million U.S. adults misused a prescription pain reliever in 2016, with 35% of the opioids prescribed by a practitioner, 53% obtained from a family member and only 6% from a drug dealer.

The nature of the diseases and injuries that orthopaedic surgeons treat places orthopaedic care at the front line of the fight against the opioid epidemic. In total joint surgery alone, it was noted that 10% of patients who were opioid-naive before surgery were still using them regularly at six months post-surgery. A recent survey conducted by Western Orthopaedic Association reported that 75% of orthopaedic surgeons agree there is an opioid epidemic. Orthopaedic surgeons are taking the battle seriously, and the recent AAOS meeting provided several educational offerings on pain management and guidance on how to reduce opioid use.

Overall, orthopaedic surgeons have responded by researching optimal quantities and refills to maintain satisfaction and reduce diversion.  This approach leaves behind concern for the impact of prescribing opioids on patient satisfaction, as studies do not support this apprehension. Multimodal pain programs have become a gold standard, and institutional opioid prescribing guidelines and retrieval programs are essential. Pursuits of non-narcotic pain management such as meditation, mindfulness, nerve stimulation and cold therapy, to name a few, are encouraged.

At the time of this writing, Karen Bush, MSN, FNP, BC, NCRP, was a HealthTrust Director, Clinical Research & Education.

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