Advocacy for patient care a top priority for AAOS' new president

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Felix "Buddy" Savoie, III, MD, has taken the helm as the 90th president of the American Academy of Orthopaedic Surgeons. 

Dr. Savoie spoke with Becker's about his goals during his term and his outlook on orthopedics in 2022.

Note: This conversation was edited for clarity and length.

Question: What are your top three goals as AAOS president?

Dr. Felix Savoie: The first goal is to improve communication to both members and to the public. We need to be able to communicate to our members, and together we need to communicate better to the public. Half of our population has an orthopedic complaint as their primary health issues, and we need to make sure we know how to help them, and we have to listen to them. 

The second goal is education and unity within orthopedics and with all the other medical groups. With augmented reality and virtual reality coming into play, we're now entering a new age of education, and I don't think you can do this in silos. So I think our other medical colleagues will have ways of doing that. I think that a united effort to explore and understand new ways of educating both our physicians and our patients requires us all to work together. I would really like to see us sort of crossing the boundaries and working with the American College of Surgeons, the American College of Rheumatology and other groups to better help our patients.

My third goal would be advocacy because it's very important, given the mandates around the federal government and insurers and all the different things that come down. So we have to make sure that Congress and our senators and congressmen, president and our state legislators understand the value of letting us take care of our patients. There's a lot of healthcare disparities out there and inequities, and we're trying really hard to work on this. But I think that the main focus of the academy is to try to advocate for our patients.

Q: What top areas of advocacy do you plan to focus on this year?

FS: The biggest problem we have is the whole issue of prior authorization and not being able or not being allowed to do what's right for our patients. We have insurance companies especially just essentially practicing medicine, and they shouldn't be doing that. They can't tell or should not be able to tell the physician that he can't take care of his patients. I do mostly revision surgery, and I've had insurance companies just flat out deny allowing a patient who is in pain, who has had a prior rotator cuff repair. They just say our policy does not allow us to let a patient have a revision or take customer care. What am I supposed to do? I need to take care of my patient. So there's just not enough empathy and care involved in this.

The second area would be surprise billing. We all came to the table and came to an agreement, and then somewhere along the line the whole premise changed. We've joined the [American Medical Association] to really try to work to put this back to where it was supposed to be when it passed Congress, and it just got changed after that.

No. 3 is access to healthcare. If you restrict the ability of patients to see a doctor, to be able to get physical therapy, to be able to get a brace or something to help them get better, that's not right. Our patients have got to be able to access the medicines and the bracing and the surgery and the medical care that they need. That does not seem to be a priority for many people, but it is a priority for us.

Q: What would you say are the most divisive areas for the orthopedic community?

FS: I would say that there's a difference between surgeons and medical specialists. I'm a surgeon. If I see someone, I think that if I can fix it, I should go ahead and fix it. Sometimes there needs to be a little bit of patience in there and with, as you understand, patients in terms of taking care of people. 

But I think the biggest thing is that we have a zero-sum game in terms of the CMS budget and different things. And so everybody's sort of fighting for a piece of it. And I think that ends up pitting one type of doctor against another, but not on an individual basis. I think in the big picture, trying to divide us makes it easier to conquer, so to speak. So I think that's the problem.

Q: How do you expect consolidation to play out in orthopedics? How will you support physicians still in private practice?

FS: Our primary purpose is to take care of all of our members, and the vast majority of our members are in solo practices or small groups. That paradigm is shifting a little bit toward hospital employment, and I think the supergroups and private equity are a way to combat that. No matter how nice the hospital employment is, you're not going to be treated as fairly as if you were in control of your own destiny. 

Most of the groups I know that are becoming really large are doing it to protect their practice and their patients. You have to be big enough to be able to negotiate in your area, valid contracts, to have access to patients and for the patients to have access to you. So I don't necessarily think that's a bad thing that is happening. I think in many ways it's just the nature of the business market allowing us to take care of patients. So I think that the trend of private equity of group consolidation is not only going to continue but will probably accelerate.

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