Dr. Daniel Guy on his goals as AAOS president, outlook for orthopedics

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Daniel Guy, MD, was recently named the 2021-22 president for the American Academy of Orthopaedic Surgeons. Dr. Guy, a Georgia-based orthopedic surgeon, spoke with Becker's Spine Review about his goals and issues facing orthopedic surgeons, from value-based care to augmented and virtual reality.

Note: This conversation was edited for clarity and length.

Question: What are your goals for AAOS as president?

Dr. Daniel Guy: It's a great honor to be elected in this position. Our goals are to continue to build on our successes of the past, and to mention a few of these, we're going to keep working with our younger colleagues who are residents. We have about 180 residences throughout the country and over 160 are represented. So it gives us a chance to involve young orthopedic surgeons early in their career before they even practice with the academy.

We have a family of registries, which started with arthroplasty, and we've added almost a new registry every year over the last few years. We're starting a fracture and trauma registry this year, and we have a few more in the pipeline.

Another new thing for us over the last year and a half has been our biologics initiative. We just want to help define which of those treatments are a real benefit to patients and which aren't, so we've committed a lot of resources to that.

Lastly, we continue to advocate for our patients, as healthcare seems to be moving steadily toward outpatient treatments and surgery. In my role as president, I just help steer the course.

Q: What is the biggest challenge facing orthopedic surgeons in 2021?

DG: We're all still challenged by COVID-19, but we've adapted, and we're making headway. We canceled our meeting last year, and we moved our meeting this year to the end of August.

On the regulatory side of things, it seems over the last number of months that prior authorization is becoming more and more of a burden for us to be able to order tests and offer treatments that require insurance. What we're seeing is a significant uptick in peer-to-peer conversations. There's not anything inappropriate with asking us why we want to do a procedure or a test, but the system is really not transparent.

Q: How do you see orthopedic care delivery changing in the next three to five years?

DG: Things are changing. Of course, we're definitely moving more in the outpatient direction, and total joint replacements for healthy patients will likely be done in an outpatient setting in the future. Since COVID-19, I'm pretty sure no one has spent more than one night in the hospital for me. One of the things that was interesting is that when you tell patients you're going to send them home the next day or the same day, they're absolutely happy to go. So there's an absolute attitude change.

Q: How do you see augmented and virtual reality growing in orthopedics?

DG: We're very interested in this emerging technology. We think it certainly offers a great benefit as an education tool; our board is having a workshop office in June. I'm actually going to go to Chicago, at Rush University Medical Center, to watch a spine surgeon do cases with augmented reality.

You know, it's one of these software-dependent things as the technology gets better. Now it's just a question of building up the software for different kinds of areas that we operate in. It's important that we embrace this stuff right now.

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