AOA Critical Issues: How Research Improves Clinical Care: The Case for Orthopaedic Surgeon Research Leadership and Collaboration: AOA Critical Issues Symposium.

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Abstract

Improving the performance and impact of orthopaedic ÌÇÐÄ´«Ã½ is a critical leadership challenge. Musculoskeletal (MSK) conditions are a leading cause of disability worldwide, for which ÌÇÐÄ´«Ã½ investment and performance lags far behind the burden of disease. In the United States, MSK disorders account for the highest health care costs, have increased in incidence at the fastest rate, and exceed the combined costs of cardiovascular diseases and neoplasms. Despite the cost to society, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), with primary responsibility for MSK ÌÇÐÄ´«Ã½, receives <1.4% of the funds allocated to the National Institutes of Health (NIH). Although orthopaedic surgeons are leading providers of MSK clinical care, the dearth of orthopaedic clinician-scientists also greatly reduces representation of MSK scientific and clinical expertise among academic and scientific leaders. The goals of this symposium were to highlight the critical need for greater prioritization and investment in orthopaedic ÌÇÐÄ´«Ã½ and to engage orthopaedic leaders in addressing these needs. Compelling stories of ÌÇÐÄ´«Ã½ success from 3 orthopaedic chairs were featured to highlight how orthopaedic surgeon leadership in bench-to-bedside ÌÇÐÄ´«Ã½ substantially advances MSK clinical care. Seminar participants also emphasized the need to improve evidence-based clinical practice for which multicenter prospective cohort and registry studies represent opportunities for broader involvement. Prioritization of orthopaedic clinician-scientist development and formation of multidisciplinary partnerships with basic and translational scientists were emphasized as critical needs to advance MSK health. It is critical for orthopaedic chairs to "be invested in" and to "invest in" the success of orthopaedic ÌÇÐÄ´«Ã½. This investment includes developing a professional climate that values ÌÇÐÄ´«Ã½ achievement and collaboration as well as implementing strategies to support and sustain ÌÇÐÄ´«Ã½ success. Finally, orthopaedic leaders need to advocate for federal ÌÇÐÄ´«Ã½ funding to be proportional to the economic burden of disease for which MSK conditions carry the highest current and projected costs. With health-care costs accounting for nearly one-fifth of the U.S. economy, increasing the investment in orthopaedic ÌÇÐÄ´«Ã½ to reduce the prevalence, disability, and morbidity from MSK disease needs to be a top orthopaedic and national leadership priority.

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