Presidential Address

Abstract

Three Quotes and Three Gifts

A good place to start is with our mission and vision statements, which we updated, and I think they do an excellent job reflecting the organization. The mission of POSNA is “To advance pediatric orthopaedics by promoting education, research, and quality care.” Our vision is “A world with optimal musculoskeletal health for all children.”

I thought the theme at the beginning of this year would be back on our feet.  And by back on our feet, I meant on the balls of our feet, being proactive instead of being caught flatfooted or back on our heels after all the events of COVID and other world changes. But COVID wasn't done with us. And we did, for much of this year, have to shuffle our feet while trying to be back on our feet as well.

 “May you live in interesting times” is actually a Chinese curse. And I think this year was interesting but certainly wasn't a curse. It was a wonderful year to work with this incredibly dedicated board, POSNA staff, the presidential line, and POSNA membership to advance the mission and the special nature of POSNA. I want to recognize Steve Albanese, who was our president from 2019 to 2020. He helped us move out of our parents' basement. This was becoming an independent organization from prior AAOS management. This involved getting office space contracts, HR, and legal documents. COVID really hit March of 2020, and our meeting in May of 2020 was cancelled. In short order, that meeting had to be pivoted to a virtual meeting, but Steve was the right person for that time—calm, detail-oriented, ability to focus on contracts and fiduciary responsibility. I also wanted to recognize Michael Vitale, who was our president from 2020 to 2021 during the heat of COVID. Michael really made a hard decision to cancel the IPOS® meeting in December 2020 because a virtual meeting just wouldn't work for that test kitchen of education and hands-on learning. He over-communicated through multiple media and really advanced JPOSNA® and the PSSP program. And Michael was also the right person for that time—calm, with an incredible vision and focus, incredibly stoic, and able to deal with obstacles.

I want to leave you with three quotes and three gifts. The first quote is from Vince Lombardi, and that is, "Hope is not a strategy." Right before COVID, we underwent a strategic planning process. This was very well-rounded and went very deep. We looked at the pediatric orthopaedic dynamics and the contemporaneous trends that were happening in pediatric orthopaedics. We compared our member benefits and what we do versus other orthopaedic subspecialties. We looked at what the value proposition is for being a POSNA member and then we underwent a detailed strength, weakness, opportunity, and threat SWOT analysis. We came up with four strategic goals: securing POSNA as a professional home for pediatric orthopaedists, advancing the specialty through education and research, defining and advocating for quality care and optimizing effectiveness, and ensuring the sustainability of the organization. For each of these goals, we had specific strategies to achieve them.

The second quote comes from Morris Chang, who was the founder of Taiwan Semiconductor. Mr. Chang said, "Without strategy, execution is aimless. Without execution, strategy is useless." And so, we focused on execution. How do we then take these strategies and develop initiatives to achieve these goals? And how do we measure that in terms of definable metrics and follow those metrics?

The third quote was by Peter Drucker, the famous management consultant, who said, "Culture eats strategy for breakfast." And this is what is unique about POSNA. That's our special sauce—the POSNA culture. What are the words we use? What are the values we use to describe POSNA? Well, we're collaborative, we're scientific, we're involved, we're caring, we're positive, we're social, we're diverse, we're respectful, we're inclusive. We have excellent leadership, and we have fun. So that's where our priorities come as an organization. And we went through the priorities this year in more detail at the Wednesday business meeting here at the Annual Meeting.

 And now, onto the three gifts. At the September board meeting, I gave the board two books. The first book was The Yogi Book by Yogi Berra, which is kind of a fun read. He talks about all these things he said that seemed to make no sense and then why he said them, and actually it makes a lot of sense. And the quote that really stuck with me is, "If the world were perfect, it wouldn't be." And that doesn't really make sense, but what he meant was if the world was perfect, we wouldn't know it was a perfect world. We need some obstacles. We need some bad things to happen and to understand what a perfect world looks like. I thought that was very timely for the situations that we're in. The other aspect of giving this book was to emphasize the board culture and the POSNA culture of fun and friendship. So along with fun and friendship, we had POSNA jeopardy with our different jeopardy categories. We learned that Scott Rosenfeld was the POSNA board member who scrubbed in for his dog’s PAOs and hip scopes bilaterally. We learned that Chip Iwinski was the POSNA board member who is one of 10 children. I think he is the sixth of 10 children. We had a reception at the new POSNA offices where we really could connect back to our POSNA staff.  And then the staff and the board went out and we cooked our own dinner, and we found that we have some amazing cooks in POSNA.

The second book was Seeing Patients by Gus White, who was a mentor to me at Beth Israel Hospital in Boston. And the reason for this book was really to emphasize the priority of diversity, equity, and inclusion that we've had this year, that we have in the organization, and that is important to us going forward. We have made the JEDI task force now into a committee that's doing great work. We had our pre-course at this meeting on diversity issues. We've changed demographics in our application surveys. We now have research grants focused on diversity, equity, and inclusion. We have the Lead Like Lori initiative and the first reception for Pride Ortho was held at this meeting. With this book, we were so fortunate to have a book club with over 100 POSNA registrants with Gus White. And we included Al Crawford who grew up with Gus White in Memphis and the Jim Crow South. Both were pioneers who shared their experiences with us and their thoughts on disparities and equity, inclusion, and diversity.  I was able to visit Memphis at the Campbell Clinic at the end of March. We visited the Lorraine Hotel where Martin Luther King Jr. was assassinated. I was struck by his quote: “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”

The third gift was the white coat. This is our board picture (Figure 1) at the September meeting in Chicago. I think we were the first board I've ever seen to wear white coats. When did clinicians, physicians, and surgeons start to wear white coats? Well, it was sometime between 1875 and 1889. These are two paintings by Thomas Atkins, the artist. The first is the Gross Clinic in 1875, where the physicians are wearing black. The second is the Agnew Clinic in 1889, where the physicians are wearing white. And why the change? It was really to emphasize cleanliness, integrity, and science because our reputation wasn't very good. And that's particularly true for surgeons. Surgeons were not in the same profession as physicians in the Middle Ages. We were part of the Barber-Surgeon Guild and much of what we did had poor outcomes from infection, antisepsis, and lack of blood control. It's why the barber shop pole has white, red, and blue. White is for gauze bandages, red is for arterial bloodletting, and blue is for venous bloodletting. So, for me, the white coats were to remind us that we're clinicians, and our focus is really on patients. That's our vision: a world with optimal musculoskeletal health for all children. We need to keep our focus on the patients. It was to remind us that we are scientists and that we don't just jump on trends and fads. We need research, we need data, and we need to focus on quality and safety. One of my favorite things to do in the first week of August is to go to the White Coat Ceremony at Harvard Medical School and to see the students get their white coats and say the oath of Hippocrates. And I think if we remember back to our own White Coat Ceremonies, we can think of the hope and wonder that we had when we got our white coats and the privilege that we had to join this profession. I think we should remember that when we're putting on our white coats.

So, three quotes, three gifts, and a few thank yous. First is to the board of directors. It's been a great year sharing ideas, opinions, having great discussions, listening to each other, respecting each other, and coming up with great decisions to help the organization move forward. To the board members coming off, thank you for your service. The new board members coming on are incredibly talented and diverse.  Thank you to the presidential line. Thank you for your stewardship of this organization, your commitment to POSNA and always leaving it in better hands. Thank you to the presidential line who've become great friends and great mentors to me–especially because the last five in the POSNA presidential line include four Buffalo Bills Fans from upstate New York. If you know anything about the Buffalo Bills Fans, it's amazing that we're even here. Thank you to the POSNA staff. I think we have the most dedicated, incredibly talented staff. Teri, Tara, Natalia, Kaitlyn, Erica, Lisa, Lily, and Jeanne. Please thank them when you see them around. Thanks in particular to Teri, who's been a good friend for many, many years. To Boston Children's Hospital and my work family, I feel very blessed to be working in a place with such incredibly talented individuals in a great culture of support and excellence. To my mentors, Dr. Sabiston and Dr. Feagin in medical school, Dr. John Hall in residency, Dr. Freddy Fu throughout my life, and Dr. Peter Waters—thank you. To Lori Karol, who we've lost and who was an excellent mentor to many of us. She was a great mentor to me when she was president and I was research council chair. To my friends, thank you for your support, encouragement, and wisdom.  To our kids and our animals, thank you for your love and your support. To my best friend and wife, Mich. We took a big leap of faith together when we met in college. And finally, to the POSNA membership, thank you for allowing me to serve this amazing membership and this amazing organization.