I decided that at the end of this year I would hand the reins over to someone with the kind of drive and energy needed to take the USBJI to the next stage in its evolution. Also, my work for the USBJI means that I have spent far too little time with my family -- my children and grandchildren in Canada as well as other family in Europe. It is time to spend more time with them.
What I call the Bone and Joint Decade, Stage One, was a relatively easy ride. The concept of raising the priority of musculoskeletal (MSK) health was not generally a difficult sell as our community is closely invested in it. It was intriguing, though, that so many thought the job could be achieved and put to bed in ten years -- or had an end stop.
There is, as I can tell you, still much more to do.
At the beginning, we knew that a much-needed goal was to break down the silo mentality among specialties. Coming from a different environment into this job, I was struck by the competitiveness in an area dedicated to treating people’s health. Today, it feels as if we have come a long way on that front. But not always. Too many occasions arise when silo mentality rears its ugly head. This cannot be beneficial to treating people’s MSK health. But the USBJI is proud of the feedback it receives for its efforts to promote team-based, coordinated and multi-disciplinary care. I hope this continues.
We stumbled over activating the Decade, the assumption being that our members would develop programs to achieve its goals. When it became clear that this wouldn’t largely happen, we began putting programs together to meet our various goals. A meeting was held early on, hosted by the NIH and chaired by then-NIH Director Dr. Elias Zerhouni. It was highly instrumental in guiding us. That meeting identified two issues that needed addressing:
- The need to improve MSK health knowledge and skills among all students at Medical Schools. That became Project 100 and achieved much progress. It continues to this day, currently with a particular focus on students pursuing primary care.
- The need to increase the pipeline of funded young investigators to increase MSK research. The Young Investigator Initiative is one of our most rewarding achievements. More information follows.
- Many people saw the importance of BMUS (burden of MSK disease data) as a foundational resource for everything we need to do, for many societies and their members, for promoting the need for raising the priority of MSK health and promoting the value of MSK care. We have published four editions and multiplied the number of Users.
- Our public education programs were gaining recognition by the end of the Decade.
- We have maintained and expanded BMUS (Burden of Musculoskeletal Diseases in the United States, prevalence, healthcare utilization, economic cost data – www.boneandjointdisease.org). We have just released the 4th Edition, have 230,000 Users and expanded its use for advocacy. We took over BMUS from the AAOS to help it become a joint project of societies, which it has. The USBJI sees its role to support its members’ advocacy activities by providing data and BMUS central to that.
- The one USBJI goal popular throughout the community is to increase MSK research. We are very proud of our Young Investigator Initiative (YII) which has helped 284 participants succeed in obtaining their first significant funding – $544 million for 1,843 projects. One participant called recently to tell us he has been awarded two grants totaling $2 million following his participation in YII. We plan to expand the program to assist those who have received their first major grant by helping them address the next steps and establish a sustained career in MSK research.
- Our public education programs are reaching more Americans, with upgraded editions launched last year. COVID-19 has given us an opportunity to offer the programs as videoconferences and recorded sessions as well as in the traditional live in-person format. This has boosted the number of sessions taking place and broadened the number of people reached. In addition, we are ready to launch new and expanded versions – Creating Opportunities for Arthritis Control @ Home (COACH). It will target non-rheumatology specialists who see people with arthritis to help them address the rheumatology workforce shortage. And we are using the MSK Health Index to locate communities with high levels of prevalence as well as underserved communities. In short, there has been increased interest in our public education programs.
Many of those I work with know I have been fighting cancer for several years and that it has become much worse during the past year. My stepping down as your earnest and intense staff person is also necessary for that reason. And while my personal experience is in a different area of medicine, the last few years have taught me a lot about patient advocacy. I regularly get invited to patient advocacy meetings and have felt increasingly knowledgeable and useful at these. I have learned a lot, aided by my own experience, about the science and approach to treatment, such as precision medicine and personalized/individualized medicine, particularly side effects. I have learned a lot about patient-oriented departments and systems in hospitals – some are excellent, some are dreadful. We rarely talk about this within USBJI, but those aspects of patient-orientation hugely affect a patient’s life during treatment.
- The biological and pharmaceutical industries focus a lot on patient advocacy. Not so much orthopaedics. Consider Zimmer Biomet’s Movement is Life as a notable exception. The USBJI should talk with orthopaedic companies about patient advocacy which would greatly assist with our overall effort.
- Falls – the USBJI has almost exclusively focused on the types of falls in the home (items on the floor, stairs, bathrooms, etc.) and outdoors, especially in the winter. Yet, we have never addressed a vast number of people falling due to the side effects of a drug that results in an osteoporotic fracture or other injury.
- We have talked over the past 10 years of increasing awareness of MSK disorders connected to other morbidities or causing them. That is an opportunity to work with other well-established groups to leverage our cause.
As I tried to drift out of the door, our Board President lassoed me with the words “not so fast” and was supported by the other Executive Committee members. He said they would like to keep me on in some type of consulting role and to help with the transition for my successor. I am more than pleased to do this. I have thoroughly enjoyed working for the USBJD/USBJI, facing the challenges we have had and working with many wonderful people. A particular shout out to my marvelous office colleagues, Shari, Tara, and Carol as well as Emily, who has been working with us for the past several months. I leave with strong positive feelings for the organization and am more than willing to continue contributing where I can. I wish my successor all the joy I have experienced, and to raise the USBJI to another level.