The Academy on the Edge: Taking Charge of Our Future*

Abstract

It’s an enormous honor for me to be standing before you this morning as your incoming President at a time of remarkable change, the magnitude of which was emphasized in the very critical Institute of Medicine report featured on the front page of this morning’s issue of USA Today 1. In preparing this talk, I’ve been reflecting on the changes that have affected my career since I attended my first Academy meeting back in 1975. That meeting was also here in San Francisco. It was my first year in practice; I had a two‐year‐old daughter. Now I have three children; they’re all grown, they’re all through college, and they’re all contributing to society in very positive ways. I remember the meeting in 1975 clearly. I remember being impressed by the depth and breadth of the science and being very proud to be a member of the Academy. Not long ago, I came across the program from 1975. As impressive as the science was, the strides we’ve made since then are nothing less than astounding. Consider that, just over twenty-five years ago, arthroscopy wasn’t on the program at all, total knee replacement was in its infancy, anterolateral instability of the knee was just being described, and total shoulder arthroplasty was experimental and performed only in patients with deficient rotator cuffs. In fact, in 1975 we had only three papers related to the shoulder and elbow. Today, these subspecialties constitute a separate discipline. This year, we have four sessions, twenty-seven papers, and more than fifty posters on shoulder and elbow topics alone. It is an entirely different world. There were no presentations on health-care reform in 1975. Now, just twenty-six years later, we live in a world of HMOs and PPOs. And the changes extend far beyond health care. We live …