Robert W. Bucholz, MD

Interviewed by Lisa K. Cannada, MD

How did you become active in Academy affairs? Did you have a mentor or someone that introduced you to the Academy? Was there a specific objective to becoming active in the Academy?

Dr. Bucholz first participated in Academy affairs about 25 years ago when there was an ad hoc study group formed to come up with a definition of delayed union and nonunion. This was just about the time when EBI was trying to obtain FDA approval for electrical stimulation and there wasn't an adequate definition. The FDA approached the AAOS to assist with a quantitative definition. He remembers Mike Chapman as being chair of the ad hoc study group. Dr. Bucholz was selected because he was a practicing traumatologist at a busy facility (Parkland). The ironic thing is - the group never came up with a really good definition, but the exercise was stimulating. This was his first chance to work on a committee with the American Academy of Orthopaedic Surgeons. He recognized that the AAOS was the "go to" for education and for setting standards for orthopaedic surgery.

Since being part of that study group 25 years ago, Dr. Bucholz worked his way up by becoming active first as faculty of CME courses for the Academy and the Orthopaedic Trauma Association (OTA), then chairman of the courses. He progressed to becoming a member on the Committee on Educational Programming and subsequently chairman of that same committee for six years. He noted that he had a stepwise sequence of progression and that he was always willing to help with new and interesting initiatives. There was no mentor. Dr. Bucholz's involvement started with the simple invitation to be a part of the ad hoc study group.

Dr. Bucholz mentioned that he initially had no specific goal or objective when he first became active in the AAOS. He was a relatively young surgeon and enthusiastically responded to every opportunity he was given, especially regarding committees and education. He also became involved with the Journal of Bone and Joint Surgery. He was the first Editorial Fellow for the Journal of Bone and Joint Surgery, the first deputy editor in 1987 and remains active with the Journal as Deputy Editor for Adult Reconstructive Surgery and Trauma. In addition, Dr. Bucholz became involved with the Residency Review Committee for six years-which he also feels helped him in is role as Chairman of Orthopaedic Surgery at the University of Texas Southwestern Medical Center in Dallas. He found that as he reviewed the programs, he would be better prepared to handle problems and challenges in the UT Southwestern residency program. He also became a director on the American Board of Orthopaedic Surgery for a five to six year period resigning only to assume his responsibilities in the presidential line at the Academy.

Is there a particular public figure or historical figure whose leadership style you admire? In what ways have you tried to emulate him or her?

Dr. Bucholz feels that there are innumerable public and historical figures that are good leaders, but he didn't specify any particular leader. He feels that an effective leader, must possess four key traits:
A keen perspective on issues. Dr. Bucholz says it is important to realize when one is dealing with many different, often conflicting topics, you should be able to identify what really is and is not important in terms of moving ahead.

Fairness. He feels that it is important for leaders to listen to everyone in such a way that each person senses they are truly heard.

Energetic. He upholds that an effective leader must be tirelessly energetic and should demonstrate that they can effectively manage the demands on their time.

Organization. Dr. Bucholz believes that organization is more important than innovation when you have specific objectives; more will be accomplished through organization.

Dr. Bucholz just finished reading a wonderful dissertation on Abraham Lincoln and believes that Lincoln demonstrated all of the qualities he just described. In fact, Mr. Lincoln surrounded himself with competitors and used their ideas to help in his decision making. He kept a perspective on everything that was going on and he never took himself too seriously, always having an amusing Kentucky story to put an issue in proper perspective.

What acts of leadership, either within the Academy or in public life, impressed you? Please describe and tell us why.

Dr. Bucholz mentioned the unselfish acts of Stuart Weinstein, MD who succeeded him as the 73rd president of the American Academy of Orthopaedic Surgeons. He said, "Here is this pediatric orthopaedic surgeon from Iowa, heavily involved in education and research, and he was asked to lead the Academy's effort on medical liability." Dr. Weinstein was first president- elect when Dr. Bucholz was president and they were very good friends and colleagues, having been traveling Fellows together in 1985. He mentioned that Dr. Weinstein had no real background on medical liability reform, but he totally immersed himself in the Academy effort on reform. He spent much time completing significant research and attending numerous meetings at various state orthopaedic organizations. Dr. Weinstein was later elected chair of Doctors for Medical Liability Reform (DMLR), the national coalition of medical associations representing high-risk specialties and became the expert for the Academy on medical liability reform.
Dr. Weinstein has led these efforts, tirelessly giving lectures across the country and educating other orthopaedic surgeons. He now heads the Orthopaedic PAC (Political Action Committee) based in Washington, DC.

What leadership skills do you think are most important in an Academy president? During your career, is there an Academy president whose style you tried to emulate. Why?

Dr. Bucholz thinks this is quite interesting to answer as now he is the 2008 nominating committee chairman. He feels that the following traits are important in a leader of the Academy:
History of contributing to the American Academy of Orthopaedic Surgeons. Evaluate their beginnings as a volunteer in the AAOS; how they advanced through the years and how they demonstrated their abilities.

Energy level. Dr. Bucholz mentioned that during his one year as president, he took 42 trips - nearly one trip per week. In reality, while one is serving as president of the Academy, you can only work 1/3 to 1/2 the time you are used to in a private or academic practice.

Be an articulate cheerleader. It is important to know the initiatives and be able to sell those initiatives to the members of the Academy.

Fairness. The incoming president must be able to listen to everyone and be able to implement all ideas, even though they might not be something that you personally support.

The ability to facilitate and lead the Board of Directors. There are many strong opinions and personalities on the Board of Directors and Board of Councilors. A good leader should lead meetings effectively by listening to everyone, while maintaining the focus on pertinent issues at hand. It is important to remain composed and able to manage the occasional unruly meeting.

There was never a past president whose style he tried to emulate as he notes all presidents and leaders have their own relative strengths and weaknesses and it is very important to remember the Academy is not run by an individual. The success of the AAOS is attributable to the wonderful staff and numerous ongoing contributions of the volunteer Fellows.

What advice would you share with young orthopaedic surgeons just beginning their careers? Why should they become involved with the Academy? How did your involvement with the Academy teach you leadership skills?

Dr. Bucholz feels that is important to get involved. It is a great experience to give back to the Academy, especially with all that the Academy gives to the orthopaedic community. And, it's intellectually fun to be involved in the Academy.

Dr. Bucholz said his involvement in the Academy improved his leadership skills mainly by watching other leaders over time. He made many friends with the staff and other AAOS volunteers.

During your tenure as Academy president, what were the key leadership challenges and how did you deal with them? In retrospect, would you have handled them differently?

There were two big initiatives which Dr. Bucholz favored. One initiative was Professional Standards. The idea originated with the Board of Councilors and he had to work with the Board of Councilors and Board of Directors in order to make their concept of standards of professionalism come to fruition.
The second initiative was to increase the role of the American Academy of Orthopaedic Surgeons as an international body. There are over 20,000 American members of the Academy yet there are 175,000 practicing surgeons in other areas of the world and many of them want to be part of the American Academy of Orthopaedic Surgeons. International membership has markedly increased with over 3,500 members currently in the AAOS and attendance at the Annual Meeting now includes approximately 5,000 international orthopaedists. The AAOS is truly the premier international orthopaedic educational and research organization.

As President of the Academy, what achievements were you most proud of? Can you describe the leadership challenges that these achievements presented? How did you overcome them?

Dr. Bucholz is most proud of the AAOS initiative with military orthopaedic surgeons. During his tenure, he visited Walter Reed and Bethesda Medical Center and helped lobby for increased Department of Defense research funding for extremity war injuries and trauma. The military members became involved in AAOS affairs and received waivers for their dues. In addition, they were assured that their contributions were of significant value and they now play a very active role in the Academy and orthopaedic specialty societies.

The second thing he is most proud of is the 75th Anniversary program. This also involved the significant challenge that he had to obtain funding for this. Between himself and Sandra Gordon, Director of Public Relations for the AAOS, they raised $2.3M to help in making the 75th Anniversary program a reality.

Lastly, Dr. Bucholz is particularly proud of the professionalism standards that he worked on and were passed. The American Academy of Orthopaedic Surgeons was never a certifying body and members could only be disciplined if they had a felony conviction. The Board of Councilors thought standards of professionalism would differentiate the Academy from other associations. Key areas addressed were unethical relationships with industry and expert witness testimony in medical liability care.

He said he wouldn't have done anything differently. He also mentioned during his tenure that he was part of the search committee that identified Karen Hackett as CEO of the Academy. She reorganized the senior management of the Academy to increase effectiveness.

What achievements in your own career are you the most proud of?

Over the past thirty years, Dr. Bucholz is most proud of waking up every day with the privilege of being an orthopaedic surgeon. He is most proud to have been a part of the training of more than 150 orthopaedic residents while at UT Southwestern. He loves taking care of patients, as well as the education of the patients and his residents. He spent 20 years as chairman and program director, only recently resigning from those positions to devote more time to his research and clinical interests.

Who, in your estimation, were the greatest orthopaedic leaders? Please explain why.

There are many great orthopaedic leaders all whom have different perspectives and ideas.

What do you believe are the most critical issues facing orthopaedic surgeons today?

Medicine is the premier profession in the world and orthopaedic surgery is the premier specialty within medicine. We are privileged to be able to practice our profession. American society allows us a monopoly on the clinical application of musculoskeletal science. In return, all of our actions should be in the best interests of our patients. The biggest challenge to our profession is that many practices are approaching orthopaedic surgery as a business, not a profession.

Finally, the age old question: Are leaders born or are they made?

Both. The Leadership Fellows program demonstrates the AAOS belief that leaders can be identified early and nurtured over time.