Welcome to what I hope everyone will find to be an interesting session. Kurt and I Zoomed with these five about a month ago, and I think we could have talked for two or three hours listening to stories, so we've been looking forward to this. We'll start with some questions and comments for the panel from us, and then just like the other sessions, feel free to send in a question, and we'll use some of those when we have time at the end. So Dr. Leach, Bob, you were our 12th president from 1983 to 84. You accepted an appeal on a manuscript of mine you had rejected originally, which led to my first AJSM publication, and in fact, it was the first time that Kurt and I collaborated on a study. So you've been one of my heroes for a long time and gave my publishing career a start, but I had to appeal to get it in. Why don't you talk a little bit? You were really involved with the journal. Talk about your year as president and maybe address some of the issues surrounding the journal and maybe what it was like to be the second editor and replace Jack Houston. The very beginning of all of this, of course, starts with the journal back in the early 70s when a man in Connecticut formed the Journal of Sports Medicine. He then sold it to the Sports Medicine Society, which we are all members of, and eventually it was bought by the journal, which really was Jack Houston, and suddenly in 1983 we owned the journal. The journal did not begin particularly well, and I'm not sure it represented the society exactly as they would have liked because Jack had to literally beg his friends to send in case reports. And so the usual thing was I operated on eight people who had such and such. They all did well, and seven of them became all pro, and obviously that wasn't going to help a lot. And eventually, as the journal did better, we began to get a lot more papers that were of note. I think that there were two seminal events that happened during my year. One, when we paid the society $50,000, and there's a picture of myself handing it over to the treasurer of the society, so that we became sort of very separate, and Jack insisted on that because he didn't want anybody interfering with it. And the next thing that happened was that we decided to become self-publishing. At that time, we were published by Williams and Wilkins, and we told them one night, or I did, that we were going to go self-publishing, and the guy said, well, we'll buy you. And I said, how much would you give us? And he said $250,000. Well, at that time, we didn't have much money, and that looked like a lot, and I said no. And I went back and told Jack, and the next morning, that guy called up and said, how about $500,000? And my thought was, if they're going to pay us that much, they obviously think the journal is going to do well, so we decided no. I was reminded today by Donna Tilton, who works for the journal, that actually four months later, they came back to us, and they went all the way up to a million dollars to buy the journal, which we did not do, and it turned out to be a rather good idea. So that was something that was good. A second thing that happened that year was, we were not as well-known as the JBJS or CORR, etc., and sometimes people, particularly those with academic backgrounds, would come and present a paper, and then they would take the paper and offer it first to the JBJS or someone else. We had a rule saying, if you presented a paper, you had to send it to the journal, and people just ignored it. So that year, I was president of the Board of Trustees of the journal, and I was president of the AOSSM. So I had a discussion between the two presidents, and we decided at that time that we would make this a hard and fast rule, and we actually said, if you do not send it to the journal, you will not be allowed to present a paper for the next three years. Not one single person went against that, so it ended up being a pretty good thing. The last thing that I'll speak about, during the time of my presidency, a man named Tom Nelson was our executive director. He'd been there about six or seven years. He was superb. He was so good that the academy stole him from us, and he had organized the infrastructure so that we actually had it. It was very interesting, because as the president, you think you know what's going on. As a member, you hope you know what's going on. The fact of the matter is, I didn't really know all that much, because Tom was handling it, and when he left, there was a real void for a period of time in the infrastructure of the society. It was then that I really understood that to get things to run well, you've got to have an executive director that's good. It's probably no great secret, even to people who are sitting in the audience, that the next few years that we had an executive director, things did not go well, and finally, things did go very well with the hiring of other people. It was interesting at that time to suddenly realize what was going on, and that you need the infrastructure to have a society which is successful. It's quite clear, just to look at it from the audience perspective, that the idea of submitting your best research to the meeting and then having to submit that to the journal has clearly elevated the journal and elevated the meeting quite clearly. The other thing is, just to re-edify, there's a clear independence between the functioning of the journal, which is independent and does its own processing papers, and from the meeting itself from AOSSM. That model is superb. I can't hear. I'm not hearing it. I was just reiterating, just summarizing a little bit what you said, Dr. Leach. I can't. What you said, he was just paraphrasing. Right. Okay. So, yeah. Go ahead. Joe, 42nd president, 2013 to 14. Being program chair is fantastic, but my proudest moment as an AOSSM member was when I served on the nominating committee that nominated you for president. I'm not sure Mars would have ever been NIH-funded without your advice and counsel as we were submitting our grants, so I have a personal debt to you. Some of the challenges you faced as president, I think you had some fellowship issues that year that bubbled up. Tell us a little bit about your experience as president. So there were really two major things that happened the year of the presidency. The first was there was a collaboration with the academy to build the new academy building and to build the OLC, and there was a tremendous amount of negotiating that went on about who was going to be involved and what the costs were going to be, and I have to say Irv Bomberger, who was our executive director then, was just phenomenal. And as Dr. Leach said, you really rely on the other members of the presidential line, but also the executive director for sort of the nitty-gritty things that you may not know how to manage. So we got through that whole process. But the other thing that happened is just before the academy meeting that year, the ACGME announced that they were going to restrict the ability of non-academic fellowships, which meant fellowships that were based in private practice, which were clearly academically involved from having fellows. And it just exploded. I mean, it was a very trying time, and we had a representative from the ACGME who came to the Board of Specialty Societies meeting, the COD meeting, and we spent a lot of time trying to figure out how to continue to allow really high-quality fellowships that were not based at universities to continue to have fellowships. And I think the smartest thing that I did that year, I had to find someone to start a task force and work on this and get all of the opinions and figure out what we had to do, and I picked Jeff Dugas. And I had known Jeff as a resident. I knew he was someone who could work with different groups and consensus build. And I thought it was really critical that year that it not be someone from a traditional HSS or Pittsburgh or UVA or other places, that we needed to have someone who was from a really, really powerful non-affiliated sports medicine program. And Jeff did a phenomenal job, and over the two or three years that followed, that all kind of quieted down, and the ACGME recognized that we have real high-quality programs. But it was really based on other specialties. There were neurology programs who had one neurologist in private practice who had a fellow, and they kind of were clamping down on that across medicine. And then the sports medicine fellowships got caught in the crossfire a little bit that first year. Yeah, there was a lot of anxiety around those times. Yeah. Clarence, 30th president, you handed the Rams off to us in St. Louis, then every time I saw you for the next five years, you'd just shake your head and say, same old sorry Rams. I'm going to be a little more colorful than that occasionally. We got a couple of good years, and then we sent them back to you. And they were pretty sorry when they showed up in LA, but they've had a decent run the last couple of years. Yeah, I think we have to thank the referees for that last four times inside the one penalty. But we did win. We came out with a W, so that was a great thing. What were some of the issues you faced as president? I think you had some editor and journal issues bubble up your year too, didn't you? Yes, they did. My friend, Dr. Leach, said, I'm retiring and you need to find another editor. And I said, excuse me? And he said, you heard me. I'm retiring and you have to find another editor. So that was in July, and it was really, we were scrambling around trying to figure out how we're going to do this. How do you replace an icon? Somebody that we all looked up to, somebody who has done a tremendous amount of labor for our society. And we started a search, and it took quite a while. We had to get an ad hoc committee as well as the board members to try to figure out who we should pick. And it ended up, as you well know, we ended up picking Bruce Reiter. And obviously, it's been an amazing journey for our journal, which we only had one at that time. And then it just continued to go, as you saw the slides from our president's presentation yesterday, we're doing very, very well, but it's a moving target. The other thing, and as Bob had just mentioned, we were self-publishing. So that was the next hurdle. We had to find somebody to partner with who could make us go from a family operation to a small business operation. I had to make several journeys down to speak with Dr. Houston about the concept, and believe it or not, I was pretty nervous that he was going to be very opposed to it. But he wasn't. I knew that when I spoke to Bob Leach that we could do this. So we had to interview a bunch of companies trying to figure out, dumb orthopedic surgeons, what's a good business model for your journal? And obviously, we didn't know, but we sort of put our heads together. We did get some coaching from Dr. Leach that he thought that this was the right decision, and it was time. So that was another hurdle for me. The next thing that happened was hard to imagine, it's been that long, was 9-11, and that sort of took the wind out of our sails for a while. After we got a new editor, no longer self-publishing, and then we moved forward, and then 9-11 came, and then we had started, some of my predecessors had started the movement for us to become, have our own specialty boards. At that point, we were pushing to get a CAQ, which the academy was vehemently opposed to. I learned a lot about other societies that had specialty boards. I could not believe it, but pediatrics had one. Family medicine had one. Even the ER people had one. So my assignment was to go to talk to each one of the chiefs or the presidents of those societies to get approval, because we needed a quorum. And Irv sort of coached me about who we should meet with, how we had to parlay the fact that we needed to get our own boards. So at that point, we got very close. We had a bunch of meetings with a lot of people in different societies, and we got a quorum. And then my tour duty was over, and then we passed it on to Pete Fowler. But it was definitely a very interesting journey when the academy was totally opposed to us. I got quite a few phone calls from leadership saying, what are you guys trying to do? You can't do this. This is going to splinter us. And well, the train was moving, and we all thought that this was the right decision. And obviously, it was, because we have our own boards now. But it was not an easy process, and a lot of people, I didn't start it, and I got it almost across the finish line. But Pete got it across the finish line. But it was really something that I know we have a different relationship with the academy now than we did in those days. But it was definitely an adversarial relationship when we wanted to have our own boards. So that was kind of my year in a nutshell. Great. Thank you. A reminder to send questions to the moderators on your phone app, if you have something you want to ask them. Bob Stanton, 39th president, 2010 to 11. Your pathway to president, as you and I have talked, may have been a little different than some of the others. Maybe comment upon that. And then your presidential address, you focused on ethics. Right. You're right. I sort of started in a different path. I got involved with the AOSSM because of that gentleman sitting two seats away from me, Bob Leach, who came to Yale when I was a resident representing the ABOS to certify our program. And for those who don't know, Bob was and still is a superb tennis player. Won some national titles, as I recall, and doubles with his son, Michael, who made the round of 16, I think, at Wimbledon. And we did a little paper together and we always sort of kept in touch. And then I volunteered to be a doctor for the Olympics in 1980 at Lake Placid Olympic Committee. And Bob was there with the U.S. Ski Team and he introduced me to Richard Steadman, who chaired this little group that took care of the U.S. Ski Team. And I was asked, would you like to do this? And it seemed like a great idea to me. And I figured I'd never hear from Richard again. And a few months later, his secretary called and said, do you want to go to Sölden? It was a little glacier town in Austria. And 35 years later, I stopped taking care of the U.S. Ski Team. So I was always a team doctor and I spent time taking care of teams. I did very little research, very little publishing. I was always too busy building a practice and taking care of athletes. And this became my family. I joined in 1983, I think. I think the meeting was in Williamsburg, Virginia. And people have always been nice to me and I've tried to return the same favor to them. And somehow I went when Bill Granite called me standing on the streets outside the Cow Palace in San Francisco at one of the annual meetings, he was chair of the nominating committee and with his real Harvard football stentorian voice said, you know, you've been nominated to be president. Do you accept? And I said, you have the wrong phone number. And eight years before this gentleman, Clarence Shield, called me with my skis on my back walking to the ski lift at Beaver Creek one morning and said, I'm chairing the nominating committee. We want you to be secretary and you're in the presidential line, which as he knows, you can't say at that point. Who knew that? He knew. So I did come at it from a slightly different perspective, non-academic. We did have residents from Yale rotating through our practice, but in my year, I was lucky. I didn't have any major issues. Jim Andrews has started the Stop Sports Injury Program in April of that year. And Jimmy is not here. It's the first meeting he's missed in 50 years. He ruptured his quadriceps tendon eight weeks ago getting off his boat. So he's home recovering and says hello to everybody we've been texting. So I got to be really involved with rolling out the Stop Sports Injury Program with him during my presidential year, which is a great, great program. We hired a full-time director that year when I was president. We no longer have a full-time person, but it's a great program and everyone uses it and it's become national. It's now gone on for a decade. And the other thing I did, and I admire Kurt for doing it, we hadn't had a strategic planning session in ages. So I organized a strategic plan and we used Tom Nelson, our former executive director, and the executive director of the Academy, who is a wonderful person, lives up in the mountains of North Carolina, somewhere near Walt, I think. And we spent a lot of time putting this together and to really put the guidelines for the society together for the next six or eight years. And now Kurt's done it again, which I think is really, really critical. So that's sort of my background. Bob, but you also spent some time, you also spent a lot of time on the publishing board. Correct. So how many years have you dedicated to being on the publishing board and publishing? So I was asked to chair that board, I don't know, eight, nine years ago. It's a five-year term. And I was, again, a non-publishing person. I spent some time writing, but very little. And I found it actually fascinating. First I learned a tremendous amount. Doug Brown was my predecessor and Chuck Bustrosius, who must be somewhere here, was my successor. And Dave Sist was one of my dear friends and mentors. And I found that you needed to have a different perspective as chair of that board to sort of look at publishing in general and not how you select a particular paper, but how you run our journals and make them successful. It's, you know, the flagship of this organization, as Bob has pointed out, and at one point was about a third of our revenue came from publishing. It's a little less now, but it's still vital to the organization. And it's how we make ourselves known. I challenged Bruce Ryder, you know, we now are represented in every continent. And he pointed out, I once challenged him, I said, you really have to go to McMurdo Sound because I want you to have Antarctica as one of our... He pointed out to me last night, he's checked the map and actually the southernmost part of Argentina, they claim a piece of Antarctica. So in fact, we are in every single continent. But publishing to me was absolutely fascinating. I really enjoyed doing that task. And I met lots of wonderful people all over the world just from having that opportunity. How many years have you covered Fairfield University? 41. So for 41 years, you've been the team physician there? Correct. On the sidelines covering Fairfield University. On the sidelines. That's what Sports Medicine is all about. I think just, I won't take much more time, but one of the real problems for the future of this organization is that, you know, everyone here is team physicians, but almost everyone in this room are team physicians. Some of the young doctors I talk to, they want to be team surgeons. They don't want to be team physicians. And maybe they're smarter than I was, but it spends a lot of time. Jo went all over the world with USA Rowing. I mean, she didn't get paid to do that. She sat in locker rooms, hung out on lakes and rivers. But you know, it was really important to her life. Her marriage is based on rowing. That's right. And my husband was a coach who sent his athletes to Bob and Fairfield. That's correct. I think it's really important that people spend time, you meet athletes, you make friends out of this. Tim Taft told me this morning that several of his personal friends and his people he met just hang out in locker rooms and all of a sudden they became friends and stayed friends. Yeah. But before I ask John a question, I think that's a good introduction. And everyone on this stage has a long history of, and a rich history of team coverage at all, all the levels from high school through professionals. My wife called it the hobby and we all know what hobbies are. You spend a lot of time doing it and you don't necessarily get paid or make money from it. How did the people, how did y'all balance an incredible commitment to the teams and what that takes and the time on the sideline with your clinical practice and more importantly, your family and your family time? Because it's, I think you're right, Bob. It's one of the things that worries me about the future is whether or not people will be willing to make that commitment. How did y'all do it? Jo? So when I started, I had the opportunity to work with Russ Warren and Ronnie Barnes with the Giants as a fellow. And that just sort of set the stage that I wanted to do this. And then my first four years in practice, I helped Dave Altschek with the Mets and I was number three in seniority. So I covered all the weekend games, the doubleheaders in the middle of the week, all of that stuff. But my kids love that because they could go to the doctor's box for the weekend games and eat all of the Cracker Jacks and hot dogs that they wanted. So they thought I had the greatest gig in the world and were quite disappointed when I stopped doing that. I got involved with running through Tim Hosey who became a really dear friend. He passed away a number of years ago. But Tim had been a rower at Harvard, had taken care of the national team and asked me to be involved. And the beauty of that was that we only traveled once a year for two weeks. So you dealt with people's issues around the country or they would come and see you, but it was not as time consuming as being a high school football doctor who's on the sidelines every Friday night. So that was actually pretty reasonable to do. And then as my kids got a little older and the WNBA began, I worked with the New York Liberty for 15 years. And again, I think I had a good balance because it wasn't a year round sport. We started in April and we finished in September. My kids were a little older, they enjoyed coming to the games. So I think the sports I worked with were a little easier than being a college team physician where you're essentially on call the entire school season or someone working in the NBA or hockey where that goes on forever in terms of the length of the season. But I loved rowing and I loved basketball and I loved taking care of those athletes. And so it was fun and it was obviously fulfilling when you when you worked with them. But it was just fun. I'll let John say something, then Bob, you can. Well, I think that sports were an important part of my life growing up. Some of my best friends are my old teammates. And so when I started to get into a practice, I just considered team physician and team coverage a part of my practice. That was what it was. That's what I did. Now, fortunately, I worked in an institution where I was salaried. So if I went away for a weekend, it wasn't like I was losing money, not operating or something. That was a part of my practice at the Cleveland Clinic, although it got to be a little testy because I wanted to get paid the same as the joint replacement surgeons. And I was working just as hard as they were and I'm working on the weekend. My chairman, he said, well, they bring in twice as much money as you bring in. Well, it went all the way to the board of governors for the Cleveland Clinic. And he said, look, sports are important to the Cleveland Clinic. Bergfeld's involved with these pro teams and you're going to pay him the same as you pay the guys that bring in all the money working in the operating room all the time. So I was very fortunate to practice in that kind of practice. It was a part of my practice. The other thing, though, I didn't participate in time-consuming hobbies like golf and tennis. My friends all now, I go shooting and duck hunting and everything. I said, Bergfeld, you started this too late in life. I didn't do that. It really took up a lot of my time. Team coverage during the week with the pro basketball and the pro football was every single weekend. Luckily, I had a wife who understood all this, who is a superstar herself, but we had dinner at home every night during the week. And luckily, I had two girls. My two girls know all the women's stores in Cleveland. They participated in sports somewhat, but luckily it wasn't, I didn't have to be going to all their sporting events. So I sort of lucked out in my practice, but it meant a lot to me to be a team physician. I enjoyed it. I just considered it was a part of my life to do that. And it was a part of my, and I luckily practiced in a good place. The other thing was, we're all teachers if you're involved in education with residents and students and everything. And as a teacher in sports medicine, we were in the clinic, we were in the operating room together, but we were also in the locker rooms and on the sidelines. And that was the one thing that I could give to the residents and fellows. I'm gonna let you see what it's really like to be a sports medicine doc. And that was an important part of my life. One of the things I really feel fortunate to be able to influence young residents, surgeons in something more than just the operating room and the clinic. The clinic, the sidelines of the games and locker rooms. Bob, were you gonna say something else? They, both of the speakers have said that they enjoyed it. And I think that was the thing that I found in taking care of teams was that, I think immediately, you know the people and if successful, of course, it's easy to enjoy it. If less successful, you work at it. But it was, I think, fun. The first big team I took care of was the Celtics and Bill Russell was the coach and because he was a iconic figure, I was scared to death of Bill Russell. If ever you hear me saying he and I were friends, we weren't because I never spoke to him. He would come sometimes, he'd say, hi, doc. I'd say, hi, Russ. And then I'd sort of hang my head and hope that he wouldn't say anything. The rest of the team and so forth was fun. But I think the basic concept was that you realized you were doing something that had an effect. People were getting better or staying better. And friendships grew up that were sort of snuck up on you when you'd be with a team for a couple of years or in college, you would realize that you were watching people grow up and you would enjoy the process almost the same as if they're your kids, it's not the same. And I just found that it was an enjoyable thing. And I remember the first great lesson I got taught was by a man who asked me to become the physician for the Celtics. And he was taking care of the Red Sox and had done some other work. And he said, the first thing I wanna tell you, Dr. Leach, is when you go in the locker room, he said, they have no interest in hearing about the fact that you accepted a pass against Rutgers. That's not in their vocabulary. All they're interested in is are you gonna get me better? So the first lesson I learned was, you're not playing, you're a doc. Clarence, you and I each did the Rams about the same, worked with the team about the same number of years. We'd have to see who watched the most losses. But how did you transmit what you learned from the sideline? Did that have value to your practice as in the other people you're taking care of? And how did team coverage impact your life? How did you balance it? Well, obviously it requires a wife who understands, who realizes how important this is to you. And as Bob said, it was always fun to me. And I think it absolutely helped me to gain the trust of the players by being around them. And then it carried over to other athletes. If you understood what you do as a defensive back on a cover two situation, you tell them, when do you feel this pain? And they said, you understand what cover two is? I said, yeah, I do. And so you begin to realize, you learn a lot from them. And by going to the, sometimes if the coaches let you in, I must admit, my coaches were a blessing compared to what Bob was talking about. They would have no issues with me in terms of, doc, tell me when they're ready. I don't want a wounded player out here. And I said, don't worry. If I tell you it's the best thing I can do for them, that's what we're gonna do. And I will let you know when they're ready. I started with Coach Knox, I had John Robinson, and it was really, I didn't realize at the time how fortunate I was, but it was the kind of thing that you realize part of what we do is to build trust with the people we take care of. I know that the players would not have trusted me if they only saw me on game day. So being around them, you have a whole different relationship. And I've taken that to taking care of high school kids. When the Rams left St. Louis, and left LA to go to St. Louis under Rick's arm, I had some free time. So I started working with some high schools. And it was funny because they didn't understand why I was standing there on the sidelines. After a while, when somebody got hurt, they realized it. But then you realize you have to build the trust with them. Just showing up isn't enough. And that also is something you try to teach the fellows, because every case that you do is not gonna turn out right. And you can get through a not so good result if the patient really trusts you and they feel that you have their best interest at heart. And it's something that I learned from being in the locker rooms. So it really did have an impact on how I take care of patients. So Rick and Clarence, I think I have you beat on losses. 1991 to 2008, Vanderbilt did not have a winning season. We did well between 2009 and 2014. But one of the things, Berge, you taught me was, there's nothing that ruins your outcomes like follow-up. And there's nothing that makes you a better surgeon or makes you a better team physician than having follow-up. So as a team physician, you have returned to play follow-up because you're gonna see whether they get back or not get back. And I think that aspect of being a team physician and having to make a decision and having to live with that decision just didn't walk out of your office and not come back. You had to see how that player reacted and you actually got your follow-up on return to play. And I think that's a real advantage of being a team physician because you actually know exactly your follow-up and return to play. Berge, do you wanna comment on that? Well, there's no question. I say there's the guy who gets a bad result, the patient never sees him again. If you have a bad result, you're gonna see him every Wednesday, every Saturday, every Sunday. I think it's a real responsibility to be a team physician. You have to accept that. And as everybody here has said, you have to be in the locker room, they have to understand you. Now, I got involved with the Cleveland Ballet. Now, I'd never seen a ballet in my life. And Lyle McHaley, the director of the Boston Ballet came to Cleveland and he asked him, he said, well, there's this guy Bergfeld takes care of athletes, maybe he would help. So I got a call from the director of the Cleveland Ballet. We were looking for a physician. So I went down and talked to him and I saw all these people doing the things that they do. I went right out to the library and got myself a book on the ballet. And my wife said, what are you doing? I said, I'm learning about the ballet because the worst thing in the world would have been to go down there and see a dancer and not speak their language. I learned a whole new language in three days. And that's what helped me because I could tell the dancer, get into this position and that position. And I learned my first couple of months with the ballet was very, very interesting, but it was a learning experience for me. One other little sidelight of being a team physician and being involved with a team, whether it's your community, if it's in your high school community, everybody in the community is gonna know you if you're on a big time, taking care of a big professional team, everybody knows who you are. And at one time I was a candidate for the department chair at Cleveland Clinic. And I really kind of wanted to do that. I was interested in academics and I was honored to be concerned, but I didn't get the job. And one of the members of the board of governors called me that night and he said, John, I know you didn't get the job as a chairman. I knew you really wanted to do it. He says, but more people in this town will remember you as a Browns and the Cavs doc than ever you as a department chair. And I can tell you now my practice average age is Bergfeld, I know that name. Weren't you the doctor for the Browns? And it's really neat. It's some little side benefit that you get, whether it's your high school community or college community, it's being a team doc was a special reward that I got. Can I say one more thing about just the word team. So we all learned as sports medicine doctors, how to be part of a team, taking care of teams. And first for that, team means you, it means the athletic trainer, it means the coaches, it means the athletes, it means the strength and conditioning. It really is a team. But I've always run my practice just the same way. And I tell my staff, we're only as good as the very first person the patient sees walking in the door. We're a team. I could be the world's best doctor and if they don't get an appointment because they call on the phone and they sit on hold for 10 minutes, or if they walk in and their registration process is annoying or if the medical assistant isn't getting people in the room right away. So, and then this society, which made it special for me, we're a team. Everyone works together, nothing happens here. Kurt pointed out this morning with the presidential line, he did a great job running this organization, but he did it with a team of past and future presidents. And so the word team to me has always been important for multiple, multiple reasons. Yeah, Kurt and Cassandra and I really wanted to make the theme of this meeting teams because we feel it's a distinguishing, one of the distinguishing factors from this specialty society to any other in orthopedics. And I think you're right, Bob, you're exactly on point. John, you were the 21st president. Like you said, you've had a great long academic career and I know training Kurt was probably your biggest challenge or struggle. Believe me. But I think you had some controversies when you were president, you tried to change the name of the organization or were involved with that process. You had committee chair time limits, you put in a fellow, you made the old people mad, you made the young people mad with the fellows exam. So you got everyone wound up that year. So tell us about it. Well, the title of my presidential talk was from adolescence to adulthood, prepare for leadership. That was the title of my talk. And we did a lot of things in that year and the years setting up to it, my predecessors and those who followed. But first thing we did was revise the bylaws. And revising the bylaws takes a lot of work. We put together the committee structure that you now have. People have a term, before that you were appointed committee chair just when somebody decided to replace you. Now everybody has a term of office, the committee members have a term and you can get reelected, but you still have the term. So we put in bylaws. The other thing we did is we coordinated the recruitment of research funds. We had a foundation for sports medicine, education and research, FSMR as we call it. That was how we as AOSSM raised money. We coordinated it with OREF. So now we're integrated with OREF. And that was a big move because we didn't wanna give up our independence, but people realized that that was probably worthwhile. We were breaking away from the AAOS. I think I can say that. Because AAOS was trying to dominate us. We would put on courses, they would send people. We put on our own first postgraduate course in Tucson, Arizona with Champ Baker as a chairman. We didn't include the AAOS, we did it all ourselves. And that was in that year. We combined the team physician course, which survives now, the team physician course. And what was great about it, we combined it with the ACSM and AAMSSM and the orthopedic society. And as you talk about teams, the primary care docs are our teams when we're team physicians. And that, one of the things I was very, very proud of, John Lombardo and I were co-chairs of that, and it exists today, and it's well attended. Under Drave Drez, we gave the first written exam to the fellows, and that was at Sun Valley, in the room, and they came in and they had to take a written exam. There was a lot of people who were upset with that, but we felt we needed to find out what our fellows were doing and were we teaching them right? And that sort of led open to, and you've already talked about this, but we kept the door open to continue to apply for the Certificate of Added Qualification, is what it was called then. And the family practice guys already had it. We didn't have it, we were way behind. And there was a tremendous, there were several of the more senior members of the sports medicine societies, we don't need that, that's a waste of time. Can you imagine now what it would be like if we didn't have a Certificate of Subspecialization? But there was tremendous resistance against it, not only from one of the more senior members and our younger members, and also the Academy of Orthopedic Surgeons, but we kept that door open, and that was one of the things I was pretty proud of. Everything didn't go really good. I've always felt that we should be combined and be closer with AMSSM. And at my presidential year, we arranged for AMSSM to have their meeting, and then a day between, and then our meeting, and we would have the interchange. Well, it didn't go well with our members, it didn't go well with their members, and obviously now they don't have that. So we weren't successful in everything, but I do feel we did progress from adolescence to adulthood prepared for what you see here going on now. I think a lot of the grassroots of that were settled in my years. So Joe, when you look out and you see a room this big and you see the crowds we've had these last three days, did you ever envision this when you first started attending and we were putting boards on an ice rink in Sun Valley for the chairs? But what are some of the risks and what are some of the benefits of this growth that we've seen and as we continue to grow? Well, it's a story a lot of people have heard, but my first AMSSM meeting, there were six of us, six women, sitting in the back of the room, and John Fagan came up and took a picture. He thought it was awesome. He took a picture of us in the days where you had to print it and put it in an envelope and mail it, and he mailed it to all of us. And it was sort of the beginning of realizing that we could be part of this organization. And so I think the growth of the organization across has been really important. I think it's gonna be really important going forward to continue to engage the members. And one of the things we talked about this morning is kind of reinforcing to everyone who's out here, whether you're just finishing your fellowship or whether you've been in practice 20 years, is that this society survives and flourishes because of the membership. And the only way to keep it growing and changing over time is to have new voices and new thoughts. So just a plug for the committee folks, get involved. I got involved in one committee earlier on, the question writing committee, which no one wanted to do, and so it was an easy one to get involved with. And then you get involved in another and another, and you suddenly realize that you can play a role in this organization that when you first sit in the back of the room, seems like something you can never be a part of. And so I think it's critically important for the continued growth of the society to maintain the friendships. Hope everyone comes tonight and has some fun at family night. And to stay involved at whatever level you feel comfortable with, reviewing for the journal, doing other things, because then you come to this meeting and you see your friends and you get to have fun and you see your own fellows and the people you trained with. And I think it's a really unique society for all of those reasons. Great, which reminds me, Cassandra Lee asked me to make an announcement of all the women members and attendees would meet at the International Center in front of the AOSSM 50 year sign, so we can get a picture. And that'll be at 1145 when this session ends. So that's great. Bob, I know, Bob Stanton, I know you've spent a lot of time and we've talked about how with growth, you still have to make it personal and relevant. I mean, do you have any thoughts to add on to what Joe was saying? I do, and actually I was gonna emphasize what she said because again, just get involved. I mean, for me, it was the exact same thing. I volunteer for what was called the liaison committee. We had our first meeting at the first Sun Valley meeting and that became the COD. We all got together, Fred Allman, who was from Georgia, said, and he had been a past president, felt the members should have involvement in the organization. It shouldn't just be the board of directors, the old farts running the organization. And we met then and it was rather controversial and Fred, to his credit, who was a little pistol of a guy and funny as you can imagine, and it became the Council of Delegates, which is really important in running this organization. And I think you just have to volunteer. Everyone can get involved. I mean, I shouldn't be on this stage and I got here, God knows how, but it's just because you volunteer. I think this is a great family and I encourage everybody, young and old, particularly the young people, we want you to be involved. And Kurt pointed out this, I think it was Kurt that pointed out, one of the, at our president's meeting, how for the first time this has become, you can see more young people being involved and it's not just the old timers who are sort of running the organization. It's the future of this organization. So I would emphasize what Joe started off with. It's really, really important. I would want to just echo, Joe, no one still wants to go on a question writing committee. Trust me, you have to resign now, so. But- Good place to start. And I never volunteered for that one. As a member here, you should not be afraid to call another member for help. And if you looked at what Jim Bradley said, when Jim Bradley started out young in 91, he called a lot of senior people for help. And I did the same thing when I started out in 91, called a lot of senior people. So if you're a young member, don't be shy. Find someone that you can call for help that's more senior or I shouldn't say help, advice. And so sometimes you get advice from three people and you get three different opinions. That means you can do what you want because they don't know what you're doing either. But so it should be a collegiality and that's the culture of AOSM. You should be, find someone that you can talk to, find someone you can call, find someone that can help in your practice. And I think that's one of the intangible beauties of this organization. Yes, John. You know, being a team doc, I learned so much being a team doc from the sidelines. And I remember when I was at the Naval Academy, Dr. Houston told us a posterior cruciate ligament was the keystone of the knee. And if they don't have one, they can't function. So I operated on not a lot, but a fair number of posterior cruciate ligament injuries. And at the Naval Academy, I have 100% follow-up. They did not do well. They had loose knees. They had this big operation. I even used a medial meniscus to reconstruct the PCL. Well, I was really worried. I said, now, and I got involved with the Cleveland Browns. What am I gonna do if one of these Browns players tears this PCL? As I went around the league, I asked each of the team docs how you get together before the game. And I said, what do you do for a PCL? Vince DiStefano said, take a look out there. There's three guys playing with no PCL. I said, what? So he said, I'm not kidding you. They have posterior cruciate ligament injuries in their playing. I came back and I did the exam. Sure enough, we had three players on the team that had isolated PCLs. And I got very, very involved and wrote a paper with my fellow Jim Paroli. We pulled back all our PCLs that we were involved with. And guess what? I found out that maybe you didn't need to operate on all of them. And that was very, because I certainly saw a fair number of them as high school kids and college kids that I would have operated on had I not had the expertise of the sidelines of talking to a team doc who really knew what he was doing, at least as far as that was concerned. So there's a lot can be learned by talking to your fellow team docs around the league that you go with, because they're faced with the same problems that you are. And lots of them have solutions to the problems and you may have some solutions for them. But that was one of the other benefits of being a team doctor was the educational aspect that you just can't quite get in every forum. Joe. That just made me think of this concept of sponsorship. And I remember as a first year person with the Mets going down to training camp and Dr. Jobe invited me on a tour of the facility. And Dr. Jobe was this incredibly famous guy. And I was like in my second year of practice. And we sat and we talked for probably three hours. And he just said to me, you know, if you ever have a problem, feel free to call me. And that sort of opens doors to the ability. I think he sponsored me in a way just for that one day that made a difference. And I think that's the reason not to be afraid to approach people. And by the same token, it's critically important for all of us to continue to do that. A couple of young orthopedic surgeons met Dr. Leach the other night. They had just won awards. And they were just thrilled with the time that you took to talk to them and tell them about your career and ask about theirs. And I think that's something can happen on the sidelines. It can happen over coffee. It can happen in the gym. Just important to keep doing. Bob, any idea how many people were in the audience at your meeting in 83, when you were president in 83, 84, your annual meeting? Actual fact, no. It was the Olympic year. And remember, we met in Anaheim. And about six weeks before the Olympics took place. I was the head physician for the Olympics and I was the president. So it was kind of a busy time. Triple M, to give you an idea of how sports medicine was progressing. Remember, in the seventies, you've got all sorts of running. You have Title IX coming in, I believe in 1972. And suddenly you've got all sorts of women athletes. And particularly for me at that time was Joan Benoit, who was a close personal friend who won the marathon. And so Triple M came in to us and they'd had nothing to do with sports medicine at that point. And they talked to Tom Nelson and then to me. And they said, we'd like to sponsor your meeting. I said, well, that's nice. What do you mean? They said, we want to pay everything. So they actually planned, paid for and did the meeting. Now, in fact, it proved to be a very successful meeting, but my guess is probably there was something like 700 or something there at most. It was very successful for the time, but we're kind of a struggling group. And I do think that we got a fair amount of notice because they did write up a number of times that there had been this meeting in Anaheim. And so I think it was good, but at that time we did not have the power or the presence that we had had beforehand. And if anyone had ever told me that this society would grow to what it is, I would have thought, well, that's like me saying I'm a good friend of Bill Russell's. It ain't gonna happen. If anyone has any questions, send them through. John, you've been to all 50 meetings. I think you told me the other night. Yeah, yeah, I have. I went to the first meeting when this society was formed. I was in the Navy and they sent all the orthopedic surgeons from the Baltimore, Washington area to the meeting in Las Vegas. And somewhere I saw, this is 1972, I saw a sign that there was a sports medicine meeting going on. So I thought, well, I think I'll go there. And the meeting was the meeting when the originators had their very first meeting at the Academy of Orthopedic Surgeons. And I was not a member and I sat in on that meeting. And I've been there, been to every one since then. And that meeting, the whole time they talked about how they were gonna get away from the AAOS because they were originally a committee of the AAOS. This society was a committee of the AAOS and AAOS did not wanna get rid of it. The leaders, Jack Houston and Donna Hugh and Fred Allman, they wanted to establish themselves and the whole time was spent talking about that. And malpractice insurers, how you got malpractice insurers. I remember Bill Allen telling me about how he was the treasurer. And he would collect the dues at that meeting. He came home with a whole pile of cash. I happened to have dinner with him when Jim had the first past president's session at a board meeting and it was in Arizona, Phoenix, Arizona. And I sat with Bill and he told me this whole, and his wife said, we were counting up money and trying to figure out who was a member and it was hysterical, you know, the other. I suspect that many people know this, but the initiating factor getting together was the fact that Dr. Houston in particular was angry because he had submitted papers to the Journal of Bone and Joint Surgery and they'd never been accepted. Dr. O'Donohue, who was the only person who was in academic life at that time, who was involved in sports medicine, he wrote a book and they got together and said, this is just not right and we can't get our papers published. So that was when they decided that they ought to get a society and they were smart enough to say, not only that, but we should get our own journal. But it was this anger with the fact that they were being shortchanged by the academy and particularly by the Journal of Bone and Joint Surgery and also clinical orthopedics. So that's kind of the beginning of that and look at the acorn, what grew from that. Yeah, quite a history. So I show 11.45 if anyone has a final comment, but if not, we'll close this session. I hope you all enjoyed it as much as I did and a huge thanks to these five heroes of our profession and society. So thank you very much. Thanks, Rick. Thank you. Thank you. Let's get it.

past presidents

AOSSM

experiences

contributions

organization

growth

strategic plan

committees

partnerships