March 2021

Health Policy Committee Update

Paul T. Rubery, MD
Health Policy Committee Chair

Despite the impact of the COVID pandemic, The Health Policy Committee (HPC) has had a productive year to date, and looks forward to more progress in the coming months. The HPC has found “Zoom” to be helpful and we have had several well attended HPC conference calls supported and organized by Courtney Kissinger from the SRS office. There are three notable projects about which the HPC would like to update the members of the SRS.

First is a multi-year effort that started under the leadership of immediate past HPC Chair, Dr. Pat Cahill. As most SRS Fellows are aware, medical device use in the United States is regulated by the U.S. Food and Drug Administration (FDA). FDA approval is an important step in bringing new medical devices to market, and this can be a challenging and expensive process. Consequently, manufacturers are unlikely to pursue approval, and potentially unlikely to develop devices, with smaller market opportunities. This particularly impacts pediatric patients and their physicians, and is certainly responsible for slowing or limiting the development of new treatments for rare spinal deformities. The FDA was created by Congress and it is “reauthorized and funded” by an act of Congress every five years. Meaningful changes in the FDA’s policies and procedures are most likely to occur during the congressional reauthorization process. The next reauthorization period is in 2022. As many of the members know, the American Academy of Orthopaedic Surgery (AAOS) is supported by an office and experienced lobbying team in Washington through the auspices of the American Association of Orthopaedic Surgeons. Under Dr. Cahill’s leadership, the HPC has collaborated with POSNA to advocate to AAOS that the pediatric device regulatory pathway should be a focus of AAOS lobbying in the coming year. HPC members joined a call with AAOS staff, and as of this writing it appears that the AAOS will make this topic one of their key agenda items in the coming legislative year. SRS member John Ratliff, a neurosurgeon, was instrumental in gaining friendly support from the AANS. SRS fellows who are interested in supporting this effort are encouraged to contact Paul Rubery or Pat Cahill for more information. SRS and POSNA are continuing to collaborate on this effort, and are in search of both patient stories and families illustrating the need for reform.

The past decade has seen the globalization of the SRS and its committee structure. Partly as a result of the very “country-specific” nature of the political process, the HPC has remained “US-centric”. The SRS Board and the Presidential Line have asked the HPC to explore ways in which the HPC can begin to support advocacy for spinal deformity patients outside the US. This has been a major focus of our meetings in the last six months. HPC members joined a call with SRS Fellows from Brazil to learn about specific advocacy opportunities there, and came away from the call with a better understanding of the importance of world-wide advocacy, but also with a greater understanding of the complexities involved in advocacy in multiple countries. In a follow-up call, the HPC discussed meaningful steps the SRS can take to globalize our advocacy efforts, and we prepared a list of potential actions which will be reviewed by the Board.

The designation of June as “Scoliosis Awareness Month” in the United States is a traditional effort of the HPC. COVID hampered the effort in 2020, but we hope to recover and expand in 2021. The effort is “state by state”, and is certainly more successful when a state resident petitions their governor. There is a predictable rhythm in politics, and the SRS staff and the HPC have learned that rhythm with regard to Scoliosis Awareness Month. In late March and April, we will start the process of petitioning each state. If you have an interest in supporting the effort in your home state, or if you have a personal connection to state government that could aid in getting exposure for the effort, we would love to have your help! Several SRS Fellows in the past have had patients and families who were interested in supporting this effort, and in some instances, this has resulted in photos with the Governor, a win for the SRS and a thrill for the patient. Please contact Courtney Kissinger at the SRS or Paul Rubery if you want to support this effort.

Thanks to the Committee members and to Courtney Kissinger from the SRS office.


Chair: Paul T. Rubery Committee: Patrick J. Cahill, Past Chair; Brian P. Hasley; Pablo J. Diaz Collado (C); Fabio Ferri-de-Barros (C); Amit Jain (C); R. Justin Mistovich (C); Elizabeth P. Norheim (C); William F. Young, Jr. (C); Brian G. Smith, Chair Elect; Daryll C. Dykes; Addisu Mesfin; John P. Lubicky; John K. Ratliff; Joseph P. O'Brien, Advisory; David W. Polly Jr., Advisory; David B. Cohen, Advisory; Jordan Vivian, Liaison