History of the HOA – From Dr. Don Jones in 1991

HISTORY OF THE HAWAII ORTHOPAEDIC ASSOCIATION

The birth of the idea of the State Orthopaedic Association started during the course of an Orthopaedic Journal Club in September of 1972. This Journal Club was hosted by the then Chairman of the Section on orthopaedic surgery at the University of Hawaii and Head of the University of Hawaii Orthopaedic Residency Training Program, Dr. Lawrence Gordon.

The thought that a State Orthopaedic Association was needed was advanced by Dr. Gordon and others because of a telephone call from the American Academy of Orthopaedic Surgeons indicating that the State of Hawaii needed to appoint an orthopaedic surgeon to act as the “Councillor” for the State of Hawaii on the New Board of Councillors that had recently been formed by the Academy. In addition at that time, the“local orthopaedic group”was participating in a revision of the relative value fee schedule. During the course of these negotiations, it had been pointed out that the Hawaii Chapter of the Western Orthopaedic Association, that was in place as the “orthopaedic organization” in the State of Hawaii at that time, did not really represent all the orthopedists in the State. This was true for several reasons. Firstly the Constitution/By‐Laws of the Western Orthopaedic Association provide that a physician to be eligible for membership in the Western Orthopaedic Association, had to be board certified. Secondly, there were in the State at that time, at least one orthopaedic surgeon who

was board certified and who had applied and been turned down for membership in the Western Orthopaedic Association because he did not participate in the Residency Training Program. Thirdly, there were physicians in the State at that time who were practicing orthopedics who were neither board certified nor even board eligible.

Therefore, at that initial meeting, it was decided that we did indeed need a State Orthopaedic Association. Secondly, it was felt that this new orthopaedic organization would be the “political organization” and be incorporated in the State and under Federal statues asa 501C6 group. Thirdly, the Western Orthopaedic Association Hawaii Chapter was going to be retained as the “scientific or professional organization” and continue to be incorporated asa 501C3 organization under Federal and State statutes. Fourthly, a Constitution and By laws committee (C&B) was appointed consisting of Drs. Akira Kutsunai, Robert L. Simmons and Donald A. Jones with the latter being the chairman. Fifthly, the relative value fee schedule negotiating chairman would continue to beDr. Ichiro Nadamoto and finally our councillor, Dr. B. Allen (Buster) Richardson would be reappointed for another term.

The Constitution and Bylaws committee was not very expeditious in doing their job. The Academy of Orthopaedic Surgeons Executive Secretary, D r . Charles B. Heck was written for help in obtaining bylaws of other State groups to act as a model for our Bylaws. Dr.Heck wrote back on September 11, 1972 stating that such Bylaws were difficult to get and that the Academy had none. He did call Dr. Robert Mussey, who after appropriate approval in his group, sent us a copy of the proposed Bylaws for the new Illinois Orthopaedic State Association. TheIllinois Bylaws were received in October of 1972 but was not until April of 1973 that the first step in developing our own Bylaws took place. At this time, the chairman of the local C&B Committee, “Hawaiianized” the Illinois Constitution and Bylaws, as the first draft of the proposed C&B of the local state organization. Between June of 1973 and May of 1974, 5 drafts of the proposed Hawaii State Orthopaedic Association Constitution and Bylaws were done. The majority of this work was performed by the chairman and the secretarial service was performed by Mrs. Jean Idemoto of the Straub Clinic’s Department of Orthopaedics. Committee input was accomplished by mail and telephone during this 11month period.

On August 7, 1973 Dr. B. Allen Richardson made his first report as the councillor for the State of Hawaii. In this letter to D r . D o n Jones, he indicated that the Board of Councillors had had approximately 2 meetings and was still discussing what role this Board of Councillors would have in the American Academy of Orthopaedic Surgeons. It was felt that it possibly should be an advisory body or maybe even function as a policy making body of the Academy, acting then in the same capacity as the House of Delegates does in the American Medical Association. Be that as it may, he indicated that each state had at least one councillor and that the larger states like New York and California had as many as 8. It was their primary objective to identify any problems in state orthopaedic societies or with state orthopedists that appeared to be important to the local surgeons, so that those matters could be brought to the attention of the Academy Board.

After completion of the 6 drafts of the Constitution and Bylaws, the Hawaiian C & B Committee had a series of 3 meetings in April and may of 1974 completing the 7th draft and developing a list of proposed chartered members. A copy of the original worksheet of the proposed members indicating their interest in the organization and a notation as to whether or not they would be coming to the organization meeting is part of this document.  Included on that document as well is a resume of other allied health personnel and physicians who were considered but not extended membership in the new orthopaedic organization.

The Hawaii State Orthopaedic Association organizing meeting was originally scheduled forSeptember 18,1974, but for reasons not documented in available records, it did not actually occur until June 27, 1975. At that time, we had a get together at the Wisteria Restaurant in Honolulu w i t h happy hour and dinner followed by a bonafide organizing meeting.

An edited copy of Dr. Rowland L. Lichter’s minutes of that organizing meeting indicates that Dr. Akira Kutsunai acted as chairman. Those present included Drs. Bacon, Cicilio, Gordon, Grollman, Gulledge, Jones, Kutunai, La Follette, Lance, Lichter, Lindberg, Lum, Ma, Maruyama, Mayfield, Nadamoto, Nakamura, Nemechek, Richardson and John Smith (20).

At this first meeting, further revision of the 7th draft of the Constitution and Bylaws occurred. Then we approved an official list of the chartered members (numbering 37) of the Hawaii Orthopaedic Association. A copy of this document, exhibit 2, is likewise attached to this document.

Prior to the completion of that organizing meeting, there was the nomination and election of the first group of officers as follows: President – Dr. Donald A. Jones, Vice President – Dr. Akira Kutsunai, Secretary/Treasurer – Dr. Bruce F. La Follette, and re-election of our councillor, Dr. B. Allen Richardson.

The activities in early years included primarily professional meetings with or without preceding happy hour or dinner whenever a consultant was present in the State. It appeared that

the first professional activity was with the Tripler group. Dr. Bruce F. La Follette, Chief of the Orthopaedic Service had a consultant, Dr. Dick Smith, a hand surgeon coming in December,

1975. This meeting apparently took place, but there in no actual record documenting that this meeting actually was held.

In addition, the new association almost immediately got a note from Dr. Albert Chun Hoon an orthopedist and then the current President of the Honolulu County Medical Society asking for aid to set up a committee to review the 1970 State RVS schedule. This review was to be the basis of a newHawaii 1976RVS. Dr.Rowland L. Lichter chaired this committee along with his members, Drs. Gene Lance, Don Murayama and Gab Ma. At about this time, it was established  in the courts that a relative value schedule was against anti-trust laws and therefore all of the hard work of this committee was for naught.

I might mention at this time, that the other two big jobs of the officers of this new Association was to solidify the organization. By September 29, 1975 there were 34 dues paid members and our bank account was $850. The main holdouts were Drs. Behnke of Maui, Chun Hoon, Dodge, Gordon and Kong. The dues at that time incidentally were $25. Drs. Behnke, Dodge and Kong never ever became charter/founding members of the organization according to available documents.

The final activity of the organization was to complete the final revisions of the Constitution and Bylaws (8th draft) which was completed by December of 1975. During Dr. Lindberg’s tenure as president we were finally incorporated in the State of Hawaii.

At the first professional activity in December of 1975 the new Orthopaedic group dealt with the newly formed Hawaii PSRO group. Exactly what part our organization played in the formation and subsequent function of this group is unclear from our written records. It was noted that Dr. Winifred Lee was President of the Hawaii Medical Association at that time.

The second professional and business meeting of the Hawaii Orthopaedic Association was held on Wednesday, March 24, 1976 at Dr. Gordon’s home. The guest speaker was Dr. Vert Mooney.

The first annual meeting was May 7, 1976. The site of the meeting is unknown but we do know that the guest speaker was Dr. James R. Doyle speaking on “Newer Things on the Horizon in Upper Extremity Surgery” and the exciting field of microsurgery in hand work.

Attached to this document are a list of the past presidents of the organization and also a documentation of the past combined Western Orthopaedic and Hawaii Orthopaedic Association’s Spring Symposiums. We know the guest speakers and site of each of the meeting and when they were held.

It was noted during this presentation that at the current time there is not one charter member who holds an office in the organization, however, 2 of the 5 member awards committee for the best presentation at the 1991 annual combined symposium are charter members. Only 1 charter member of the organization is on the program this year (1991). This obviously points out that this organization clearly now is in the hands of the young turks and that there is still much work to be done. The Constitution and Bylaws as currently written in 1975 do not reflect the current way that the organization operates and need to be revised. It was suggested that the current president, Dr. Morris Mitsunaga, or the new president, Dr. Clifford Lau undertake this task as a project during their tenure as president.

It was also pointed out that this organization did not come into being without a lot of hard work from a lot of people. Among those are Mrs. Jean Idemoto of the Straub orthopaedic secretarial service who did all of the secretarial work in the early organizing period of the Association. The Straub Clinic in addition to providing the secretarial service also paid for all the postage (first class, then was only 20¢) for the first 4 years. The Tripler Orthopaedic service also contributed much support with meeting arrangements, announcements and preproduction and distribution of the Constitution and Bylaws. Once the president, Dr. Don Jones became Chief of Staff of the Shriner’s Hospital in 1979, his secretary Ms.Chloe Nakamura did the major part of the HOA work until she left the employ of the Shriner’s Hospital. Thereafter since 1985 it has been Mrs. Kathy Iwai (secretary to Dr. Lance in his research lab at the Shriner’s Hospital) who has been our first and only paid staff.

We first had technical exhibits 2 years ago in 1989, but have regularly had donations of cash and/or professional speakers courtesy of many organization such as Howmedica, Intermedic, Richards, and Zimmer, plus local orthotic/prosthetic corporations.

Therefore, this organization has grown from 37 members and 20 attendees at the organizational meeting at the Wisteria Restaurant to 70 members and 51 attendees at the Sixth Annual combined symposium at the Kahala Hilton Hotel. The future of the organization appears to be assured but it will continue to require significant individual effort on the part of orthopedists in this state of Hawaii.

This presentation was prepared and given at the Sixth Annual Combined Spring Symposium on June 7, 1991 at the Kahala Hilton Hotel.

Mahalo. Respectfully submitted, Donald A. Jones, M.D.

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