Hubert Labelle, M.D., FRCSC
President, The Canadian Orthopaedic Foundation
Montreal, QC

The light at the end of the tunnel is almost blinding - and it's not an oncoming express train, either. Brace yourself! We've got good news for a change.  

Financially, the Canadian Orthopaedic Foundation is back on track. The turnaround is recent - and rather unexpected.

Last June, the outlook was decidedly gloomy, when we realized that revenues from the Toronto Hip Hip Hooray walk were going to be much lower than hoped for. (Although the number of Toronto walkers remained the same, the number of donors and the amounts pledged were much lower than previous years.) We put a brave face on it, noting that the Foundation was doing well elsewhere in Canada, that we were debt-free and that the remaining revenues were net income. Still, it was discouraging.

So what's the secret of our sudden success? A small windfall of unaccounted income as a result of the change to the Foundation's fiscal year-end gave us a bit of a headstart. Also, our bare-bone administrative costs helped the bottom line. But what really made the difference was a surprising amount of mail-in donations after Hip Hip Hooray. So many, in fact, we've almost made up the difference between the shortfall on the day of the event and our projected fundraising targets.

Aside from the financial boost, this public generosity is all the more heartening because it's spontaneous. Even though many people couldn't get involved on the day of Hip Hip Hooray, they still felt enough of a connection to the Foundation to donate. This is a nationwide response that deserves much consideration, since it would appear that we have a more complex relationship with our constituency than we might think. We're obviously doing something right, and it would be helpful to know what it is. At the very least, we should think about adding a message aimed at potential mail-in donors, when our mailing programme sends out the 2003 Hip Hip Hooray invitations.

On that score, I'm pleased to say that we're ahead of schedule in our planning. An electronic template of the 2003 campaign pamphlet has been sent out to event sites, so that the various organizing committees can adapt it to local needs and print it on site. A campaign poster is soon to follow. Our hard-working manager of fundraising, Barry Baker, is full of energy and optimism, clearing paths and building bridges. Indeed, we're so confident we intend to add 10 more sites to next year's Hip Hip Hooray, and the Toronto group has decided to hold two parallel walks: one downtown and another in the north of the city.

But we're not quite out of the tunnel, yet. Prudent growth and value-for-the-dollar must remain our guiding spirits. Not until we have more money in the bank, and that means not until after the 2003 Hip Hip Hooray, can we contemplate really strengthening our existing programmes and envisage new initiatives.

In the meantime, we have funded four research awards and provided financial assistance to ortho-paedic nurses, residents and peer reviewers, as well as increased local disbursements. This year, we allocated $40,000 to research; we'd like to double that amount in 2003. Also we've applied to the Canadian Institutes for Health Research for matching funds. If our bid is successful, we could see a fourfold increase in research funding.

One area we are determined to revive is our web site, so that we have a more visible education and social-marketing profile for our patients and the broader public. A professional designer who has volunteered her services is putting the finishing touches to a new look for our web site, and we will be developing content for this new editorial space. Eventually we hope to publish an authoritative guide for orthopaedic patients (preop, in the OR and postop), but for the moment, we'll content ourselves with launching an MSK "news service," which will summarize news items of particular interest to our patients.

At first we're going to have to rely heavily on US sources, but we hope that the COA membership will see the service's value to patients and the public, and feel inclined to contribute the odd item or provide the Canadian "voice" in response to a developing story. (The recent controversy over the relative benefits of arthroscopy for OA compared to placebo springs to mind, or the profession's response to Quebec's Law 114 is another example.) As the news service matures and an archive of brief reports accumulates, we hope word-of-mouth and interest will attract an ongoing readership.

If successful, the MSK news service will encourage a dialogue between the Foundation and the very community from which it is seeking to recruit patient advocates. The dialogue will also allow the web site's content to be responsive to the needs of the community. We think this exciting initiative meets the criterion of value-for-the dollar and will strengthen the Foundation's identity in the public and political arenas.

So keep your fingers crossed, the wheel of fortune seems to be turning in our favour for the moment. We seem to be on a roll.