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January 13, 2016 ACFAS.org | FootHealthFacts.org | JFAS | Contact Us

News From ACFAS


Simplify Your Life with ACFAS Marketing Toolbox
If your New Year’s resolutions include promoting your practice, head to the ACFAS Marketing Toolbox for easy, ready-to-use hacks that can help draw new patients to your practice and retain existing ones.

Within the past six months, we’ve added several new PowerPoint presentations to the Toolbox and also created a new Infographics section that features sharable and printable graphics on diabetic foot care, pediatric foot injuries and more. Additional PowerPoints and infographics are in the works, plus we’re redesigning many other pieces to give you a fresh perspective for 2016.

Visit acfas.org/marketing throughout the year for updates and make your resolutions a reality!
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New Paths Start at the ACFAS 2016 Job Fair
No matter if you’re an employer or a jobseeker, the ACFAS 2016 Job Fair (sponsored by PodiatryCareers.org) has everything you need to find the right candidate or position.

Take advantage of a resume expert on site in Austin to review your resumes and offer tips for marketing your job skills and experience. (By appointment only.)

Employers can post available positions through PodiatryCareers.org’s online career center and on bulletin boards at the Job Fair. Jobseekers should bring extra copies of their resumes to post on the boards as well. And remember, ACFAS members receive reduced rates on online job postings.

If you’re not attending ACFAS 2016, note that all positions and resumes received will be posted to PodiatryCareers.org before the conference.
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ACFAS on the Road in Houston
Join us in Houston April 15–16, 2016 for ACFAS on the Road: Complex Forefoot Surgery with Advanced Solutions and learn new treatment approaches for forefoot injuries and deformities.

This intensive two-day program kicks off on Friday night with a presentation and case studies. Saturday includes hands-on instruction in four sawbones labs as well as insightful lectures with expert faculty. Earn 12 continuing education contact hours upon course completion.

Space is limited, so visit acfas.org/ontheroad to reserve your spot today.
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Divisions Support Residents’ Research at ACFAS 2016
To support future researchers close to home, ACFAS’s 14 Regional Divisions are once again providing financial support to resident poster presenters and manuscript presenters at ACFAS 2016 in Austin.

Individual resident poster presenters will receive $250 in support, and resident manuscript presenters will receive $500. To claim their funds, residents need to submit an application to their Division, have their research accepted for presentation at the conference, attend the conference and also attend their Division’s membership meeting during the event. Each Division is setting its own individual budget to determine how many awards it can provide this year.
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Foot and Ankle Surgery


Heavy CT Scan Use Raises Concerns About Radiation Exposure
Diagnostic imaging is a $100 billion-a-year business, but the dangers of CT scans have brought the practice into the spotlight. CT scans use ionizing radiation, and while they are one of the crowning achievements of science in the 20th century, that radiation comes with a host of issues. Most notably, they can potentially lead to cancer, which often is not detected until years later. The National Cancer Institute estimates that the additional risk of developing a fatal cancer from a scan is 1 in 2,000. Some experts believe the technology is too important to worry about the drawbacks, which, in comparison to regular cancer risk, are decidedly small. But most experts agree that indiscriminate exposure to radiation is a danger, and the fact that an estimated 30 to 50 percent of scans are believed to be medically unnecessary only brings the practice more into question. New Medicare rules will require doctors to consider appropriateness criteria developed by the American College of Radiology when ordering imaging. In addition, Medicare will reduce reimbursement for CT scans by five percent if they are done with machines that fail to meet modern standards.

From the article of the same title
Healthcare Finance News (01/06/16)
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Minimally Invasive Versus Open Distal Fibular Plating for AO/OTA 44-B Ankle Fractures
Minimally invasive surgery (MIS) could be a solution to decrease complications resulting from open reduction and internal fixation (ORIF) to treat unstable ankle fractures. A recent study proposed an algorithm of MIS for fibular plating and compared results between ORIF and MIS. The MIS group experienced less blood loss but spent more time in the operating room and also received greater exposure to fluoroscopy. Both groups had similar union time, fibular length, talocrural angle, medial clear space and tibiofibular clear space. At last follow-up, no significant differences were found in pain score. Researchers concluded that MIS yields similar results to ORIF, with less pain and fewer wound complications.

From the article of the same title
Foot & Ankle International (01/16) Chiang, Chao-Ching; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; et al.
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Practice Management


At the Hospital, Better Responses to Those Beeping Alarms
A myriad of devices in hospitals can produce so much beeping and noise that many doctors and nurses simply choose to ignore them. Now, hospitals are looking for solutions to fix this issue. As many as 90 percent of alarms are false, according to studies. But when staffers experience "alarm fatigue" and ignore some of the rings, it can lead to fatal errors. Ronald M. Wyatt, the Joint Commission’s medical director for healthcare improvement, says the 138 deaths from alarm fatigue since 2010 could have been prevented by taking the proper steps. The Joint Commission has set January 2016 as the deadline for hospitals to have safety policies and procedures in place. This includes programs to educate staff about alarm mechanics and settings. But as some experts say, the problem is more than simple mechanics. “Culture is probably the hardest part of alarm management because staffers are used to doing things their own way,” says Rikin Shah, a senior consultant at the ECRI Institute. Some hospitals are turning to cameras and video technology to alleviate the issues that alarm overload can bring. Children's Hospital of Philadelphia is using an oxygen measurement device that sounds the alarm immediately for a major drop in oxygen and delays the sound for a lesser drop.

From the article of the same title
Wall Street Journal (01/04/16) Landro, Laura
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Avoid Bad Online Physician Reviews: 5 Tips
One bad review can be the difference between gaining a new patient and losing one. A poor online reputation can stymie your practice's growth and ruin the work you have done. Here are five ways to avoid bad online reviews:
  1. Open the lines of communication. If a patient seems unsatisfied with a visit, ask what is wrong. Fielding questions and concerns can turn a potential bad review into a glowing one.
  2. Get them to say something nice. Do not depend on the patient to write a good review all the time. In many cases, it is OK to ask a patient to leave a good review.
  3. Be careful about responding to bad reviews immediately. Knee-jerk responses can come off as inflammatory. Think critically about your response. A poor response can cause even more damage to your reputation.
  4. Get out in front of it. Survey patients on your own. Administer surveys and get patient satisfaction scores. Do it now, and do not wait until the last minute.
  5. Get better. Learn from your mistakes. In some cases, a bad review is well-earned. Make sure you change your methods so that it does not happen again.
From the article of the same title
Physicians Practice (01/06/16) Perna, Gabriel
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EHRs Can Improve the Patient-Doctor Relationship
Electronic health records (EHRs) are often looked at as tools that hamper the patient-doctor relationship, but Dr. Jeremy Fischer believes otherwise. Dr. Fischer, program director for Family Medicine at Henry Ford Macomb Hospital, thinks EHRs can be used to improve that relationship. One major advantage is transparency. EHRs allow patients to see exactly what the physician diagnosed and can be a huge help when taking the diagnosis to other physicians. Patients tend to explain diagnoses in vague terms; having it written in the EHR can avoid any potential complications stemming from a misunderstanding. Physician communication can also be greatly improved. While EHR interoperability is currently limited, the future holds great promise once the technology becomes more adept. Patients will be able to arrive at your office with all of their relevant information already available to you. No time-consuming explanations will be needed, and both you and the patient will be able to view all important stats and figures. Patient portals will also help, as patients will be able to view their records whenever they desire, wherever they may be. Current EHR iterations are undoubtedly cumbersome, but once the bugs in the system are worked out, both patients and physicians will benefit tremendously.

From the article of the same title
Physicians Practice (01/04/16) Fischer, Jeremy
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Email Communication May Improve Health in Patients With Chronic Conditions
Patients who can communicate with their doctor via email may be able to better improve their health, according to a study in the American Journal of Managed Care. Those patients with chronic conditions such as diabetes or congestive heart failure had better results with better communication. Thirty-two percent of 1,041 patients who exchanged emails with their doctors reported improvements in their health, although 67 percent said emails had no effect. For 42 percent of patients, email reduced the number of phone calls necessary and 36 percent reported fewer visits to the doctor. "As more patients gain access to online portal tools associated with electronic health records, emails between patients and providers may shift the way that healthcare is delivered and may also have an impact on efficiency, quality and health outcomes," said lead author Mary Reed.

From the article of the same title
Endocrinology Advisor (01/06/16)
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Health Policy and Reimbursement


ACA Insurers Sweeten Plans with Free Doctor Visits
Some health insurers in certain cities will offer free visits to primary care doctors in their networks in 2016. In Atlanta, Chicago, Dallas, Miami and more than a dozen other markets, the benefit will ease financial burdens for many customers. The stated goal is to encourage visits to doctors to catch illnesses before they become harder and more expensive to treat. Consumers have until Jan. 31 to sign up for coverage. Insurers offering the free visits include Harken Health, Zoom+, Florida Blue and Molina Healthcare. Experts say the move could set these insurers apart and attract younger, healthier people who do not have relationships with a doctor. Consumer advocates applaud the trend, which they say underscores why people need to look beyond the monthly premium when shopping for a plan. Some insurers can offer free visits because they operate health clinics staffed by salaried physicians.

From the article of the same title
MedPage Today (01/04/16) Galewitz, Phil
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House Votes to Send Bill to Repeal Health Law to Obama’s Desk
The House has voted to repeal the Affordable Care Act and will send the bill to President Obama's desk. It is the 62nd such vote and will almost certainly be vetoed, but it remains another sign of the law's divisiveness. This is the first challenge to the law that has made it to the Oval Office, which many lawmakers claim shows that things need to be changed. Bill Hoagland, senior vice president of the Bipartisan Policy Center in Washington, said even some Democrats recognize there likely should be changes, while some Republicans admit that certain provisions cannot be struck down. The expected veto would only be President Obama's eighth during his two terms. A recent Kaiser Family Foundation poll found that 46 percent of Americans had an unfavorable view of the law, compared with 40 percent who viewed it favorably. More than 17 million uninsured people have gained coverage since its adoption in 2010.

From the article of the same title
New York Times (01/06/16) Steinhauer, Jennifer
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New Program Aims to Link Medical, Social Services
Medicare and Medicaid patients will now have more resources available for non-medical needs. The federal government is launching a $157 million project that connects patients to needed social services such as housing, healthy food and transportation, aspects of living that often mean more to overall health than medical interventions. The Accountable Health Communities project will fund up to 44 separate experiments over five years to test whether identifying and addressing health-related social needs can reduce costs and boost efficiency. Some of these programs already exist. At Hennepin Health in Minnesota, similar programs have reduced hospital and emergency room admissions. The government's goal is to assist in "scaling up" and providing these services to a much larger population. The program will be run by the Center for Medicare and Medicaid Innovation, a branch created by the Affordable Care Act to find and develop ways to improve healthcare. It will assess each of the 44 programs to learn what works and what does not.

From the article of the same title
HCPLive (01/06/16) Rovner, Julie
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Medicine, Drugs and Devices


FDA Drug Approvals Climb to Highest Level Since 1996
Approvals for new drugs in 2015 reached their highest levels in 19 years, figures show. The U.S. Food and Drug Administration approved 45 drugs with never-before-sold ingredients in 2015, an increase over the 41 approved the year before. One explanation could be that drug makers are getting more adept at picking the most promising drugs that come out of research and development. It also points to a new industry-wide focus on drugs for rare and hard-to-treat diseases.

From the article of the same title
Associated Press (01/04/16)
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FDA to Create Early Warning System for Medical Devices
The U.S. Food and Drug Administration (FDA) has proposed telling the public about possible security risks in medical devices before determining whether those risks actually exist. FDA stated that there is a need to notify the public about "emerging signals" that could point to security threats. Such notifications could include the seriousness of adverse events, the likelihood of occurrence, how broadly the device is used or whether there is a disproportionate effect on certain demographics. FDA's efforts follow complaints from critics who claim the agency is not doing enough to ensure medical device safety. Some doctors argue that FDA fails to address "root problems" and simply does not test the safety of a majority of devices. As evidence, these critics point to FDA's ever-shrinking list of drug and device problems. FDA will accept public comments on the proposal for the next 60 days.

From the article of the same title
Medscape (12/31/15) Lowes, Robert
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Hospitals Struggle to Offer Meaningful Health Apps, Lose Money
Only two percent of patients use hospital-provided mobile health apps, according to new research from Accenture. The 100 largest hospitals in the nation lose a significant amount of revenue each year because of this, considering that 66 percent of hospitals invest in mobile apps for consumers. In addition, 38 percent have developed proprietary apps for their patients. The biggest issue involves the relevance of the apps: only 1 percent of the health systems that develop apps create a product that customers find useful. Three areas that customers care about the most are access to electronic health records, the ability to book, change and cancel appointments and the ability to request prescription refills electronically. In fact, seven percent of patients have switched healthcare providers because of dissatisfaction with customer service channels such as mobile apps. A look at the app marketplace yields damning results: commercially available health apps have average ratings far higher than provider apps.

From the article of the same title
Health Data Management (01/07/16) Slabodkin, Greg
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

Daniel C. Jupiter, PhD

Jakob C. Thorud, DPM, MS, AACFAS


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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

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