January 21, 2015 | | JFAS | Contact Us

News From ACFAS

ACFAS Adopts New Code on Interactions with Companies
The ACFAS Board of Directors has adopted a new Code of Interactions with Companies that further fosters high ethical standards for ACFAS leaders in their relationships with companies. “We borrowed heavily from the Council of Medical Specialty Societies’ model code that is now being adopted, in whole or in part, by a wide variety of national medical specialty societies,” said ACFAS President Thomas S. Roukis, DPM, PhD, FACFAS. “We are the only podiatric CME provider to have taken these proactive steps, many of which go far beyond CPME’s CME standards.”

The new code contains 27 regulations that ensure independence from industry influence and transparency of conflicts to members and the public. These regulations also help prevent bias in CME programs and exhibits. Similar regulations will soon be considered for research grants, clinical position statements, the scientific journal and related College programs.

ACFAS has long had the most stringent conflict of interest policies in podiatry, which differentiates ACFAS programs from other CME providers, and helps ensure that College members receive the most bias-free information possible.

Visit for the complete code and other ACFAS conflict of interest policies and procedures.
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What Will You Learn from the HUB?
ACFAS 2015 in Phoenix is just a few short weeks away—have you decided which HUB sessions you’d like to attend? The HUB, supported by PICA and back by popular demand, is an interactive theater designed to encourage open and informal discussion on hot topics like cyberliability, risk management, fellowships, job hunting and how to best communicate with patients in an electronic age. There’s no pre-registration to attend a HUB session, so choose which sessions you want to attend by viewing the full session directory in the conference program found online at

This year’s HUB will accommodate 45+ people, so arrive early to HUB sessions to secure your seat at what is once again expected to be one of the liveliest spots at the conference!

For HUB highlights and more, visit
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Job Fair Returns to ACFAS 2015
Take advantage of all the popular Job Fair at ACFAS 2015 has to offer! Whether you’re an employer looking to fill a position or a surgeon looking for a job, the ACFAS Job Fair, sponsored by, has just the tools and support you need for success.

Employers can take advantage of the online career center and can also post their positions on paper to place on bulletin boards at the Job Fair. Job seekers should bring extra copies of their CVs to post on the boards as well. Plus, the online scheduling tool allows job seekers and employers to list their availability for a potential interview right onsite in a private room at the conference.

Not attending ACFAS 2015? All positions posted to in advance of the conference will be listed within the Job Fair, and potential employees can contact you directly.

Don’t forget, all ACFAS Members receive reduced rates on job posting and is providing a show special—those employers who purchase a 30-day posting at the conference will receive an additional 30 days free.

Visit and the Job Fair on the Exhibit Hall floor. Post your available position or your resume in advance of the conference through
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Coming to You This Spring: Advanced Forefoot Workshop & Seminar
What better way to welcome the arrival of spring than with the opportunity to refresh your advanced forefoot reconstruction skills? ACFAS is coming to the east coast with its popular Advanced Forefoot Reconstruction and Complications Workshop and Seminar. Set for April 17–18 in Buffalo, New York, and May 1–2 in Portsmouth, New Hampshire, this program gives you the chance to learn the latest surgical approaches and techniques from renowned faculty.

Class begins on Friday evening with a presentation on how to handle common forefoot surgical complications followed by a review of participants’ case studies. Saturday features hands-on workshops, labs, lectures and panels to examine problematic cases (bring your work cases for review).

Visit to register today!
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Foot and Ankle Surgery

Anterolateral Tibial Osteotomy for Accessing Osteochondral Lesions of the Talus in Autologous Osteochondral Transplantation
A study was held to document functional and magnetic resonance imaging (MRI) results in patients who underwent autologous osteochondral transplantation (AOT) for treatment of cystic osteochondral lesions of the talus via an anterolateral tibial osteotomy. The study involved retrospective review of records of patients who underwent an anterolateral tibial osteotomy for AOT, and pre- and post-operative Foot and Ankle Outcome Scores (FAOS) and demographic data were recorded. Magnetic resonance observation of cartilage repair tissue (MOCART) was employed to evaluate morphologic state of tibial cartilage at the repair site of the osteotomy. Quantitative T2 mapping MRI was analyzed in the superficial and deep cartilage layers of the repair site and in adjacent normal cartilage to function as control tissue. Seventeen patients received anterolateral tibial osteotomy with an average follow-up of 64 months. MOCART data was available in nine patients, while quantitative T2 mapping was available in six patients. FAOS improved from an average 39.2 out of 100 points pre-operatively to 81.2 after surgery, and the average MOCART score was 73.9 out of 100 points. Quantitative T2 analysis indicated relaxation times were not significantly divergent from the normal native cartilage in both the deep half and superficial half of interface repair tissue.

From the article of the same title
Foot & Ankle International (01/15) Gianakos, Arianna L.; Hannon, Charles P.; Ross, Keir A.; et al.
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Effectiveness of Intravenous Ilomedin Infusion and Smoking Cessation in the Treatment of Acutely Symptomatic Buerger Disease
A study was held to evaluate the efficacy of iloprost therapy to manage symptomatic Buerger disease (BD) and smoking cessation compliance, based on a single-center experience. Thirteen subjects suffering from BD were treated with sessions of intravenous (IV) Ilomedin infusion. Pain status alteration, number of analgesics required, ankle-brachial index (ABI) change, compliance with supervised smoking cessation and amputation-free rate were recorded at a one-year follow-up. Pain status showed considerable improvement according to a visual analog scale, the number of analgesics required declined substantially and all patients improved their pain-free walking distance, the ABI, and their self-reported quality of life. Minor amputations were required in only two patients. The mix of IV Ilomedin infusion, supervised smoking cessation and a specific follow-up protocol may improve pain-free walking distance, pain status, quality of life and reduce amputation risk.

From the article of the same title
Angiology (02/01/15) Vol. 66, No. 2, P. 114 Spanos, K.; Georgiou, E.; Saleptsis, V.; et al.
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Practice Management

How an Employee Manual Can Help Control Risk, Contain Costs
Medical practices must have an employee handbook to notify staff and supervisors of workplace rules and policies in a uniform manner. The handbook should:

1) Supply clarity in terms of expectations and the standards that must be followed.

2) Alert employees about workplace policies for enhancing a practice's operational viability and efficiency, such as overtime issues.

3) Clearly and consistently inform employees of their rights and benefits.

4) Notify employees about proper grievance and complaint procedures.

5) Clarify an employee's at-will status and that the employee did not have an implied or express contract.

The practice manager also should make sure to collect and maintain signed acknowledgements from all employees that they received, read, and understand the handbook, that it preempts prior handbooks, and acknowledge they will comply with its terms. These acknowledgements should be kept in each employee's file, as they may assist in a legal action if an employee claims ignorance of workplace policies.

In addition, the practice should not over-promise or be too inflexible in outlining its policies, as this may lead to a limitation on the practice's ability to act. The practice should ensure the manual is consistent with its culture and workplace practices and that management agrees with its terms. Frontline supervisors should be consulted to ensure consistency between policies and actual practices and to ensure that the policies included in the handbook are enforceable.

From the article of the same title
Medical Economics (01/09/15) Zwerling, Andrew L.
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Six Ways to Hire Like an HR Pro at Your Medical Practice
Medical practices must address hiring and employment management, and if no human resources professional is on hand, practice managers can still bring strong team members on board by following six recommendations:

1) Determine the required job competencies prior to recruiting, and carefully plan your recruiting and interviewing process around them.

2) Request referrals from current employees.

3) Weigh the applicant's background, as past actions often anticipate future behavior. Past achievements and actions should be stressed, and basic assessment tools should be used for an overview of the applicant's work and communication styles, if possible.

4) Ask open-ended, behavioral-based questions during the interview, with the applicant talking 80 percent of the time while the interviewer maintains control of the dialogue. Among the questions to ask is “Why are you looking for a job?”

5) Request the staff's input about the applicant's qualifications and ensure that everyone on the hiring team concurs that the applicant fits well within the practice culture.

6) Be cognizant of hiring statutes, such as avoiding questions about or refusing to hire an applicant based on their status; avoiding queries about prior arrests; obtaining I-9 information on all new hires within three business days of hiring; being cautious with employment offers and contracts; and avoiding status-based discrimination against an employee whether in hiring, management or termination.

From the article of the same title
Physicians Practice (12/22/14) Morris, Tracy
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Health Policy and Reimbursement

Deadline to Volunteer for ICD-10 End-to-End Testing Extended
The Centers for Medicare and Medicaid Services (CMS) has pushed back the deadline for healthcare providers to apply to participate in the second round of ICD-10 testing with Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange contractors. On Jan. 8, CMS announced that it was pushing the application deadline back from Jan. 9 to Jan. 21. Application forms are available on MAC websites. About 850 volunteers will be selected to represent a cross-section of provider, claim and submitter types. The second round of testing is scheduled for April 26 to May 1. Providers will have another opportunity for end-to-end testing during the week of July 20 ahead of the Oct. 1 deadline for adopting ICD-10.

From the article of the same title
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DoJ Uses Big Data to Crack Medicare Fraud Schemes
In 2007, the offices of the inspector general for the Justice Department, FBI and Department of Health and Human Services formed a joint strike force in Miami that was tasked with using big data mining techniques to search for potential healthcare billing fraud affecting Medicare. Such billing fraud is estimated to cost taxpayers more than $60 billion every year, and the thought was that big data analytics techniques could be used to identify patterns of fraudulent behavior in Medicare's billing database. The effort has paid off many times over. In 2013, the strike force recovered a record $4.3 billion in fines and restitution. In the last five years, the project has recovered $19.2 billion, with a staff of only 35 investigators nationwide. The data mining approach specifically hones in on identifying doctors who abuse their Medicare identifying numbers to charge for unnecessary procedures or for procedures that are never performed. In 2013, the strike force helped charge 36 such doctors, including Detroit oncologist Farid Fata who last year pleaded guilty to a $225 million scheme that involved ordering unnecessary chemotherapy treatments. DoJ says it is looking at possible areas outside of healthcare where the data mining techniques might also be useful.

From the article of the same title
Financial Times (01/12/15) Scannel, Kara
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Medicare Pays Doctors to Coordinate Seniors' Chronic Care
Medicare will now pay primary care doctors a monthly fee to better coordinate care for the most vulnerable seniors, those with multiple chronic illnesses, even if patients do not have a face-to-face meeting with the physician. The goal is to help patients stay healthier between physician visits and avoid more expensive hospital stays and nursing homes. About two-thirds of Medicare beneficiaries have two or more chronic conditions, like diabetes, heart disease or kidney disease. These patients often tend to visit multiple doctors for different illnesses. Unfortunately, all too often no one oversees their overall health to make sure treatments do not interact negatively and to confirm x-rays or other tests are not repeated because one doctor may not know what other doctors have ordered. To earn the fee, doctors must develop a care plan for qualified patients and spend time each month on activities like coordinating their care with other health providers and monitoring patient medications. The new fee could allow physicians to hire extra nurses or care managers to do more preventive work.

From the article of the same title
Associated Press (01/10/15) Neergaard, Lauran
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Medicine, Drugs and Devices

FDA Launches Project to Cut Quality Control Lapses at Drug Makers
On Jan. 12, the U.S. Food and Drug Administration (FDA) announced the launch of a new initiative aimed at reducing lapses in quality control among pharmaceutical manufacturers. The new initiative is some 10 years in the making, according to Dr. Janet Woodcock, head of the FDA's pharmaceuticals division. Woodcock says the initiative's main goal will be the design and establishment of consistent quality standards for all drugs, brand name or generic, to be sold in the U.S. To that end, FDA has established a new Office of Pharmaceutical Quality that Woodcock says will be responsible for the process and for making some 10,000 decisions a year. Drugs already in the FDA approval pipeline will retain their existing review team and process, but Woodcock says effective immediately, new applications will now be filed with the new Office of Pharmaceutical Quality. This will mean a more integrated review process and greater communication with FDA for drug companies. The rulemaking process will involve FDA proposing a set of new quality metrics to drug makers and opening them up to public comment before finally producing a final rule. Woodcock did not provide a definite timeframe for when the rulemaking process would begin.

From the article of the same title
Reuters (01/12/15) Clarke, Toni
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New Analysis Challenges Arguments for Repealing Tax on Medical Devices
A tax on medical devices, created by the Affordable Care Act, has become a target for Republicans, some Democrats and industry lobbyists, but a new report from the Congressional Research Service challenges economic arguments for repealing the tax. Critics of the tax say it is costing jobs and encouraging manufacturers to move overseas, but the Congressional Research Service, a nonpartisan arm of Congress, says many of the criticisms are unfounded. The report says the effects on jobs, research and company profits are "relatively modest" and that only an estimated 47 out of 1,200 workers could lose their jobs, which accounts for one one-hundredth to two-tenths of 1 percent of jobs in the industry. The report also says the impact on innovation and research would be minimal.

From the article of the same title
New York Times (01/13/15) Pear, Robert
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Potential Overtreatment of Type 2 Diabetes in Older Adults with Tight Glycemic Control
A substantial proportion of older adults with diabetes mellitus may potentially be overtreated, according to new research. The study examined data on 1,288 adults aged 65 years and older with diabetes from the National Health and Nutrition Examination Survey from 2001 through 2010. About 51 percent of the patients were classified as relatively healthy, 28 percent had complex/intermediate health and 21 percent had very complex/poor health. Overall, 62 percent had an HbA1c value of less than 7 percent, with no significant differences across health status categories, and about 55 percent were treated with insulin or sulfonylureas, which could lead to severe hypoglycemia, the researchers said.

From the article of the same title
JAMA Internal Medicine (01/12/15) Lipska, Kasia J.; Ross, Joseph S.; Miao, Yinghui; et al.
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U.S. Hospitals Make Strides in Cutting Key Infections
The Centers for Disease Control and Prevention (CDC) has released a report finding that U.S. hospitals have been successful in reducing the rate of hospital-acquired infections, especially the superbugs Methicillin-resistant Staphylococcus aureus (MRSA) and C. difficile. The report shows that blood infections caused by central line catheters fell by 46 percent and surgery-related infections related to 10 procedures like heart and colon surgeries fell 19 percent between 2008 and 2013. Meanwhile, bloodstream infections caused by MRSA, a drug-resistant strain of staph, fell by 8 percent between 2011 and 2013, while C. difficile infections, which affect the gut, fell by 10 percent. "Hospitals have made real progress to reduce some types of healthcare-associated infections. It can be done," said CDC Director Dr. Thomas Frieden.

From the article of the same title
Reuters (01/14/15) Steenhuysen, Julie
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

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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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