February 10, 2021 | | JFAS | Contact Us

News From ACFAS

FASTRAC is Live and Ready for Your Research!
Get your research ready—the new ACFAS Open Access journal, Foot & Ankle Surgery: Techniques, Reports & Cases (FASTRAC) is now accepting article submissions.

FASTRAC is looking for the latest advances in cutting-edge surgical techniques for correction of foot and ankle disorders. The journal’s more streamlined submission process allows ACFAS members and other foot and ankle surgeons around the world to stay up to date on the best clinical practices. You can submit your research your way, in any format, and once accepted your paper will be reformatted to fit the journal's template. ACFAS members receive a 25 percent discount on the author fee charged upon acceptance of a paper.

Progress the profession today! Visit for more information and to submit your latest research!
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One Annual Conference–Two Ways to Participate
It’s been a challenging year, but what better way to get back to normalcy than by being a part of the ACFAS Annual Scientific Conference May 18-21, 2021?

ACFAS is planning to hold this year’s meeting in-person in Las Vegas. While we know not everyone will be able to join us, we have you covered with the ACFAS 2021 Digital Portal! Through a private website, you’ll have access to:
  • More than 20 hours of sessions we will record at ACFAS 2021 – including our keynote presenter, Zubin Damania (or as you know him as ZDoggMD!)
  • Select live webinars
  • Connect to on-site exhibitors and browse our Product Showcase
  • Recordings of our famous HUB sessions!
  • View our posters online
  • Videos and I nterviews from the show floor, networking opportunities and more!
Everyone registered for ACFAS 2021 will get access to this secure portal–whether joining us in person or not. We want everyone to be able to be part of ACFAS 2021! Visit for more information and to see what else is in store for this year’s meeting.
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You Have to Play to Win–New Associate Member Raffle Winners
Congratulations to all the newly board-qualified DPMs who recently achieved their status with the American Board of Foot and Ankle Surgery and became members of ACFAS. Plus, a special shout-out to new ACFAS members Rebecca S. Herman, DPM, AACFAS, from Staten Island, New York and Vanessa L. English, DPM, AACFAS, from Kyle, Texas by recently becoming ABFAS Board Qualified and joining the College, they each won a pair of Apple AirPod Pros!

The ACFAS Membership Committee holds an annual raffle to congratulate the newly Board Qualified physicians and encourage them to join the College. Many kudos to Drs. Herman and English for starting their careers and getting it on the right path with—membership in ACFAS!
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Foot and Ankle Surgery

Congenital Talipes Equinovarus: Results of Treatment and Are We Bracing Effectively?
The study aimed to assess authors' management of Congenial Talipes Equinovarus (CTEV) in relation to national standards published by the British Society for Children's Orthopaedic Surgery (BSCOS). It also aimed to evaluate if a more tailored bracing regime than the one advocated in the traditional Ponseti technique would be appropriate for some cases of CTEV. The study involved 133 feet in 96 patients treated between June 2006 and January 2016. The results of Ponseti surgical procedures fell within the BSCOS guidelines. The rate of radical subtalar surgical release was higher than advocated at 12.3 percent, partly due to the number of primary syndromal patients in the series. There was a significantly lower mean time spent in bracing of 14.3 months compared to recommended national guidelines. There was a clinically significant difference in the lower relapse rate of female patients compared to male patients and also a higher propensity of surgical intervention in male patients.

From the article of the same title
Journal of Foot & Ankle Surgery (01/30/21) Ranson, JM; Nuttall, G; Paton, RW
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Surgical Treatment of Diabetic Foot Ulcers Complicated by Osteomyelitis with Gentamicin-Loaded Calcium Sulphate-Hydroxyapatite Biocomposite
Diabetic foot ulcers, complicated by osteomyelitis, can be treated by surgical resection, dead space filling with gentamicin-loaded calcium sulphate-hydroxyapatite (CaS-HA) biocomposite and closure of soft tissues and skin. The study investigated the feasibility of this treatment regimen by looking at 64 patients with forefoot (44), midfoot (14) or hindfoot (nine) ulcers complicated by osteomyelitis. Authors observed wound healing in 54 patients and treatment success in 42 patients. Treatment failures led to minor amputations in four patients and major amputations in seven patients. Factors associated with treatment failures in univariable Cox regression analysis were gentamicin-resistant osteomyelitis, hindfoot ulcers and surgical procedures with gentamicin-loaded CaS-HA biocomposite that involved minor amputations.

From the article of the same title
Journal of Clinical Medicine (01/19/21) Hutting, Kor H.; aan de Stegge, Wouter B.; van Netten, Jaap J.; et al.
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Using The 2019 IWGDF Diabetic Foot Infection Guidelines to Benchmark Practice and Improve the Delivery of Care in Persons with Diabetic Foot Infection
The study used the 2019 International Working Group on the Diabetic Foot (IWGDF) - diabetic foot infection (DFI) guidelines as an audit tool for clinical practice in patients with diabetes attending a High-Risk Foot Service. Data from 93 consecutive patients were collected over a 19-month period in patients attending a High-Risk Foot Service. Across the 109 DFI events, nineteen (63 percent) of the recommendations were met, 7 (24 percent) were partially met and four (13 percent) recommendations were not met. Fourteen of the sample had no documented requests for full blood counts. Tissue was obtained for culture in 32 (29 percent) of the sample. No percutaneous bone biopsies were performed. Only 13 (28 percent) patients had intraoperative bone specimens sent for culture and sensitivities, with no bone specimens sent for histopathology. Modification of antibiotic therapy following available culture results was low, occurring in 12 out of 63 possible occasions (19 percent).

From the article of the same title
Journal of Foot and Ankle Research (01/28/2021) Malone, Matthew; Erasmus, Adriaan; Schwarzer, Saskia; et al.
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Practice Management

Reducing Burnout While Delivering Virtual Care
The piece discusses best practices for healthcare organizations to follow when delivering care virtually. The first key step is to integrate patients' medical records with the telemedicine platform. Integrating a telehealth platform into the electronic health records system and patient portal eases documentation and reduces clinician burden. An integrated solution does not require multiple clicks to bounce between video screens and documentation, reducing clinician burden. Practices and hospitals should also consider getting a mobile app developed specifically for them. Mobile apps support both patient engagement and value-based care models. Any telemedicine platform should include a dedicated patient portal. Since the physicians have access to the patient's history prior to the appointment, it results in personalization of care. This facilitates the secure exchange of messages, helps in quickly refilling prescriptions and enhances accessibility.

From the article of the same title
Physicians Practice (02/04/21) Varshneya, Rahul
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Strength in Numbers: How Physicians Can Work Together and Thrive
Independent practice owners can help each other stay afloat by creating or joining an independent practice association (IPA) and/or a clinically integrated network (CIN). IPAs provide practices with many of the clinical support services, technological resources and group purchasing advantages enjoyed by hospital systems and large multispecialty practices while allowing their members to remain independent. Approximately 300,000 physicians are in an IPA, according to the Independent Practice Association of America. In a CIN, participating practices form an “umbrella” corporate structure, usually a limited liability company (LLC), under which they aggregate quality and cost data with the goal of demonstrating the network’s ability to provide high-value care. The LLC can use that data to negotiate value-based contracts that apply across its member practices. Practices that aren't able to maintain their quality levels can be removed from the network.

From the article of the same title
Medical Economics (02/03/21) Bendix, Jeff
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Many Doctors Have Negative Perceptions of Patients With Disabilities — and That Impacts Quality of Care, Study Finds
A study from Harvard Medical School and Massachusetts General Hospital has found that over 82 percent of American doctors say they believe patients with significant disabilities have a worse quality of life compared to people without disabilities. According to the researchers, these negative views can have significant impacts on the quality of care disabled patients receive. For example, many doctors do not believe disabled patients are sexually active. This means they often do not provide them with information on contraception, sexually transmitted infections and testing for cancers associated with sexual activity. Many surgeons also presume women with disabilities who have breast cancer prefer mastectomies instead of breast-conserving surgery. This is because doctors presume these patients do not care about their physical appearance. The study also found that 56.6 percent of doctors strongly agreed that they welcome disabled patients into their practice. Meanwhile, 40.7 percent of doctors said they were confident in their ability to provide the same level of care to patients with disabilities.

From the article of the same title
CNN (02/04/21) Kent, Lauren
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Health Policy and Reimbursement

Burned by Low Reimbursements, Some Doctors Stop Testing for COVID
Physicians across the country say they are seeing low reimbursement rates for COVID-19 testing, and those rates fail to cover even the cost of testing supplies. As a result, some physicians have completely or partially stopped testing patients for the coronavirus. The problem of low reimbursement rates appears to be most common among pediatricians, who provide much of the testing infrastructure for American children through in-office rapid testing. Some large testing sites overseen by health departments and pharmacies do not test children. Several physicians have identified UnitedHealthcare and certain state Medicaid plans as the ones that routinely pay test rates that do not cover the cost of supplies. Although federal legislation passed last spring requires insurers to fully cover the cost of tests, the rules do not stipulate what is considered "complete" reimbursement. Physicians who have complained to UnitedHealthcare and other health plans say they have been largely rebuffed.

From the article of the same title
New York Times (02/03/21) Kliff, Sarah
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Medicare Increases Access to Care, Affordability for Seniors
A study published in Health Affairs concluded that Medicare coverage generally increases seniors' access to care and reduces affordability barriers. The study examined data from the 2008–17 Medical Expenditure Panel Survey–Household Component and the 2008–18 National Health Interview Survey. It compared access to care and care affordability measures between people aged 64, who are pre-Medicare eligibility age and those who were 66 years of age and are Medicare eligible. The results showed that once they were able to enroll in Medicare, the portion of seniors who said they experienced barriers in access to care declined by 50.9 percent, while the share of those who said they had access to care but could not afford it fell by 46 percent.

From the article of the same title
HealthPayerIntelligence (02/03/21) Waddill, Kelsey
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Medicine, Drugs and Devices

Hospitals Suffer New Wave of Hacking Attempts
Hospitals already are struggling to manage the coronavirus pandemic also must contend with persistent cyber threats. Data reported to the U.S. Department of Health and Human Services found that more than 1 million people were impacted by data breaches at health-care organizations nearly every month in 2020. Hackers and compromised technology were the main reasons for the breaches. The cancellation of elective procedures and the reallocation of resources due to the pandemic resulted in financial losses for health-care organizations. As a result, Sentinel Labs Inc.'s Jared Phipps said they were unable or unwilling to undertake major security projects at the very time they were necessary. Imperva's Terry Ray noted that providers often use a patchwork of third-party systems instead of their own technology, store sensitive information on unprotected servers and fail to use two-factor authentication or run the latest operating systems.

From the article of the same title
The Wall Street Journal (02/02/21) Rundle, James
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New Diabetes Cases Linked to COVID-19
Researchers have been tracking a possible connection between COVID-19 and new-onset diabetes. As many as 14.4 percent of patients hospitalized with severe cases of infection have been affected, an international group of researchers reported in Diabetes, Obesity and Metabolism last November after analyzing data from more than 3,700 COVID-19 patients in eight different studies. It remains unclear whether the infection stimulates a blood-glucose imbalance that is already emerging or if it actually causes the condition. Many COVID patients who develop diabetes during or after their bout with the virus have a family history of the disease or other comorbidities, including obesity, while others are treated with the steroid dexamethasone, which is associated with elevated blood glucose levels. At the same time, some diabetes diagnoses in the COVID population have been assessed in patients with no predisposition or risk factors for the disease. Investigators do not know if the new diabetes cases are permanent or just a temporary complication of COVID-19. They also are entertaining the possibility that coronavirus may have spawned a hybrid type of diabetes, with a different pathogenesis from known forms of the disease.

From the article of the same title
Washington Post (02/01/21) Blakemore, Erin
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Some Healthcare Workers Are Still Saying No to a COVID-19 Vaccine
Some healthcare workers continue to reject getting COVID-19 vaccines. Deborah Burger, a president at National Nurses United, says many nurses in the union felt that information about vaccines became politicized and wanted to know more so they could decide for themselves whether it was safe. She says education and more information is increasing uptake among nurses. Officials from Ohio estimated recently that 60 percent of nursing-home staff so far declined to take the vaccine, while Gov. Andrew Cuomo of New York says state officials anticipate that 30 percent of healthcare workers offered the vaccine in the state will turn it down. In a January survey of 1,563 respondents by researchers at the Kaiser Family Foundation, 79 percent of U.S. adults who have not yet been vaccinated said they would be likely to turn to a doctor, nurse or other healtcare provider when deciding whether to get a vaccination. Of 128 healthcare workers surveyed by Kaiser, 28 percent said they wanted to wait and see how the vaccine is working for other people before getting it themselves. Several healthcare systems say some female employees are hesitant because of a lack of data about the vaccines' effect on pregnancy.

From the article of the same title
Wall Street Journal (01/31/21) Wernau, Julie
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, 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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