February 13, 2013

News From ACFAS

What’s Happening at the Largest-Ever Annual Conference in Vegas?
ACFAS history has been made -- a record number, 1,502 foot and ankle surgeons, emerged from across the country to Vegas for the highest-attended ACFAS Annual Scientific Conference ever. Not only did we have the most attendees, we had the most exhibitors and the highest number of poster submissions ever recorded -- and it’s not over yet.

From stellar educational programs during the day to the fun networking events in the evening, attendees have been inspired by the best in open minds, debate and possibilities, including:
  • A powerful and inspiring opening session by Ted Kennedy, Jr., on “Facing the Challenges” that come with changes to healthcare policy in America
  • An enthusiastic debate about ethical decision-making and how to deal with offers from competing medical salespeople
  • An enlightening discussion differentiating medical fads from the cold, hard facts
This year’s conference ends tomorrow, February 14, but don’t miss next year’s most valuable clinical program in the profession. Make your plans now to join us at ACFAS’ 2014 Annual Scientific Conference, February 27-March 2, in Orlando, Florida.
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Your New Board of Directors
Congratulations to new ACFAS President, Jordan P. Grossman, DPM, FACFAS; President-Elect, Thomas S. Roukis, DPM, PhD, FACFAS; Secretary-Treasurer, Richard Derner, DPM, FACFAS; and Immediate Past-President, Michelle Butterworth, DPM, FACFAS. The new Executive Committee took office yesterday in Las Vegas at the Annual Scientific Conference Honors and Awards Ceremony along with the new and returning director members:
  • Kris DiNucci, DPM, FACFAS
  • Sean T. Grambart, DPM, FACFAS
  • Christopher Hyer, DPM, FACFAS
  • Christopher Reeves, DPM, FACFAS
  • Laurence G. Rubin, DPM, FACFAS
  • John S. Steinberg, DPM, FACFAS
  • Randal Wraalstad, DPM, FACFAS, Division Presidents Council Chair
A special thank you to last year’s President and now Immediate Past-President, Michelle L. Butterworth, DPM, FACFAS, for her outstanding year of service to ACFAS.
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Foot and Ankle Surgery

Age and Sex Differences between Patient and Physician-Derived Outcome Measures in the Foot and Ankle
A study was held to determine the five outcome factors of greatest importance to the patient and the effect that age and gender have on these factors, and then to compare them with factors within two of the most commonly used outcome tools for the foot and ankle. A survey completed by 783 subjects identified the five most important outcome factors as limited walking, activity-related pain, constant pain, difficulty with prolonged standing and inability to perform one’s job or housework. There were significant gender-related differences in terms of shoe-related issues and foot and ankle weakness, while constant pain, inability to play sports, inability to participate in a job or housework and recurrent foot or ankle skin sores or infections were significantly divergent between age groups. Between 38 percent and 50 percent of the outcome points found on two commonly used foot and ankle instruments included variables not of primary importance to the patient.

From the article of the same title
Journal of Bone and Joint Surgery (02/06/2013) Vol. 95, No. 3, P. 209 Baumhauer, Judith F.; McIntosh, Scott; Rechtine, Glenn
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Results of Dynamic Pedobarography Following Surgically Treated Intra-Articular Calcaneal Fractures
Researchers investigated clinical results and gait analysis findings by dynamic pedobarography in patients following surgically treated single, closed, dislocated intra-articular calcaneal fractures using a cohort of 26 patients with an average follow-up period of 34 months. The subjective and objective clinical outcome was evaluated using the Zwipp score and a score based on a visual analog scale (VAS). Dynamic pedobarography was employed to acquire gait patterns, while analysis was carried out using the Emed-Software. For the Zwipp score (±200 points), the average was +54.4 points (±48.2); for the VAS score (0–100 points), the average was 58.3 points (±24.3). Limited mobility was observed in the ankle joint, while pedobarography revealed a clearly disturbed gait with greater pressure for the fractured side in the midfoot region and under the fifth metatarsal bone. The gait line exhibited lateralization. The force-time-integral indicated significant differences for the medial and lateral midfoot region.

From the article of the same title
Archives of Orthopaedic and Trauma Surgery (02/13) Vol. 133, No. 2, P. 259 Jansen, Hendrik; Frey, Sonke P.; Ziegler, Christine; et al.
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Practice Management

Docs Avoid Drugs Errors with Mobile Apps
A study by Epocrates has found that doctors are turning to mobile apps to find drug information to prevent accidents. Doctors are using online information to ensure drugs are safe for patients and as a result 27 million harmful drug interactions are avoided annually. Epocrates surveyed 2,743 doctors and found that 22 percent prevented one dangerous drug event a week by checking online first. Seventeen percent said they avoided two a week, and 23 percent said they avoided three or more a week. The rise in smartphone and tablet use has also found its way into the doctor's office. The survey by Epocrates says 80 percent of doctors are using mobile technology and 60 percent visit the Epocrates website often during office hours.

From the article of the same title
Healthcare IT News (02/04/13) Wicklund, Eric
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Getting the Most from Physician Online Ads
The difference between successful practice online ad campaigns and worthless ones is the amount of planning and homework that go into identifying the correct audience, creating the most effective message and choosing what the audience’s call to action should be. Online marketing gives physicians the ability to target specific groups by bidding on certain keywords they think their target audience would employ in a search to find them. The majority of marketers see search engine ads as far more effective than Facebook ads because the people seeing them actually are seeking your product or service, while Facebook ads target a group of people who you think might be interested in your offerings.

Identifying the practice's target audience can be challenging, as the patient is not always the target. For instance, one expert notes that when it comes to prostate issues, it is more often the wives or significant others of the patients who are searching for a physician. Additional analysis will help ascertain the best times of day to contact the target demographic, as some programs let advertisers choose a time of day to display their promotions. Most online ad programs allow users to pick geographic areas, and while a practice’s primary patient population may come from within a 10-mile radius, it may be the only practice offering a specific procedure within a 50-mile radius.

Following identification of the target audience, the practice must study the terms, phrases, images and content that would resonate with them in order to create an ad that grabs their attention. One expert suggests creating several ads to test and then determining the one with the most efficacy. The ad's content should be modified regularly, according to ongoing analysis of what is working best. Ads also must feature a call to action in addition to attention-capturing content. Meanwhile, practices should set a realistic online ad budget, which is determined by quantifying the size of the potential audience and how many times the ad might be watched by that audience, especially in comparison with rival ads.

From the article of the same title
American Medical News (02/04/13) Dolan, Pamela Lewis
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Tips to Better Manage Incoming Calls at Your Medical Practice
Handling calls in your practice can be a daunting logistical task that is both unnerving and time consuming, but there are methods to lessen the burden and streamline the process to make for more efficient patient relations. First, you should try to simplify, shorten and reorder the greeting on your phone message. Greetings tend to make patients wade through layers of menus before finding what they need, thus tying up your phone lines. Phone menus should stick to a few main categories: physicians calling, pharmacy calling, patient calling and needing to speak with a provider and patient calling and needing information from office staff. The menus should also be ordered depending on call volume, which in most cases will put patients first. You should also reduce the number of rings the phone makes before going to voice mail, especially if the caller is typically sent to voice mail anyway.

For patients leaving a voice message, you should make sure there is a prompt that tells the patient a specific time that they can expect a call back. Office staff should be clear on their duties when answering the phone. Remind them to be attentive and friendly, businesslike, task-oriented and responsible for taking on tasks that the phone staff is authorized for. In instances where the phone staff is asked to complete a task they are not authorized for, they should be trained to acquired all the required information that will be needed to fulfill that task before ending the call with the patient. Reducing the number of calls your practice receives can help eliminate phone line congestion. This can be accomplished by establishing an Internet portal for customers to use should they have questions, complete with a way to send messages electronically. Giving patients printed materials at the end of their visit with answers to routine questions can also reduce the number of call backs. Taking time at the end of a visit to address any lingering questions the patient has can help them better remember the information you gave them and reduce the chance of them later calling the clinic for clarification.

From the article of the same title
Physicians Practice (01/30/13) Stryker, Carol
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Health Policy and Reimbursement

CBO Analysis Renews Calls for SGR Repeal
A Congressional Budget Office (CBO) analysis released this week lops $107 billion from the cost of eliminating the Sustainable Growth Rate (SGR) funding formula, renewing efforts by some in Congress and physicians' lobbyists to repeal the mandate. The new estimate explains that repealing the SGR would cost $138 billion over the next 10 years—significantly less than the $248 billion priced in previous estimates. CBO attributed the lower cost to a decline in the rate of Medicare spending growth when compared with historic trends and lowered estimates for spending for physician services.

From the article of the same title
HealthLeaders Media (02/07/13) Commins, John
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CMS Seeks Information on Aligning Physicians' Quality Measures
The U.S. Centers for Medicare & Medicaid Services (CMS) has sent out a request for information asking clinical professionals to give their recommendations for how clinical quality measure data already used by physicians can also be used to meet the requirements of CMS' Physician Quality Reporting System and its electronic health record incentive program. According to the information request, CMS is in particular looking for ways to align the reporting requirements of the American Board of Medical Specialties' Maintenance of Certification program with the Physician Quality Reporting System.

From the article of the same title
Becker's Hospital Review (02/05/13) Rodak, Sabrina
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Sebelius Urges Docs to Adopt New Pay Models
U.S. Health and Human Services Secretary Kathleen Sebelius says healthcare providers have an obligation to try new payment models that could help lower the growth rate of health spending. "Far too many healthcare providers are still content to sit back and let others blaze the trail to a 21st century healthcare system," said Sebelius at the AcademyHealth National Health Policy Conference. Sebelius urged attendees to help speed up the rate of change in the industry. A major component of the Affordable Care Act was the new payment models, which are changing how care is delivered, said Sebelius. The U.S. spends 1.5 times more on healthcare than any other country. While Medicare and Medicaid grow at slower rates than the private sector, Sebelius says they can still lead reform efforts. "History shows that innovations in how we pay for care often can begin with Medicare and then spread to the private insurance industry," said Sebelius.

From the article of the same title
MedPage Today (02/04/13) Pittman, David
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Medicine, Drugs and Devices

Bone Regeneration Using Cell-Mediated Responsive Degradable PEG-Based Scaffolds Incorporating with rhBMP-2
Researchers examined the regeneration of bone using cell-mediated responsive degradable PEG-based scaffolds infused with recombinant human bone morphogenetic protein-2 (rhBMP-2). They found that the scaffolds induced the formation of ectopic bone in mouse thigh muscles. Researchers also found that the rhBMP-2 scaffolds were gradually resorbed and replaced by new bone and that they induced reunion of bone marrow cavity at 12 weeks, much better than what was seen in the self-repairing group. The study concluded that osteoinduction and appropriate degradation play an important role in accelerating and promoting augmentation and in achieving effective proangiogenesis.

From the article of the same title
Biomaterials (02/01/2013) Yang, F.; Wang, J.; Hou, J.; et al.
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How Long to Treat with Antibiotics Following Amputation in Patients with Diabetic Foot Infections?
Researchers reviewed the literature assessing antibiotic treatment in diabetic foot infections (DFI) post-amputation to determine if the Infectious Diseases Society of America recommendations for treatment duration are reasonable. Evidence for utilization of antibiotics following amputation is mainly drawn from perioperative surgical prophylaxis studies evaluating the rate of infection after amputation. Three studies were identified and two found a five-day course of antibiotics post-amputation resulted in a reduction of infection rate, while the third determined no extra benefit. Comparative antibiotic studies in DFI also demonstrates evidence for treatment duration, of which 10 studies were identified. Five featured patients received amputations, but only one reported treatment outcomes in a subset of diabetics requiring amputation. The authors of this study concluded that antibiotic treatment is probably required following amputation.

From the article of the same title
Journal of Clinical Pharmacy and Therapeutics (01/13) Johnson, S.W.; Drew, R.H.; May, D.B.
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Ramipril May Improve Pain-Free Walking Among Patients with PAD and Intermittent Claudication
A study published in the Journal of the American Medical Association has found that ramipril is effective at treating patients with peripheral artery disease (PAD) and intermittent claudication. Researchers found that the PAD patients who were given ramipril for 24 weeks experienced a 75 second increase in average pain-free walking time and a 255 second increase in maximum walking time compared to those who were given a placebo. Ramipril was also associated with improvements in Walking Impairment Questionnaire (WIQ) scores as well as the overall Short-Form 36 Health Survey median Physical Component Summary score. Researchers said that the increase in WIQ scores in patients who were given ramipril suggests that the drug improves patients' perception of their ability to perform normal daily activities.

From the article of the same title
News-Medical.Net (02/06/13)
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