February 20, 2013

News From ACFAS

ACFAS 2013 Marks College History
They say what happens in Vegas stays there, but ACFAS took with it a record number of attendees from the 2013 Annual Scientific Conference last week. In all, 1,502 foot and ankle surgeons from across the country flocked to Las Vegas to be a part of the most recent research and discoveries for the practice of foot and ankle surgery. The latest in the profession was presented through numerous panels, debates, workshops, 77 manuscript submissions with 22 presented and 350 scientific poster displays. There were also 240 industry exhibitors, which showcased their latest advancements in medical devices, supplies and services.

Don't miss out on all that ACFAS' Annual Scientific Conferences have to offer -- make plans to be at ACFAS 2014 in Orlando, Florida, from February 27 to March 2, 2014.
Share Facebook  LinkedIn  Twitter 
Download ACFAS 2013 Handouts
If you attended the ACFAS 2013 Annual Scientific Conference, you're eligible to download the session handouts. The majority of the handouts are available today for download at the web link below with the full library following suit by the end of the week. Login is required.
Share Facebook  LinkedIn  Twitter  | Web Link
Promote Your ACFAS 2013 Attendance
Publicize to your patients and community that you’ve furthered your education by attending the ACFAS 2013 Annual Scientific Conference in Las Vegas with ACFAS’ Fill-in-the-Blanks Press Release. This free marketing tool, customized just for ACFAS 2013 attendees, is available online at (login is required). Just open the release template, fill in the blanks with your professional contact information, add your logo and send off to your local media -- it’s that easy.

While on the ACFAS Member Marketing page, you’ll also find other great practice promotional items available free to members, including other Fill-in-the-Blanks Press Releases, FootNotes newsletter templates and ACFAS member logo files.
Share Facebook  LinkedIn  Twitter  | Web Link
Stienstra Honored in Las Vegas
John J. Stienstra, DPM, FACFAS, was the 2013 recipient of the ACFAS Distinguished Service Award. This award, presented annually by the ACFAS Board of Directors, recognizes long-term, behind-the-scenes volunteerism to the profession and the College.

Dr. Stienstra was recognized at a ceremony during the Annual Scientific Conference in Las Vegas last week. We congratulate Dr. Stienstra and thank him again for his dedication and continued service to the profession and the College.
Share Facebook  LinkedIn  Twitter 
Passing of JFAS Editor Richard Reinherz
Richard Reinherz, DPM, FACFAS passed away on January 29 after a long-term illness. He was a member of ACFAS for 33 years, and served as past Editor of the Journal of Foot Surgery, the predecessor of today’s Journal of Foot & Ankle Surgery.

"Rick, as he was known, brought a state of organization to the Journal by engaging a new publisher and, at the same time, acting as a managing editor to perform the day to day workings of our publication. He was always busy soliciting articles from residency directors to fill the pages of JFAS in its early years," said Lowell Scott Weil, Sr., DPM, FACFAS, an ACFAS past president and also an editor emeritus of JFAS.

The College's thoughts and prayers are with Dr. Reinherz' loved ones and colleagues.
Share Facebook  LinkedIn  Twitter 

Foot and Ankle Surgery

Both Autologous BMMNC and PBPC Therapies Similarly Improve Ischemia in Patients with Diabetic Foot in Comparison with Control Treatment
Researchers compared the effect of bone marrow mononuclear cells (BMMNC) and peripheral blood progenitor cells (PBPC) therapy in patients with diabetic foot disease (DFD) and critical limb ischemia (CL) unresponsive to traditional therapy. The researchers looked at 28 patients with DFD, 17 who were treated with BMMNC and 11 who were treated by PBPC, and compared them to 22 patients in a control group. They recorded transcutaneous oxygen pressure (TcPO2) and rate of major amputation in the BMMNC, PBPC and control groups over six months. The researchers found that TcPO2 increased for both the BMMNC and PBPC groups over the study period, but they saw no change in oxygen pressure levels for the control group. The rate of amputation for both BMMNC and PBPC groups was 11 percent during the trial, significantly lower than the control group's 50 percent. The researchers concluded that BMMNC and PBPC are superior treatments for patients with DFD, with no significant difference in efficacy between the two treatments.

From the article of the same title
Diabetes & Metabolism Research and Reviews (02/01/2013) Dubsky, M.; Jirkovska, A.; Bem, R.; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Micromechanical Properties and Collagen Composition of Ruptured Human Achilles Tendon
A controlled laboratory study was performed to test the hypothesis that a ruptured human Achilles tendon exhibits inferior biomechanical properties and altered collagen composition in comparison to a noninjured tendon. Biopsy specimens were acquired at the rupture site and the noninjured part of the tendon in 17 patients with acute Achilles tendon rupture, while age- and weight-matched human cadaveric Achilles tendons also were collected. Ruptured and internal control tendons displayed a lower mean Young modulus than external control tendon, while similar differences in failure strength were not observed. No regional differences in collagen content, lysyl pyridinoline (LP), hydroxylysyl pyridinoline (HP) and pentosidine (PENT) were seen between ruptured and noninjured tendon, although collagen content was less in ruptured noninjured tendon versus external control tendon. PENT exhibited similarity in all tendon samples and was positively related to age in all samples. Collagen content was positively related to failure stress exclusively in ruptured samples. HP, LP and PENT content were not associated with failure stress and Young modulus in ruptured, noninjured and cadaveric tendon.

From the article of the same title
American Journal of Sports Medicine (02/01/13) Vol. 41, No. 2, P. 437 Hansen, Philip; Kovanen, Vuokko; Holmich, Per; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Outpatient Taping in the Treatment of Idiopathic Congenital Talipes Equinovarus
Researchers recently tested a new non-operative regime to reduce treatment intensity for congenital idiopathic clubfoot without affecting the treatment outcome. The researchers treated 402 clubfeet in patients with ages less than three months and with Harold and Walker grades of 6 percent mild, 25.6 percent moderate and 68.4 percent severe. All of the patients underwent a dynamic outpatient taping regime over five weeks based on Ponseti manipulation, modified Jones strapping and home exercises. At a three-year follow-up, the researchers found that taping alone corrected 357 of 385 feet, or 92.7 percent. At a long-term follow-up of greater than 10 years, researchers found that of 44 feet, 52.3 percent were in excellent condition, 38.6 percent were in good condition, 6.8 percent were in fair condition and 2.3 percent were in poor condition. The researchers concluded that the dynamic taping regime is a simple non-operative method that delivers improved medium-term and promising long-term results.

From the article of the same title
Journal of Bone and Joint Surgery - British Volume (02/01/13) Vol. 95-B, No. 2, P. 271 Singh, A.K.; Roshan, A.; Ram, S.
Share Facebook  LinkedIn  Twitter  | Web Link

Practice Management

How Doctors Can Spot Patients Likely to Sue
A lawyer has detailed the warnings signs of patients that are likely to sue a doctor. A 2012 study in Clinical Orthopaedics and Related Research found that low-income patients with less access to legal resources are less likely to sue. In contrast, those with higher social statuses, wealth and higher education are more likely to file a lawsuit. Behavioral signs of those prone to filing suit include patients who plead for or demand a procedure and those who ask for diagnosis beyond a doctor's area of expertise. Experts say if a patient personally knows a doctor that too can also raise the chances of a court battle. Doctors should also avoid making comments that criticize another doctor's work; such remarks can encourage a patient to sue. Should a doctor need to end a relationship with a patient it is suggested they go through the proper guidelines to avoid an "abandonment" suit. A doctor is ethically and legally required to provide services as long as the patient needs them. The termination should be verbal as well as written detailing the reason for the split. Signs a suit is pending could be a subpoena, request for medical records or experiencing an outcome the patient is not happy with.

From the article of the same title
American Medical News (02/04/13) Gallegos, Alicia
Share Facebook  LinkedIn  Twitter  | Web Link

How to Create Online Videos for Your Medical Practice
Creating a video to help advertise your practice or to explain certain medical procedures or treatments can help attract new patients to your facility and make you stand out more than a physician who does not display such technological savvy. The first step to making a video is to identify the video's purpose. Videos can educate patients in a particular area of treatment like flu vaccines, videos can be used to explain your practice and what potential patients can expect when they first visit, or videos can be used to demonstrate how certain procedures are done, among other things. Videos can be created in various formats, but they should always be kept shorter to cater to minimal attention spans. For example, if you are going to make a video to answer a series of clinical questions, it would be better to split that video into several separate videos -- one for each question.

The second step to making a video is to actually sit down and create it, and this will require several tools including a video camera and video editing technology. Many current desktops, laptops and smart phones come equipped with built-in cameras, which although low quality will serve the purpose of creating a simple video. You can also buy separate webcams that will plug into your computer, or you could buy a small camcorder that has the ability to offload movie files to your computer. Once you have a camera, you will need to find video editing software like Mac's iMovie program or Windows' Movie Maker. If you want to spruce up your video a bit, you could opt to put music into it. In order to avoid potential copyright infringement you should make your own music, which can be done by using a program like Mac's GarageBand.

For those who feel a bit camera shy, PowerPoint offers the ability to transform a slideshow into a movie for posting online. The final step to sharing your video is to post it online for others to see. Video hosting sites like YouTube and Vimeo make this easy and even allow you to embed the video on your practice's website. Social media sites like Facebook allow for the direct embedding of video, and medical video websites like VideoMD offer a content-specific place for you to post.

From the article of the same title
Physicians Practice (02/01/13) Torrieri, Marisa
Share Facebook  LinkedIn  Twitter  | Web Link

Is There a Thief in Your Practice?
The best way to protect against embezzlement at a practice is to make sure it doesn't happen. Practice management experts say that physicians should set systems in place from the beginning so that those processes become second nature. Keith C. Borglum, a healthcare consultant from Santa Rosa, California, advises physicians to ask these questions about office and payment systems:


• Are employees required to rotate duties and responsibilities when possible?

• Are "write-offs" and adjustments reviewed by the doctor monthly?

• Can the insurance processing be easily observed by the doctor or administrator?

• Is the physical insurance processing system adequate?

• Is it used diligently?

Past-Due Collections:

• Are accounts sent to the collection agency monthly?

• Are accounts in internal collection contacted at least monthly?

• Does a doctor approve all accounts referred to a collection agency?

• Are accounts sent to a collection agency within 90 days of nonpayment?

• Are accounts that are referred to a collection agency written off the accounts receivable?

• Does your collection agency offer a precollection service?

• Is your collection agency doing an adequate job?


• Are fees set using an RBRVS protocol?

• Are downcoding and denials routinely appealed?

• Are patient bills easy to read and understand?

• Do doctors resist arbitrary fee reductions to patients?

Accounts Payable and Miscellaneous:

• Do you have your CPA or an outside person perform periodic reviews?

From the article of the same title
Medscape (01/24/13) Crane, Mark
Share Facebook  LinkedIn  Twitter  | Web Link

Health Policy and Reimbursement

Congress Urged to Scrap Pay System for Medicare Doctors While Price Tag Is Low
Medicare Payment Advisory Commission Chairman Glenn M. Hackbarth told a House panel Feb. 14 that Congress should take steps to reform Medicare's physician payment system to take advantage of a new and lower cost estimate and replace it with a system that balances reimbursement among physician groups and encourages doctors to participate in new payment models. Hackbarth told the House Energy and Commerce Health Subcommittee the current physician payment system should be replaced because it is creating uncertainty for physicians and beneficiaries. He said the system is harming patient access to care, particularly among those seeking primary care services.

From the article of the same title
BNA's Health Care Daily Report (02/19/13) Teske, Steve
Share Facebook  LinkedIn  Twitter  | Web Link - Publication Homepage: Link to Full Text Unavailable

Feds' E-Health Initiative Reaches out to Patients
Federal officials are leading a multi-billion dollar effort to get doctors and hospitals to use health information technology to reach out to patients and families to help them become e-patients. Farzad Mostashari, the National Coordinator for Health Information Technology at the Department of Health and Human Services, and other top health IT officials outlined plans in February to expand access, promote innovation and ensure privacy while giving patients a larger role in their care, which evidence suggests enhances quality and improves coordination and communication among multiple health providers. "Engaged patients — those who actively seek to know more about and manage their own health — are more likely than others to participate in preventive and healthy practices, self-manage their conditions and achieve better outcomes," wrote Mostashari in the journal Health Affairs.

From the article of the same title
Politico (02/11/13) Kenen, Joanne
Share Facebook  LinkedIn  Twitter  | Web Link

Lawmakers Call Again for Device Tax Repeal, Touting Bipartisan Support
Reps. Erik Paulsen (R-Minn.) and Ron Kind (D-Wis.) have reintroduced legislation in the House that would repeal the 2.3 percent excise tax on the sale of certain medical devices that went into effect on Jan. 1. Part of the Patient Protection and Affordable Care Act, the tax has been defended by hospitals and group purchasing organizations, some of whom tried unsuccessfully to pressure the IRS to require that device manufactures certify that they would not pass the cost of the tax on to customers. Manufactures unsurprisingly oppose the tax and some have already stated their intention to pass the cost of the tax along to purchasers and hospitals. The legislation to repeal the tax passed the House last year but was not considered by the Senate. President Obama has said he would veto the repeal should it pass, but Rep. Paulsen says that the reintroduced legislation has attracted bipartisan support in the form of 175 Republican and Democratic cosponsors, which he believes will "force the administration to take a second look."

From the article of the same title
Modern Healthcare (02/06/13) Lee, Jaimy
Share Facebook  LinkedIn  Twitter  | Web Link

NQF Panel Weighs in on Quality Measures
The Measure Applications Partnership (MAP) has released its second annual list of recommendations on quality measures for use in federal health programs. MAP, brought together by the National Quality Forum (NQF), reviewed over 500 measures currently being considered by the Department of Health and Human Services (HHS) for 20 federal programs. Of those 500 measures, 140 were given the green light for immediate use. MAP supported 166 measures on the grounds that they receive more testing or a NQF endorsement; among those, 166 were measures for early elective deliveries and shared decision-making for neurosurgery patients. MAP, however, did not support 165 measures for HHS programs and 64 were recommended for removal.

From the article of the same title
Modern Healthcare (02/04/13) McKinney, Maureen
Share Facebook  LinkedIn  Twitter  | Web Link

Medicine, Drugs and Devices

A Comparison of Botulinum Toxin A and Intralesional Steroids for the Treatment of Plantar Fasciitis
Researchers recently compared intramuscularly applied botulinum toxin A (BTX-A) with intralesional steroids for the treatment of plantar fasciitis and found that BTX-A and plantar fascia stretching exercises had better results than intralesional steroids. The researchers divided the 36 patients in the study into two groups according to the treatment they received and evaluated each group over six months. Nineteen of the patients received BTX-A while 17 received steroids. The researchers found that patients who received BTX-A exhibited more rapid and sustained improvement over the duration of the study than those who received the steroids.

From the article of the same title
Foot & Ankle International (01/13) Vol. 34, No. 1, P. 8 Elizondo-Rodriguez, Jorge; Araujo-Lopez, Yariel; Moreno-Gonzalez, J. Alberto; et al.
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Paid Subscription

Substitutes of Structural and Non-Structural Autologous Bone Graft in Hindfoot Arthrodeses and Osteotomies: A Systematic Review
Researchers have published a systematic review of 10 studies in order to compare autologous bone grafts with structural and non-structural substitutes with regard to the odds of union in hindfoot arthrodeses and osteotomies. They found that the pooled random effect odds for union were 12.8 for structural allografts, 5.7 for cortical autologous grafts, 7.3 for cancellous allografts and 6.0 for cancellous autologous grafts. Researchers also found that the odds of union in hindfoot arthrodeses achieved with cancellous autologous grafts was similar to that of demineralized bone matrix or platelet derived growth factor augmented ceramic granules. These findings suggest an equivalent incorporation of structural allografts as compared to autologous grafts in hindfoot arthrodeses and osteotomies.

From the article of the same title
BMC Musculoskeletal Disorders (02/07/13) Muller, Marc Andreas; Frank, Alexander; Briel, Matthias; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Copyright © 2013 American College of Foot and Ankle Surgeons

To change your email address, please click here. If you wish to unsubscribe click here.

Abstract News © Copyright 2013 INFORMATION, INC.
Powered by Information, Inc.