To view this online go to:
BlackBerry users please scroll down for story text.


This Week's Headlines

News From ACFAS
Foot and Ankle Surgery
Practice Management
Health Policy and Reimbursement
Technology and Device Trends

News From ACFAS

This Week's Healthcare Reform Update

Last week President Obama signed a bill to delay the Medicare physician reimbursement cut until April 1. The Senate is expected to vote today on a jobs bill that would extend the delay through September 30 and give Congress more time to fix the current sustainable growth rate reimbursement formula.

Experts in physician reimbursement and practice management urge physicians to:
  • Submit all claims promptly
  • Carefully monitor claims from March 1 on to be sure of receiving the proper reimbursement
  • Be mindful of the hard cap of $1,860 annually on outpatient physical or occupational therapy that went into effect January 1.
The president is currently embarked on a campaign to persuade members of Congress to take action on a healthcare reform bill sooner, rather than later, by means of legislation already proposed. His administration has also taken aim at health insurers, casting a critical eye on proposed double-digit rate hikes in many states and advocating a new federal agency to review and regulate health insurance premiums.
Read Online-only Case Reports from JFAS

One of the many benefits of membership in the College is free online access to issues of the Journal of Foot & Ankle Surgery. Log in today to read the March/April 2010 issue, featuring a comprehensive guide to conducting research and getting it published, as well as four bonus case reports available only online:
  • Clostridium septicum necrotizing fasciitis of the forefoot
  • Gastrocnemius recession in a patient with peripheral neuropathy
  • Treatment of metastatic prostate adenocarcinoma to the calcaneus
  • Application of an interosseous suture and button device for hallux valgus correction
This issue is in the mail, but you can use your member access any time to browse its original research, literature reviews, case reports, and tips, quips and pearls, as well as articles in press and the entire journal archive.
Reach Out to Patients with FOOTNOTES

Share useful foot and ankle health information with your patients and market your practice with FOOTNOTES, the free patient education newsletter exclusively for ACFAS members.

FOOTNOTES educates current and prospective patients about all the things you can do for them. You can place it in your waiting room, send it out with your billing, distribute it at community health fairs or post it on your practice’s web site.

The Spring 2010 issue helps patients learn how to spot symptoms of plantar fasciitis, safeguard children’s foot health and avoid foot pain during pregnancy. You can download it now when you log in at the ACFAS web site.

Foot and Ankle Surgery

Isolated Talonavicular Arthrodesis in Patients With Rheumatoid Arthritis of the Foot and Tibialis Posterior Tendon Dysfunction

Talonavicular joint destruction and tibialis posterior tendon dysfunction are major contributors to early development of foot deformities, and a group of researchers carried out isolated talonavicular arthrodesis in 26 patients with an average age of 43.6 years at the time of surgery between 2002 and 2005. The mean interim of immobilization after the surgery was four weeks, followed by rehabilitation; full weight bearing was permitted two to three months after surgery. Examination via magnetic resonance imaging identified a torn tendon in nine patients with no significant destruction of the talonavicular joint viewed on x-rays; the postoperative followup average was 4.5 years, while the average of AOFAS Hindfoot score improved from 48.2 preoperatively to 88.6 points at the last postoperative followup. Excellent results were seen in 18 cases, six patients had moderate foot pain, and two had severe pain in assessment with the score. The researchers conclude that early isolated talonavicular arthrodesis can greatly relieve pain and prevents further progression of the foot deformities in patients with rheumatoid arthritis and tibialis posterior tendon dysfunction.

From the article of the same title
BMC Musculoskeletal Disorders (02/27/10) Popelka, Stanislav; Hromadka, Rastislav; Vavrik, Pavel; et al.

Opening Wedge Osteotomy Performed With Plate Fixation Maintains Metatarsal Length

The employment of a specialized plate to stabilize an opening wedge first metatarsal osteotomy for patients suffering from hallux valgus exhibits good healing and correction while maintaining metatarsal length. William M. Granberry, MD, said that he would recommend the procedure "if there is any pre-existing transfer metatarsalgia." Granberry executed a proximally based opening wedge osteotomy using a low-profile plate with wedges of varying lengths on 36 feet in 28 patients, mostly women with a mean age of 55 years. "All but three of these osteotomies healed at the first x-ray," he noted.

From the article of the same title
Orthopedics Today (03/10) Brockenbrough, Gina

Obese Kids More Likely to Injure Legs, Ankles, Feet

Injury patterns of obese children look different from those of thinner children, a new study published in the journal Pediatrics shows. Researchers found that obese children had more leg, ankle, and foot injuries, but fewer injuries to the head and face, than normal-weight children. While the researchers had no information on how the children in their study were injured, they speculate that heavier kids may be more vulnerable to getting hurt while walking or running, while thinner kids may be more prone to engage in activities and sports that carry a risk of head injury.

From the article of the same title
Reuters (03/01/10) Harding, Anne

Practice Management

AMA Teams With UnitedHealth, Dell to Push Electronic Health Records

The American Medical Association has formed a partnership with UnitedHealth Group's Ingenix subsidiary to help physicians adopt and implement electronic health records. As part of the deal, AMA will offer Ingenix CareTracker, a Web-based medical record system, through its Web site. Ingenix will be part of a yet-to-be-named larger platform being created on its site to help physicians develop new technologies to enhance their practices and improve their day-to-day work environment. AMA has also signed an agreement with Dell to help doctors adopt new health information technologies.

From the article of the same title
Chicago Tribune (03/03/10) Japsen, Bruce

Electronic Prescriptions Reduce Errors by Seven-Fold

Research by physician-scientists from Weill Cornell Medical College has determined that the use of an electronic prescription system can make health care providers seven times more likely to reduce the incidence of errors committed by those writing prescriptions by hand. Lead author Rainu Kaushal says that almost two out of five handwritten prescriptions in community practices had mistakes, while senior author Erika Abramson notes that the errors "could result in callbacks from pharmacies and loss of time for doctors, patients and pharmacists." The study authors say that illustrating improvements in safety via e-prescribing is critical to encouraging its employment, particularly among community providers. The providers who took up e-prescribing in the study utilized a commercial, standalone system that supplies dosing recommendations and checks for drug-allergy interactions, drug-drug interactions, and duplicate drugs; all the practices that adopted e-prescribing were provided with technical support. It is the conclusion of the study that, in the absence of extensive technical assistance, it is difficult for physician practices to achieve high rates of e-prescribing usage and subsequent medication safety enhancements.

From the article of the same title
Newswise (02/26/10)

Medicare Pay-for-Reporting Still Gets Bad Grades from Physicians

Physician practices seeking to improve patient care by accessing feedback reports from past years continue to be frustrated by Medicare's Physician Quality Reporting Initiative (PQRI), according to a recent report from the Medical Group Management Association (MGMA). An MGMA survey of practices representing over 11,000 doctors learned that less than 50 percent could access their PQRI feedback reports from the 2008 reporting year, versus 51 percent in 2007; furthermore, 60 percent of practices that could access their 2008 reports reported dissatisfaction or extreme dissatisfaction with the information. Practices complained that the information is too complex and outdated to be much help in improving the quality of patient care. More often than not the practices elected to participate in PQRI for the opportunity to get bonuses, while many others got involved because they expect the voluntary Medicare program to eventually become obligatory. Still, Teresa Leidner with Ridgewood Orthopedic Group notes that "the measures appropriate for orthopedics, in the office environment, do not improve the quality of care for the patient."

From the article of the same title
American Medical News (03/01/10) Silva, Chris

Health Policy and Reimbursement

Health Courts Could Become Tort Reform Option

In a letter to congressional leadership, President Obama has called for funding alternative demonstration projects, such as health courts, for resolving medical malpractice disputes. Health courts, virtually unknown in the United States but used in other countries, could provide an alternative to jury trials in current medical malpractice cases. The nonpartisan Common Good, with support from the Robert Wood Johnson Foundation, has been working with a Harvard School of Public Health research team to develop a proposal for how the United States might establish a health court system.

From the article of the same title
HealthLeaders Media (03/03/10) Simmons, Janice

U.S. Medicare Panel Urges Insurer Payment Cuts

MedPac is again urging the federal government to pay private insurers that offer Medicare Advantage the same as it pays when Medicare reimburses providers directly. The commission "remains concerned that Medicare's payments to (Medicare Advantage) plans will again exceed" Medicare's fee-for-service program, a statement from the panel said.

From the article of the same title
Reuters (03/01/10)

Technology and Device Trends

How the Silk From a Fly Could Help Surgeons

The silk spun by the larvae of the caddisfly underwater could help in the creation of an adhesive tape to be used during surgery. Scientists from the University of Utah have been studying the silk and claim that its design and properties could be duplicated to design a tape that could close incisions much like a surgical suture.

From the article of the same title (03/02/10) Siegel, Lee

Is Transcutaneous Peroneal Stimulation Beneficial to Patients With Chronic Stroke Using an Ankle-foot Orthosis?

Researchers evaluated whether community-dwelling chronic stroke patients wearing an ankle-foot orthosis would benefit from changing to functional electrical stimulation of the peroneal nerve. For the study, the ankle-foot orthosis of 26 patients was replaced by a surface-based functional electrical stimulation device. Ankle-foot orthosis and functional electrical stimulation were found to be equally effective with regard to walking speed and activity level, but patients were more satisfied with functional electrical stimulation than with their ankle-foot orthosis regarding the effort and stability of walking, quality of the gait pattern, walking distance, comfort of wearing, and appearance of the device.

From the article of the same title
Journal of Rehabilitation Medicine (02/01/10) Vol. 42, No. 2, P. 117; van Swigchem, Roos; Vloothuis, Judith; den Boerm, Jasper; et al.

Abstract News © Copyright 2010 INFORMATION, INC.
Powered by Information, Inc.

You have received this newsletter as a service of the American College of Foot and Ankle Surgeons. To change your email address, please click here. If you wish to unsubscribe click here.
March 10, 2010