May 6, 2015 | | JFAS | Contact Us

News From ACFAS

Want an Apple Watch? “Watch” for Your ACFAS Survey!
Let your voice be heard—respond to either the ACFAS Member Insights or Practice Economics Survey arriving in your inbox next week! Your feedback influences the College’s direction for the next three years. Plus, six respondents will win their choice of an Apple Watch, free registration to the 2016 Annual Conference in Austin or free 2016 membership dues.

Starting May 12, via email, half of ACFAS members will receive the Practice Economics Survey, and the other half will receive the Member Insights Survey. Random sample determines which survey you’ll receive. All responses are anonymous and are only reported in the aggregate by a third-party survey consultant. Look for results on in late summer.

Keep an eye out for an email from and respond ASAP!
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Arthroscopy Students Experience New State-of-the-Art Facility
Participants in our Foot and Ankle Arthroscopy course this past weekend were the first group of ACFAS students to put their skills to the test at the brand-new Orthopaedic Learning Center (OLC) in Rosemont, Illinois.

This spacious high-tech facility features upgraded scopes and cameras and the latest surgical and audiovisual equipment to give attendees a truly hands-on educational experience. Matched with quality high-level faculty, attendees had a fabulous weekend of learning.

Our next Foot and Ankle Arthroscopy course, scheduled for June 19–20 at the OLC, is sold out, but you can contact Maggie Hjelm to be waitlisted for cancellations or 2016 programs.

Laurence G. Rubin, DPM, FACFAS, chair of the May Foot and Ankle Arthroscopy course, works with attendees in the new OLC.
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Introducing . . . the ACFAS Residency Director Center
Everything you need to make your life easier as a residency program director is now available in one place—on the new ACFAS Residency Director Center at

ACFAS’ Residency Director Center provides you with various resources, documents and tools required to obtain and maintain CPME approval. You can even access examples of CPME-required documents, including affiliation agreements, contracts, presentations from the Residency Directors Forum held at ACFAS 2015, rotational competencies and even assessment forms you can use as guides in the development of your own individual programmatic documentation—all from your computer on your time.

Developed by the ACFAS Post-Graduate Affairs Committee, the Residency Director Center is a new resource for residency programs and will consistently grow as new information is made available and developed.

Visit or through the ACFAS website Member, Resident & Student Centers tab on the right of the homepage.
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Foot and Ankle Surgery

Effect of a Home-Based Balance Training Protocol on Dynamic Postural Control in Subjects with Chronic Ankle Instability
A study was conducted to confirm the presence of postural deficits in patients with chronic ankle instability (CAI) and to determine the effectiveness of an 8-week balance training program. A total of 43 patients with CAI participated. Patients with CAI underwent the eight-week training, which included three sessions per week. Prior to training, CAI patients displayed higher instability rates than the controls; after balance training, all subjective stability scores improved significantly. There was no effect on dynamic postural control.

From the article of the same title
International Journal of Sports Medicine (04/22/15) De Ridder, R.; Willems, T. M.; Vanrenterghem, J.; et al.
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Traumatic Proximal Tibio-Fibular Dislocation: A Marker of Severely Traumatized Extremities
Researchers sought to detail the epidemiology and clinical implications of traumatic proximal tibio-fibular dislocation (PTFD). Of 1,816 patients observed, 30 had PTFD. Half of those cases were associated with a tibial shaft fracture, and the other half were associated with tibial plateau fractures. Two patients required amputation for a non-reconstructable extremity. Compartment syndrome appeared in 29 percent of the remaining 28 patients, and peroneal nerve palsy was evident in 36 percent.

From the article of the same title
Journal of Orthopaedic Trauma (04/15) Herzog, Greg A.; Serrano-Riera, Rafael; Sagi, H. Claude
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Practice Management

Building Effective Patient Education Programs
The most effective patient education programs are customized to each patient. Physicians can define general care plans and then customize those on a patient-by-patient basis by following these steps:
  1. Determine what conditions to tackle by getting to know the patient population. Physicians should hone in on those areas to begin with, set up and fine-tune a program or two and then replicate successful programs across the entire patient base.
  2. Assess patients' needs. Physicians should determine what actual resources and help particular patients require by asking about their specific self-management needs and challenges. Physicians should also assess patients' challenges and skills and build a program that can adequately meet them.
  3. Use what is available. Physicians need not start from scratch. They can adopt a program that already exists and make adjustments as needed to fit specific patients' needs and the physician's style of practicing medicine.
  4. Communicate effectively and set small targets. Physicians should let patients know about the programs and educate them about what they are expected to do. Priorities should be clearly stated, mutually understood and mutually agreed upon, and patients should be provided with information about what to do if they deviate from the plan. Physicians should keep the goals small and manageable to begin with and not overload a patient with information. Tip sheets and goal targets should be the core of the program. More information can be added as the patient progresses. Material should be kept simple, clear and to the point.
From the article of the same title
Physicians Practice (04/22/15) Madden, Susanne
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Your Best Malpractice Defenses
Physicians should follow three general guidelines to minimize damage from malpractice suits. They should reduce the risk of harming patients by following established protocols at all times, attempt to reduce the chance of a lawsuit should harm actually occur and reduce the chance of losing a suit if the patient decides to sue. Experts say that poor outcomes are not the primary impetus for legal action; instead, it is the perceived lack of communication or caring on the doctor's part that exacerbates the outcome and prompts a patient to sue. Doctors should keep lines of communication open to prevent this. Staff should be educated in proper communication skills. Follow-up is important as well. If a patient ends up taking legal action, thorough documentation could be the difference between winning and losing a case.

From the article of the same title
Medical Economics (04/20/15) Bendix, Jeffrey
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Health Policy and Reimbursement

Banned from Medicare, Still Billing Medicaid
An investigative report from Reuters indicates that more than one in five doctors in the United States who are prohibited from billing Medicare are still able to bill state Medicaid programs. The Affordable Care Act explicitly requires that states suspend billing privileges of most providers who have been revoked by another state or Medicare. The act required the U.S. Centers for Medicare and Medicaid Services to use a data-sharing system that would allow states to find terminated providers, but that system is flawed.

From the article of the same title
Reuters (04/29/15) Pell, M.B.; Cooke, Kristina
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CMS Releases Strategic Vision for Physician Quality Reporting Programs
The Centers for Medicare and Medicaid Services (CMS) has released a strategic, long-term vision for physician quality reporting programs. A blog post from Patrick Conway, principal deputy administrator and chief medical officer at CMS, says that the vision evolved out of a desire to plan for the future in how CMS administers physician quality reporting systems. CMS believes five principles will ensure that quality measurement and public reporting play a critical role in improving healthcare: input from patients, caregivers and healthcare professionals guides the programs; feedback and data drive quality improvement; public reporting provides meaningful information; quality reporting programs rely on an aligned measure portfolio; and quality reporting and value-based purchasing program policies are aligned.

From the article of the same title
Healthcare Informatics (04/24/15) Leventhal, Rajiv
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GAO Reports Three Potential Uses for Electronically Readable Medicare Cards
A report by the Government Accountability Office (GAO) found that the Centers for Medicare and Medicaid Services (CMS) could use electronically readable Medicare cards for a variety of reasons. These include authenticating consultations between providers and beneficiaries, electronically sharing data and giving insurance and identity data to providers. The cards could reduce reimbursement errors, improve medical recordkeeping and potentially curtail Medicare fraud. However, CMS officials have said that claims should still be paid even when cards are not used, in order to maintain beneficiaries' access to care, so fraud reduction would likely be minimal. Challenges in adopting these cards include interoperability and ensuring consistency with provider records.

From the article of the same title
Healthcare Informatics (04/27/15) Perna, Gabriel
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Medicare Provider Penalties, Incentives Detailed in Report
Almost 40 percent of healthcare providers treating Medicare patients failed to comply with the Physician Quality Reporting System in 2013 and will face payment deductions of 1.5 percent this year, according to the Centers for Medicare and Medicaid Services. The system was launched in 2007 to measure and improve quality of care yet is unpopular among some physicians who claim it is time-consuming and offers little clinical benefit. About 83 percent of respondents in a recent poll claimed that the programs allowed them less of a chance to care for patients. Officials are reportedly working to streamline the process and make it less burdensome.

From the article of the same title
Wall Street Journal (04/26/15) Beck, Melinda
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Medicine, Drugs and Devices

Increased Vertical Impact Forces and Altered Running Mechanics with Softer Midsole Shoes
A study was conducted to quantify the effect of shoe midsole hardness on ankle and knee joint stiffness and the associated vertical ground reaction force. Ninety-three runners aged 16 to 75 were observed. The vertical impact peak increased as the shoe midsole hardness decreased. Apparent ankle joint stiffness also increased as shoe midsole hardness decreased. Apparent ankle joint stiffness increased with soft midsoles compared to medium midsoles.

From the article of the same title
PLoS ONE (04/15) Baltich, Jennifer; Maurer, Christian; Nigg, Benno M.
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Obama Proposes That Medicare Receive the Right to Negotiate Drug Costs
President Obama's budget request to Congress proposes a new initiative to develop personalized medicine tailored to an individual's genetics, while expressing concern about the costs of such treatment. Obama has asked Congress to let Medicare officials negotiate prices with drugmakers, which is forbidden under current law. The National Institutes of Health is developing the administration's “precision medicine” initiative to develop personalized therapies for diseases such as cancer and cystic fibrosis. However, existing personalized medicines remain costly, and patients often pay high out-of-pocket expenses. The Medicare Payment Advisory Commission told Congress in March that the “use of high-cost drugs poses a big challenge” for the government and Medicare beneficiaries, who usually pay 25 percent to 33 percent of the cost of specialty drugs.

From "Obama Proposes That Medicare Be Given the Right to Negotiate the Cost of Drugs"
New York Times (04/28/15) P. A16 Pear, Robert
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Open Payments Database Draws 1M Visitors
The 4.45 million public records of financial relationships between healthcare providers and pharmaceutical and medical device companies had 1 million online viewers last year, the Centers for Medicare and Medicaid Services (CMS) said in its annual report to Congress. Under the Affordable Care Act, CMS must gather information about financial relationships to encourage transparency of the ties between industry and providers. In its first annual Open Payments report, CMS said that traffic spiked with increased social media attention between Feb. 8-14, 2015, when visitors triggered 2.5 million unique page views. The published data represent $3.7 billion in payments to physicians and teaching hospitals from drug and device companies in the last five months of 2013.

From the article of the same title
Medical Marketing & Media (04/27/15)
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Senators Reintroduce MEDTECH Act Loosening FDA Regulation on HIT Software
The Medical Electronic Data Technology Enhancement for Consumers' Health (MEDTECH) Act, which exempts certain health-related software and technology from federal regulation, has been reintroduced by a bipartisan duo of senators. Sens. Orrin Hatch (R-Utah) and Michael Bennett (D-Colo.) are backing the act, which they suggest will help provide greater certainty within the regulatory environment and be a boon for innovation in health IT. The bill itself would exclude some devices and software from oversight by the U.S.Food and Drug Administration. These devices include items used for administrative and operational support of a healthcare organization. Also included for exemption is software intended to assist in healthy living and electronic patient records and lab reports that do not include software intended for clinical diagnoses.

From the article of the same title
Becker's Health IT (04/29/2015) Jayanthi, Akanksha
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

Daniel C. Jupiter, PhD

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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