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News From ACFAS

ACFAS 2021 – Vegas Style!
ACFAS 2021 is officially underway as attendees join us both virtually and in-person in Vegas for the 79th Annual Scientific Conference.

We kicked off this year’s meeting Monday with virtual pre-conferenceZDoggMD at ACFAS 2021 programs and yesterday ZDoggMD led the opening general session energizing the crowd for the first full day of sessions. Today brings more trending topics on the latest in foot and ankle surgery and the 2021 poster and manuscript winners were honored at the ACFAS Honors and Awards Ceremony. Congratulations to this year’s award winners!

We’re excited to bring you a new adventure with #ACFAS2021. Be a part of the action by following along with us on social media and if you’re joining us from home or in Vegas, share your meeting experience with us.
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Dr. Eric Walter Receives the 2021 Distinguished Service Award
Congratulations to Eric Walter, DPM, FACFAS on receiving this year’s ACFAS 2021 Distinguished Service Award!

Dr. Walter embodies the drive and attributes of a leader and has been heavily involved with the College from the time he joined. Immediate Past President Scott Nelson, DPM, FACFAS recognized Dr. Walter during the ACFAS virtual Member Meeting in March. Dr. Nelson shared, “I have had the pleasure of seeing Eric Walter lead our Regions Presidents Council and serve on the Voard of Directors. His work ethic, creative ideas and personal skills exemplify the qualities of this award, and I am proud to be able to give him this award.”

Read more about Dr. Walter’s involvement with the College and history of service in the current issue of ACFAS Update at
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Christine Grossman Honoree
The 2021 Christine Grossman Award was presented to Amber Shane, DPM, FACFAS this week at ACFAS 2021 in Las Vegas. Each year, ACFAS honors the spouse of a Past ACFAS President recognizing their steadfast commitment and support of their significant other while they serve on the ACFAS Board.

The award, presented by Jordan Grossman, DPM, FACFAS, is named for his late wife Christine who served as a Christine Grossman Honoree, Amber Shane, DPM, FACFASperfect model for this honor as a tremendous source of support throughout Dr. Grossman’s career and tenure as president of the College, while she balanced her own career and their family. As this year’s recipient, Dr. Shane exemplifies the true meaning behind the recognition with her own personal dedication to the College as she gracefully balanced her own career as a foot and ankle surgeon while being the support system and rock for her two children and husband, past ACFAS President Christopher Reeves, DPM, MS, FACFAS.

Thank you to Dr. Shane for your continued support and to Dr. Grossman for helping us recognize the behind-the-scene heroes in honor of Christine.
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Foot and Ankle Surgery

Is Early or Delayed Weightbearing the Better Choice After Microfracture for Osteochondral Lesions of the Talus? A Meta-Analysis and Systematic Review
A study sought to determine whether early weightbearing (EWB) or delayed weightbearing (DWB) is the better rehabilitation option following arthroscopic microfracture for treating osteochondral lesions of the talus (OLT). The researchers searched five databases for relevant studies and reviewed full-text articles comparing EWB and DWB. Analysis of five randomized controlled trials including 283 patients showed no significant difference in pain scores between EWB and DWB following microfracture three months, six months, 12 months and 24 months postoperatively. Function assessment yielded similar results. Comprehensive analysis of current evidence still suggests EWB and DWB produce comparable clinical outcomes in terms of pain and functional activity after microfracture of OLT. EWB is thus recommended to shrink the duration before returning to work or sports after microfracture of OLT.

From the article of the same title
Journal of Foot & Ankle Surgery (05/10/21) Song, Mingzhi; Li, Shipeng; Yang, Simengge; et al.
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Lower Limb Biomechanics in Individuals With Chronic Ankle Instability During Gait: A Case Control Study
A case-control study was held to identify kinematic, kinetic and electromyography (EMG) differences in lower limb biomechanics between individuals with chronic ankle instability (CAI) and healthy controls during walking. The researchers recruited 28 individuals with CAI and 26 controls to walk at a self-selected speed during which lower limb kinematics, kinetics and EMG were assessed. The CAI group had greater ankle inversion angles from 14 to 48 percent of the stance phase (%SP), ankle eversion moments from 40 to 78%SP, knee abduction moments from 3 to 6%SP and peroneus longus muscle activity from 0 to 15%SP and 60 to 76%SP versus the control group. No significant between-group differences in ankle sagittal and transverse angles and moments, knee angles, knee sagittal and transverse moments or gluteus medius, vastus lateralis, gastrocnemius lateralis and tibialis anterior muscles activity were observed. Individuals with CAI could be at more risk of sustaining recurrent lateral ankle sprain during the first half of the stance phase mostly because of greater ankle inversion angles. Yet the greater ankle eversion moments and peroneus longus muscle activity during the second half could efficiently correct this maladaptive problem and allow attenuation of faulty ankle movements during the pre-swing phase.

From the article of the same title
Journal of Foot and Ankle Research (05/03/2021) Vol. 14, No. 36 Moisan, Gabriel; Mainville, Camile; Descarreaux, Martin; et al.
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Midterm Outcome of Subtalar Joint Revision Arthrodesis
A study sought to evaluate the midterm clinical and radiologic outcomes of subtalar joint revision arthrodesis and analyze risk factors that might influence these results. The investigators conducted a retrospective review of 20 patients post-subtalar joint revision arthrodesis for malunion, using interposition of iliac crest bone graft. Mean age was 55.75 years with an average follow-up of 48.93 months. Eighty-five percent of patients had at least one risk factor identified before revision. A fusion rate of 80 percent was documented whereas 20 percent of cases concluded with a painful pseudarthrosis requiring more surgery. Pedobarographic measurements showed that loading skews toward the lateral column, but with no substantial effect on gait. Seventy percent of patients in this group were satisfied, 20 percent found the result fair and 10 percent were unsatisfied. Versus the preoperative assessment, postoperative functional scores showed significant improvement on the Foot and Ankle Outcome Score, American Orthopaedic Foot & Ankle Society Scale and Foot Function Index.

From the article of the same title
Foot & Ankle International (05/03/21) Chraim, Michael; Recheis, Simon; Alrabai, Hamza; et al.
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Practice Management

How to Improve Your Practice's Online Presence Post-Pandemic
Private healthcare practices have been slow to bring online marketing of their services into the modern era, but the pandemic and the environment to follow could jolt them into action. Recent innovations now make marketing resources used by large healthcare firms available to mid-sized practices at a more affordable cost than hiring a full-service agency. Of vital importance is Google having accurate information about practices in order to accommodate "Zero Click Searches," and practices can ensure the constant accuracy of their online information by using Software as a service platforms (SaaS) that manage all the various digital sources with one click. Also of value to practices is implementing a voice strategy so customers to get direct, actionable answers to spoken queries, regardless of how they ask their questions. New SaaS marketing platforms can further deliver an all-encompassing marketing view for only about a $100 a month.

From the article of the same title
Physicians Practice (05/11/21) Penn, Nicole
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How to Simplify and Improve Physician Referrals With Data
Decision support technology can simplify the referral process for physicians and patients, saving time and improving the patient outcome and experience. Probing the referral physician's performance, which should include an analysis of a broad set of cost, quality, outcome and other data, can help spot opportunities where the accountable care organization (ACO) can back that physician in performance improvements. By showing the physician objective data on cost and outcomes, the ACO or health system can illustrate how they could boost referral volume and improve quality metrics and drive stronger financial performance for the organization. Health systems and ACOs may need to partner with a third-party data provider to fill gaps in claims data for care delivered out of network, which also can supply years of non-publicly available quality data for a referral network. Also essential are social determinants of health factors of the patient, like their primary language or proximity to the patient's home location. All of this information can be automatically compiled and analyzed via population health management technology that can produce a numerical score for each physician in the referral network based on patient factors and the physician's performance across multiple quality and cost metrics.

From the article of the same title
Medical Economics (05/07/21) Cheatham, Matt
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MGMA: The COVID Impact on Medical Practices
An MGMA survey highlighted the COVID-19 pandemic's challenges to physician practices and medical groups. Nearly one-third of healthcare leaders disclosed an unexpected physician retirement last year as clinical staffers faced unprecedented stress from treating infected patients. Almost every physician practice observed declining patient volumes in April 2020, but by June 87 percent had recovered some of that, while work Relative Value Units by June had exhibited near or above the reported levels for February and March. Over 80 percent of healthcare leaders said the pandemic impacted some or all their providers' compensation, with surgical and nonsurgical physicians experiencing the largest compensation decrease from the beginning of the crisis into summer 2020. Practices witnessed a drop in total operating costs due to increased personal protective equipment expenses and lower patient volumes, which triggered spending cuts elsewhere. The poll also cited six factors that healthcare leaders recognized as helping their practices weather the pandemic: rapid, efficient response to relief aid efforts; staffing stability and resilience; finding the right telehealth offerings; reexamining payments and collections for patients; maintaining open communication and engagement digitally and by phone; and addressing concerns of employee well-being.

From the article of the same title
HealthLeaders Media (05/10/21) Blackman, Melanie
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Health Policy and Reimbursement

Biden Administration Announces Reversal of Trump-Era Limits on Protections for Transgender People in Healthcare
The US Department of Health and Human Services (HHS) announced that the Biden administration is reversing a Trump-era policy that limited protections for transgender people in healthcare. Healthcare providers and other health-related organizations who receive federal funding will be banned from discriminating based on someone's gender identity or sexual orientation. "The Supreme Court has made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation," stated HHS Secretary Xavier Becerra. "That's why today HHS announced it will act on related reports of discrimination." HHS said on Monday that 25 percent of LGBTQ people who have faced discrimination delayed or avoided receiving necessary medical care out of fear of further discrimination. "The mission of our Department is to enhance the health and well-being of all Americans, no matter their gender identity or sexual orientation," said HHS Assistant Health Secretary Rachel Levine. "All people need access to healthcare services to fix a broken bone, protect their heart health and screen for cancer risk. No one should be discriminated against when seeking medical services because of who they are."

From the article of the same title
NBC News (05/10/21) Shabad, Rebecca
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House Hearing on HHS Budget Looks at Grab Bag of Issues
This week's House hearing on the US Department of Health and Human Services (HHS) budget request for fiscal 2022 highlighted subjects like COVID-19 provider relief funding, surprise billing and medication-assisted treatment. "Now more than ever, we must ensure that HHS has the resources to achieve its vision and protect the health of our communities,"said HHS Secretary Xavier Becerra before the House Energy and Commerce Health Subcommittee. US Rep. Frank Pallone (D-NJ), chairman of the full House Energy and Commerce Committee, queried about disbursing Provider Relief Fund money, stressing that the administration should "permit providers who have received these critical funds to extend their availability to the end of 2021, as we continue to respond to COVID."

From the article of the same title
MedPage Today (05/12/21) Frieden, Joyce
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One Million Sign Up for Healthcare During Special Enrollment
The White House announced on May 11 that 1 million Americans had signed up for health insurance under the Affordable Care Act (ACA) during a special enrollment period for those needing coverage during the coronavirus pandemic. The insurance markets were reopened in February for a special six-month enrollment period, and President Biden said the United States has made "enormous progress" in expanding access to health insurance. He also said he wants to build on the ACA to push the United States toward coverage for all.

From the article of the same title
Associated Press (05/11/21)
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Medicine, Drugs and Devices

Healthcare Organizations Are Ideal Prey for Cybercriminals. What Can Be Done to Foil Them
Healthcare organizations are a lucrative target for cybercriminals because they offer a wealth of sensitive data, including patients' home addresses, social security numbers and banking information. Moreover, none of the information stolen in breaches against healthcare can be changed upon detection, and many organizations rely on outdated security software and make low cybersecurity investments. Strategies that healthcare companies are advised to implement to boost cybersecurity and protect patient information include adopting zero-trust network access, encrypting medical files to foil data leaks in ransomware and keeping up-to-date backups available. Other recommended safeguards include training employees on cybersecurity and using a virtual private network for a safe online connection.

From the article of the same title
Managed Healthcare Executive (05/21) Noble, Oliver
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Social Media Networking Doesn't 'Level the Playing Field' for Women Physicians
Research published in JAMA Network Open found networking on social media does not equalize professional benefits between male and female physicians. The researchers polled 577 people between February 6 and March 20, 2019, and men were more likely than women to receive requests to give talks and participate in other scholarly activities through social media. Male participants also were more likely to use social media for research and educational purposes, while women were motivated to use social media for additional social support. Northwestern's Nicole Woitowich attributed this to men encountering less sexual and verbal harassment and gender bias than women in academic medicine and not requiring an outlet to seek advice and counsel from their same-gendered peers. "It turns out the same biases that promote men are occurring online as well," she said. The University of Illinois Chicago's Shikha Jain said women can avail themselves of resources to make sure these inequities do not persist, including groups like Women of Impact and the Women in Medicine Summit, which have founded strategic social media amplifiers to highlight underrepresented voices. "Others, such as IMPACT and Dear Pandemic, have leveraged social media to collaboratively lift up the voices of women experts while also becoming trusted resources during the COVID-19 pandemic," she added.

From the article of the same title
Northwestern Now (05/13/21) Samuelson, Kristin
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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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