June 12, 2013
Have you seen the all-new yet?

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News From ACFAS

New Free Marketing Tool: “The Foot and Ankle Surgeon” Brochure
Help market yourself and your practice to new patients with the new, free ACFAS Marketing Tool, "The Foot and Ankle Surgeon" brochure. This easy-to-follow, fact-filled, downloadable brochure explains these topics and more to your current and future patients:
  • Why choose a Foot and Ankle Surgeon?
  • When should you see a Foot and Ankle Surgeon?
  • Is it normal to have pain in the foot and ankle?
  • If I go to a Foot and Ankle Surgeon, does that mean my pain will be treated surgically?
The brochure is just one of the valuable tools you'll find in the new ACFAS Marketing Toolbox on the redesigned website. Members can either print copies of the brochure right on their office printer/copier or send it to a commercial printer for larger quantities. Plus, the brochure also has a customization box for you to add your practice information. Just log in to the page, download the brochure and print and distribute at your local health fairs or lectures, in your office or give to referring physicians to pass along to their patients. The promotional opportunities are endless.
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Don't Miss Out - Practice Management Seminar Next Month
Space is filling quickly for the 2013 Perfecting Your Practice: Coding/Practice Management Workshop, which will take place July 19-20 at the Millennium Knickerbocker Hotel in Chicago, just steps from the "Magnificent Mile," otherwise known as Michigan Avenue. Invite your office staff to join you in the Windy City to brush up on the latest changes for how to best manage your practice, and later, venture out to the wonderful night life the city has to offer along State Street, Navy Pier, or in the popular River North neighborhood.

Attendees will be exclusively privy to our speakers’ analyses of these topics:
  • Coding for Evaluation and Management, Surgical Procedures and Use of Modifiers
  • Electronic Health Records and Meaningful Use Attestation
  • HIPAA Omnibus Final Rule Requirements
  • Transitioning to ICD-10
  • Providing and Getting Reimbursed for Durable Medical Equipment
  • Measuring Practice Success
The seminar brochure and registration form are available at, under the Practice Management heading in the Education and Professional Development tab. Register today! Availability is limited.
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New ACFAS Student Club Presidents Take Office
As one school year has ended and another is soon beginning, ACFAS is proud to welcome our newest student club presidents to our team! We hope these ACFAS student clubs are off to a good start and have a highly successful year.

Presidents for the 2013-2014 school year include:
  • AzPod: David R. Hatch, Class of 2015
  • Barry: Philip Adam Jones, Class of 2015
  • CSPM: Benjamin McGrath, Class of 2015
  • DMU: Jordan Gardner, Class of 2016
  • Kent State: Jared Preston, Class of 2015
  • NYCPM: Heidi Godoy, Class of 2015
  • Scholl: Blake Brannick, Class of 2016
  • Temple: Michael Berger, Class of 2015
  • Western U: Bryant Nachtigall, Class of 2016
Each of the nine podiatric medical schools within the United States maintains an ACFAS Student Club. Benefits of belonging to any one of these clubs are that they expose students to more specific surgical techniques, they are visited annually by ACFAS Board Liaisons, and most clubs provide opportunities for community service and fundraising events.
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Foot and Ankle Surgery

Additional Surgical Factors Affecting the Recurrence of Hallux Valgus After Ludloff Osteotomy
Researchers reviewed 91 patients (103 feet) who underwent a Ludloff osteotomy combined with additional treatments to assess factors affecting the recurrence of hallux valgus after the procedure. According to the combined procedures performed, patients were divided into three groups: Group I (31 feet; first web space release), Group II (35 feet; Akin osteotomy and trans-articular release) or Group III (37 feet; Akin osteotomy, supplementary axial Kirschner (K-) wire fixation and trans-articular release). Each group was then further subdivided into severe and moderate deformities.

The mean hallux valgus angle correction of Group II was significantly greater than that of Group I (p = 0.001). The mean intermetatarsal angle correction of Group III was significantly greater than that of Group II (p < 0.001). In severe deformities, postoperative incongruity of the first metatarsophalangeal joint was least common in Group I (p = 0.026). Akin osteotomy significantly increased correction of the hallux valgus angle, while a supplementary K-wire significantly reduced the later loss of intermetatarsal angle correction.

Additionally, HAVING NO K-wire fixation (OR 5.05, 95 CI 1.21, 24.39); p = 0.032) and the preoperative hallux valgus angle (OR 2.20, 95 CI 1.11, 4.73; p = 0.001) were shown to be factors affecting recurrence of hallux valgus after Ludloff osteotomy.

From the article of the same title
Bone & Joint Journal (06/13) Vol. 95-B, No. 6, P. 803 Choi, G.W.; Choi, W.J.; Yoon, H.S.; et al.
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Effect of Elastic Taping on Postural Control Deficits in Subjects with Healthy Ankles, Copers and Individuals with Functional Ankle Instability
Researchers examined the immediate and prolonged effects of kinesio taping on postural control in healthy, coper and unstable ankles as measured through single-limb balance on a force plate. Sixty physically active participants were grouped into healthy, coper or unstable groups using the Cumberland Ankle Instability Tool (CAIT) combined with their history of ankle injury. Dependent variables included time-to-boundary (TTB) measures and traditional center of pressure (COP) measures in both the mediolateral (frontal) and anteroposterior (sagittal) planes. Testing was performed prior to tape application, immediately after application of the tape, 24 hours following tape application and immediately after tape removal.

Significant differences between groups were observed for COP standard deviation and range in the sagittal plane. Significant differences between tape conditions for TTB absolute minima and standard deviation were also noted. Post hoc testing revealed large to medium effect sizes for the group differences and very small effect sizes for the differences between conditions.

From the article of the same title
Foot & Ankle International (05/13) Shields, C.A.; Needle, A.R.; Rose, W.C.; et al.
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Practice Management

5 Note-Taking Apps that Will Boost Physician Productivity
There are a variety of different smartphone and tablet apps, some of which are free or cost less than $10, that healthcare professionals can use to help them be more productive both inside and outside the office. Among them is Evernote, a free productivity app that Medical Web Experts blogger Suzy Mage says is the best of its kind. The app allows doctors to take patient notes and photos and record voice memos for themselves. Another free app is Catch Notes, which allows users to create and share notes and to-do lists with their colleagues. This app uses hashtags similar to those used on Twitter to make categorizing and searching notes easier. Healthcare professionals whose handwriting tends to be illegible might find an app called MyScript Notes to be helpful. This app, which costs $7.99, converts handwritten notes into digital text that is easier to read. Using such apps, particularly on a tablet, can help healthcare professionals gain 1.2 hours of productivity each day, a study released earlier this year by CDW found.

From the article of the same title
Medical Economics (06/03/13) Ritchie, Alison
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Doctors Are Choosing iPad Tablets over Other Devices, Survey Says
A recent Black Book Rankings survey has found that a large number of doctors are accessing electronic health records (EHRs) on mobile devices, usually Apple iPads. The survey found that 83 percent of physicians are now using EHRs on mobile devices, and that 59 percent of office-based doctors are using tablets for record keeping. Of those who are using tablets for record keeping, 68 percent said they preferred the iPad over tablets running Android and other operating systems. Although the large majority of physicians surveyed said they carried a smartphone, they said that they tended not to use these devices as much as tablets when accessing EHRs because their displays are too small. Meanwhile, vendors are also embracing iPads for EHR systems, the survey found. More than 120 vendors already use iPads for EHRs, according to the survey, and an additional 135 are planning to use the devices for future medical entry systems.

From the article of the same title
The Inquisitr (06/02/2013)
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What Practices Should Look for in Job Seekers' Social Media Presence
Experts say practices that wish to search potential job candidates' social media sites should first have some idea of what information to look for. A 2012 survey by Harris Interactive found that 65 percent of practices that use social media want to see if candidates present themselves professionally, 51 percent want to ascertain if a candidate fits well within the practice culture and 45 percent want to learn more about a candidate’s qualifications. Twelve percent said they use social media to seek reasons not to hire a candidate.

Practices search social media because they are seeking consistency in culture and want to determine that the person they are hiring possesses the same qualities they think that person has. There are degrees of offensiveness that most employers would not find useful. Social media searches can also be helpful to ensure a potential new practice member has not made any inflammatory remarks or is not a member of a hate group. The importance of conducting rigorous background searches via social media increases with the importance of the position being filled.

Practices run a legal risk of acquiring access to information that they cannot apply legally in the hiring process, such as ethnicity, religion, disability and pregnancy. Those wishing to use social media during the interview process should hire a third party with a background in screening job candidates to conduct the search, since that person would have knowledge of relevant state laws. A practice that wants to conduct the search itself should assign the task to someone in the human resources department and restrict the search to business sites such as LinkedIn, where data pertinent to the job is more likely to be found. The search should go back no further than a decade. Searches can also be made on sites meant exclusively for physicians.

From the article of the same title
American Medical News (06/03/13) Caffarini, Karen
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Health Policy and Reimbursement

CMS Unveils Charges for Outpatient Hospital Procedures
Pricing data on 30 hospital outpatient procedures released by the Centers for Medicare & Medicaid Services show that the amounts that hospitals charge patients vary greatly. Disparities in pricing for the same procedure could result in greater scrutiny and regulation of hospitals, which in turn could require them to make even more disclosures and provide a rationale for the prices of the procedures they perform, a report issued last month by Moody's concluded. Meanwhile, Federation of American Hospitals CEO Chip Kahn criticized the release of the pricing data, saying that it does nothing to provide price transparency to consumers. To help consumers have a better idea of what their out-of-pocket healthcare expenses will be, Kahn said, insurers should be required to provide their members with "meaningful cost-sharing information."

From the article of the same title
Modern Healthcare (06/04/13) Kutscher, Beth
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House Republicans Focused on SGR Fix
The House Energy and Commerce Committee has released a draft bill that would repeal the sustainable growth rate (SGR) formula, though a Pennsylvania Democrat has introduced a proposal of her own. The committee's bill would implement a period of payment stability and calls for the development of an improved fee-for-service program. The legislation would also apply quality measurement to payments and allow healthcare providers to opt out of the new fee-for-service program and instead adopt an alternative such as an accountable care organization or a patient-centered medical home.

The proposal has been criticized by Rep. Allyson Schwartz (D-Pa.), who says that it only slightly modifies the fee-for-service model rather than moving away from it altogether. Schwartz has released a proposal of her own that also repeals SGR and calls for a 2.5 percent annual increase between 2015 and 2018 for primary care, preventive and care coordination services provided by clinicians for whom 60 percent of their Medicare charges are for those services. All other physicians services would receive a 0.5 percent annual increase for four years.

From the article of the same title
Modern Healthcare (06/04/13) Zigmond, Jessica
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Politics May Give HHS Chief Control of Medicare IPAB
Congress and President Obama have not yet recommended individuals for the Medicare Independent Payment Advisory Board (IPAB). If none are appointed, Health and Human Services Secretary Kathleen Sebelius would be given responsibility for cutting the Medicare program in years where spending outpaces growth targets. Even though such cuts are not projected to happen for several years, many lawmakers are concerned about too much power over the health system being consolidated in a single person. If the IPAB does not submit cuts when called for, the secretary must do so, and the budget recommendations automatically become law unless Congress replaces them or the Senate overrules the panel with a two-thirds majority vote.

From the article of the same title
American Medical News (06/03/13) Fiegl, Charles
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Medicine, Drugs and Devices

Obama Administration Seeks to Ease Approvals for Antibiotics
The Obama administration is taking several steps to bring new antibiotics to market more quickly, as part of an effort to address the growing problem of drug-resistant infections. Perhaps the most controversial proposal by federal health officials involves allowing drug companies to perform smaller studies of patients with life-threatening infections and few treatment options that do not compare the use of new antibiotics with standard treatments. Studying only a small number of patients could reduce the cost of developing new antibiotics, one Food and Drug Administration official said, which in turn could make antibiotics research and development more profitable for drug companies. But some experts have criticized the proposal, saying that drug companies that want to develop new antibiotics should be required to prove that their products actually save lives.

From the article of the same title
NPR Online (06/04/13) Knox, Richard
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Research Shows Way to Improve Stem Cells' Cartilage Formation
Researchers at the University of Pennsylvania say they may have developed a technique for growing new cartilage from a patient's own stem cells. The technique, described in a study published in the Proceedings of the National Academy of Sciences, involves using mesenchymal stem cells and encapsulating them in a gel that contains a peptide that mimics the action of cadherins.

Researchers tested several types of gels, and found that gels containing the cadherin peptide displayed the highest number of genetic markers of chondrogenesis. These peptide-containing gels also performed more like natural cartilage than the other gels and produced more markers of cartilage matrix formation. Researchers said that further studies need to be done on how chondrogenesis response translates into longer term tissue function in vivo.

From the article of the same title
Medicalxpress (06/04/2013)
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Skele-Gro: How Scientists Are Attempting to Regrow Bones
Scientists at Britain's Southampton and Northampton universities have developed a new technique for growing bone and cartilage that could be particularly beneficial for patients who are too injured to exercise. The technique involves injecting patients with a gel containing growth factors and stem cells taken from various locations in their bodies, such as the skin. The gel solidifies once inside the body to create a scaffold for stem cells to grow on. In addition, the growth factors interact with the stem cells and cause them to develop into cartilage. Magnetic nanoparticles are also attached to the outer surface of the stem cells. Patients then put on a magnetic bandage to encourage the stem cells to grow into bone. The technique has proven successful at repairing damaged bones in mice and chickens. Pre-clinical trials that will test the use of the technique in humans are scheduled to begin later this year, with clinical trials taking place sometime within the next five years.

From the article of the same title (06/02/13) Gray, Richard
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