July 8, 2015 | | JFAS | Contact Us

News From ACFAS

2014 Open Payments Data Now Live
According to the Centers for Medicare & Medicaid Services, doctors and teaching hospitals received $6.49 billion from drug and medical device makers in 2014. Payments are listed in two categories: 1) money to fund research and 2) payments to entertain doctors or compensate them for consulting or other non-research purposes. The disclosures cover payments to about 607,000 doctors and 1,121 teaching hospitals. Overall, companies made $3.23 billion in payments for research and $2.56 billion for other purposes, according to a summary posted on the Open Payments website. The data also includes ownership interests of $703 million.
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Get On the Road with ACFAS
If the life you love is learning alongside your colleagues, then get “On the Road” again with ACFAS this fall for Complex Foot Surgery with Advanced Solutions.

This new regional program features cutting-edge content developed by our Education and Scientific Affairs Committee and includes a hands-on (sawbones) lab. You’ll also earn 12 continuing education contact hours while working with your colleagues in a state-of-the-art environment.

Dates are listed, and registration information will be available next week. Don’t miss the things you may never see again in complex foot surgery!
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Live & In Concert: ACFAS 2016 in Austin
Willie Nelson, Sandra Bullock and Matthew McConaughey can’t be wrong. They call Austin, Texas home, and in just seven short months, the Live Music Capital of the World will also be home to ACFAS 2016.

Join us February 11–14, 2016, at the Austin Convention Center for all of your favorite hits—show-stopping sessions and workshops, applause-worthy exhibits and award-winning posters, papers and case studies.

And getting to Austin is easier than ever now that Austin-Bergstrom International Airport has nonstop flights from Orlando, London, Seattle and everywhere in between.

Watch and ACFAS publications for the latest updates and prepare to take center stage with us soon!
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Make Work for You, ACFAS’ consumer education website, had a record-breaking 4.837 million visitors in 2014 and is on track to have another banner year.

Many of these visitors could be your potential patients, so follow these easy tips to make the most of

Add a Link to on Your Website
  1. Copy and paste the following code to the back end of your website:
<a href=“”></a>
  1. Include text with the link such as, “To learn more about foot and ankle conditions, visit the American College of Foot and Ankle Surgeons’ patient education website,"
Get Listed on
  1. Log into your account at
  2. Click on Profile near your name at the top of the page.
  3. Click “Yes” next to Consumer Physician Search.
  4. Your name and practice contact information will now appear in physician search results on
Remember, you can log into anytime to update your expanded profile.
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Foot and Ankle Surgery

A Randomized Controlled Trial Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot Ulcers
A recent randomized controlled trial aimed to compare telemedical and standard outpatient monitoring in the care of patients with diabetic foot ulcers. Researchers randomized 401 participants for the study. Of 374 who were eligible, 193 received telemedical monitoring, and 181 received standard care. No significant differences were detected between the groups regarding wound healing or amputation. A higher mortality incidence in the telemedical group was noted. Researchers concluded that the lack of a significant difference between the two groups was a promising development. However, the higher mortality rate for telemedicine raises further questions about monitoring diabetic foot ulcers. Further studies are warranted to investigate the effects of telemedicine on mortality and other clinical outcomes.

From the article of the same title
Diabetes Care (06/15) Rasmussen, Benajmin S. B.; Froekjaer, Johnny; Bjerregaard, Mads R.; et al.
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Influence of Ankle Position and Radiographic Projection Angle on Measurement of Supramalleolar Alignment on Anteroposterior and HAV
Researchers recently sought to determine how changes in x-ray beam projection angle from the horizon, tibiotalar joint angle and axial rotation of the foot influenced measurements of the medial distal tibial angle (MDTA) on the anteroposterior (AP) and hindfoot alignment views (HAV). They used digitally constructed radiographs (DRRs) to do this. Seven cadaver foot-ankle specimens were scanned at fixed tibiotalar joint positions ranging from 15 degrees of dorsiflexion to 25 degrees plantarflexion. DRRs were created from each scan. When the horizontal projection angle was altered by 5 degrees and >10 degrees, the MDTA for the AP view and the HAV were significantly altered. Shifting dorsiflexion and plantarflexion caused minor changes in the MDTA that were only significant for the HAV. Axial rotation changed the MDTA on both views and were more pronounced for the HAV. The MDTA on the AP view was less sensitive than the HAV counterpart. The researchers suggested that the AP view should be used to avoid misinterpretation of the MDTA.

From the article of the same title
Foot & Ankle International (06/26/2015) Barg, Alexej; Amendola, Richard L.; Henninger, Heath B.; et al.
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Tool for Rapid & Easy Identification of High-Risk Diabetic Foot: Validation & Clinical Pilot of the Simplified 60 Second Diabetic Foot Screening Tool
Early identification of patients at high risk for diabetic foot ulcers is critical to avoid amputation. The Simplified 60-Second Diabetic Foot Screening Tool is designed to rapidly detect high-risk diabetic feet. It is geared toward low and middle-income settings. Researchers put together a study to evaluate the clinical performance and reliability of the Simplified 60-Second Diabetic Foot Screening Tool to determine its applicability. Eighteen Guyanese patients with diabetes were assessed. In total, 48 percent of patients either had existing diabetic foot ulcers or were determined to be high-risk patients. If it is adopted on a larger scale, the amputation rate for patients with diabetes could decrease significantly.

From the article of the same title
PLoS ONE (06/15) Woodbury, M. Gail; Sibbald, R. Gary; Ostrow, Brian; et al.
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Practice Management

Help Your Medical Practice Hire Well
For managers, the hiring process can be a long and difficult task with risk. To hire more efficiently:
  1. Look for internal candidates. Often, the best options are right under your nose, and their familiarity with the practice could lend itself to a more well-rounded employee. If looking internally is not an option, post the position as soon as possible.
  2. Use the Internet or job boards on websites within your network of hospitals and medical societies. In addition, you should use employment applications that ask questions not answered in a resume. This will reveal information like ending pay rate and the reason the applicant left a certain position.
  3. Review job applications prior to the interview. This will allow for more comprehensive and confident questioning and will give you several more topics to address during the interview.
  4. Communicate your follow-up process. If you like a particular candidate, it is essential that he or she know when to expect a hiring decision.
From "Help Your Medical Practice Hire Well"
Physicians Practice (06/24/15) Capko, Judy
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Study: Disconnect Between Patients and Physicians on Use of Online Communication Tools
New research suggests that patients and physicians engage in discourse over social media platforms despite recommendations from some hospitals and organizations that this contact should be limited. The study, conducted by researchers at the Johns Hopkins Bloomberg School of Public Health, noted a disconnect between what patients expect and what physicians are willing to divulge online. Study leader Joy Lee said the medical profession must incorporate online interaction into practices because it is a new reality that must be harnessed to allow patients the access and control they desire. According to Lee, the percentage of patients using websites like Facebook to contact their doctors will likely increase even though most institutions discourage the activity. Patients between the ages of 25 and 44 were most likely to use email or Facebook to contact their doctors; 49 percent of those respondents claimed to have used these methods within the last six months. In addition, 46 percent of patients reported the desire to use email and social media to fill prescriptions. The American College of Physicians and the Federation of State Medical Boards advises physicians to strictly limit their online communication with patients. The study was published online June 24 in the Journal of General Internal Medicine.

From the article of the same title
News-Medical (06/27/15)
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The Doctor Will See You Eventually: Long Wait Times Scrutinized
A new report released by the Institute of Medicine (IOM) shows that large variability exists in how long Americans wait to see a healthcare professional, ranging from same-day service to waits of up to several months. The report, titled Transforming Healthcare Scheduling and Access: Getting to Now, seeks to answer two questions in particular: How can timely care be ensured in various healthcare settings, and what are the reasons why care is sometimes not timely? Several principles are outlined, including immediate attention to patients' needs and timing preference at the time of inquiry, need-tailored care with reliable alternatives and surge contingencies. The report also says any changes will only come with national leadership. Reducing wait times will take "systems-based approaches" akin to those applied successfully in other industries. "There is a need for leadership at both the national level and at each healthcare facility for progress to be made in improving health care access, scheduling and wait times," said IOM President Victor Dzau, MD.

From the article of the same title
Medscape (06/29/15) Brooks, Megan
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Health Policy and Reimbursement

High Court’s Decision on Same-Sex Marriage Expected to Boost Health Coverage Among Gay Couples
The recent Supreme Court ruling, which legalized same-sex marriage in the U.S., will likely boost health insurance among gay couples, according to analysts. While fewer than half of employers offer health benefits that make insurance available to unmarried same-sex partners, nearly all of them offer coverage to spouses. New York legalized gay marriage in 2011, and within a year, the number of same-sex couples covered by employer-sponsored health insurance increased. Experts expect most companies to cover same-sex spouses if they already offer benefits to opposite-sex spouses, but the ruling does not require them to do this. That said, any employer who refuses to offer insurance to all married couples could face sex discrimination charges.

From the article of the same title
Kaiser Health News (06/29/15) Hancock, Jay
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States Eye Health Exchange Options
The Supreme Court ruling upholding federal health-insurance exchange subsidies may encourage state-run exchanges to create regional networks or use the federal marketplace.  Many of the states operating exchanges under the Affordable Care Act are facing financial strains and could join the three dozen states currently using the federal marketplace, creating a largely national exchange program.  Some state-run exchanges are also looking into forming regional exchanges as a way of preserving local control.

From the article of the same title
Wall Street Journal (06/26/15) Armour, Stephanie
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FDA Wants to Conduct EHR to EDC Data Capture Tests
The U.S. Food and Drug Administration (FDA) plans to conduct demonstration projects to test the capability and performance of a single-point data capture approach between electronic health records (EHRs) and electronic data capture (EDC) systems.  According to a notice recently filed in the Federal Register, the demonstration project would test the use of standards-based technology to foster the collection of healthcare and clinical research information within one system and workflow. The notice states that the need for single-point data capture has newly emerged following the growth of disparate health information systems.  FDA's proposed demonstration projects would assess and report the value and challenges of an EHR-to-EDC single-point capture of source data.  The agency is asking for comments and requests for participation for the demonstration project.

From the article of the same title
Becker's Hospital Review (06/29/15) Jayanthi, Akanksha
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Medicine, Drugs and Devices

Drug and Medical Device Makers Paid $6.49 Billion to Doctors, Hospitals in 2014
A new federal government transparency initiative shows that drug and medical device makers paid $6.49 billion to U.S. doctors and teaching hospitals in 2014. The payments were made out to more than 600,000 doctors and 1,100 hospitals for services such as consulting, speeches, and the value of free meals provided to doctors by sales representatives. About half of 2014's payments were categorized as research-related activities. Around 81 percent of those payments were made with cash. The records have been compiled into a searchable online database called Open Payments. The desire for transparency is driven by concerns that doctors' prescribing decisions are sometimes influenced by the money and gifts they receive from companies. Supporters appreciate the transparency, but some opponents claim the process is cumbersome and unnecessary. The American Medical Association issued a statement reading, "The vast majority of the data released today has not been independently validated by physicians, which makes it less usable for the patients it's intended to benefit."

From the article of the same title
Wall Street Journal (06/30/15) Loftus, Peter; Walker, Joseph
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Minimal Invasive Suture-Tape Augmentation for Chronic Ankle Instability
The modified Brostrom procedure can result in postoperative complications such as skin irritation and scar formation. A prospective study was conducted to assess the clinical outcomes of mini-open ligament augmentation (internal brace technique) using suture tape for chronic ankle instability (CAI). Researchers followed 34 female patients weighing less than 70 kg for more than two years after suture tape augmentation for lateral ankle instability. After the final follow-up, Foot and Ankle Outcomes Scores and Foot and Ankle Ability Measures improved significantly to 92.5 points. Sefton grading revealed that 91.2 percent of cases achieved functional results. Exercise activity resumed after an average of 10.2 weeks for jogging and 9.6 weeks for walking on uneven ground. Talar tilt angle and anterior talar translation had significantly improved to an average of 4.5 degrees and 4.1 mm, respectively. Aside from one case of chronic inflammation, no complications were reported. Researchers concluded that minimally invasive suture tape augmentation is an effective alternative treatment for young women with CAI. Future studies must be conducted to address the possibility of progressive elongation over time.

From the article of the same title
Foot & Ankle International (06/15) Cho, Byung-Ki; Park, Kyoung-Jin; Kim, Seok-Won; et al.
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Study Reveals Bone-Building Protein's Impact on Bone Stem Cells
In a study published in Nature Communications, UCLA researchers showed that administering the protein NELL-1 intravenously can stimulate significant bone formation because of the regenerative properties of stem cells. Researchers exposed adult stem cells that have the ability to create bone-building osteoblasts to NELL-1. The stem cells exposed to the protein created osteoblasts that were far more effective at building bone than those from unexposed bone. The findings could signal exciting new developments for the more than 200 million people living with osteoporosis. It could also help people with traumatic bone injuries. The NELL-1 method has not yet been tested in humans, but the possibilities are almost endless. "Our findings are exciting because they have big implications for possible clinical application in the coming years," said the study's first author, Dr. Aaron James.

From the article of the same title
Medical Xpress (06/30/15) Vogt-James, Mirabai
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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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