July 22, 2020 | | JFAS | Contact Us

News From ACFAS

Ready, Set, Submit those Posters!
Get your research ready and submit your posters now for the 2021 Annual Scientific Conference in Las Vegas, February 25-28, 2021.

If you are part of a study that would be beneficial to the profession, submit your poster for consideration by the abstract submission deadline of October 21, 2020. Visit the Annual Scientific Conference page at for information on submission criteria and applications.
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ACFAS Urges CMS to Modify Wound Care Coverage & Payment Policies
Along with the Alliance of Wound Care Stakeholders, ACFAS submitted comments to CMS this month urging them to update select wound care coverage and payment policies considering the needs of wound patients and front-line wound care providers amid the coronavirus pandemic.

The comments focused on additional flexibilities needed in wound care related to: codes to be utilized when billing for wound care services via telehealth that has been temporarily relocated to a patient’s home; dNPWT telehealth billing; standard written order provisions, provisions that currently disallow total contact casting on the same date of service as another procedure; Merit-based Incentive Payment System (MIPS) program relief and a range of other issues.

For more information on wound care policy and advocacy initiatives, visit the on the Alliance’s COVID-19 Action and Resource Center.
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ACFAS OnDemand Access Extended to August 30
In light of the continuing COVID-19 situation, ACFAS is extending access to its OnDemand education platform through August 30. Open access to the College’s library of materials continues for all podiatric medical students, residents, post-grad fellows and their educators. The College hopes these valuable ACFAS resources continue to supplement your medical education as your access to in-person surgical training is not yet back to normal.

The OnDemand platform houses over 3,500 educational tools, including:
  • Clinical Sessions
  • Podcasts
  • Surgical Technique Videos
  • A Medical Bookstore Library
ACFAS has also created a list of recommended educational pathways to aid with your didactic learning. Pathways have been organized into basic, intermediate and advanced tracks, with recommended content for students, residents and post-graduate fellows. There is also specific content focusing on teaching research.

To access ACFAS OnDemand:
  • Visit
  • In the Upper Right-Hand Corner, Sign In by:
  • Entering in your ACFAS login (email) and password
  • The default password is your ACFAS ID, 105067, plus your initials, i.e. 12345sn
  • Once logged in, you will receive the special programmed pricing, set at zero dollars, extended through August 30
Not able to access?
If you’re having trouble with your login details, please contact the ACFAS Membership Department for assistance.
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Foot and Ankle Surgery

Augmented Reality-Guided Osteotomy in Hallux Valgus Correction
Researchers investigated whether augmented reality (AR) would improve the accuracy of the distal osteotomy during hallux valgus surgery. Distal osteomies of the first metatarsals were performed on a foot model by two surgeons with different levels of experience, each with and without overlay of a hologram depicting an angle of osteotomy perpendicular to the second metatarsal. The deviation of the osteotomy angle in the transverse plane was then analyzed. Overall, AR decreased the extent of deviation and the AR guided osteotomies were more accurate compared to the freehand cuts. However, while the inexperienced surgeon performed more accurate osteotomies with AR compared to freehand, no significant difference was noticed for the experienced surgeon with an osteotomy angle of around 3 degrees in both cases.

From the article of the same title
BMC Musculoskeletal Disorders (06/17/20) Viehofer, Arnd Fredrik; Wirth, Stephan Hermann; Zimmermann, Stefan Michael; et al.
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Identification of Ankle Injury Risk Factors in Professional Soccer Players Through a Preseason Functional Assessment
The study aimed to identify risk factors present in the preseason assessment that may predispose professional soccer players to ankle injuries. A total of 89 professional soccer athletes were evaluated in the preseason period, including athlete history and anthropometric data collection, an isokinetic ankle evaluation and functional tests: the Dorsiflexion Lunge Test and Y-Balance Test (YBT). The athletes were monitored during the competitive period, and the incidence of injuries was surveyed. A higher incidence of ankle injuries was associated with lower YBT scores in the dominant and nondominant limbs. A higher body mass index was also associated with a higher injury occurrence.

From the article of the same title
Orthopaedic Journal of Sports Medicine (06/24/20) Manoel, Lucas Sartori; Xixirry, Macela Godoy; Soeira, Thabata Pasquini; et al.
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Tibiofibular Space Widening Assessment with a Ball-Tipped Probe in a Syndesmosis Injury Model
The study investigated the use of a ball-tipped probe under arthroscopy for quantitative assessment of tibiofibular space widening in a syndesmosis injury model. The test specimens were five uninjured ankles from cadavers of two male subjects and three female subjects with a mean age of 82.4 years at death. The ball-tipped probe consisted of a metal probe having a ball at each end with diameters ranging from of 1.5 millimeters to 5.0 millimeters, in increments of 0.5 millimeters. The tibiofibular joint was observed arthroscopically as the largest-diameter ball probe as possible was inserted into its anterior third, middle or posterior third portion with the ankle in natural plantarflexion or under external rotational stress. The maximum possible diameter of ball probe that could be inserted was 1.5 millimeters to 2.0 millimeters in the uninjured state, 3.0 millimeters to 3.5 millimeters in the sectioned anterior inferior tibiofibular ligament model and 5.0 millimeters in the severe-state model.

From the article of the same title
Journal of Foot & Ankle Surgery (07/07/20) Teramoto, Atsushi; Shoji, Hiroaki; Anzai, Ken; et al.
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Practice Management

Coronavirus Liability: Nine Insurance Issues
The article lists nine liability insurance issues to examine as a vital part of a medical practice's asset protection plan. These include general liability insurance, medical malpractice insurance, Directors and Officer's (D&O) insurance, data breach and cyber liability coverage, Business Interruption Insurance, employment practices liability insurance (EPLI), active shooter insurance and workers compensation coverage. David Moore of Shepherd insurance in Scottsdale, Ariz., adds that there is often a dangerous disconnect between the office manager and the practice owner when it comes to insurance, which can lead to important coverage being omitted or purchased on price without regard to significant differences in coverage. In particular, Moore mentioned that he continues to see a pattern of under-insured exposures in the areas of D&O and EPLI insurance and price resistance among practices that may be facing significant financial challenges.

From the article of the same title
Physicians Practice (07/14/20) Devji, Ike
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Drowning in Data
Devices and apps that measure health data, known as wearables, can provide a large amount of patient data that providers need to sort through in order to use. Physicians should realize that health technology is still developing and that very few wearable devices have been clinically validated. Even if the data were all valid, for patients who wear their devices frequently or regularly, no physician would be able to sort through the amount of data that would accumulate. Experts say the data a patient brings from wearables can help physicians get a better snapshot of that patient's health during a clinical visit or to the root of complex problems. Physicians should try to understand wearables and eventually find their way into the design conversation as these technologies evolve. In short, one expert says, “providers need to understand their patient population and what data from certain cohorts would really help to improve outcomes.”

From the article of the same title
Medical Economics (07/13/20) Rosenfield, Jordan
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Women Physicians 2020: The Issues They Care About
Medscape surveyed over 3,000 women physicians about the major challenges they face and what issues absorb them the most. Work-life balance was by far the most important issue for women, with 64 percent of them naming it their number-one problem, compared with 43 percent who cited it as their leading concern. Combining parenthood and work was more of a challenge for women under 45, while women over 45 are more concerned with compensation, gender equity and age discrimination. Sixty-three percent of women said work-related burnout puts stress on their primary relationships, and 94 percent said they have made personal life tradeoffs because of work obligations. Moreover, 36 percent said being a woman has affected their compensation in a negative way, and 39 percent said they struggle with negotiating for a higher salary. Fifty-two percent said they were not in a leadership or supervisory role, and 62 percent said their workplace does not offer developmental opportunities.

From the article of the same title
Medscape (07/15/20) Kane, Leslie
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Health Policy and Reimbursement

Analysis Finds Nearly 5.5 Million Have Lost Health Insurance Amid Pandemic
An analysis from Families USA estimates that 5.4 million people lost their health insurance between February and May after losing their jobs. That estimate does not include family members who may also have been on those plans. Nearly one-half of the coverage losses occurred in five states: California, Texas, Florida, New York and North Carolina. The analysis also notes that states that opted not to expand Medicaid to cover more low-income adults have traditionally experienced higher uninsured rates. Those rates are now even higher, according to the analysis.

The Kaiser Family Foundation estimates that overall, nearly 27 million people may have lost employer-sponsored insurance as of May 2, including family members. The majority of people who become uninsured will be eligible to sign up for Medicaid or qualify for a special enrollment period on the Affordable Care Act's marketplace. The Trump administration has said it will reimburse hospitals for the treatment of uninsured COVID-19 patients, but the effectiveness of that program is unclear.

From the article of the same title
The Hill (07/14/20) Hellmann, Jessie
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HHS Announces over $4 Billion in Additional Relief Payments to Healthcare Providers Impacted by the Coronavirus Pandemic
The US Department of Health and Human Services (HHS) will provide about $3 billion in funding to hospitals serving a large percentage of vulnerable populations and approximately $1 billion to specialty rural hospitals, urban hospitals with certain rural Medicare designations and hospitals in small cities. HHS is providing support to healthcare providers fighting the pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers. On June 9, HHS announced plans to distribute $10 billion in Provider Relief Fund payments to safety net hospitals serving vulnerable citizens. HHS expects to distribute over $3 billion across 215 acute care facilities, bringing the total payments for safety net hospitals from the Provider Relief Fund to $12.8 billion to 959 facilities.

From the article of the same title
HHS News Release (07/10/20)
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Trump Takes a First Step Toward Returning Medical Supply Chains to the US
The Trump administration has awarded a $354 million contract to Phlow Corp., a Virginia start-up that will produce a variety of generic drugs and their ingredients at advanced manufacturing facilities in the United States. Over the past 20 years, most US generic drug production has shifted offshore, notably to sites in China and India, a dependence on foreign suppliers that has become controversial as the coronavirus pandemic rages. Phlow will lead a private sector team that will use a continuous chemical process rather than the step-by-step approach of traditional pharmaceutical manufacturing. AMPAC Fine Chemicals, Civica Rx and the Medicines-for-All Institute at Virginia Commonwealth University round out the partnership.

From the article of the same title
Washington Post (07/11/20) Lynch, David; Whalen, Jeanne; McGinley, Laurie
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Medicine, Drugs and Devices

Drug Giants Create Fund to Bolster Struggling Antibiotic Start-Ups
Twenty leading pharmaceutical companies have announced the launch of the AMR Action Fund, which aims to bring two to four new antibiotics to the market in the next 10 years. Drug-resistant infections are responsible for hundreds of thousands of deaths each year. The $1 billion fund is created in partnership with the World Health Organization and financed by drug companies including Roche, Merck and Johnson & Johnson. The International Federation of Pharmaceutical Manufacturers and Associations, an industry trade group, is administering the fund. The fund plans to make investments in antibiotic companies that have already identified a promising drug.

An advisory panel composed of drug company executives, scientists and other experts will select the recipients. In addition, the companies will provide free expertise to biotech firms with promising candidates. "Antibiotics are the mortar that holds the entire healthcare system together," said David A. Ricks, CEO of Eli Lilly, who helped spearhead the effort. "We make drugs for diabetes, cancer and immunological conditions, but you couldn't treat any of them without effective antibiotics."

From the article of the same title
New York Times (07/09/20) Jacobs, Andrew
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Hospitals Stock Up on COVID-19 Drugs to Prepare for Second Wave in Fall
US hospitals are stocking up on drugs for treating COVID-19 in an effort to avoid another scramble for critical medications should a second wave of the virus threaten new drug shortages. Hospitals in New York and other areas that faced large numbers of COVID-19 patients earlier this year bought and used large amounts of drugs. Those purchases siphoned medicines already in short supply from the market, with the result that some preferred drugs became unavailable, or hospitals had to turn to alternatives. "Now it's like, what are we going to do going forward in the future?" said Indu Lew, chief pharmacy officer at RWJBarnabas Health, which operates 11 acute care hospitals in New Jersey. "When we look at a surge, we don't know when it's going to happen, we don't know what factors are going to cause it to happen, and we don't know what our volume will be."

About 90 percent of hospitals and health systems are building safety stocks of about 20 critical medications, according to Premier Inc., one of the nation's largest group-purchasing organizations. Premier says more than 50 percent are trying to build at least a month's supply of medications. Meanwhile, as providers have become more experienced at treating COVID-19, revising treatment guidelines to reflect new research, they are in some cases relying less on ventilators, reducing the need for related medications.

From the article of the same title
Wall Street Journal (07/14/20) Hopkins, Jared
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House Spending Bill Would Give FDA Drug Recall Authority
A House committee has voted to approve a $3.212 billion budget for the US Food and Drug Administration (FDA) as part of the fiscal year 2021 Agriculture, Rural Development, Food and Drug Administration and Related Agencies bill. The bill is now on track to be considered by the full House. The chamber's Appropriations Committee says the bill carries an amendment that would "give FDA legal authority to require the recall of unsafe prescription and over-the-counter drugs." The proposed 2021 budget also includes $31 million to help FDA review therapies and possibly vaccines to address COVID-19. In addition, $70 million is earmarked for medical product development acceleration, along with strengthening medical product and food safety activities.

From the article of the same title
Regulatory Focus (07/10/2020) Oakes, Kari
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, AACFAS

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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