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News From ACFAS

ACFAS 2022: Early Bird Rates End Next Week
Don’t miss out on money-saving rates for the ACFAS Annual Scientific Conference in Austin by registering before the Early Bird Rates end November 15.

Join us in Austin to advance your knowledge and skills with four days of cutting-edge sessions, hands-on workshops and the opportunity to network and reconnect in person with your friends and colleagues. Register today at
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Renew Your ACFAS Member Dues
Don't forget to renew your ACFAS dues to continue reaping the benefits of membership! Need a refresher on the perks? Your dues give you access to our robust education and professional development offerings, practice growth and management tools and our top-rated Annual Scientific Conference.

ACFAS 2022 is coming up in February and promises to be another exciting learning and social event that you won't want to miss. Renew your membership today to register at the member rate and save. You can renew online or via mail or fax. Please reach out to the Membership Department at or visit the Member Center at if you have any questions about your membership benefits.
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Research Series Set for November
Join us for the November Student Research Lecture Series on Wednesday, November 17 at 7pm. This month’s topic, which is number 3 of the 9 in the series, features conducting a retrospective study. The program is hosted by the Barry University School of Podiatric Medicine with presentations by Bradley Lamm, DPM, FACFAS and Nicole Cates, DPM, AACFAS.

Don’t miss it – register today at
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Foot and Ankle Surgery

Open Evaluation of Peroneal Tendons in Chronic Lateral Ankle Instability Undergoing Ankle Arthroscopy Patients with Lateral Ankle Stabilization
A study was held to assess preoperative magnetic resonance imaging's (MRI) detection of peroneal tendon pathology in patients with chronic lateral ankle instability, with consecutive surgical cases involving arthroscopic evaluation and management of lateral ankle instability sequelae assessed retrospectively. Preoperative MRI images were compared to intraoperative findings to ascertain sensitivity, specificity and positive and negative predictive values. Eighty-two patients, including 58 females and 24 males, satisfied inclusion criteria. Average age at time of surgery was 46 years, and peroneal tendon pathology was identified intra-operatively in 76 (92.7 percent) patients and on MRI in 40 (48.8 percent) patients. The most frequently detected pathologies were tenosynovitis, tendinopathy and longitudinal split/tear, with the peroneus brevis tendon being most commonly involved. MRI was 38.7 percent specific and 50 percent sensitive, with a positive predictive value of 92.5 percent and a negative predictive value of 7.1 percent. The authors determined that procedural selection should not be exclusively based on MRI results, and the peroneal tendons should be evaluated intra-operatively in patients receiving arthroscopic procedures for lateral ankle instability.

From the article of the same title
Journal of Foot & Ankle Surgery (11/01/21) Clair, Benjamin L.; Winder, Michelle L.; Neubauer, Elizabeth F.
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Jigless Knotless Internal Brace Versus Other Open Achilles Tendon Repairs Using a Progressive Rehabilitation Protocol
A biomechanical study was held to compare jigless knotless internal brace surgery (JKIB) with other open surgery techniques for Achilles tendon repair that follow a progressive rehabilitation protocol. The authors obtained 60 fresh porcine Achilles tendons to compare the JKIB with the four-stranded Krackow suture (4sK) and the triple-bundle suture (TBS) in biomechanical testing with cyclic loading set at 1 Hz. The TBS procedure was the most robust technique, followed by the JKIB and the 4sK, where the average survived cycles were 2639.3 ± 263.55, 2073.6 ± 319.92 and 1425.25 ± 268.96, respectively. A post hoc analysis and the Mann–Whitney U test following the Bonferroni correction confirmed significant differences. The authors concluded that the JKIB could be an option in acute Achilles tendon repair with the minimal invasive surgery technique, as it is more robust than the 4sK.

From the article of the same title
BMC Musculoskeletal Disorders (10/28/21) Vol. 22, No. 908 Ko, Po-Yen; Hsu, Chieh-Hsiang; Hong, Chih-Kai; et al.
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Clinical Foot Measurements as a Proxy for Plantar Pressure Testing in People With Diabetes
A study probed the contribution of joint range of motion and foot deformity measures on plantar pressures in a community-dwelling cohort with diabetes. Barefoot and in-shoe plantar pressure variables, weight bearing ankle dorsiflexion, hallux range of motion, lesser toe deformities and hallux abductus scale were evaluated in 136 diabetic adults. Thirty-two percent of subjects exhibited two or more foot biomechanical pathologies, while participants with two or more foot biomechanical pathologies displayed significant increases in all barefoot plantar pressure regions other than forefoot, compared to those with less than two pathologies. No significant changes were observed among in-shoe plantar pressure factors. A regression model explained between 9.9 percent and 29.6 percent and between 2.5 percent and 43.8 percent of the variance in the barefoot and in-shoe plantar pressure variables, respectively.

From the article of the same title
Journal of Foot and Ankle Research (10/27/2021) Vol. 14, No. 56 Chuter, Vivienne H.; Spink, Martin J.; David, Michael; et al.
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Practice Management

US Mandates Vaccines or Tests for Big Companies by January 4
Tens of millions of US residents who work at companies with 100 or more employees will need to be fully vaccinated against COVID-19 by January 4 or get tested for the virus weekly under new government rules. The new requirements, which were first previewed by President Joe Biden in September, will apply to approximately 84 million workers at medium and large businesses, although it is not clear how many of those employees are unvaccinated. The Occupational Safety and Health Administration (OSHA) regulations will force the companies to require that unvaccinated workers test negative for COVID-19 at least once a week and wear a mask while in the workplace. OSHA left open the possibility of expanding the requirement to smaller businesses. It asked for public comment on whether employers with fewer than 100 employees could handle vaccination or testing programs.

Tougher rules will apply to another 17 million people who work in nursing homes, hospitals and other facilities that receive money from Medicare and Medicaid. Those workers will not have an option for testing. They will need to be vaccinated. Workers will be able to ask for exemptions on medical or religious grounds.

From the article of the same title
Associated Press (11/04/21) Koenig, David
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Why You Should Stress Empathy and Gratitude in Your Practice
Both medical practices and patients benefit when practitioners express empathy and gratitude. Leaders who show employees respect and compassion in this way make the workplace healthy, engendering trust among team members. Empathy and gratitude can be incorporated into a practice's culture in a number of ways, first by avoiding the impulse to fall back on scarcity thinking during crises. An appreciation for each other motivates people to find ways to help each other. Practitioners can also think of all the things they can do and for whom. A third strategy is to approach one's teammates for support and reciprocate, especially during tough times.

From the article of the same title
Physicians Practice (10/29/21) Bailey, Michele
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Is an MBA Right for You?
A Masters in Business Administration (MBA) degree is increasingly seen as advantageous for doctors as medicine becomes increasingly corporatized. Three paths to a degree are open to doctors: one is to enroll in a full-time MBA program while also practicing full time, while a second path is to acquire and MBA at the same time as a medical degree through a joint medical-business school program. The third is to go through an executive MBA program, which is oriented more toward working professionals, with most classes held on weekends. One benefit of joint programs is that learners usually can complete the MBA component in less than the two years required in most standalone MBA programs. Pursuing an MBA can also better prepare medical students for residency, while obtaining an MBA after being in practice a few years can return more immediate benefits. Overall, doctors' reasons for gaining an MBA tend to be so they can improve their management skills, advance in an organization and understand healthcare policy better.

From the article of the same title
Medical Economics (11/03/21) Bendix, Jeff
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Health Policy and Reimbursement

CMS Releases Final Rule for CY 2022 Medicare Physician Fee Schedule
The US Centers for Medicare and Medicaid (CMS) has issued the final calendar year (CY) 2022 Medicare Physician Fee Schedule to promote greater telehealth use, increase reimbursement rates for vaccine administration, and enhance health equity. The rule will reportedly implement "a series of standard technical proposals” as part of CY 2022 rate-setting. The 2022 conversion factor will be $33.59, a $1.30 decrease from the CY 2021 conversion factor. Next year's rate factors in statutory changes to relative value units and the expiration of the 3.75 percent temporary CY 2021 payment hike Congress approved via pandemic-related legislation.

From the article of the same title
RevCycle Intelligence (11/03/21) LaPointe, Jacqueline
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Why Aren't More People Comparison Shopping for Health Plans?
Theoretically, all beneficiaries with traditional Medicare with Part D coverage or who are interested in or enrolled in Medicare Advantage programs should be comparison shopping for health plans during the annual open enrollment period, but this is not occurring. A Kaiser Family Foundation analysis found 71 percent of beneficiaries said they did not compare plans during the open enrollment period in 2019, while even fewer Black and Hispanic beneficiaries, people over 85 and those with lower income and less education did the same. About half had never visited the official Medicare website, used its 1-800-MEDICARE help line or read the yearly published "Medicare & You" brochure. Moreover, only 8 percent to 10 percent of beneficiaries voluntarily switched their Medicare Advantage or stand-alone Part D plans in 2019. This might be partly explained by people's satisfaction with their coverage and an overwhelming number of plans to choose from. "The entire system relies on savvy actors maximizing their choices, and that just does not happen," said the Center for Medicare Advocacy's David Lipschutz. A recent Commonwealth Fund study determined that traditional Medicare and Advantage plans currently draw similar numbers in terms of demographics and health, with high rates of satisfaction in both groups.

From the article of the same title
New York Times (10/30/21) Span, Paula
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Hundreds of Groups Ask Governors to Expand Telehealth Licensure Flexibilities
Hundreds of healthcare and industry groups are urging governors nationwide to expand access to telehealth through licensure flexibilities. In a letter to governors, more than 230 organizations said: "Given the urgency of the times as more states consider rolling back flexibilities enacted at the start of the pandemic, states must act now to ensure patients can access the care they need where they reside and when they need it, without having to choose between cancelling an appointment or traveling long distances and risking potential exposure to the COVID-19 virus for an in-person visit." Although expanded licensure flexibilities during the pandemic enabled medical professionals to expand their scope of treatment to patients across state lines, many states have started allowing those emergency declarations to expire. "This has been extremely detrimental and disruptive to necessary and ongoing patient care," according to the letter.

From the article of the same title
Healthcare IT News (11/01/21) Jercich, Kat
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Record Low Premiums and a Stable Uninsured Rate Mark Open Enrollment Season
The US government promoted record low premiums for Affordable Care Act coverage and a stable uninsured rate as it marked open enrollment season. The number of uninsured Americans stabilized last year to between 8.6 percent and 9.7 percent of the population, about 28 to 31.6 million people. Roughly 30 million Americans were uninsured before the pandemic in 2019, and Medicaid enrollment grew by 16 percent.

From the article of the same title
Healthcare Finance News (11/02/21) Morse, Susan
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Medicine, Drugs and Devices

Out of Control: America's Losing Battle Against Diabetes
Medications hyped for 20 years to lower blood sugar to a specific target have had a harmful effect on diabetics in the US. Aggressive pursuit of an A1c score of below 7 percent led to an epidemic of hypoglycemia among Americans with diabetes, resulting in millions of medical emergencies and thousands of deaths. Queries with many scientists, doctors and patients and a review of documents found leading insulin makers started to promote the ideal A1c score just as they were launching new formulations and other diabetes treatments that they then heavily marketed to patients. The IQVIA Institute for Human Data Science reports that US sales of diabetes drugs have skyrocketed to $74 billion in 2020r from $7.3 billion two decades earlier, reflecting more prescriptions and higher prices. The American Diabetes Association has revised its guidance, upholding the overall target of A1c below 7 percent while adding exceptions and warnings for seniors and others who have suffered from a disproportionate impact of overtreatment. But Harvard Medical School Professor David Nathan decries the marketing push, saying, "We need to do this wisely. And somehow that got lost."

From the article of the same title
Reuters (11/04/21) Respaut, Robin; Terhune, Chad; Nelson, Deborah J.
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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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