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Happy Thanksgiving!

ACFAS extends sincere best wishes to you and yours for a safe and happy Thanksgiving!

This Week's Headlines

News From ACFAS
Foot and Ankle Surgery
Practice Management
Health Policy and Reimbursement
Technology and Device Trends

News From ACFAS

This Week's Healthcare Reform Update

The big news over the weekend is that 60 Senators voted in favor of cloture on the proposed healthcare reform bills, which means that the bill will go to the Senate floor to begin debate after Thanksgiving. It will be one of the most closely watched, intense debates Washington has seen in a while, as supporters and opponents — and their lobbyists — pull out all the stops. The “public option” and abortion issues are the most controversial. In addition, much of the focus of lobbyists will be on persuading a handful of key centrist Democratic Senators who are undecided.

Stay tuned for further developments in This Week @ ACFAS.
Promote Your Practice, Free and Easy

Advertising for your practice can be pricey and time-consuming. ACFAS offers you an easy alternative: free news releases you can customize with your name and practice information. Send them to local newspapers, radio stations, hospital PR departments, or to other community organizations for their newsletters.

“Healthy Feet Make the Best Dancing Feet,” the latest ACFAS news release, explores the types of injuries that commonly afflict dancers, and reminds the public of the importance of supportive footwear and prompt attention to foot and ankle pain.

You can put yourself in the news with this same story using a pre-formatted Fill-In-The-Blanks Press Release from Download the form and start promoting your practice today!
Volunteer Your Skills for the College

You can help shape the advancement of your profession, the future of the College and, ultimately, the care of patients. The College is looking for talented, dedicated ACFAS members to serve on 2010–11 committees.

Visit Volunteer Opportunities on the ACFAS web site for more information on getting involved, including committee descriptions and application information. The 11 committees cover a wide range of responsibilities.

Give back to your profession by volunteering! Applications are due at ACFAS headquarters by December 15, 2009.

Foot and Ankle Surgery

Comparison of Two Intraoperative Assessment Methods for Injuries to the Ankle Syndesmosis

Intraoperative stress testing is required for the detection of syndesmosis instability following an ankle fracture. This study compared two stress tests for the detection of syndesmotic injury using cadaver joints. The researchers concluded that for the detection of syndesmotic instability at the site of ankle fractures on stress radiographs, the lateral stress test is superior to the external rotation stress test.

From the article of the same title
Journal of Bone and Joint Surgery (American) (11/01/09) Vol. 91, No. 11, P. 2646; Stoffel, K.; Wysocki, D.; Baddour, E.; et al.

Oxygen Tensiometry as a Predictor of Wound Healing in Total Ankle Arthroplasty

Total ankle arthroplasty (TAA) typically involves an anterior approach to the ankle that has been shown to have a risk for wound healing problems. In this study, researchers assessed the possibility of using oxygen tensiometry as a predictor of incision healing problems in patients. They found that oxygen tensiometry is not useful for predicting patients at risk for postoperative wound healing complications after TAA, suggesting that, if adequate pulses are present before surgery, the trauma of using excessive superficial traction on the skin during surgery is more responsible for wound healing problems than the underlying blood supply.

From the article of the same title
Acta Orthopaedica et Traumatologica Turcica (12/01/09) Vol. 43, No. 5, P. 381; Farber, D. C.; Deorio, J. K.

Three-dimensional Analysis of the Intramedullary Canal Axis of Tibia: Clinical Relevance to Tibia Intramedullary Nailing

The purpose of this study was to evaluate the appropriate insertion point for a tibial intramedullary nail by measuring the intramedullary canal axis of the tibia in three dimensions. The researchers found that the appropriate insertion point for a tibial nail was the slightly medial aspect of the lateral tibial spine. However, given that this led to a broad range, they concluded that individual variations must be taken into consideration.

From the article of the same title
Archives of Orthopaedic and Trauma Surgery (11/09) Song, Sang Jun; Jeong, B. O.

Practice Management

Disk Encryption

Typically the data stored on a laptop hard drive is more valuable than the laptop itself, and disk encryption software is an effective way to counter the threat of thieves getting hold of sensitive data. Disk encryption makes it impossible for a thief to physically remove a laptop's hard drive and read its contents with another computer. Disk encryption software is available both commercially and as open source, and that it can be found on the Web by searching a phrase such as "disk encryption plausible deniability."

From the article of the same title
Physicians Practice (11/09) McCallister, Jonathan

Nothing to Sneeze At: Doctors' Neckties Seen as Flu Risk

The start of the flu season and the concern over the H1N1 flu virus has brought renewed focus on the issue of risks posed by physicians' neckties. In 2004, a study of neckties worn by doctors at a hospital in New York found that half carried bacteria that could cause illnesses such as pneumonia and blood infections. Some hospitals have discussed banning neckties. But entrepreneurs are also entering the arena, and a company called SafeSmart is marketing ties with a coating that it says “repels bacterial contamination.” Some hospitals are buying batches of these ties for doctors who want to wear ties.

From the article of the same title
Wall Street Journal (11/20/09) Smith, Rebecca

Don't Be Afraid to Contact Your Insurer When You Smell a Suit at Your Doorstep

As soon as a physician gets an attorney’s request letter, a summons or a complaint relating to patient care, he or she should immediately contact their liability insurance carrier. This is important for several reasons, all relating to preservation of records and testimony. The carrier will insist on the practice securing all relevant records, which is critical because of the number of years that can pass between filing a lawsuit and trial. The insurance company will also send an investigator to talk to the physician and other witnesses. Because the liability insurer has been given early notice, those statements can be taken while memories are fresh. Sometimes physicians notify the insurer even before a claim is filed, when they have a strong suspicion a lawsuit may be filed, now or in the future. This can have the same advantages. The disadvantage is that once the file is opened, it may adversely affect future premiums.

From the article of the same title
Medical Economics (11/06/09) Johnson, Lee J.

Health Policy and Reimbursement

Bill Would Allow Medicare Payment Delays, Seeks to Bolster Anti-fraud Efforts

The Fighting Medicare Payment Fraud Act of 2009 introduced by U.S. Sen. Chuck Grassley (R-Iowa) would allow HHS to delay Medicare payments in order to give the government more time to review suspect claims. Grassley said that Medicare's rule requiring prompt payment to providers is hindering the government's ability to make sure that claims are valid before they're paid.

From the article of the same title
Modern Healthcare (11/16/09) Blesch, Gregg

Medicare Fee-for-Service Payment Error Rate More Than Doubles, White House Says

Medicare and Medicaid improperly paid out $54.2 billion in fiscal 2009, with the rate of Medicare fee-for-service errors more than doubling over the previous year, according to Peter Orszag, director of the Office of Management and Budget. CMS is reporting a 2009 fee-for-service error rate of 7.8 percent, or $24.1 billion, compared with 3.6 percent in 2008. Orszag said much of the increase reflects methodological changes in the way errors are counted in Medicare fee-for-service, adding that the White House will soon issue an executive order aimed at preventing such losses in the future.

From the article of the same title
Modern Healthcare (11/17/09) Blesch, Gregg

Blumenthal: Tear Down Walls That Block Information Exchange

David Blumenthal, who heads the federal government's effort to transform the nation's healthcare system from paper to digital, is urging the health IT industry to break down barriers to health data exchange. In an e-mail sent Thursday – the third in a series – Blumenthal outlines the provisions of the HITECH Act that addresses barriers to exchange. The full text of the letter can be found at

From the article of the same title
Healthcare IT News (11/13/09) Monegain, Bernie

Technology and Device Trends

Enhanced Plasma Shortens Time Off for Injured Athletes

Injured athletes injected with their own platelet rich plasma (PRP) are healing faster and spending less time out of the playing rotation, according to researchers at The Methodist Center for Sports Medicine in Houston. The hope is that this treatment will eventually eliminate the need for surgery or other treatments such as cortisone injections for some orthopedic injuries. PRP injections work best when given within 24 to 48 hours after the injury occurs and can be done in a doctor's office having the necessary equipment.

From the article of the same title
Newswise (11/12/09)

York U Researchers Identify Trigger for Blood Vessel Growth

Researchers at York University have identified a cell-signaling process called p38 MAPK (mitogen-activated protein kinase) activation, which stimulates blood vessel growth. The research is intended to improve outcomes for patients with peripheral artery disease. Blood flow itself, in a process known as "shear stress-induced angiogenesis," can be a regulator that induces the growth of new vessels. The researchers found that increased blood flow stimulates endothelial growth receptors within the vascular system, which causes p38 activation. The study will appear in the Journal of Cellular Physiology in January.

From the article of the same title
Exchange (11/17/2009)

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November 24, 2009