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November 24, 2021 ACFAS.org | FootHealthFacts.org | JFAS | FASTRAC | Contact Us

Happy Thanksgiving!


The ACFAS office will be closed on Thursday and Friday in observance of the holiday. We wish our members and their families a safe and healthy Thanksgiving!

News From ACFAS


ACFAS Board Candidate Profiles Now Available
Profiles and position statements for the five candidates recommended by the Nominating Committee to fill three vacancies on the ACFAS Board of Directors are now available at acfas.org/Nominations:
  • Shane Hollawell, DPM, FACFAS;
  • Alan A. MacGill, DPM, FACFAS;
  • Jason A. Piraino, DPM, MS, FACFAS;
  • Brett D. Sachs, DPM, FACFAS;
  • Amber M. Shane, DPM, MS, FACFAS.
Online voting will be open December 10-27. Eligible voters will receive an email with a unique link to the election website when the election opens. Watch your email and ACFAS publications for more information on how to vote.
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Region Support for ACFAS 2022
Are you a resident or post-graduate fellow presenting an accepted poster or manuscript at the ACFAS Annual Scientific Conference in February? Could you use some extra money to apply toward your travel costs? The ACFAS Regions can help!

If you've submitted a poster or manuscript that is accepted for presentation at the conference and you are interested in receiving funding from your local Region, complete an application for support. Poster submitters are potentially eligible for $250, and manuscript presenters are potentially eligible for $500. Complete rules for acceptance and provision of funds can be found on the application form.

Please submit the completed form directly to your Region's President by Friday, January 21, 2022. Each Region will determine the number of awards they can provide based on the number of submissions received and will contact you directly with next steps. Region Presidents are listed on the form and on their individual Region webpages.

The ACFAS Regions are happy to be able to support the next generation of researchers in their parts of the country.
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Sugar and Spice – and Logo Gear!
It’s time to write your holiday wish list! Head to the ACFAS Logo Store to show your College pride and get decked out in College gear. The ACFAS Logo Store has shirts, jackets, pullovers and scrubs in a wide range of colors and sizes. You can also pick up drink wear, pens and other one-size-fits-all items to show off your membership in the College to your healthcare colleagues.

Visit acfas.org/LogoStore now to shop the full collection of ACFAS-branded merchandise.
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ABFAS Transitions to Continuous Certification in January
The American Board of Foot and Ankle Surgery (ABFAS) is making a major change to the way its Diplomates will keep their Board Certified status current.

Launching in January 2022, the new program LEAD: Longitudinal Education and Assessment for Diplomates will replace ABFAS’ traditional, once-every-ten-years recertification and self-assessment examinations. All Diplomates will begin participating in the LEAD program in January 2022, regardless of certification expiration date.

LEAD will allow Diplomates to participate in a self-paced online assessment of 30 questions per quarter, anytime and from anyplace, on any device. In addition, Diplomates will receive instant feedback on questions, as well as references and rationales, resulting in a process of continuous learning...with no need to travel to a testing center.

Both holders of Time-limited Certificates (certified after 1990) and holders of Lifetime Certificates (certified before 1991) will participate in the LEAD program.

Diplomates will periodically participate in LEAD throughout their entire ten-year certification cycles. The LEAD program does not change a Diplomate's existing certification expiration dates. ABFAS does not require Diplomates to participate every single quarter; rather, each Diplomate will participate in periodic assessment based on their own certification cycle.

ABFAS Diplomates can learn more by visiting the LEAD homepage abfas.org/lead. That webpage includes an introductory video explaining the program's flexibility, as well as an interactive Program Requirements tool for Diplomates to learn how they will participate. After reviewing these resources, Diplomates who still have questions about the transition to the LEAD program are welcome to contact ABFAS at lead@abfas.org or (415) 553-7800.
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Foot and Ankle Surgery


A Comparison of Trans-Articular Screw Versus Dorsal Bridge Plate versus Compression Locking Plate Fixation in B2 Lis Franc Injuries
A retrospective case series sought to identify whether trans-articular screws, dorsal bridging plates or a four-corner compression plate yields better functional outcome after B2 Lis Franc injuries. Thirty-eight patients underwent surgical fixation over five year and were treated with either trans-articular screw, dorsal bridge plate or four-corner compression plate fixation. Injury type, energy of mechanism and open versus closed status showed no significant difference within any fixation group, and with 94.7 percent (n=36), good anatomical reduction was realized. A clinically crucial improvement in Manchester Oxford Foot & Ankle Questionnaire scores and improved Euroqol-5DL outcomes between four-corner compression plate and trans-articular screw group was observed. Differences in metalware failure, metalware removal and soft tissue complication were insignificant.

From the article of the same title
Journal of Foot & Ankle Surgery (11/15/21) Kommalapti, V.; Wek, C.; Coffey, D.; et al.
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Clinical Outcomes of Tightrope System in the Treatment of Purely Ligamentous Lisfranc Injuries
A study assessed the use of the Tightrope system to reconstruct the Lisfranc ligament for elastic fixation in patients with purely ligamentous Lisfranc injuries. The authors retrospectively analyzed 11 cases treated with the Tightrope system from 2016 to 2019, including eight male and three female. The average follow-up time was 20.5 months (range, 17-24), with no statistically significant difference in the distance between the first and second metatarsal joint and visual analog score at three months, six months and the last follow-up when compared with preoperative values. The average postoperative American Orthopaedic Foot & Ankle Society mid-foot score and Maryland foot score were 92.4 ± 4.3 and 94.1 ± 3.5, respectively. The Tightrope system remained in place and the foot acquired better biomechanical stability, with no complications during surgery.

From the article of the same title
BMC Surgery (11/07/21) Vol. 21, No. 395 Yongfei, Fan; Chaoyu, Liu; Wenqiang, Xu; et al.
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Distal Metatarsal Articular Angle in Hallux Valgus Deformity. Fact or Fiction? A Three-Dimensional Weightbearing CT Assessment
A study was held to compare the Distal Metatarsal Articular Angle (DMAA) in hallux valgus (HV) and control populations, prior to and following computer correction of M1 pronation and plantarflexion with a dedicated weightbearing computed tomography (WBCT) software. The researchers theorized that DMAA will not be increased in HV compared to controls following computer correction. The study involved 36 HV and 20 control feet, with DMAA measured as initially described on conventional radiographs (XR-DMAA) and WBCT in both cohorts by measuring the angle between the distal articular surface and the longitudinal axis of M1. The DMAA was then measured after computerized correction of M1 plantarflexion and coronal plane rotation using the a angle (3d-DMAA). The XR-DMAA and the 3d-DMAA had higher significant mean values in HV group versus controls. Comparing a subset of eight precorrected juvenile HV and 28 nonjuvenile HV yielded no significant difference in the measure DMAA values, although the a angle was significantly higher in the juvenile HV group.

From the article of the same title
Foot & Ankle International (11/13/2021) Lalevee, Matthieu; Mansur, Nacime Salomao Barbachan; Lee, Hee Young; et al.
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Practice Management


Nurse Salaries Rise as Demand for Their Services Soars During Covid-19 Pandemic
Nurses are obtaining raises worth thousands of dollars annually from hospitals, as the sector contends with a tight labor market. The average annual salary for registered nurses, not including bonus pay like overtime, rose approximately 4 percent in the first nine months of the year to $81,376, according to healthcare consultancy Premier, which analyzed the salaries of roughly 60,000 nurses. That is up from the 3.3 percent rise in average annual nurse wages in all of 2020 and 2.6 percent growth the year prior to the pandemic, according to the US Department of Labor. The need for nurses is so great that many have been able to make even more money by leaving hospital payrolls and instead floating between temporary jobs seeking emergency staffing, hospital recruiters and executives say. The changes have resulted in greater turnover at hospitals, leading to chronic staffing shortages. Nurse turnover rates have risen to approximately 22 percent this year, compared with an annual rate of about 18 percent in 2019, according to Premier.

From the article of the same title
Wall Street Journal (11/17/21) Evans, Melanie
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Six Ways to Get More Patients
Medical practices can attract more patients and increase revenue using various strategies. One strategy is to arrange a schedule with slots for "short" and "long" appointments, easing the ability for the scheduler to book patients. Same-day appointments should be accepted, and patients should never be bumped. Patient-focused websites that provide pricing information and even pre-payment options can also be helpful, and practices should research what services are reaching patients in their local area. Marketing is essential, and practices should schedule a patient's next appointment at the end of their current one. Creating personal "wow" experiences for existing patients is more likely to generate referrals to new ones, and all practices should have a recall or recare program.

From the article of the same title
Medical Economics (11/12/21) Lutton, Logan
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Specific Tax Fraud Traps Physicians Should Avoid
Physicians should be aware of certain tax planning schemes that the Internal Revenue Service recommends avoiding, lest they be penalized for tax fraud. Syndicated conservation easements, in which promoters twist a provision of tax law using inflated appraisals of undeveloped land and partnerships, is one example. Another is abusive captive insurance arrangements, where accountants or wealth planners convince owners of closely held entities to enroll in schemes that lack many of the attributes of insurance; they often feature excessive "premiums" used to circumvent tax law. Potential misuse of the US-Malta Tax Treaty should also be evaded or should only be employed by high-net worth and ultra-high net-worth individuals assisted by seasoned legal and tax counsel to guarantee strict compliance. Additional traps include improper claims of business credits and improper monetized installment sales, and the first transaction generally entails failures to participate in or substantiate qualified research activities and/or meet requirements related to qualified research expenses. The second is an abusive tax shelter in which the seller receives the bulk of transaction proceeds, but improperly postpones the gain recognition on the appreciated property until the final payment on the installment note.

From the article of the same title
Physicians Practice (11/09/21) Devji, Ike
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Health Policy and Reimbursement


Congressional Doctors Lead Bipartisan Revolt Over Policy on Surprise Medical Bills
A bipartisan coalition of 152 lawmakers oppose the Biden administration's plan to regulate a law curbing surprise medical bills for patients treated by hospitals or doctors outside their insurer's network. The No Surprises Act passed last December imposed a 30-day negotiation period that would be followed by arbitration when agreements cannot be reached, with providers and insurers, not patients, the only negotiators. However, many doctors, their medical associations and members of Congress now claim the rule issued by the administration in September for implementing the law benefits insurers.

From the article of the same title
News-Medical (11/17/21)
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Long-Awaited Cures 2.0 Bill Unveiled
US Reps. Fred Upton (R-MI) and Diana DeGette (D-CO) have unveiled the Cures 2.0 bill to allocate new funding for the US Food and Drug Administration and Centers for Medicare and Medicaid Services programs and establish the $6.5 billion Advanced Research Projects Agency for Health (ARPA-H). "By creating ARPA-H, we will be bringing together some our nation’s greatest minds to help find cures to ... devastating diseases," the sponsors said. "And we will—for the first time—be putting the full weight of the federal government behind the ongoing efforts to end these terrible illnesses as we know them."

From the article of the same title
Regulatory Focus (11/16/2021) Mezher, Michael
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Medicine, Drugs and Devices


Administration Finalizes Rule That Requires Insurers to Submit Data on Drug Costs, Rebates
Private insurers will be required to report prescription drug costs to the federal government under an interim final rule issued by the Biden administration. The rule, which also includes a request for comment, implements provisions of the No Surprises Act and the Consolidated Appropriations Act of 2021. Insurers providing employer-sponsored coverage, other group plans or individual plans must submit key data on drug costs to the US departments of Health and Human Services (HHS), Labor and Treasury. The data will then be used by HHS' Assistant Secretary for Planning and Evaluation to publish a report on drug pricing trends and rebates, along with their impact on insurance premiums and consumers' out-of-pocket costs, according to an announcement from the US Centers for Medicare and Medicaid Services. Data submissions must start with information from the 2020 calendar year, but the agencies will defer enforcement until Dec. 27, 2022, to allow insurers time to comply.

From the article of the same title
Fierce Healthcare (11/17/21) Minemyer, Paige
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Aduhelm, Priced at $56,000 a Year, Is a Key Factor Driving Up Medicare Premiums
The US Centers for Medicare and Medicaid Services (CMS) says the Alzheimer's disease drug Aduhelm, priced at $56,000 a year, is a key driver of rising Medicare Part B premiums for 2022. The agency calculates that the standard monthly payment will jump from $148.50 to $170.10. A CMS official said about $10 of the premium increase is due to Aduhelm, with the rest fueled by a general increase in healthcare prices and usage and from congressional action that constrained the rise in Part B premiums for 2021 during the pandemic. "Without a change in current law, there's little the administration can do on its own to protect seniors," warns Tricia Neuman with the Kaiser Family Foundation's Program on Medicare Policy. CMS still has not determined whether and how it will cover Aduhelm, which would incur additional costs for testing, medical facility fees and doctors' charges. Medicare's actuaries must ensure that the program has sufficient funding in case coverage is authorized, though CMS says the premium hike does not suggest this will be the result.

From the article of the same title
CNN (11/16/21) Lubby, Tami
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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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