December 16, 2015 | | JFAS | Contact Us

News From ACFAS

Two New Holiday Infographics Released
Help your patients keep their feet healthy during the holidays and after the new year with two new ACFAS infographics, 5 Tips for Healthy Holiday Feet and Keep Your Feet Safe at the Gym.

Download these new promotional tools from the ACFAS Marketing Toolbox and:
  • post them on your social media sites
  • print and distribute them to your patients
  • display them in your exam and waiting rooms
From choosing the right footwear to avoiding infection and gout, these infographics outline useful tips that can help patients keep healthy during this festive season.

Visit throughout the year for more infographics designed to simplify your patient education efforts and promote your practice.
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More Specialists to Join ACFAS 2016 Speaker Lineup
We know how important your medical colleagues are in providing fresh perspectives on your cases. That’s why we’ve added more non-DPMs, specializing in regenerative medicine, metabolic science, radiology, infectious disease, rheumatology and more, to the ACFAS 2016 speaker lineup.

Get insightful perspectives on trending therapies as these specialists share their expertise and offer strategies you can take back to your practice.

Download the conference program at to see the complete listing of sessions and speakers.
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Wanted: Your Expertise on Privileging and Credentialing
ACFAS is identifying volunteers to serve on the Credentialing and Privileging Advisory Team (CPAT). Volunteers should be well versed in privileging and credentialing issues in a variety of healthcare settings. Previous hospital credentialing experience is a must. CPAT volunteers will assist members with their credentialing questions.

For more information, contact Sarah Nichelson, ACFAS director of Health Policy, Practice Management and Research.
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Don't Forget to Vote!
The ACFAS Board of Directors election closes Wednesday, Dec. 30. If you have not voted yet, watch for a reminder email with the subject line: ACFAS Board of Directors Election—We Need Your Vote! to arrive early next week from with your unique link to the election. Members without an email address were sent voting instructions by US Mail in late November. If you have questions about accessing the ballot site, contact our independent election firm at
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Foot and Ankle Surgery

Efficacy of the Modified Brostrom Procedure for Adolescent Patients with Chronic Lateral Ankle Instability
Lateral ankle sprains represent up to 30 percent of sports-related injuries. The Brostrom technique has shown to be effective in repairing these sprains in adults. A new study looked at the efficacy and outcomes of the modified Brostrom technique in children and adolescents. Twenty-four patients underwent concomitant arthroscopy for intra-articular pathology. All had thickening of Bassett ligaments and three had cartilage lesions. In all, 71 percent of patients achieved good-to-excellent results. Researchers concluded that surgical treatment for chronic ankle instability following lateral ankle sprain was viable through the use of the Brostrom procedure. It resulted in improved stability, low complication rate and solid clinical outcomes.

From the article of the same title
Journal of Pediatric Orthopaedics (12/08/15) Kocher, Mininder S.; Fabricant, Peter D.; Nasreddine, Adam Y.; et al.
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Outcome of Arthroscopic Treatment of Posterior Impingement of the Ankle
A hindfoot endoscopy procedure that reduces pain and results in maximal range of motion (ROM) could be the most viable option for patients with posterior ankle impingement. Researchers looked to determine this by assessing outcomes of the procedure. Twenty patients, 19 of whom were competitive athletes, were studied postoperatively. The visual analog scale for pain and American Orthopaedic Foot and Ankle Society hindfoot scores both showed significant improvement from preoperative levels. Three patients who were professional athletes returned to their previous level of activity. Fifteen percent of patients reported postoperative neuritis. ROM variables were not significantly different between the affected side and the unaffected side, indicating that the endoscopy procedure was mostly successful.

From the article of the same title
Foot & Ankle International (12/15) Carreira, Dominic S.; Vora, Anand Mahesh; Hearne, Kelly L.; et al.
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Practice Management

5 Steps to Protect Against Hackers
Medical data is one of the most sought-after forms of information by criminals and computer hackers. A partial healthcare record can snag $50 on the black market, so demand is high. Here are some tips to protect your practice against the inevitability of a data breach:
  1. Perform a risk assessment. The only way to improve security is to know where you currently stand. Look at whether you have enough staff, whether your current framework can handle new demands and whether you are willing to make the investment in improved security.
  2. Review your vendor and customer agreements at least annually. Understand all relationships with organizations that house your data. Ensure your counsel properly vets and reviews all business associate agreements for compliance requirements.
  3. Assign responsibility within your organization for compliance management. Breaches can result in crushing regulatory fines, so make sure someone in your organization is responsible for development and implementation of HIPAA policies and procedures.
  4. Hold security awareness training. Those responsible for security should be well-trained and thoroughly understand the ins and outs of applicable compliance structures.
  5. Establish a security framework. This framework should include security governance, policy, engineering and operations, monitoring and reporting, and optimization.
From the article of the same title
Medical Practice Insider (12/07/15) Thies, Brad
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Burnout Increasing Among U.S. Doctors
Burnout among U.S. doctors is getting worse, according to a study from the Mayo Clinic. The research compared data from 2014 to data from 2011 and found that the classic signs of professional burnout increased. More than half of physicians felt emotionally exhausted, and more than half said that work was less meaningful. Fifty four percent of physicians said they had at least one symptom of burnout, compared with 45 percent just three years ago. In addition, another study recently found that physicians in training have significantly higher depression rates than the general population. Experts say the only solution is a systemic change. According to researchers, all healthcare organizations must work together to fix the situation.

From the article of the same title
Washington Post (12/08/15) Sun, Lena H.
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Manage Medical Practice Staffing over the Holidays
The holiday season is upon us, and it is important to manage your staff correctly over the next several weeks to ensure your practice continues to run smoothly. First, have a written policy that states the ins and outs of vacation and time-off requests, and be sure that your staff is completely aware of the policy. In addition, make sure that all of your staff knows at least the basics of every job associated with their work station. If one employee goes on vacation, it only makes sense to have several more who can seamlessly assist in picking up the daily activities that the employee is leaving behind. Communication must also be very clear, especially when it comes to time off. If more than one person is approving time off, it can lead to conflict among employees. Be sure to have a streamlined system where employees know they can go to notify the practice about vacation time. Finally, if many employees are out for the holidays and only a few are left in the office, consider condensing the work week. Your staff with appreciate it, and it will make for a better holiday season for everyone.

From the article of the same title
Physicians Practice (12/05/15) Cloud-Moulds, P.J.
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Safety Culture Affects Patients Outcomes
New research indicates that a hospital's safety culture plays as big a role in improved surgical outcomes as a surgeon's skills or equipment. The study tracked seven Minnesota hospitals and determined that communication, adoption of best practices, tracking of results, voicing concerns, learning from mistakes and more were all indicators of a reduction in surgical site infections. While many hospitals have assumed that this mix of qualities led to better outcomes, this study is the first to prove it with data. "While we have traditionally only studied the incremental patient benefits of different medications and surgical interventions, it turns out that organizational culture has a big impact on patient outcomes," said lead author Martin Makary.

From the article of the same title
Outpatient Surgery (12/10/15)
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Health Policy and Reimbursement

Congressional Budget Deal May Hamstring ACA Funding
The Affordable Care Act (ACA) is at the heart of the congressional budget that must be passed to fund the government. Republicans want the omnibus budget package to extend funding restraints that insurance companies and failing co-op insurers say are forcing them out of the ACA's insurance exchanges. The Cadillac tax is also at risk, and lawmakers are considering a one-year delay on it. The tax is particularly divisive due to numerous Democratic leaders joining the chorus of Republicans claiming it needs to be struck down. Even though health economists widely support the tax, lawmakers are likely to see more of a political upside in killing or delaying it. The budget deadline could be extended to accommodate lawmakers who want to discuss further.

From the article of the same title
Modern Healthcare (12/09/15) Muchmore, Shannon
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Doctors, Hospitals Condemn Out-of-Control Drug Prices as Senate Investigation Begins
The Senate is investigating drug price increases as healthcare specialists descend on Washington to testify. The Special Committee on Aging will investigate drugs such as Daraprim, which made headlines after Turing Pharmaceuticals increased its price from $18 to $750 overnight just a few months ago. Advance testimony spotlighted an important facet of the arguments, namely that doctors and companies feel powerless to control the prices. One common complaint is that drug manufacturers simply do not do enough to help the people paying for their drugs. Another issue to contend with is that raising the prices of old drugs is not necessarily wrong. Turing CEO Martin Shkreli made it clear by saying, "No one wants to say it, no one's proud of it, but this is a capitalist society, a capitalist system and capitalist rules, and my investors expect me to maximize profits." Some proposed solutions include "marketing the spread," which means negotiating undisclosed rebates with pharmacies if a drug's sticker price is too high. Erin Fox, director of the Drug Information Service at University of Utah Health Care, said that the time for change is now. "Our physicians are extraordinarily frustrated by having to make decisions about whether to use these critically important but extremely expensive medications in emergency situations, especially when they have been using these drugs for years," Fox said.

From the article of the same title
Washington Post (12/09/15) Johnson, Carolyn Y.
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Medicare Penalizes 758 Hospitals for Safety Incidents
The federal government is penalizing 758 hospitals for higher rates of patient safety incidents. More than half of the hospitals were penalized last year as well, including Stanford Health Care and the Denver Health Medical Center. The penalties are the toughest sanctions Medicare has taken to improve hospital safety, and they are still divisive. Patient safety advocates think the fines are not large enough; those opposing the fines believe they are too stringent and ultimately unproductive. The government considers multiple factors when doling out fines, and Medicare said average hospital performance actually improved in two of the three measures used to levy penalties. A total of 407 hospitals were penalized both years of the program.

From the article of the same title
NPR Online (12/10/15) Rau, Jordan
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Medicine, Drugs and Devices

FDA to Hold Workshop on Medical Device Cybersecurity
The U.S. Food and Drug Administration (FDA) will conduct a two-day workshop in January aimed at discussing ways to address medical device cybersecurity. The workshop will occur five months after FDA released a statement raising concerns about the security of certain medical devices. FDA has also previously released final guidance that called on device manufacturers to design their products with cybersecurity in mind. The workshop, called "Moving Forward: Collaborative Approaches to Medical Device Cybersecurity," will discuss past collaborative efforts to unveil security flaws, talk about existing frameworks and other "unresolved gaps and challenges."

From the article of the same title
RAPS (12/03/2015) Brennan, Zachary
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Medical 3D Printing Lowers Risk and Cost of Complex Surgeries
Some surgeons are turning to medical 3D printing to navigate complex surgeries to achieve better outcomes. Adnan H. Siddiqui, chief medical officer at The Jacobs Institute, has used 3D printing methods to great effect. Siddiqui deals in neurosurgery, but his tactics can be used in a broad range of procedures. The surgeon models the patient's anatomy with a CT scan, converts it into drawings, feeds the data into a 3D printer and prints out a model of the image. The only limit of the technology is the 24-hour turnaround, meaning it cannot be used for emergency surgeries yet. The other major effect of the 3D method is that it lowers cost. Using the printers can create a dry run of a potential surgery and can lower the risk of unnecessarily complex procedures. "Operating room time is a very scarce resource in the medical space, and it's expensive," said Mike Gaisford, director of medical solutions at Stratasys Ltd. "I've seen studies that show it costs up to $100 a minute, and so if you can shorten the amount of time that a procedure takes, then you can significantly reduce the cost to a hospital."

From the article of the same title
TechTarget (12/10/15) Lee, Kristen
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Should Doctors Also Act as Device Sellers?
The legality of physician-owned distributorships (PODs) has come under fire. PODs come into existence when physician investors practice in the hospitals to which they distribute medical devices. Some legislators, such as Senate Finance Committee Chair Orrin Hatch, have questioned whether this is ethical. "We are seeing more and more of these physician-salespeople using the very devices they sell in the surgeries and procedures they perform," Hatch said last month. Many have argued that this gives some physicians a financial incentive to recommend and perform unnecessary surgeries. Hatch has even issued a fraud alert on PODs, calling them "inherently suspect." Federal law states that physician-owned entities can only be 40 percent owned by physicians and only have 40 percent of their income come from physicians, which raises legality issues for PODs, which in some cases are 100 percent physician-owned and make 100 percent of their money from doctors. Some healthcare systems have responded to the POD issue. In Salt Lake City for example, the Intermountain Healthcare system "will not enter into any agreement to purchase from a [physician-owned entity] any item or service other than professional medical services personally furnished by the physician owner."

From the article of the same title
MedPage Today (12/06/15) Frieden, Joyce
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This Week @ ACFAS
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Mark A. Birmingham, 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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