December 17, 2014 | | JFAS | Contact Us

News From ACFAS

Linger a Little Longer in Phoenix: Attend ACFAS 2015 Pre-Conference Workshops
If you’re looking for a reason to stay in warm and sunny Phoenix for an extra day in February, plan to attend any of three ACFAS 2015 pre-conference workshops set for Wednesday, February 18. Not only will you kick off your ACFAS 2015 experience one day early, you’ll gain valuable skills to improve your surgical technique and streamline your practice.

These in-depth, hands-on workshops include:
  • Perfecting Your Practice: Coding/Practice Management Workshop (8am–5:30pm)
  • Diabetic Deformity: Master Techniques in Reconstruction (7:30am–Noon)
  • In Master Surgical Techniques: Fine-Tuning with the Experts (12:30–5pm)
Space for these workshops is limited, so reserve your spot today at
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Second Annual HUB to Bring New Sessions, Plus Last Year’s Favorites, to ACFAS 2015
The HUB is returning to the Annual Scientific Conference in Phoenix with plenty of new sessions in store, as well as attendee favorites from last year.

Sit in on sessions covering timely topics such as cyberliability, communicating with patients in an electronic age and common mistakes and misconceptions in research (two-part session). Sessions back by popular demand include The Great Job Hunt, Preparing for Success: ABFAS Board Certification Process and Don’t Say “Umm”: Effective Public Speaking.

Space in the HUB is limited—plan ahead to attend as many sessions as you can so you can be part of the discussion!
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Practice Marketing PowerPoint Now Available
If attracting new patients to your practice is on your list of resolutions for 2015, then you’re in luck—a brand-new PowerPoint presentation, Common Athletic Injuries of the Ankle, is now available for download in the ACFAS Marketing Toolbox.

Use this second installment in ACFAS’ free patient education/promotion series during community health talks or patient presentations at the hospital to outline the basics of ankle sprains, chronic lateral ankle instability, peroneal tendon injuries and achilles tendon tears.

The presentation also includes a script and a customizable slide for your practice’s contact information for when people have questions or would like to make an appointment with your office.

The ACFAS Marketing Toolbox contains plenty of resources to help you promote your practice, from press release templates to the FootNotes patient newsletter to patient education CDs and more. Visit the toolbox often—PowerPoint presentations on heel pain and common foot and ankle conditions are coming soon!
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Officite’s Holiday Special for ACFAS Members: Free Practice Websites
Officite, an ACFAS Benefit Partner, is helping ACFAS members celebrate the holiday season with a free website and four months of free hosting. Claim yours with the purchase of a Premium Boost Web Presence package, and you’ll enjoy a customized, mobile-ready website with reputation monitoring, social media and online patient education—all at discounted ACFAS member rates.

This offer expires on December 31, 2014, so call Officite’s Web Presence Advisors today at (877) 708-4418 to start 2015 in style with your new practice website. For more information, visit
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Foot and Ankle Surgery

Radiographic Results After Hallux Metatarsophalangeal Joint Arthrodesis for Hallux Varus
A recent study examined the radiologic results seen in hallux varus patients who underwent hallux metatarsophalangeal (MP) joint arthrodesis, a procedure that is generally performed following failed surgery or is used to treat severe deformities or the onset of osteoarthritis. The authors of the study, which involved 26 patients with 29 feet that had symptomatic hallux varus deformities, theorized that correcting the hallux valgus angle would also result in improvements in the 1-2 intermetatarsal angle (IMA). The study's authors said the procedure resulted in a predictable increase in the 1-2 IMA. The study also found that the average 1-2 IMA changed from 4.8 degrees to 8.4 degrees, while the average HVA increased from -20.7 degrees to 8.2 degrees.

From the article of the same title
Foot & Ankle International (12/03/2014) Geaney, Lauren E.; Myerson, Mark S.
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Practice Management

Walgreens App Makes Virtual Doctor Visits a Reality
Walgreens has introduced a new mobile app that will allow users to make virtual doctor visits for non-emergency medical conditions. The app, which will be available on both Android and Apple iOS devices, will give users access to 2,000 doctors at MDLive, the virtual health services provider that is offering the app in conjunction with Walgreens. Doctor visits made through the app will cost $49, which could be covered by some insurance plans. MDLive's doctors will be able to write prescriptions for patients, if necessary. The service is being made available to residents of California and Michigan and will be introduced elsewhere in the next several years. Walgreens Chief Medical Officer Dr. Harry Leider says more consumers could be turning to telemedicine apps due to the shortage of primary care physicians and the increase in the number of people with health insurance offered through the Affordable Care Act.

From the article of the same title
Chicago Tribune (12/08/14) Hirst, Ellen Jean
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New Medical Practice Staff Performance Reviews: 5 Tips
Practice management consultants, healthcare industry human resources experts and others in the healthcare industry say physicians' practices can take several steps to ensure the success of 90-day performance reviews for new staffers. For instance, the person responsible for the performance review should be sure to speak to physicians and other staff members with whom the employee works to get a full picture of how the new hire works with his or her colleagues in various situations, says SS&G Healthcare Director Cynthia Blain. In addition, performance reviews should offer employees constructive criticism that they can use to improve, says Carol Stryker of the practice management consulting firm Symbiotic Solutions. This includes working with the employee to identify ways to address any performance issues the new hire may have, Stryker says. Stryker also recommends that performance reviews focus on how well a new employee learns from his or her mistakes, rather than how often errors are made. Finally, a performance review should be a two-way conversation in which the reviewer elicits feedback from the new employee about issues such as his or her feelings about working at the practice and ways the orientation process could be improved, says Troy Jaklich of Legacy Human Resources, which specializes in working with medical offices.

From the article of the same title
Physicians Practice (12/09/14) Westgate, Aubrey
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Health Policy and Reimbursement

Doctors Advise FDA and Companies, Too
The Food and Drug Administration (FDA) is coming under fire for failing to disclose the majority of the connections between medical device companies and the doctors who sit on agency panels charged with evaluating orthopaedic, cardiology and gynecology devices. An analysis by the Wall Street Journal shows that one-third of the 122 doctors who sit on these panels received financial or other types of compensation from medical device companies between 2012 and 2014. Almost 10 percent of these doctors received some type of compensation from a medical device company before they evaluated a product from that company. However, FDA only disclosed about 1 percent of the connections between these doctors and medical device makers, the analysis found. Yale School of Medicine professor Joseph Ross says FDA's failure to reveal these connections is worrisome because it creates doubts about the panels' decision-making capacity and could hurt the public's confidence in their recommendations. FDA, for its part, says it only reveals its advisers' financial connections in cases where they need waivers to serve on its advisory panels. Such waivers are issued in cases where FDA is willing to allow the adviser to serve on a panel despite potential conflicts of interest because the adviser has a level of expertise that others do not.

From the article of the same title
Wall Street Journal (12/09/14) Walker, Joseph
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ICD-10 Delay Appears DOA in Congress This Year
A healthcare consultant speaking on condition of anonymity says Congress is unlikely to pass a measure in its lame duck session that would delay the implementation of ICD-10 for another two years. The consultant says this statement is based on conversations he or she had with staffers working for the congressional leaders of both parties. The remarks come after the Texas Medical Association asked congress to push back the adoption of the new coding set to 2017. The proposal reportedly won the support of House Rules Committee Chairman Pete Sessions (R-Texas), who asked House leaders to insert a provision in the budget agreement that would grant the association's request. But delaying ICD-10 could invite blowback from other players in the healthcare industry who have already taken steps to prepare for the adoption of the system next year.

From the article of the same title
Modern Healthcare (12/08/14) Conn, Joseph; Demko, Paul
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Study: Doctors Paid More for Multiple Procedures Than for Multiple Patients
Researchers at the University of California, Los Angeles released a study Dec. 8 that suggests efforts to move from a pay-for-service payment model to one based on patient outcomes are not yet having the desired effect. The study found that higher-earning physicians generally attempt to increase their earnings by ordering multiple and perhaps unnecessary procedures for individual patients instead of trying to treat patients as efficiently as possible to increase their patient volume. Although the researchers said they were very surprised by their findings, critics of the pay-for-procedure model say the results of the study should have been expected given what is known about how the payment model influences physician behavior. The findings could cast doubt on the effectiveness of the Centers for Medicare and Medicaid Services' Shared Savings Program, which was implemented under the Affordable Care Act to move away from a pay-for-service payment model to a patient outcome-based model. But the report concluded by calling on clinicians rather than the government to lead the effort to transition to an outcome-based payment model, as they are "uniquely empowered to ensure that all individuals access the procedures they need and are not exposed to those they don't."

From the article of the same title
U.S. News & World Report (12/08/14) Soergel, Andrew
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HIMSS Members Asking Congress for Meaningful Use Relief
The Healthcare Information and Management Systems Society (HIMSS) is asking its members to contact their congressional representatives and ask that they support a bill that would limit the electronic health record (EHR) meaningful use reporting period to 90 days in 2015. Under current law the meaningful use reporting period for both fiscal and calendar year 2015 will be a full year, despite numerous appeals to the Department of Health and Human Services to limit it to 90 days. As a consequence, HIMSS is asking members to request that their representatives in Congress support H.R. 5481, a one-paragraph House bill that would, "permit the use of a 3-month quarter EHR reporting period to demonstrate meaningful use ... without regard to the payment year or the stage of meaningful use criteria involved." HIMSS is asking members to act immediately while Congress is still in its post-election lame-duck session. Once the current Congress adjourns on Jan. 3, all bills will need to be reintroduced once the 114th Congress is seated. However, H.R. 5481 might not necessarily need to pass. HIMSS notes that if the bill attracts enough political attention, HHS may choose to act on its own.

From the article of the same title
Health Data Management (12/14) Goedert, Joseph
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Medicine, Drugs and Devices

Oral Administration of Morphine Versus Ibuprofen to Manage Post-Fracture Pain in Children: A Randomized Trial
A new study states that morphine and ibuprofen are roughly equally effective in treating pain in children with uncomplicated extremity fractures, a finding that comes amid increased use of these drugs for fractures and other common injuries due to concerns about the use of codeine. The study involved 134 children with uncomplicated extremity fractures who were randomly assigned to receive either 0.5 mg/kg of morphine or 10 mg/kg of ibuprofen four times for 24 hours after being discharged from the emergency room. An analysis of changes to Faces Pain Scale - Revised (FPS-R) scores between the time before the drugs were administered to 30 minutes after each of the four doses were administered showed no significant differences between the 66 patients in the morphine group and the 68 patients in the ibuprofen group. However, 56.1 percent patients experienced adverse events while taking morphine, compared to 30.9 percent of patients who were given ibuprofen. This difference was significant. The study concluded that of the two drugs examined, only ibuprofen was safe and effective for use in outpatient pain management in children with uncomplicated fractures.

From the article of the same title
Canadian Medical Association Journal (12/09/2014) Vol. 186, No. 18 Poonai, Naveen; Bhullar, Gina; Lin, Kangrui; et al.
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Etanercept Ameliorates Inflammation and Pain in a Novel Mono-Arthritic Multi-Flare Model of Streptococcal Cell Wall Induced Arthritis
Researchers have developed a rat model that for the first time allowed them to simultaneously evaluate the effect three arthritis treatments had on inflammation and pain. The rats used in the study received intra-articular injections of Streptococcal Cell Wall (SCW) at the hind ankle followed by intravenous injections of SCW several weeks later to induce three arthritis flares. The study's authors then examined the effects etanercept, dexamethasone and buprenorphine had on pain and inflammation at the hind paws during the second and third flares only, as pain and inflammation went away on their own during the first flare. The study found that the therapeutic administration of dexamethasone inhibited paw swelling and pain during the second and third flares. The prophylactic use of etanercept inhibited pain and swelling during the second flare. The therapeutic use of etanercept inhibited pain and swelling during the third flare, although the treatment completely lost its effectiveness in the third flare if it was also used during the second flare. The therapeutic use of buprenorphine inhibited pain but had no impact on paw swelling during the second flare. The study's authors proposed that their model be used to assess anti-rheumatic agents that target inflammation and pain in the multiple flare paradigm.

From the article of the same title
BMC Musculoskeletal Disorders (12/04/14) Chakravarthy, Kalyan; Faltus, Robert; Robinson, Gain; et al.
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Six- Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study
A recent study has found that a six-week regimen of antibiotics is just as effective as 12 weeks of therapy in treating diabetics with osteomyelitis of the foot. The study involved 40 patients, half of whom received antibiotics for six weeks while the other half received antibiotics for 12 weeks. No significant differences between the two groups were observed in terms of remission rates. A total of 26 patients achieved remission, which was defined as complete healing of any wound and an absence of recurrent infection at the initial site or in adjacent digital rays for four or more weeks, as well as a lack of a need to perform surgical bone resection or amputation at the 12 month follow-up. Finally, the study found that patients in the six-week group experienced gastrointestinal adverse events caused by antibiotics at a lower rate than their counterparts in the 12-week group.

From the article of the same title
Diabetes Care (11/14) Tone, Alina; Nguyen, Sophie; Devemy, Fabrice; et al.
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

Daniel C. Jupiter, PhD

Jakob C. Thorud, DPM, MS, 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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