To view this online go to:
BlackBerry users please scroll down for story text.


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 Senate healthcare bill has passed two procedural hurdles, and a final vote on the bill is expected Christmas Eve. After Christmas, the joint House and Senate conference committee will begin negotiations. Once a consensus is hammered out, the conference report — containing the final legislation — will be presented first to the House and then to the Senate for debate and vote. No amendments are permitted.
Update: 2010 Medicare Physician Fee Schedule

As expected, Congress has passed legislation that will delay the scheduled January 1, 2010, reduction in Medicare physician payments. The action was taken as part of the military appropriations process and freezes payments at 2009 levels through February 28. It is anybody’s guess whether the House and Senate conference report will include at least a temporary fix; if it does not, ACFAS fully expects that Congress will take separate action to prevent implementation of the 21.2 percent fee reduction.
Research Grants Awarded

The ACFAS Research Committee has recently awarded the 2009 ACFAS Clinical and Scientific Research Grant to several recipients.

Emily Cook, DPM, will receive a grant for the proposed study, “Does Ketorolac Delay Bone Healing and Improve Post-Operative Pain? A Prospective Double-Blind Placebo-Controlled Randomized Clinical Trial.”

Lawrence Ford, DPM, and Christy King also were selected for their proposed study, “Pre-operative and Post-operative Analysis of Plantar Pressures for Hallux Valgus Correction.”

If you’d like to propose a topic of study for consideration for the 2010 grant, you can get more information on the ACFAS web site.
Peer Reviewers Key to Quality

Peer review is an essential part of scientific publishing. Without the efforts of volunteer peer reviewers, we would not be able to assure the high quality of the content published in the Journal of Foot & Ankle Surgery.

Peer reviewers serve as the voice of a journal’s readership, providing constructive criticism on the scientific merit and overall interest a manuscript presents. Two hundred and sixty-two reviewers participated in evaluating manuscripts from October 2008 to September 2009. A list of their names appears at

If you’re interested in serving as a peer reviewer, please visit and click on “Become a Reviewer.”
ACFAS HQ Holiday Hours

The ACFAS headquarters office in Chicago will be closed several days in observance of the coming holidays:
  • Thursday, December 24
  • Friday, December 25
  • Friday, January 1
Have safe and very happy holidays!

Foot and Ankle Surgery

Risk of Blood Clots After Surgery Higher Than Thought

According to data from the U.K. Million Women Study, the risk of blood clots following surgery is about 1 in 50 procedures, higher than previously thought. Earlier studies suggested that surgery increases the risk of blood clots as much as 22 times, but the newest study found that the risk for blood clots is 70 times higher in the first 6 weeks of an inpatient surgery. This risk remains higher than average for at least 12 weeks after surgery, compared to those who do not undergo surgery, researchers wrote in the British Medical Journal. Those who had inpatient surgeries were at much higher risk than those who had outpatient surgeries. During the first 6 weeks following surgery, hip and knee replacements had the highest risk, while gynecology procedures had the lowest.

From the article of the same title
Reuters Health Information Services (12/04/09)

Dabigatran Versus Warfarin in the Treatment of Acute Venous Thromboembolism

A fixed dose of dabigatran is as effective as warfarin for the treatment of acute venous thromboembolism, researchers have determined. The double-blind study involved 2,564 adults from 228 clinical centers in 29 countries. The researchers concluded, "For patients and health care providers, dabigatran is a far more convenient drug than warfarin because it has no known interactions with foods and minimal interactions with other drugs, and therefore does not require blood-coagulation testing."

From the article of the same title
New England Journal of Medicine (12/06/09) Vol. 361, No. 24, P. 2342; Schulman, Sam; Kearon, Clive; Kakkar, Ajay K.; et al.

Low Doses of Lidocaine Given Intravenously Help Control Pain After Ambulatory Surgery Procedures

Low doses of intravenous lidocaine have the potential to provide a safe, cost-effective, and reliable way to improve pain control after minimally invasive or minor surgery, according to a study in the December issue of Anesthesia & Analgesia. The study followed 67 patients undergoing common ambulatory procedures, with one group receiving injections of lidocaine—more commonly used as local anesthetic—and the other receiving a salt solution. Those receiving the anesthetic through an IV expressed an average pain score, on a scale of 0 to 10, of about 3--compared to 4.5 for those receiving saline solution; and they needed about 40 percent less of strong pain-relieving drugs during and after surgery.

From the article of the same title
The Medical News (12/10/2009)

Practice Management

Independent but Not Alone (MGMA Annual Meeting)

There was significant focus on practice integration at the annual conference of the Medical Group Management Association. Sessions highlighted strategies for medical practices to join with bigger entities while holding on to some measure of independence. Experts recommended that as a first step, practices analyze what they hope to achieve from linking with hospitals or other physicians. Advocates of integration say that teaming with another entity can improve reimbursement, generate economies of scale — especially for adoption of electronic health records — and aid in the recruitment and retention of physicians. Among the options highlighted were participating in a hospital-run managed service organization which would manage human resources and administrative tasks, thereby allowing the physicians to focus on clinical care. Another strategy discussed was limited or divisional mergers in which a small practice retains its core identity but links with other practices to form a corporation.

From the article of the same title
American Medical News (12/07/09) Elliott, Victoria Stagg

Doctors Seek Aid from Business Schools

Physicians with responsibilities for managing the business aspects of a practice or hospital department are seeking training opportunities to help them navigate the increasingly complex business and management processes. A number of MBA programs have responded by creating new programs. Harvard Business School recently launched a 9-month, non-degree program called “Managing Health Care Delivery.” Participants meet for three one-week sessions and pay $22,000 in tuition. The University of Pennsylvania Wharton School of Business holds a non-degree leadership program for providers in the University of Pennsylvania Health Care System. Duke, Vanderbilt, and Dartmouth business schools are all planning to launch programs of some type in 2010.

From the article of the same title
Wall Street Journal (12/17/09) Porter, Jane

Top 10 Smartphone App Trends for 2010

Physician adoption of smartphone technology is expected to jump from the current rate of 64 percent to 81 percent by 2012 as new applications offer the possibility of dramatically expanding use from simply a reference device. Anticipated products for 2010 include applications that allow physicians to access EMR systems, view images, map the spread of diseases in their area, perform some mobile testing (e.g., eye charts, hearing tests) and download clinical guidelines.

From the article of the same title
HealthLeaders Media (12/11/09) Johnson, Cynthia

Health Policy and Reimbursement

Doctor-owned Hospitals Worried Reform Will Cripple Them

Physician-owned ambulatory surgical centers will face serious restrictions on growth under provisions in both the House and Senate versions of health system reform. Both versions would eliminate the exception to the Stark self-referral ban that allows physicians to refer to hospitals in which they have an ownership interest unless the hospital met certain specific criteria. According to Physician Hospitals of America, “not a single physician-owned hospital” would quality for growth under the provisions. The American Hospital Association continues to maintain that physician-owned facilities skim profitable patients from community hospitals.

From the article of the same title
HealthLeaders Media (12/17/09) Clark, Cheryl

P&G Buying Remaining Stake in Concierge Doc Network MDVIP

Consumer product giant Procter & Gamble (P&G) — manufacturer of Tide, Pampers, Crest and Pepto-Bismol — is making an unusual move into health care delivery with the recent announcement that it has assumed full ownership of MDVIP, a “concierge” physician network operating in 28 states. Since 2007, P&G has held a 48 percent interest in MDVIP. Under the MDVIP model, physicians are independent, but they agree to cap their practices at 600 patients. Patients pay a monthly fee, and physicians get a “significant portion” of that fee. MDVIP will benefit enormously from P&G's branding and marketing expertise.

From the article of the same title
Modern Physician (12/09) Robeznieks, Andis

Technology and Device Trends

Spray-On Skin Speeds Up Healing Burns

Painful skin grafts could be avoided and burns could heal in just a few days with a new spray-on skin technology that is about to begin a clinical trial in the United States. The technology uses a very small amount of a patient’s healthy skin to heal a large area of burned skin, closing burns very quickly and reducing the risk of infection. It involves a tiny donor site on the patient’s body about the size of a postage stamp and a scraping of just fifteen one-thousands of a centimeter deep. The scraping collects basal stem cells and melanocytes that are then dissolved and sprayed back onto the burn site, where they then divide and expand. The site will grow new healthy skin within a week that matches the surrounding skin much more closely than a graft.

From the article of the same title
ABC Science Online (Australia) (12/03/09) Bland, Eric

Researchers Tackle Protein Mechanisms Behind Limb Regeneration

Researchers have conduced the most comprehensive study to date of the proteins in a species of salamander that can regrow appendages. The research could provide important clues to how similar regeneration could be induced in humans. The research has been published online in the journal Biomedical Central Biology.

From the article of the same title
EurekAlert (12/14/09)

Abstract News © Copyright 2009 INFORMATION, INC.
Powered by Information, Inc.

You have received this newsletter as a service of the American College of Foot and Ankle Surgeons. To change your email address, please click here. If you wish to unsubscribe click here.
December 23, 2009