ACFAS By the Decade

In 1938 Dr. William Stickel, then Executive Secretary of the National Association of Chiropodists (later to become APMA), had a vision of a qualifying organization for foot surgeons. He appointed Dr. Douglas Mowbray to develop a group that would identify surgical standards and grant fellowship to candidates who met these criteria. Mowbray and four other pioneers in foot surgery (average age 31) incorporated the American College of Foot Surgeons (ACFS) on March 23, 1942. One of the College’s first achievements was the creation of a rigorous surgical certification process. The process evolved to include submission of case histories with detailed documentation followed by successful navigation of written and oral examinations.

The second decade began with ACFAS merging with a small west coast group, the American Society of Foot Surgeons. A group of notable foot surgeons, including Drs. Earl Kaplan and Irv Kanat, started offering surgical training to members and ACFS began sponsoring educational programs at the Civic Hospital in Detroit, Michigan, where the first residency training program in foot surgery were also established. In 1958, ACFS held its first independent scientific conference. Regional divisions were developed during this time to conduct local programming. At the end of the decade another facility for surgical postgraduate training, the California Podiatry Hospital, was dedicated in San Francisco, California.

The College’s initial scientific journal, the American College of Foot Surgeons’ Journal (later to become the Journal of Foot & Ankle Surgery (JFAS)), started publishing regularly in 1964. Detailed descriptions of officer and committee positions were created. Workshops and surgical techniques clinics became a growing activity for the College and regional divisions. The first woman and first African-American members both joined in 1961. Medicare and Medicaid was created in 1965 and would forever change how health professionals would practice medicine.

Podiatric residencies began springing up nationally, modeled after the first foot surgery program at Detroit’s Civic Hospital. The College’s role as a certifying body was spun off into a separate organization, the American Board of Podiatric Surgery (ABPS, later to become ABFAS) with ACFS Fellows serving as the core examiners. ACFS student chapters were established to extend educational opportunities to students. The first edition of Complications in Foot Surgery was published in 1976 and the Journal of Foot Surgery was accepted for citation by Index Medicus the following year. Dr. Kaplan retired after serving the College for 18 years in various capacities including officer, president, journal editor, and executive secretary.

ACFS moved its headquarters to San Francisco with John Bennett serving as Executive Director of both the College and ABPS. The College required ABPS certification as a prerequisite for Fellowship. Special interest committees in areas such as arthroscopic surgery, biomaterials, laser surgery, etc., were introduced by the ACFS and the Standards of Care Committee was created to promote the activities and parameters of podiatric surgeons. The College retained a Washington-based legislative consultant, developed position papers for podiatric surgeons, published member and consumer brochures, and held international surgical conferences.

To meet the demands of an expanding membership, Cheryl Beversdorf was named the first full time executive director and the headquarters was relocated near Chicago’s O’Hare Airport. In 1992, the College celebrated its 50^th anniversary and its new name – the American College of Foot and Ankle Surgeons (ACFAS) – and a recommitment to the educational mission of the College. The Annual Scientific Conferences and other programs and workshops all enjoyed increased member attendance and participation, including cadaver-based Surgical Skills Courses. Preferred Practice Guideline documents (later to be titled Clinical Practice Guidelines) were introduced. The College expanded its international presence with World Congresses in the U.S. and programs abroad engaging large international audiences of foot and ankle surgeons. In 1996, Thomas R. Schedler, CAE, became the College’s executive director. The College increased its member advocacy role by establishing deeper working relationships with regulators, insurance companies, and industry. By the end of the decade, ACFAS reached milestones in membership growth, revenues, and best practices for medical association management.

Entering the new millennium, the College continued its expansion into surgical, consumer and practice management education. Internet-based learning was launched including podcasts and online CME courses. ACFAS secured new Joint Commission regulations permitting podiatric surgeons to conduct H&P privileges (later following by similar Medicare regulations). FootHealthFacts.org was launched as a dedicated website for consumers and patients. The first College-sponsored multi-site clinical research project was conducted. Outreach to students, residents, and non-North American foot and ankle surgeons were expanded. J.C. (Chris) Mahaffey, MS, FASAE was named Executive Director in 2003. The strategic plan, business plan and budget were tied to outcomes of member and practice surveys. Mandatory dual membership with APMA was ended in 2008.

With three-year residencies now the norm, new emphasis was focused on state scope of practice statutes and hospital privileging to ensure professional equity for all DPMs. By 2015, only four states did not include the ankle in state scope statutes. The Recognized Fellowships Initiative sparked growth in standardized post-graduate training nationwide. The number of papers published in JFAS grew substantially. The federal Affordable Care Act was adopted in 2010, sparking the most significant overhaul of the U.S. healthcare system since Medicare in 1965. The “Take a New Look at Foot and Ankle Surgeons” public relations campaign encouraged nurse practitioners, diabetes educators, and family physicians to refer patients to ACFAS members. Membership reached 7,500 and attendance at the Annual Scientific Conference soared to nearly 2,000 DPMs by the College’s 75^th anniversary in 2017.