ACFAS Position Statement

Practice Management Competencies for Foot and Ankle Surgeons

Approved by the ACFAS Board of Directors, February 2020

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To build a stronger foot and ankle surgical community, it is important to use common competency sets to promote communication among healthcare providers and facilitate practice and career growth. Foot and ankle surgeons must assume a greater responsibility for defining the knowledge, skills, attitudes, and values necessary to practice the surgical arm of podiatric medicine. Keeping up with current trends and regulations related to practice management is something all ACFAS members should continue to strive to accomplish.

The following core competencies developed by ACFAS Practice Management Committee and approved by the ACFAS Board of Directors, serve as a resource for foot and ankle surgeons and their staff to carry out practice management activities effectively.

Patient Management:
  • Provides quality patient care through time and office management assists patients in navigating healthcare system complexities and establishes physician-patient communication
  • Understands the legal basis of the physician-patient relationship (i.e. HIPAA and other confidentiality issues related to use of office equipment and access of healthcare records, etc.)
Medical Knowledge:
  • Understands the components of the medical record and appropriately complete documentation in a timely fashion. Proficient in CPT and ICD 10 coding, modifier usage and CCI edits and remains up to date on changes made
  • Knows how to report adverse events and is aware of liability issues
Physician Relationships:
  • Develops relationships with healthcare providers, agencies and accreditors involved in maintaining quality of foot and ankle surgical care including the Joint Commission, the Centers for Medicare and Medicaid Services, local hospitals and state podiatric medical and/or state medical associations
  • Familiarizes themselves with different types of payors and their policies for physician reimbursements including Medicare, Medicaid and other third party payors
Business Management:
  • Understands basic components of creating a business plan for purchasing, buying in, or establishing a practice
  • Distinguishes the differences between all types of medical practices including solo, small or large group practices, academic, orthopaedic, multi-disciplinary and hospital-based
  • Knows professional liability issues including available carriers, types of coverage and its limitations and how to respond to a malpractice claim
  • Understands legal and revenue implications of being bought by a hospital, healthcare system or other emerging type of risk sharing arrangement
  • Understands how physician compensation agreements may evolve, including the impact of profitsharing, wRVUs and bonuses on compensation agreements
  • Understands components of non-physician compensation agreements
Personnel Management:
  • Understands personnel management issues pertaining to employment contracts, practice associations and partnerships, disability, Worker’s Compensation and other emerging human resource trends.
  • Employs highly-qualified personnel to assist in patient foot and ankle care
  • Develops a comprehensive policy manual for delineation of office duties, employee responsibilities and conduct
  • Focuses on privacy concerns and each staff person’s legal duty related to patient privacy, systems integrity, security, etc.
Technology:
  • Engages in the appropriate use of social media, including maintaining privacy use with patients
  • Uses of secured servers during electronic correspondence with patients and colleagues; maintains HIPAA compliance in any such electronic correspondence
  • Utilizes encryption, firewalls, and cyber security; maintain PCI compliance
  • Use of certified electronic medical records
  • Proper maintenance of practice website with certified SEO company
  • Recommend obtaining separate protective policies for litigation related to breech