ACFAS Update (Vol. 27 No. 3) by ACFAS

ACFAS VOLUME 27 ISSUE 3

NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

New Dates, New Content Coding & Billing 2020

Survey Identiﬁes Members’ COVID-19 Concerns The College recently surveyed members to identify their biggest professional and practice-related challenges they expect to face in the next year due to the COVID-19 crisis.

Take 2020 to prepare yourself for the new E&M coding changes set to hit January 1, 2021 by attending Coding & Billing for the Foot and Ankle Surgeon with two sessions available this year. Register today for one of two workshops— September 11-12 (Friday/Saturday) in downtown Chicago at the Palmer House Hilton or on the new, rescheduled date of December 4-5 (Friday/Saturday) at the Walt Disney Swan & Dolphin Hotel in Lake Buena Vista,

FL (which replaces the July date due to the COVID crisis.) Join experts for tips on how to simplify your coding and reimbursement practices, including telehealth coding as well as the many upcoming coding and billing changes, including coding added for prolonged services and several CCI edits relating to foot and ankle surgery. Register now at acfas.org/practicemanagement.

Reignite Your Practice Marketing page 4

page 11

While there was a range of concerns listed, the overwhelming majority were tied to keeping practice doors open. Top concerns included patient and surgery volume; providing a safe environment for patients, self and staff; combating fear of going to doctors offices; covering office expenses; obtaining CME, maintaining salary (continued on page 5)

President’s Perspective

BEING STOIC page 2

perspective

BEING STOIC Challenging, uncertain and unprecedented are some adjectives used to describe the current times in which we are living. The seismic impact felt by our country in the last couple of months from the COVID-19 crisis is reverberating for us all. We have been asked to shelter up, quarantine and shut down in an effort to be considerate of others. It is amazing to watch this play out and see the strides we have made. On top of it all, it is almost assured there will be additional aftershocks we will need to work through in the near future and the only guarantee is, change will continue to happen. With significant change comes our “good friends” stress and anxiety, but we can find comfort in knowing we are not the first to deal with these opponents. We can learn from lessons of the past, even as far back as the Roman Empire, about being stoic during times of crisis. Stoicism during difficult or dark times is a common philosophy and can help mentally frame thinking to ease negative thoughts. Being stoic means, you understand what is in your control and what isn’t and encourages you to turn your attention internally. Roman emperor Marcus Aurelius highlights in his book Meditations four key virtues to happiness: wisdom, courage, justice and self-control. During his reign as emperor he dealt with the ‘Plague of Galen’ (smallpox) and wars, which lead to a decimated economy. He had to sell imperial jewelry, and forced others to as well, in an effort to stimulate the economy (the original stimulus package.) He applied his

teachings to help maintain a strong moral character and clear headedness to successfully manage the empire. He made it evident, “You have power over your mind—not outside events. Realize this, and you will ﬁnd strength.” During this pandemic, I have been impressed with how ACFAS is functioning at such a high level despite the obstacles. I am very proud of the staff being able to continue excellence while following the request to stay home while transitioning to a new executive director. The team helped build a COVID Resource Page on our website, which contains valuable resources and content tailored to College members and our speciﬁc needs during this ever-changing situation. I encourage everyone to check it out at acfas.org/COVIDResources. The work the College is doing on our behalf, such as the resource page, as well as the collaboration with our partner organizations and working with our local, state and national governments to represent our members, has truly proven invaluable to us as members and to the profession. All done under extraordinary circumstances, which is truly impressive, and reminds me of another stoic philosopher Epictetus as he states how situations like this can highlight our true character. “Circumstances don't make the man, they only reveal him to himself.” It’s because of these efforts, we can appreciate that the structure of ACFAS is in great shape and will continue to thrive.

Questions for Dr. Nelson? Write him at president@acfas.org. 02

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As the country starts to return to normal activity, our future endeavors may look differently than they once were—the way we deliver healthcare may include more telemedicine options and the way we earn our CME may be temporarily altered as well. Fortunately, ACFAS already has a large cache of electronic learning modules for all our members with our ACFAS OnDemand learning platform at acfas.org/OnDemand. Opening this platform further to include residents and students so they could continue their education when elective surgical cases had to be shut down, was an easy decision. The flagships of the College, including the Journal, our face-toface CME and our ACFAS Annual Scientific Conference will go on and we will continue to work hard to make sure they are still the best in the business, as we’ve all come to expect. By learning from the past, we can better prepare for our future. The world has a longstanding history of dealing with adversary and we will have to ensure success during this situation as well. The College and its collective leadership will continue to adapt, and I have supreme confidence we will also continue to serve our members at the highest level possible. I am excited to see how the future takes shape, but also ready for a sense of normalcy to resume.

Scott C. Nelson, DPM, FACFAS ACFAS President

update: news from the american college of foot and ankle surgeons

www.acfas.org

2020 EDUCATION PROGRAMS

education

Grab Your Spot for Arthroscopy

July 11–12, 2020 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Courses Orthopaedic Learning Center (OLC) Chicago, IL August 29–30, 2020 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Courses Orthopaedic Learning Center (OLC) Chicago, IL September 11–12, 2020 (Friday/Saturday)

On the Road with ACFAS—Fixing a Flat We’re looking ahead and slowing getting back to business with our skills courses—you have four upcoming opportunities to join us for Arthroscopy Skills! Take your pick and register now to get the latest techniques, didactic lectures and surgical demonstrations. July 11–12, 2020 (Saturday/Sunday)

DoubleTree Suites by Hilton Charlotte SouthPark Charlotte, NC September 11–12, 2020 (Friday/Saturday)

Coding & Billing for the Foot and Ankle Surgeon Palmer House Hilton Chicago, IL October 4–5, 2020 (Sunday/Monday)

Arthroscopy of the Foot and Ankle Course

Arthroscopy of the Foot and Ankle Courses

Orthopaedic Learning Center (OLC) Chicago, IL

August 29–30, 2020 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Course Orthopaedic Learning Center (OLC) Chicago, IL October 4–5, 2020 (Sunday/Monday)

Arthroscopy of the Foot and Ankle Course Orthopaedic Learning Center (OLC) Chicago, IL October 24–25, 2020 (Saturday/Sunday)

October 10-11, 2020 (Saturday/Sunday)

Surgical Management for the Active Patient TBD October 24–25, 2020 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Courses Orthopaedic Learning Center (OLC) Chicago, IL November 13-14, 2020 (Friday/Saturday)

On the Road with ACFAS—Fixing a Flat

Arthroscopy of the Foot and Ankle Course

Embassy Suites by Hilton St. Louis Downtown St. Louis, MO

Orthopaedic Learning Center (OLC) Chicago, IL

November 14-15, 2020 (Saturday/Sunday)

Advanced Arthroscopy TBD

Don't miss this popular, highly interactive program. Visit acfas.org/skills to register to secure your spot today!

December 4-5, 2020 (Friday/Saturday)

Coding & Billing for the Foot and Ankle Surgeon Walt Disney World Swan and Dolphin Lake Buena Vista, FL

*To be waitlisted for sold-out courses, contact Maggie Hjelm at hjelm@acfas.org.

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update: news from the american college of foot and ankle surgeons

www.acfas.org

education

ACFAS OnDemand: Learning Begins When Youâ&#x20AC;&#x2122;re Ready

Clinical Sessions

Podcasts

The education never ends with ACFAS. You can access our most in-demand online education resources from home with ACFAS OnDemand. Access a variety of clinical sessions designed to help keep you on top of your surgical game, complimentary podcasts for quick, deep dives into a wide range of topics from clinical to practical, surgical

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Surgical Techniques

Medical Bookstore

techniques available for purchase to download and share with your staff and a medical bookstore with our e-books series accessible from laptop, desktop, tablet or smartphone. Class starts when youâ&#x20AC;&#x2122;re ready. Head to acfas.org/OnDemand to access your new learning portal today!

update: news from the american college of foot and ankle surgeons

www.acfas.org

CALL TO SCHEDULE A SURGERY

844. 602. 6637

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Survey Identiﬁes Members’ COVID-19 Concerns (continued from cover)

NON-FUSION SOLUTION

base/cash ﬂow; telehealth setup and maintenance; job security and availability; ability to keep and pay staff; and stress and burnout. This feedback is extremely important and will help ACFAS strategize ways to better support you as we continue navigating this uncharted territory together. Watch ACFAS newsletters for the latest news and resources put together to help members.

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volume 27 issue 3

update: news from the american college of foot and ankle surgeons

A G LO B A L E X T R E M I T Y C O M PA N Y

www.acfas.org

practice management

Exit Strategies for Moving to Private Practice There are various capacities in which a foot and ankle surgeon can practice, but what happens when it’s time for you to branch out into the world of private practice? Exit Strategies, led by Frank Luckino, DPM, FACFAS, Maryellen Brucato, DPM, FACFAS, and Danielle Butto, DPM, FACFAS, was a discussion in the HUB at ACFAS 2020 on managing the transition into private practice and was a great resource for anyone moving toward a private practice, or simply a reminder of the option for those newer to the field. As with any big life decision, there’s groundwork to be done to make sure you’re making the right decision. First things first, figure out if you’re ready to make a move. Why does this seem like the right time? Is location a factor? Are you financially and mentally ready for that step? Take the time to write up a plan and make sure this is the

Frank Luckino, DPM, FACFAS

correct choice for you. Many factors go into making this decision and it’s something you should put plenty of careful consideration and thought into. Once you’ve made the decision to move to a private practice, the groundwork begins. Here are some things to think about once you’re ready to move forward with the move. Contract: Check your contract with your current practice. Dr. Butto strongly suggests always paying attention to the fine print and this is especially important as you start a new position. “Read your contract, no matter your future plan. Even when first starting a position, act as if you plan to leave that job so you can make sure the contract is clearly defined, and don’t be afraid to ask for what you want in a professional way. A solid, clear contract will allow you to leave as easily as possible and make the transition a smooth one.”

Maryellen Brucato DPM, FACFAS

Danielle Butto DPM, FACFAS

Location: If you’ve found the right one, is it move-in ready? Will there need to be work done before you can move in? Make a concrete timeline to know when you’ll be ready to move in. Keep in mind, shared office space is always an option if you don’t want to take on an entire building and it's a great way to share overhead with your officemates. Financing: Will you be working with a bank loan for ﬁnancing? How much are your startup costs? Talk to someone who’s been in the situation before and get a list of every expense you will run into during the move. Having a nest egg when getting started will be helpful as numerous costs come up when moving to a new location. Dr. Brucato suggests creating a website as soon as you’ve made the decision to move to private practice. “Start your website or hire someone to design it with your own name so you own it and can take it with you.” Once you have your timeline mapped out, it’s time to move ahead with the transition. This requires letting your current practice know. Before having this conversation, it’s always a

A solid, clear contract will allow you to leave as easily as possible and make the transition a smooth one. — Danielle Butto DPM, FACFAS 06

volume 27 issue 3

update: news from the american college of foot and ankle surgeons

www.acfas.org

There are numerous ways to market yourself and many other helpful resources in the ACFAS Marketing Toolbox at acfas.org/marketing. Use everything you can to get the word out. — Frank Luckino, DPM, FACFAS good idea to check your contract to make sure you know how much notice is required. Give as much notice as you can to avoid leaving your current practice in a tough spot. Most importantly, make sure your practice hears it from you first. You don’t want to leave your employer on bad terms. As Dr. Brucato points out, “Podiatry is a small community. If you leave on a bad note or leave someone high and dry, other people will find out. The more notice you give, the more favorably the former employer will look at you. You can even offer to help them find your replacement.” After you’ve given notice, look at your case load or any new cases that might come in at that time. If you have a patient whose follow up with would be past the point of when you’re at the current employer, don’t take on that case—this could be viewed as abandoning a patient. Make sure your cases can all be tied up and closed by the time you leave to allow for a smooth and clean exit. Another piece of advice to keep in mind, don’t on your way out, try to bring people with you. This goes for staff at the current office as well. You want the transition to be as amicable as possible. If patients want to see you, they will find you. If you do have old patients come to you once you're in private practice, have them sign a waiver to help avoid any legal

implications stating they were not solicited and came to you on their own accord. Once you’ve found your practice location or are purchasing an existing practice, you will need to begin credentialing yourself with hospitals and insurance plans as soon as possible. You will want to create a business tax ID, which is essentially your business social security number. Allow for three months to credential yourself with hospitals and at least three to six months for insurance plans. If you are buying out an existing practice, one thing to consider is working under the existing physician’s tax ID to start. This allows you to see patients and generate revenue while becoming credentialed under your own tax ID. You may encounter problems where insurance plans may say their panel is closed to additional providers. In this scenario, you will want to send appeal letters to the insurance company. One important recommendation would be to negotiate your reimbursement rates with insurances prior to signing any contracts because once you sign your contract, it is difficult to make modiﬁcations. There are services available to help negotiate rates with insurance.

patient volume to keep the practice afloat? Dr. Luckino has a few ideas to start marketing the practice almost immediately. “Send letters, referral pads, establish a website, create a social media presence, meet doctors in person to establish referral relationships and join committees. There are numerous ways to market yourself and many other helpful resources in the ACFAS Marketing Toolbox at acfas.org/marketing. Use everything you can to get the word out. Ultimately, you are the brand.” Just as important as finding patients, is finding a good staff. To retain a good staff, you must provide good benefits and health insurance. While it's not required to provide health insurance, as it is an added cost, it is something that will attract quality candidates. Making the office environment a welcoming and mutually beneficial one will help to reduce in the long run by retaining great staff. You will also need insurance coverage for you and your family. Do your due diligence, research and look around at plan options. Reach out to your state medical and podiatry associations/boards as they may have plans in place you can take advantage of with reduced rates.

After taking all the necessary steps and you’re in your practice, how do you create a steady

Start your website or hire someone to design it with your own name so you own it and can take it with you. — Maryellen Brucato DPM, FACFAS volume 27 issue 3

update: news from the american college of foot and ankle surgeons

www.acfas.org

news from the college

The Results Are In: ACFAS Gap Analysis To maximize the member experience and shape future educational programs, ACFAS conducted its triennial Gap Analysis survey in October 2019. Survey results are essential to develop new educational offerings or pinpoint ways to improve current programming. For the ﬁrst time, this year’s survey included a Net Promoter Score (NPS) question to assess members' loyalty to their association— a very common metric used in membership associations. Overall, ACFAS members exhibit very high loyalty to the organization, with 63 percent rating their likelihood of recommending ACFAS as 9-10—an NPS of 51.4, compared to an overall association NPS of 21, and an overall healthcare/medical association score of 29. With these high scores, it's evident ACFAS has an extremely loyal membership

compared to other organizations of its type. Annual Scientific Conference Program Chair, “Naohiro Shibuya, DPM, FACFAS was pleased to see the results of the score for ACFAS. “There are a lot of dedicated and loyal members who promote ACFAS as an authority in foot and ankle surgical education.” Dr. Shibuya is eager to use the results as a springboard to continue delivering educational content members want, and also to solidify the College’s position as a leader in foot and ankle surgery. “We’ve identified we have a considerable number of loyal members who promote ACFAS as an authority in foot and ankle surgical education and I want to continue keeping them engaged and satisfied with our programming while also reaching those members who aren’t as

invested.” We are looking at different ways to survey members moving forward to gather different thought processes. Task Force Chair, Matthew Williams, DPM, FACFAS also stresses the importance of accessibility with future educational programs. “Finding ways to make education available in ‘smaller bites’ and in more convenient ways for membership will likely be essential moving forward. Being open to change in educational offerings, both content and delivery method—not change for change sake—but being organizationally nimble.” As we continue to navigate the uncertainty of a global pandemic, additional offerings in a variety of platforms will continue to emerge.

There are a lot of dedicated and loyal members who promote ACFAS as an authority in foot and ankle surgical education. — Naohiro Shibuya, DPM, FACFAS, Annual Scientiﬁc Conference Program Chair

volume 27 issue 3

update: news from the american college of foot and ankle surgeons

www.acfas.org

CALL TO SCHEDULE A SURGERY

844. 602. 6637

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Anatomical Shape with Lock-in Flanges Apart from member engagement, Dr. Shibuya was surprised by a change in respondents’ interests. “Members’ academic interest changed signiﬁcantly in the last three years.” Of the 37 topics provided, those areas of highest interest included forefoot trauma, revision surgery, ambulatory infection management, new techniques and appropriate uses of internal ﬁxation. Topics relating to value-based medicine piqued the lowest interest, but most topics saw an overall increased interest compared to the 2016 analysis.

Being open to change in educational offerings, both content and delivery method—not change for change sake—but being organizationally nimble. — Dr. Matthew Williams, DPM, FACFAS, Task Force Chair

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– Adam Landsman, DPM, PhD, FACFAS, Cambridge Health Alliance, Cambridge, MA

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update: news from the american college of foot and ankle surgeons

A G LO B A L E X T R E M I T Y C O M PA N Y

www.acfas.org

news from the college ★ ACFAS

PodiatryCareers.org Job Fair Makes an Impact

SAN

A NTO NI O

2020 ★

Candidates and employers alike came together to make connections and build their networks at the seventh annual ACFAS 2020 Job Fair in San Antonio. During the job fair, hosted by the College's exclusive online job board PodiatryCareers.org, candidates were able to post their CVs, get free professional headshots, and even met with hiring employers on site. New in 2020, a virtual CV review program gave job seekers the opportunity to have a professional CV reviewer make individualized recommendations and suggestions on how best to promote

themselves on paper. Hiring employers posted available positions at the job fair during the conference.

Open positions can be posted leading up to the conference as well as year-round on acfas.org/Career-Center/Employers.

It’s not too early to start planning for next year’s job fair in Las Vegas now! Polish your CV, dust off your best interview outﬁt, and arrive ready to network. Employers: don’t miss your chance to access the best and the brightest foot and ankle surgeons! At ACFAS 2021, be sure to take advantage of the opportunity to meet with talent on site. Attendees seeking new opportunities can post their CVs at the job fair and are available for interviews daily.

To see all the current foot and ankle surgeons jobs available, visit acfas.org/Career-Center/Job-Seekers. In addition to position listings on PodiatryCareers.org and the annual job fair, other career-focused resources are available on acfas.org including webinars and a special career timeline to help students and residents to stay on track.

patient outreach

New Patient Success Videos to Further Promote Your Profession The College is always looking for new ways to promote your profession and share the impact foot and ankle surgeons have on their patients. Now we have three more resources for you to showcase just how important foot and ankle surgeons are! The ACFAS Patient Success Story videos share personal accounts from three ACFAS members and the patients whose lives they've changed. Each video features a patient’s unique story of their struggle with varying foot and ankle conditions, and how their foot and ankle surgeon helped them heal and get back to a normal, active lifestyle. Whether it’s every-

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day foot pain, an injury sidelining someone from a professional running career or unbearable pain from a chronic wound, these stories showcase how essential footcare is and the importance of the work that foot and ankle surgeons do on a daily basis. These videos are the newest addition to the Take a New Look at Foot and Ankle Surgeons campaign and will be used to promote who you are and what you do! The videos can be found on the ACFAS social media accounts, our YouTube channel and in the ACFAS Marketing Toolbox. The videos can be posted to your social media

accounts or shared on your practice website or in your office waiting room. It’s just another way to promote your profession and share how foot and ankle surgeons transform patients’ lives through treatment.

update: news from the american college of foot and ankle surgeons

www.acfas.org

Reigniting Your Practice Marketing After COVID-19 While everything shut down amid the coronavirus pandemic, priorities shifted, and new issues arose. While many found more downtime to focus on backburner projects, others were inundated with new challenges. Now, as we ﬁnd ourselves on the other side of this global crisis and slowly shift back to a normal routine, it’s the perfect time to think of new ways to jump start your marketing strategy and get back to business! While most marketing strategies take months and a lot of manpower to create and execute, we’ve got you covered! Check out the ACFAS Marketing Toolbox and here you’ll ﬁnd numerous, free resources available for you to use to promote your practice and educate your patients. Here are some of the resources available to you in the Marketing Toolbox: 䡲

PowerPoint Presentations: Download free presentations on some of the most

䡲

common foot and ankle conditions. Use them in your practice waiting room or at health education events. Infographics: These customized colorful graphics are a great resource for patient education. These can be printed to hang in exam rooms, given to patients or posted on social media. Fill-In-The-Blank Press Releases: Access a library of customizable press releases on various foot and ankle health topics. These can be sent out to your local media and used to promote your practice. FootNotes: This patient newsletter includes seasonal topics that your patients can use to keep their feet and ankles healthy throughout the year. Each issue is customizable with an open space for you to add your practice information. Hand these out to patients, post on your practice website or keep in your waiting room.

䡲

Patient Reference Form: Use this printable form to take notes on for your patients. The form also includes FootHealthFacts.org information to direct them back to our patient education website in case they have questions about other foot and ankle conditions.

While it’s exciting to get back to old routines, this transition may come with some anxiety. Don’t let practice marketing be a source of stress. Let ACFAS help you promote your practice and ramp up patient education. Visit the ACFAS Marketing Toolbox at acfas.org/marketing and take advantage of all it has to offer.

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volume 27 issue 3

update: news from the american college of foot and ankle surgeons

www.acfas.org

VOLUME 27 ISSUE 3 | NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

Get details about these member services at acfas.org/beneﬁtspartners.

in this issue

Patient Success Videos

Exit Strategies for Moving to Private Practice

The Results Are In: ACFAS Gap Analysis

page 10

page 6

page 8