ACFAS Update (Vol. 27 No. 4)

ACFAS VOLUME 27 ISSUE 4

NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

ACFAS In-Person Meetings Still On ACFAS is planning to continue with the remainder of its 2020 programs as scheduled. We continue to follow CEC guidance and will evaluate the situation as our scheduled programs grow closer.

If you don’t have an opportunity to join us for an educational program, there’s a way to access education right from your home with ACFAS OnDemand at acfas.org/OnDemand. Stay one step ahead of your annual licensure and privileging requirements

with the College's e-Learning portal. Access a wide range of podcasts, Clinical Session videos, e-Books, Surgical Techniques DVDs and more to earn CME hours at your convenience. New products are added to the e-learning portal every six weeks, and each tool in the portal includes a short exam you can complete and submit to obtain your CME.

Clinical Sessions

Podcasts

Surgical Techniques

Medical Bookstore

Class starts when you’re ready!

Visit acfas.org/OnDemand to see all ACFAS OnDemand has to offer.

It Could Happen to You: Malpractice Lawsuits page 12

How to Get Published in JFAS

page 14

President’s Perspective

TEAMWORK page 2

perspective

TEAMWORK The timing of the release of The Last Dance the Michael Jordan (MJ) docuseries was impeccable and brought together sport and culture in a time when both are in flux.

Having lived through those years, I enjoyed being a fan of the Bulls during their championship run and it was great to remember those moments in life happening around those games. I was amazed at how a six-foot, six-inch man could play the game of basketball as well as a role in culture that was larger than life. He seemed to do this effortlessly and, with watching the docuseries, it exposed the fact that he struggled at times and learned he couldn’t do it alone.

He needed pieces to the puzzle to make the perfect picture.

different educational offerings, is Roya Mirmiran, DPM FACFAS, chair for post graduate affairs. She proved the importance of our post graduate affairs and was quick to assemble a multi-discipline conference call to help identify our best course of action for our students and residents during the uncertain time of COVID. Working with the American Board of Foot and Ankle Surgeons, the Council of Podiatric Medical Education and our College, we came to a solution that created a positive effect for thousands by offering our educational programs for those residents and students impacted by the Coronavirus limitations.

While there were many memorable quotes in the series, one from MJ resonated with me, “Why would I think about missing a shot I haven’t taken?” His words speak to his mentality and how he attacked the opportunities presented to him. He was often given the ball at times when success was needed to win. He wasn’t always perfect, but his mentality of the situation never changed— it’s this mentality that reminds me of our own members of ACFAS. Over the past few months committee chairs have been given “shots” and I can say, without a doubt, they were “nothing but net.”

Danielle Butto, DPM FACFAS, chair for Practice Management and Sam Nava, DPM, FACFAS, chair for Health Policy worked with remarkable speed to help get our position statements in order and organize a COVID resource page for our members to access. The page proved to be a tremendous resource for our members with tips on how to maintain a practice and health policy fact sheets when safety was at a priority. The Practice Management committee also quickly put together the highly attended informational webinar on Practice Survival During COVID. All were very coordinated efforts, which required great communication and thorough understanding of the issues.

One such member, whom I’ve had the opportunity to work with on several

Shane Hollawell, DPM FACFAS, chair for Education and Scientific Affairs committee,

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

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has been active in our response to the changing climate occurring in CME delivery during the pandemic. Our first virtual CME offering was initiated, and this option of delivery will only grow and strengthen in the years to come.

These leaders are a part of the team and again they can’t do it without their own supporting team members. The members on their committees, as well as other unnamed committee chairs and members, are working hard for all of us as well—all done alongside the hard work of our staff at the College who make these things possible.

In watching The Last Dance, I was reminded how MJ needed to accept his role as a better teammate in the triangle offense and try not to do everything himself. Once he had a strong support in coaching and players, the sky was the limit. I feel we are already at that point here at the College and we have members ready, willing and able to contribute.

Just as important is our openness to new ideas and focus on continual improvement.

Don’t worry, we are not asking you to take the last shot in the game—but if you want to help contribute and make a positive impact, get involved because in the end, we all want to be like Mike.

Scott C. Nelson, DPM, FACFAS ACFAS President

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

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www.acfas.org

2020 EDUCATION PROGRAMS

education

Don't Miss the New Coding Changes for 2021: Register for Coding & Billing

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 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

Stay in the know for the new coding and billing changes set to go into effect January 2021 by attending Coding and Billing for the Foot and Ankle Surgeon this September and December. The July course was moved to December to better ensure safety and adhere to any travel restrictions brought forth by COVID–19.

Register for one of two opportunities to join experts for tips on how simplify your coding and reimbursement practices: 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 Courses Orthopaedic Learning Center (OLC) Chicago, IL 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)

December 4-5, 2020 (Friday/Saturday)

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

You won't want to miss this course as we cover how to simplify your coding and reimbursement practices, including telehealth coding as well as the many upcoming coding and billing changes, such as coding added for prolonged services and several CCI edits relating to foot and ankle surgery. Register now at acfas.org/practicemanagement.

On the Road with ACFAS—Fixing a Flat Embassy Suites by Hilton St. Louis Downtown St. Louis, MO November 14-15, 2020 (Saturday/Sunday)

Advanced Arthroscopy TBD 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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practice management

Maximize Your Practice Efficiency After COVID-19 While some offices have been flooded with patient traffic and emergencies, smaller practices may have seen a slower patient volume than normal amid COVID19. Once offices open to full operating capacity and government restrictions are eased, some foot and ankle surgeons are concerned offices will be flooded with people who put off visits during quarantine or didn’t have an urgent need for medical care. Whatever the case may be, it is important to have a structure in place to be prepared for the outcome.

Manage Your Schedule During a HUB Session on maximizing practice efficiency in San Antonio, foot and ankle surgeons Michael Dujela, DPM, FACFAS and Matthew Sorensen, DPM, FACFAS outlined ways to manage your patients and schedule for a more productive and successful practice. While the subject of streamlining your day is helpful to implement at any time, it’s an especially timely topic now as offices are re-opening and looking ahead to a post-COVID world.

Look at ways to improve your day from an office flow standpoint—patient scheduling, appropriate staffing, handling staffing issues, managing day-to-day operations.

Dr. Dujela suggests, “Grouping similar

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procedures together in different time blocks throughout the day is one way I manage my day effectively. Save more challenging cases, such as second opinions for last appointment space of the morning or end of the afternoon so you can spend appropriate time.” He adds, “I start clinic at 7am and work hard until noon. I run a short clinic in the afternoon with the last patient scheduled at 3pm to allow for afternoon meetings, consulting or family time.” Setting structure and planning your schedule in advance will help to better manage your time. Your day may have a mix of new patients, follow-up appointments and post-op appointments that you can organize and group together accordingly. Dr. Sorensen reminds doctors, “manage your practice or your practice will manage you.” This leaves room for a better work life balance which in turn contributes to your mental health and wellbeing.

Dr. Dujela also recommends looking at scheduled appointments the day before to maximize time. “Looking at appointments the day before is helpful to not only mentally prepare yourself, but to plan ahead and review test results or advanced imaging.” Dr. Sorensen suggests including staff as well and going through the schedule with them before each day starts.

Michael Dujela DPM, FACFAS

Matthew Sorensen DPM, FACFAS

As we begin entering a more normal scope of life, there is still the threat of COVID-19 and social distancing practices are still in place. If you have high-risk patients, group those together to limit crossing and exposure to other patients.

Manage Your Staff Utilize your staff and delegate what you can. Having a PA allows doctors to spend their time more effectively on tasks that require medical decisions. Approximately 10 minutes of every hour is devoted to medical decision making, and doctors should be focused on making those medical decisions rather than things that can be delegated to PA or ARNP. Dr. Dujela suggests, “The more you can train your staff to do within the scope of the law, the better.”

Looking at different staff needs and having designated people for certain things can help to keep office operations running smoothly. Having a scribe is an additional cost but having a right-hand person with you during appointments to take notes saves time in between when you would have to go back to your office to write notes and update charts.

Manage Protocols Along with arming staff with the proper knowledge and authority, policies and

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

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www.acfas.org

CALL TO SCHEDULE A SURGERY

844. 602. 6637

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NON-FUSION SOLUTION

procedures can save time in the long run.

Outline clear protocols and be consistent with them and your expectations. Train your staff to know what they can do and what you can do. This will free up time for the entire staff and save time questioning how things should be done. An example is training staff to know which patients need X-rays—this isn’t something only a doctor needs to decide, and this saves you time.

Train your staff to identify things without the doctor so their time is spend making medical decisions.

Once practices are put in place, monitor, and evaluate regularly. Dr. Dujela believes in constantly working to improve, “Our practice mantra is always be sharpening the sword. We meet frequently as a group to get feedback from key players to identify areas of weakness. You may think something works well, but it’s the people in the trenches who can identify where rate limiting steps are occurring.”

While patient volumes may not be back to full capacity, now is the time to look at your practice operations and procedures.

Talk to staff and evaluate what you do well and what you can do better. Before you know it, things will be back to normal, practices will be bustling with activity and you will be glad you took the time to better streamline your day.

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practice management

Keeping Patients in the Loop During COVID-19 Businesses have seen a dramatic shift due to the restrictions put in place in response to the coronavirus pandemic. Medical practices integrated more telemedicine programs, but many have seen a decrease in patient volume as people followed government orders and limited time in public. Some practices are seeing a pick-up in patient volume, but it is as important as ever to stay in touch with patients to make them aware of all office changes.

Initially, patient volume took a hit as confusion about the virus spread and patients were unsure of whom and what was open. Foot and ankle surgeons have taken extra steps to keep lines of communication open with their patients, but to also let them know they are open and operating. Colorado-based foot and ankle surgeon Gregory Still, DPM, FACFAS communicated with patients via email and text

messages through their EMR. Bela Pandit, DPM, FACFAS shares, “My practice ran a campaign via text message, social media and email notifying patients of our stringent cleaning procedure, options for telehealth and a comforting note we are all on the same team.

The amount of support and messages back was astounding. I have a permanent notice on my website as well.”

Patients want to know what you are doing to keep them safe and what measures practices are adopting to adjust to the current situation.

Based in Illinois where restrictions have lasted longer than other areas, Dr. Pandit’s practice requires all staff to wear PPE and offer the same to patients. Pre-screening is done and patients are filtered through telemedicine appointments to only bring in patients for necessary procedure-based work. Staff hours

Bela Pandit DPM, FACFAS

Gregory Still DPM, FACFAS

were adjusted, and hours rotated to allow for limited exposure and to keep costs down.

Curbside pickup is now also available for any patients needing over the counter products. Dr. Still and his staff are taking similar precautions requiring masks to be worn by both patients and staff while in the office and staff is working 32 hours or less each week to accommodate for the decreased patient volume and to limit exposure time. His practice is back to doing elective surgeries, but only if they test negative for COVID-19 prior to the appointment.

Another more positive change Dr. Pandit includes, “We have taken the time to practice mindfulness and appreciation. I can’t remember the last time I was able to take a minute to just re-organize, clean and re-read manuals and protocols. I have used any extra downtime to focus on re-training staff,

My practice ran a campaign via text message, social media and email notifying patients of our stringent cleaning procedure, options for telehealth and a comforting note we are all on the same team. The amount of support and messages back was astounding. I have a permanent notice on my website as well. — Bela Pandit, DPM, FACFAS 06

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patient outreach

Our office didn’t do a lot of telemedicine appointments throughout the pandemic.

I personally only did about 25 the entire time. Currently, I may have one a day, but most people want to come into the office.

— Gregory Still, DPM, FACFAS

ramping up social media and working on future lectures. I also implemented new technology, which allows for more check-in to be done from home for patients, so they are physically in the office less.”

Dr. Pandit explains that while 10-15 percent of her current appointments are telemedicine visits, they prove challenging.

“Being a foot and ankle surgeon, telemedicine is difficult because we are procedure based. Most of the telemedicine appointments are longer-term post-op appointments, skin conditions, prescription refills or general inquiries.” Dr. Still found telemedicine wasn’t preferred among his patients. “Our office didn’t do a lot of telemedicine appointments throughout the pandemic. I personally only did about 25 the entire time. Currently, I may have one a day, but most people want to come into the office.” Now as things in Colorado are slowly returning to normal, Dr. Still is seeing about 75 percent of his normal patient volume.

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Communication with patients not only proves to be essential during a crisis, but additionally when looking to the future and planning for practice success. Dr. Pandit adds, “Existing patients want to hear from you, and you want them to continue coming back. They want to feel a personal connection to you as their doctor and a human. Health issues do not stop. New patients are the key to continued successful growth, so marketing your skills and practice continually will bring in new patients eventually.”

As this situation continues to unfold, now is the perfect time to take inventory of your practice communication process.

Understanding how important it is to stay in touch with current patients and forming new relationships through communication with prospective patients could make a difference in your practice success and patient volume down the road.

Summer FootNotes Provides More Patient Resources & COVID Tips It has felt like Groundhog Day being stuck at home the last couple months, but we’re heading into summer, and with that comes another issue of FootNotes!

This is another timely issue to help patients navigate foot and ankle issues and stay healthy during the pandemic and beyond.

This edition is a helpful resource for patients finding themselves dealing with foot and ankle conditions amid the COVID-19 crisis.

Conditions are listed out to help patients know whether it requires a telemedicine appointment or a visit to the doctor’s office, and outlines what practices are doing to keep patients and staff safe and healthy. For those pounding the pavement as a release from stay at home orders, tips on how to spot Morton’s neuromas and how to keep your feet pain free and safe while making the transition into flip flops this summer.

Use FootNotes to maximize your reach and market your practice to current and potential patients. Add your practice contact information to the customizable second page and distribute in it in your office, post to your website or share on social media. Visit the Marketing Toolbox at acfas.org/marketing to access other tools to help you ramp up your practice marketing efforts.

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news from the college

Cheers to the 2020-2021 ACFAS Student Club Presidents!

ACFAS Student Club Presidents fill an important role as the liaison between the College and their various schools. All nine of the podiatric medical schools have a club presence on campus and provide valuable ways for students to get involved and keep

learning outside of the classroom. With the help of the other officers, club presidents coordinate activities such as presentations and lectures, surgical skills and suturing labs, discussion forums, new student recruitment, and more. The ACFAS Student Clubs are

often the first interaction podiatry students have with ACFAS and are instrumental in welcoming future foot and ankle surgeons into the profession.

ACFAS Student Club presidents for the 2020–2021 school year are: AZPod: Kayla Weber, Class of 2022

DMU: Travis (Drew) Anderson, Class of 2022

Scholl: Trevor Page, Class of 2023

Barry: Karissa Badillo, Class of 2022

Kent State: Hamidat Momoh, Class of 2022

Temple: Alexandra Brown, Class of 2022

CSPM: Shane Hall, Class of 2022

NYCPM: Justin Erfanian-Taheri, Class of 2022

Western U: Kevin Trinh, Class of 2023

Let’s wish the newest class of ACFAS student leaders success in growing the ACFAS community!

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CALL TO SCHEDULE A SURGERY

844. 602. 6637

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First Year of ACFAS Membership Free for New Grads!

Class of 2020—get your first year of membership for free through the generous support of the ACFAS Regions. Membership in ACFAS is important as you embark on the next step in your education and your career.

The College offers various resources you will be able to take advantage of during your residency, including: 䡲

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In-print and online access to The Journal of Foot & Ankle Surgery Discounts on education such as Arthroscopy of the Foot and Ankle Surgical Skills Course Information on ACFAS Recognized Fellowships Access to research resources and scientific literature reviews

Download a membership application today from acfas.org/join.

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patient outreach

New Infographic Illustrates How Foot & Ankle Surgeons Keep Offices Safe Showcase to your patients what your practice is doing to keep patients safe in a post-COVID world with our new infographic: How Foot & Ankle Surgeons Are Keeping the Office Safe.

How Foot & Ankle Surgeons Are Keeping the Office Safe As a foot and ankle surgeon, we always take your safety and the safety of the office staff very seriously, but especially so during this unprecedented time with the COVID-19 crisis.

Please know this office follows the recommended cleaning and disinfecting practices set forth by the Center for Disease Control to keep the office clean. We are also following recommended patient flow/triage protocol to keep everyone safe while in the office.

Cleaning & Disinfecting We’re taking extra care to clean and disinfect all high-touch surfaces and patient care areas throughout the office.

Patient Protocol

TeleHealth Services

Our office is asking COVID screening questions prior to every appointment and then again when you arrive at the office.

Our office is also seeing patients virtually via a TeleHealth appointment. To make an appointment, contact our office and request a virtual visit.

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If you’re not feeling well, or think you’ve been exposed, please call our office for care options.

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We’re wearing masks for all our safety and ask that you do, too.

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When coming to the office, we are practicing social distancing in the waiting room and in the patient care areas where it’s possible.

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Patient care schedules are spaced out to help keep patient to patient contact to a minimum.

This infographic shows the steps foot and ankle surgeons are taking to ensure the safety of their staff and patients amid the COVID-19 crisis. Offices are following recommended cleaning and disinfecting measures set forth by the Center for Disease Control and are following patient flow/ triage protocol to keep everyone safe while in the office. These measures include:

Things we can see via TeleHealth include, but not limited to: 䡲

Heel and arch pain, general foot pain

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Skin rashes and athlete’s foot

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Achilles tendinitis

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Big toe pain

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Metatarsalgia (pain in the ball of your foot)

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Arthritis

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Gout

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Plantar warts

For more information on foot and ankle health, visit FootHealthFacts.org, the patient education website of the American College of Foot and Ankle Surgeons.

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Cleaning and disinfecting of all high-touch surfaces Implementing new patient protocols, including prescreening of patients, mandatory wearing of masks while in the office, social distance measures in waiting rooms and spaced out appointments to limit the crossing of patients.

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Offering TeleHealth appointments for patients suffering from minor issues including, heel and arch pain, skin rashes or athlete’s foot, tendinitis, Plantar warts, big toe pain, gout or arthritis.

Access the newest infographic along with a library of others on various topics in the ACFAS Marketing Toolbox at acfas.org/ marketing. Display the infographics in exam rooms, print them out for waiting rooms, post them on your social media accounts and your practice website or print them out as flyers to include with billing statements or hand them out at any upcoming community health events.

Visit the ACFAS Marketing Toolbox for even more practice marketing tools to help promote your practice and the profession and to showcase what foot and ankle surgeons are doing to keep patients safe!

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www.acfas.org

news from the college

How Foot & Ankle Surgeons Are Welcoming Patients Back ACFAS is hoping to ease patient fears as we head into life post-COVID-19 with the new “Welcome Back” national social media public relations campaign.

The campaign was launched to restore patients’ peace of mind by showing how foot and ankle surgeons are welcoming patients back to the office amid new office procedures to keep everyone safe and healthy. A video showing the changes foot and ankle surgeons have made to continue offering safe, CDCand state regulation-compliant office environments will be circulating in ads on Facebook.

The video was created with pictures submitted

by members to help show the changes offices are making. The video will also help to alleviate patients’ fears making them more comfortable when returning to doctors’ offices to address and take care of their foot and ankle needs.

If you have photos of you and your staff welcoming patients back or implementing new policies and procedures to keep everyone safe, please share them with us by submitting to publicrelations@acfas.org.

The College would love to keep showing the great work you all are doing and the lengths that you’re taking to keep people healthy and on their feet.

Kent State Student Club Makes Waves with First Annual ACFAS Surgery Day The Kent State ACFAS Student Club 20192020 Executive Board hosted the first annual ACFAS Surgery Day. This brand-new initiative was launched to offer extra training to third year podiatric medicine students before embarking on externships.

More than 70 third year students attended the inaugural event in January where they had a

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full day of learning. Students rotated through several surgical stations learning to use the tools and conducting hands-on procedures with guidance from surgical faculty. Rotations included a forefoot, mid- and rearfoot, external fixation and ankle fusion stations. The day closed with group glove and gowning and a review on X-ray and MRI readings.

Feedback was overwhelmingly positive and, as a result, ACFAS Surgery Day will be offered every year to third year students at Kent State to give a boost of confidence before leaving on externships.

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news from the college

It Could Happen to You: Malpractice Lawsuits As foot and ankle surgeons, you are the caregiver and medical professional responsible for your patients. Unfortunately in this role, lawsuits are a part of the profession and something most physicians will have to deal with at some point. As it goes with all human relationships, there is room for miscommunication, uncertainty, sometimes error or lack of trust. While many have the attitude that it simply will not happen to you, it is important to prepare yourself for any situation.

The College has hosted numerous podcasts and educational sessions highlighting the anatomy of a lawsuit and how it affects physicians professionally, mentally and emotionally.

Boston foot and ankle surgeon Barry Rosenblum, DPM, FACFAS urges physicians to always be thinking ahead.

“Unfortunately, there is a climate of defensive medicine. Documentation is important in case of a lawsuit.”

Common reasons one might face a lawsuit are failure to diagnose or treat a condition, treatment resulting in injury, poor documentation or medical error. Physician burnout is an increasingly common problem and a workplace hazard that can often lead to mistakes or missing something one may have normally noticed. These problems can also stem from a lack of communication or a patient feeling their needs are not being met. Denver-based foot and ankle surgeon Alan Ng, DPM, FACFAS adds, “Most of the patients I see who are mad at their previous physician have lost trust and faith with that physician. They feel the previous physician did not tell them the truth or lied to them. Most patients understand there are risks with surgery and if an adverse event occurs, they would rather the physician be honest with them and fix the problem instead of just telling them it will get better or that nothing is wrong.”

Barry Rosenblum DPM, FACFAS

Alan Ng DPM, FACFAS

Physicians undergoing lawsuits may find themselves feeling isolated, anxious and alone. Professionally, it affects your work and may have physicians second guessing their actions, or even apprehensive about performing regular duties once done with confidence and ease. Apart from the professional implications, the mental and physical toll a lawsuit takes on a physician and their family is huge. Dr. Ng suggests using your support system to help manage the stress and anxiety.

“Don’t hide away and feel like you are the only one who has dealt with this situation. Even if you have done nothing wrong, you still have to prove you did it right. It’s normal to feel isolated, depressed, and you will second guess yourself when all this is happening. Rely on your partners for support, odds are they have gone through it themselves, ask your carrier for counseling if you need it.” He adds, “All malpractice carriers have counselors and

Most patients understand there are risks with surgery and if an adverse event occurs, they would rather the physician be honest with them and fix the problem instead of just telling them it will get better or that nothing is wrong. — Alan Ng, DPM, FACFAS

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colleagues to help you if you are spiraling down.”

If you find yourself going through a lawsuit, Dr. Ng urges looking to the future and using the experience to make yourself a better physician. “Learn from your mistakes if you made one and don’t second guess yourself. It is easier said than done, but it’s the only way you can get through the situation.” Once the lawsuit is over and you’ve come out on the other side, it’s still a strange feeling. Dr. Ng had a positive outcome in his experience, but he still felt as if he lost something. He credits the support of his family and colleagues with having him helped get back into the groove.

Ultimately, Dr. Ng suggests using this as a learning experience. “Listen to your malpractice carrier and attend their risk management meetings. They hold educational meetings for a reason, and you will

always take something away from them to protect yourself in practice.” He adds, “Always be honest with your patient and try to impart to the patient you do care about them. Once the patient has lost confidence in you or feels like you don’t care, that’s when you get in trouble.” Dr. Rosenblum agrees, “Patients most often do not want guarantees, but rather they want honesty with respect to outcomes.”

Communication is key with your patients.

They want your professional opinion and guidance, but they also want to know you care about them and their health enough to be open and honest with them.

If you happen to find yourself in a legal situation, remember you are not alone. Rely on your network and use the people around you to get through this. Rely on friends, family, colleagues and your attorneys for support. Dr. Ng points out, “Almost everyone who has

practiced for a long period of time has had to deal with medical legal issues at some point in their career. If you are doing the work, the odds are you will get sued at some point, even if you have done everything right.” He adds, “Your attorney and partners should support you and you shouldn’t be embarrassed to ask for help. We all have egos, but when something like this happens you need to set the ego aside and take care of yourself. You will be surprised to find out you are not the only one who has been through this.” The entire legal process can be daunting and isolating.

Dr. Rosenblum notes it’s an important time to have a mentor. “Having someone to validate your feelings and show they’ve been there and gotten through it is a reminder the sun came up the next day for them, and it will for you.

We need to be a healer and lifeline, not just for our patients, but each other.”

Having someone to validate your feelings and show they’ve been there and gotten through it is a reminder the sun came up the next day for them, and it will for you. We need to be a healer and lifeline, not just for our patients, but each other. — Barry Rosenblum, DPM, FACFAS

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news from the college

How to Get Published in JFAS While the COVID-19 crisis may have slowed patient volumes, there are ways to stay productive and now might be the perfect time to think about submitting a report of your research to The Journal of Foot & Ankle Surgery.

Before getting started, visit the Journal website’s For Authors page. This page is a great resource for any stage of your process.

Starting with preliminary information on ethics in publishing, using inclusive language, authorship and copyrighting, to preparing for research with article structure and manuscript templates, keywords, artwork and level of clinical evidence to after your research has been accepted. This page should be your home base to help you through the entire process.

If you have an interest and a research questions, you first need to decide how you are going to answer that question. Study the

literature and see if the question has been answered. Journal Editor D. Scot Malay, DPM, MSCE, FACFAS notes, “Just because a question has been answered, doesn’t mean you shouldn’t write the article. Read the available published studies to give you a sense of what the outcome was, so you already have data accumulated and can see what’s missing or how it failed.”

One of the most important elements of manuscript preparation is following the Journal’s submission guidelines—all can be found in the ‘For Authors’ section of jfas.org. Dr. Malay advises you pay special attention to this part or your paper won’t go very far. “The paper has to have certain elements or its going to come back to you. There are available templates that will tell you exactly what elements you need to have in your paper.

There’s also a submission checklist that should

D. Scot Malay, DPM, MSCE, FACFAS Journal Editor

Jason DeVries, DPM, FACFAS Journal Section Editor

be used to be sure you’re covering everything and ready to submit.”

Dr. Malay looks at subject matter he believes will pique reader interest, “The more interesting, timely and topical the research is, the more likely it will get published. Having an informative title and interesting topic is important.” If it catches Dr. Malay’s attention, he will show it to a Section Editor who will invite peers to read the report, in an effort to gauge their interest in it, and to critically appraise the information.

The Journal Section Editors are vital in checking content to have all criteria met.

Journal Section Editor Jason DeVries, DPM, FACFAS adds, “Having good data is important, but knowing the process is equally as important. You put your heart and soul into the paper, but if you are missing elements, Dr. Malay will send it back with a list of guidelines

Just because a question has been answered, doesn’t mean you shouldn’t write the article. Read the available published studies to give you a sense of what the outcome was, so you already have data accumulated and can see what’s missing or how it failed. — D. Scot Malay, DPM, MSCE, FACFAS, Journal Editor

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you need to follow. The Journal website templates are incredibly useful to make sure you’re using the appropriate format and including all the elements required for publication. Running through and doing this ahead of time will save you a lot of time and headaches.”

reviews, Dr. DeVries (or other section editors) reviews the reviewers’ critical comments, adds his own critique, then decides to accept, accept with revision, or reject a submission. Dr. DeVries sends this information to Dr. Malay, who will decide to accept, reject or revise the manuscript.

One you have submitted, what does the turnaround process look like? Dr. Malay states, “Peer review is where most things take the most time—21-30 days is the standard time frame to get the paper form submission to review. At least two reviews are needed per paper, and each have a two to three-week time frame to review.” Once there are two complete

Ideally, this whole process takes 30-40 days, but if you run into issues and have not heard a response, visit the author webpage and send a query to inquire about the process of your submission. You should expect a response within a week from the person currently reviewing your research.

Submitting an article for the first time to any journal has a learning curb but know the second time will be a little easier and by the third submission, everything clicks. It is a goal for the foot and ankle profession to push out better scientific information, so consider publishing research your professional duty.

Submitting research is your way to progress the profession forward. If you are interested in learning more about submitting research, visit jfas.org for more information.

The Journal website templates are incredibly useful to make sure you’re using the appropriate format and including all the elements required for publication. Running through and doing this ahead of time will save you a lot of time and headaches. — Jason DeVries, DPM, FACFAS, Journal Section Editor ACFAS CORPORATE SPONSORS Platinum Level

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VOLUME 27 ISSUE 4 | NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

©2020 American College of Foot and Ankle Surgeons 8725 West Higgins Road, Suite 555 Chicago IL 60631-2724 All rights reserved

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

in this issue

New Infographic Illustrates How Foot & Ankle Surgeons Keep Offices Safe

Keeping Patients in the Loop During COVID-19

Maximize Your Practice Efficiency After COVID-19

page 10

page 6

page 4