ACFAS Update (Vol. 28 No. 2)

ACFAS

NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

FASTRAC is Live and Ready for Your Research!

The new ACFAS Open Access journal, Foot & Ankle Surgery: Techniques, Reports & Cases (FASTRAC) is now accepting article submissions.

FASTRAC is looking for the latest advances in cutting-edge surgical techniques for correction of foot and ankle disorders. The journal's streamlined submission process allows ACFAS members and other foot and ankle surgeons around the world to stay upto-date on the best clinical practices. You

Visit acfas.org/LasVegas for the latest information on ACFAS 2021!

FASTRAC

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can submit your research your way, in any format, and once accepted your paper will be reformatted to fit the journal's template.

ACFAS members receive a 25 percent discount on the author fee charged upon acceptance of a paper.

Get your research ready and help progress the profession today! Visit acfas.org/FASTRAC for more information and to submit your latest research.

Picking Practice Types: Pros & Cons page 6

VOLUME 1, NUMBER 1

AN OFFICIAL PUBLICATION OF THE

AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

FOOT & ANKLE SURGERY: TECHNIQUES, REPORTS & CASES

ELSEVIER

President’s Perspective

KNOCK, KNOCK page 2

perspective

KNOCK, KNOCK “Knock on wood.” It seems so silly, right?

Why do we say it? You speak something into existence and then clarify it with a ‘knock on wood’ to avoid bad luck. Some like to pin it on a possible religious origination but its most likely a pagan belief. One that believed trees had spirits in them and by knocking you’re asking them for good luck. We’ve all done it, and it’s just a simple way to recognize there are things beyond our control.

choices. We need as a profession to have the vision of a better future and work over those obstacles to be successful. “Do not be afraid.

Do not settle for mediocrity. Put out your nets in the deep and let down your nets for a catch,” as Pope Saint John Paul II said. That is the mentality we deserve and it’s been great watching the College work with this mindset over the past few years, which I expect us to continue in the future.

will do a superb job with her great ideas and high morals always keeping the College’s goals first. Our collection of leaders is committed to giving you the best member benefits. As always, we are looking for those motivated to help lead the College. However, motivation is not always the answer because it’s temporary. We need you to convert your motivation to commitment as our current leaders did when they started their journey.

If there is one thing I can now say with more conviction is that obstacles will be placed in front of you and you will have no control over them. We can try to control the circumstances around them, but things will continue to pop up in front of you. It is what makes life beautiful though. Your obstacles MAKE your path. Does a hurdler complain about the hurdles or does a cross country runner complain about the hills?

No, because it is their race and they are expected to attack them. They even expect to get better each time they do it. That is the mentality we need to overcome our troubled situations. Unfortunately, our mind has a distinct advantage over us. Fears, insecurities and weaknesses need to be accepted and you need to commit to being uncomfortable to get better. Make your mindset to quit the bad habit of making self-limiting

From my perspective the future of the College is bright. Having been leading the charge this past year, I fully appreciate this is a team effort. Without our hardworking staff of the College and administrative direction by our executive director, we wouldn't be in the great position we are in. The new members of the board of directors had to hit the ground running and their new perspective and ideas have been awesome. Our established board members had to take on new challenges as well and I appreciate their flexibility in managing this and their own professional and personal lives. I want to especially thank Immediate Past President Christopher Reeves, DPM, MS, FACFAS for his ear this year. I will be excited to watch our new President Thanh Dinh, DPM, FACFAS take control and lead our organization for the next year. I am confident she

As I reflect on my own personal journey with the College I wish I could say it was all roses, but after this year that is impossible.

I could sit and sulk about all the bad things that occurred, but I would rather beam about what we accomplished. Who knew we would be writing to the Senate/Congress/National Governors Association or any of the dozens of other things we tackled as they popped up. There have been so many good things that far outweigh any bad. I am excited to see what develops over the next few years on current items we have been working on and it will be fun to see it from a new perspective. I wish our 70th president the best of luck and know she will have an awesome year, but just in case, ‘knock on wood’.

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

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Scott C. Nelson, DPM, FACFAS ACFAS President

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education

Don’t Miss the Arthroscopy Surgical Skills Course Join us for one of these 2021 dates to get the latest techniques, didactic lectures and surgical demonstrations at the Orthopaedic Learning Center (OLC) in Rosemont, Illinois.

2021 EDUCATION PROGRAMS March 20-21, 2021 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Surgical Skills Course Orthopaedic Learning Center (OLC), Rosemont, IL April 15-17, 2021 (Thursday–Saturday)

AAFAO Advanced Internal Fixation Course Hyatt Regency DFW International Airport, Dallas April 17-18, 2021 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Surgical Skills Course Orthopaedic Learning Center (OLC), Rosemont, IL May 17, 2021 (Monday)

ACFAS 2021 Pre-Conference Workshops Mandalay Bay Resort & Convention Center, Las Vegas May 18-21, 2021 (Tuesday–Friday)

79th Annual Scientific Conference Mandalay Bay Resort & Convention Center, Las Vegas July 31-August 1, 2021 (Saturday/Sunday)

Advanced Arthroscopy and Cartilage Restoration Orthopaedic Learning Center (OLC), Rosemont, IL August 14-15, 2021 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Surgical Skills Course Orthopaedic Learning Center (OLC), Rosemont, IL October 2-3, 2021 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Surgical Skills Course Orthopaedic Learning Center (OLC), Rosemont, IL December 11-12, 2021 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Surgical Skills Course Orthopaedic Learning Center (OLC), Rosemont, IL

*To be waitlisted, please contact Michelle Majewski at michelle.majewski@acfas.org

Visit acfas.org/skills for more information on the upcoming courses.

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education

A New Future for Prominent Skeletal Fixation Training Program AAFAO’s skeletal fixation courses have been a staple in the foot and ankle surgery arena for many years, with most podiatric surgery residents throughout the country completing the course as part of their training. The programs provide attendees the opportunity to advance their techniques and skills of skeletal fixation, trauma, and reconstructive surgery of the foot and ankle in this popular hands-on surgical training course with intense faculty support.

Through a mutual interest in ensuring highquality surgical skills training for residents and fellows, the College is pleased to be working with AAFAO to transition their respected skeletal fixation courses to ACFAS. An AAFAO and ACFAS joint task force is working through the transition plans that will occur in August 2021. Going forward, these annual skills course offerings will become a prominent component of the educational opportunity the College provides to residents, fellows, and members.

Task Force co-chairs John Steinberg, DPM, FACFAS and James Thomas, DPM, FACFAS worked with leaders from both ACFAS and AAFAO to ensure an efficient transition of the courses to ACFAS. The focus will be to continue providing high intensity hands-on-

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learning of core skeletal fixation principles and reach as many residents as possible each year. A pathway has been laid to transition from the current Basic/Advanced Course offerings to a single comprehensive course. Dr. Thomas shares, “AAFAO leadership felt due to ACFAS’ long standing history of leadership and commitment to the education of the profession and our residents, it is the right organization to continue the AO/AAFAO tradition of being the national leader in providing the highestquality resident education in comprehensive and advanced techniques of internal fixation of the foot and ankle.”

ACFAS President Scott Nelson, DPM, FACFAS adds, “As President of The American College of Foot and Ankle Surgeons, I am very excited for the opportunity to continue with the foundation laid by the AAFAO regarding surgical skills for osteo-synthesis.

Having integrated this into my daily life as a foot and ankle surgeon, I understand the importance this has to our members.

I believe the College will do an excellent job delivering a high-quality program and advance the knowledge of reconstructive surgery and trauma care to improve the future of our profession.”

Visit aafao.org to learn more and to register for AAFAO’s Basic Internal Fixation and the Advanced Internal Fixation courses in Dallas on April 15-17, 2021.

Watch your ACFAS communications for announcements on the August 2021 internal fixation program.

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news from the college

CALL TO SCHEDULE A SURGERY

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New Board Members Elected Congratulations to the newly elected ACFAS board members from online balloting that ended on December 28:

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George T. Liu, DPM, FACFAS (Incumbent) Andrew J. Meyr, DPM, FACFAS Drs. Liu and Meyr will serve three-year terms (2021–2024).

Also serving on the 2021-2022 Board of Directors are Thanh Dinh, DPM, FACFAS, President; Michael J. Cornelison, DPM, FACFAS, President-Elect; Eric A. Barp, DPM, FACFAS, Secretary-Treasurer; Scott C. Nelson, DPM, FACFAS, Immediate Past President; Christopher Lotufo, DPM, FACFAS; Alan MacGill, DPM, FACFAS; Alan Ng, DPM, FACFAS; Barry Rosenblum, DPM, FACFAS; and Matt Williams, DPM, FACFAS.

ACFAS Update & Member Recognition Attend the ACFAS virtual membership meeting on March 4, 2021 at 8pm CT/9pm ET for the installation of the 2021 ACFAS Board of Directors. Eric Walter, DPM, FACFAS will also be honored as the 2021 Distinguished Service Award recipient, new Fellows will be recognized, and an update on the 2021 Annual Scientific Conference will be provided. To register, visit acfas.org. volume 28 issue 2

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

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practice management

Picking Practice Types: Pros & Cons Life is full of options and decisions. For foot and ankle surgeons, practice type is one of those options. When picturing your ideal professional path, how important is practice type?

There are private practices, hospital groups and multi-specialty groups, but how do you decide which is right for you? ACFAS members, Danielle Butto, DPM, FACFAS, Gregory Still, DPM, FACFAS and Frank Luckino, DPM, FACFAS lay out differences between practice types, factors to consider when weighing a possible move and some pros and cons of each.

Dr. Butto shares why she made the move from a hospital group to a private practice. “I was at a point in my practice where I wanted more control of my everyday schedule and practice.”

It seems to be a more common move being made to not only advance in their career and take more ownership. Dr. Still’s decisions to make the switch came after his former practice’s bylaws only allowed family practice/internal medicine physicians to become a partner. He explains, “I left purely for business reasons. I wanted ownership, I wanted to be involved in profit sharing, I wanted to possibly have something to sell to another doctor when I retire.” For Dr. Luckino, the move to a private practice was for two reasons.

“Part of it was location—I wanted to be closer to family. The other part was I wanted to be my own boss. The group I was previously a part of

Depending on what each physician is looking for, there comes a point where it is time to make a move. Whether it is from a hospital group or multispecialty group to a smaller or private practice, there are pros and cons for each, so what are some reasons you might be considering a switch?

was essentially a large private practice, which made it an easier transition for me.”

As with every decision in life, there are pros and cons. While your current practice type may not be the most ideal for you, you can at least weigh the options and learn more about various practice types and their operational differences before making a move. Trust your colleagues and friends in the profession. Ask around and compare notes to see if the grass really is greener on the other side. As Dr. Luckino says, “I think it comes down to what makes you happy.” What works for you may not work for someone else, but if you take the time to look around and gather the facts, you can make a more informed decision for your professional future.

What are the biggest factors to consider when making a practice move?

Compensation

Updated technology

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Partnership opportunities

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Ability to serve on committees and help make decisions

Profit Sharing

Retirement plan

Malpractice insurance coverage

Insurance

Contract—is it fair and are there ways for both parties to exit in a fair manner?

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www.acfas.org

What’s your current practice situation and where were you previously?

Danielle Butto DPM, FACFAS

Gregory Still DPM, FACFAS

Frank Luckino, DPM, FACFAS

“My current office staff is three MAs, one front desk staff and a surgical coordinator.

“The current office I am in has three doctors, nine staff and one independent contractor staff member (10 total).

“I’m currently in private practice and have roughly five staff—two front office and three back office.

Previously, I was in a multi-specialty group for 11 years and left them about 7.5 years ago.

I was an independent contractor and at the time I was one of a few 'specialists’ that was neither a family practitioner or internal medicine doctor. I worked in two offices and each had 9-10 staff members and five doctors, so it was similar. “

The large podiatry supergroup I was a part of previously had roughly 100 employees.”

At the hospital there was more uppermanagement staff, but in my office there was one front desk staff member and one MA only. I shared an office manager and surgical coordinator with multiple specialties.”

Private Practice

PROS More control of schedule, pay, office organization, administrative decisions, etc.

You are your own boss. You can take time off when you want, have the potential to keep overhead down and a smaller staff to manage.

Earning potential is greater

Potential to have high overhead. It’s hard to be competitive with insurance contracts—no negotiating power as a group of one. IT/computer security can also be very costly.

You are the big boss all the time. As the owner, all problems come back to you. No paid time off and when you do take time off, the office doesn't make money. There aren’t other doctors to share cases or difficult situations with.

PROS Guaranteed salary, health benefits, CME and paid time off

Hospital/ Multi-Specialty Group

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CONS Hard to compete with larger groups to keep employees (benefits, wages, etc.)

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Internal referrals, cross coverage for one another

Negotiating power with insurances

Benefits of health insurance/retirement plans and malpractice insurance was covered

CONS Less control from an administrative standpoint: office staff, office location, office hours or daily schedule

Constant tracking of "benchmarks"

Small fish in a big pond

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news from the college

ACFAS Creates Special Task Force to Review CPME 320/330 Draft Re-Write Documents The Council on Podiatric Medicine (CPME) recently released draft changes to their 320 and 330 documents, which provide oversight to residency education in the podiatric profession. In response to the call for comments, the College assigned a special task force to thoroughly review both documents and create a response to submit back to CPME. The task force is led by Michael Vaardahl, DPM, FACFAS and includes Thanh Dinh, DPM, FACFAS, Timothy Ford, DPM, FACFAS; Timothy Uglem, DPM, FACFAS; and Roya Mirmiran, DPM, FACFAS. Dr. Vaardahl states, “The 320/330 documents are the standards and guiding philosophy of how our profession is trained. These documents move our training in specific directions and help our residents and practitioners stay relevant in the medical community. They provide for the training

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that shapes our profession as foot and ankle surgeons.”

“CPME was tasked with updating the 320/330 documentation to ensure our profession addresses changes occurring in the medical community in general, and to continue to provide the highest educational standards and best practices in teaching the next generation of foot and ankle surgeons,” Dr. Vaardahl states. “While our task force agreed with many of the Council’s rewrite recommendations, there were several specific changes we felt reflected ACFAS members’ ideals regarding our profession along with the best interests for the next generation of foot and ankle surgeons and their education,” he added.

The submitted comments and requested changes to CPME 320 by the College include the following items:

Standard 5.5, The role of faculty in didactic training, recommending the role be changed from “mandatory” to “recommended.” This allows flexibility in which faculty is providing the didactic teaching.

Standard 5.6, Faculty must be represented by both ABFAS and ABPM certification. Recommending this also be a recommendation and not mandatory.

The task force believes board-qualified faculty could be as effective, and this opens the door for up-and-coming leaders and teachers to gain experience training residents.

Standard 6.2, Requirements for resident logging. Recommending residents should log both clinical and didactic activities.

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news from the college

Standard 6.7, Protected time for didactic activities. Recommending clarification on times of the year that are more challenging to schedule, i.e. major holidays, during CRIP interview week and graduation week.

Standard 7.3, In-training exams for both ABFAS and ABPM Boards required in the third year of training. Recommending changing this mandate to at least one of the boards taken in the third year.

Residency programs should be allowed to make sure the education is tailored in the best interest of the residents and their post-residency plans rather than have a specific mandate for all residents at a specific time.

Appendix A – Volume and Diversity Requirements. Requesting clarification regarding the wound care MAV requirement, when wound care is not a required rotation.

Appendix B – Surgical Code Procedures.

Requesting clarification regarding wound care as a separate category since it is not a required rotation and recommending moving it under category 6: Practice Based Procedures.

Appendix C – Milestones. Recommending CPME utilize stronger language and provide more guidance on moving the residency programs to a more standardized approach for evaluating and assessing each resident using milestones.

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CPME has not yet communicated the next steps in their rewrite process. The task force also requested clarification from the Council regarding whether there will be further discussion by their rewrite committee, if there will be more revisions, and if the community of interest will be given an opportunity to vote for or against the proposed changes. The task force will await next steps and be prepared to act accordingly.

Dr. Vaardahl explains the basis for their review and decision-making process. “The ACFAS task force looked at its future members’ best interests. Our residents’ education, and the standards these documents set, must create opportunities for the residency programs to continue to provide high-level training. The task force provided comments with the goal to ensure the documents allow for the best training of our future foot and ankle colleagues.”

Dr. Vaardahl continues, “The residency educational process sets the standard for foot and ankle medicine and will guide how ACFAS members care for patients and are involved in the medical community for the next generation. As members of ACFAS, we must be engaged and have our voices assist in the development and philosophy of these documents.”

Naohiro Shibuya, DPM, MS, FACFAS

JFAS Names a Deputy Editor Naohiro Shibuya, DPM, MS, FACFAS has been named the Deputy Editor of The Journal of Foot & Ankle Surgery (JFAS). Dr. Shibuya brings more than 10 years of experience as a research section editor and will work alongside current JFAS Editor, D. Scot Malay, DPM, MSCE, FACFAS in all areas of journal management including article intake and review processes.

Journal submissions have continued to grow steadily over the years making this additional role crucial for its continued success. This extra management support, along with a new managing editor through J & J Editorial, will help to strengthen and streamline the submission process and accommodate the growing volume of submissions ensuring its spot as the authority in foot and ankle research.

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

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Big News for Journal Management

Applications for New Fellowship Programs Due May 1

The Journal of Foot & Ankle Surgery (JFAS) has ramped up its administrative support with J&J Editorial joining the ranks as the journal’s managing editor and peer review management. J&J joins the journal team to oversee and manage the administrative side of JFAS ensuring that articles are circulated through the peer review process efficiently and published in a timely manner. J&J will also manage day-to-day operations of the journal including report pulling, improving existing processes and responding to inquiries.

If you are a fellowship program director and would like to seek ACFAS status for your program, the deadline to submit your application to the College is May 1, 2021.

This partnership gives current Journal Editor, D. Scot Malay, DPM, MSCE, FACFAS and Deputy Editor Naohiro Shibuya, DPM, MS, FACFAS much needed time to focus their efforts fully on the academic and content side of things.

The ACFAS Fellowship Committee meets in late July to review any new applications and will share new programs in August.

Contact Michelle Kennedy, ACFAS director of Membership and Post Graduate Affairs, at michelle.kennedy@acfas.org to request an application or to learn more about the College's Recognized Fellowship Initiative. You can also visit the College’s website—go to the Fellowship Center within the Member Center to learn about:

MAY

researching and applying to fellowships;

understanding the College’s processes and calendars for fellowships;

view various standardized documents and templates, including the Minimal Criteria for Recognition, templates for a manual, surgical case logs, and applications;

and to view the 51 fellowships that currently hold ACFAS status on our online listing.

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VOLUME 28 ISSUE 2 | NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

©2021 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

A New Future for Prominent Skeletal Fixation Training Program page 4

ACFAS Creates Special Task Force to Review CPME 320/330 Draft Re-Write Documents

Don’t Miss the Arthroscopy Surgical Skills Course

page 8

page 3