ACFAS Update (Vol. 29 No. 3)

ACFAS 2023 is Heading to L.A. LIVE!

Register today to join your peers in Los Angeles, CA on February 9-12 at the 2023 Annual Scientific Conference! ACFAS 2023 is being conveniently held in L.A.'s largest entertainment district, L.A. LIVE.

The ACFAS Annual Scientific Conference planning committee has developed a preeminent program that boasts nearly 50 sessions (up to 34 CME) and more than 100 expert speakers, including several leading international speakers. Other conference programming includes pre-conference work shops, new topics in the HUB, international research, hands-on workshops, a wrap party and so much more!

Registration is now open at acfas.org/asc. We look forward to seeing you at ACFAS 2023 for a star-studded annual scientific conference. IN ACFAS

President’s Perspective

VOLUME 29 ISSUE 3

NEWS from the AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS

PARTICIPATE IN ACFAS

When I think of the things that have made my career as fulfilling as it has been, one that immediately comes to mind is my ACFAS membership. Aside from allowing me to continuously stay on the cutting edge of foot and ankle surgical knowledge through its educational offerings, my membership has also facilitated my ability to stay connected with classmates, colleagues, and mentors alike, and has been the basis for forging countless new connections. Such are the benefits of simply being a member, but ACFAS’s volunteer community presents you with opportunities for so much more.

Personally, my participation in ACFAS committees and the Board has significantly broadened my career. It has broken up the rep etition of my daily clinical routine, expanded my personal professional interactions, and kept me dialed in to the forefront issues of our specialty. It has invigorated my career.

I would venture to say that those who have volunteered for the College in any capacity feel the same way. I encourage you to con sider how participating in ACFAS may pos itively impact your own professional experience. Here are some of the ways you can participate:

Volunteer for ACFAS Committees

The College’s 11 committees and task forces are the backbone of ACFAS’ governance, as guided by its strategic compass.

Some committees are focused on the College’s continuing education: Education/ Scientific Affairs, Surgical Skills, Practice Management, and Annual Scientific Confer ence Committee. Those focused on training include the Post Graduate Affairs and Fellow ship Committees. The Council for Journal Management and Research Committee focus on the College’s role in scholarly research. And those focused on optimizing the provision of resources to the College’s mem bers, including interaction with govern ment, the healthcare community, and the public are the Consumer Education, Health Policy and Membership Committee. Visit acfas.org/get-involved/volunteer-opportunities for descriptions of each of these committees.

Apply to be an Instructor

The College’s educational program committees develop the specialty’s most respected CME curriculum, including the Annual Scientific Conference, hands-on surgical skills courses, and single-topic seminars including practice management and regional symposia. They also develop content for podcasts, e-books, and

other e-learning tools. ACFAS always seeks to diversify its faculty with new instructors who possess the expertise and experience needed to maintain the College’s high standards and attendee expectations.

Participate in Regional Leadership

The College’s nine Regions give members the ability to connect locally through seminars, meetings, and labs. Regions also provide outreach to students and residents through scholarships and grants. ACFAS invites all members to get involved in their local Regions and support the profession at the grassroots level.

You can also submit scientific manuscripts to our Journals, posters, or abstracts for pres entation at the Annual Scientific Conference, complete the College’s surveys, or contact ACFAS with a question or concern.

The existence of ACFAS is dependent on one thing: its membership. Its success and effectiveness hinge on being able to tap into the talents and experience of its members. Consider sharing yours with fellow members by getting involved with the College. Visit acfas.org to find out more. Chances are it will pay dividends in enriching your practice as it has for so many volunteers over the years.

Michael J. Cornelison, DPM, FACFAS ACFAS President

education

Join Us In December for Our Last Arthroscopy Course of 2022

Get the latest techniques, didactic lectures and surgical demonstrations when you attend Arthroscopy of the Foot and Ankle in Chicago.

October 1-2, 2022

November 12-13, 2022

December 10-11, 2022

This two-day, interactive courses led by skilled arthroscopy surgeons will give you the opportunity to learn and practice established and cutting-edge techniques in foot and ankle surgery with 9+ hours of hands-on lab time with the latest equipment and techniques. The lecture presentations will include videos of actual arthroscopy cases with ample time for faculty interaction.

2022 EDUCATION PROGRAMS

October 12, 2022 (Wednesday)

Insurance Reviews: Get the Inside Scoop for Proper Reimbursement

Webinar

October 19, 2022 (Wednesday) How Do I Know If My Practice is Doing Well? Webinar

October 26, 2022 (Wednesday)

Malpractice Preparation: Because it Happens to Everyone Webinar

November 10-11, 2022 (Thursday/Friday)

Comprehensive Fixation for the Ankle and Foot: A Resident's Course

Marriott O’Hare Chicago, Chicago, IL

November 12-13, 2022 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Course

Orthopaedic Learning Center (OLC), Chicago, IL

December 10-11, 2022 (Saturday/Sunday)

Arthroscopy of the Foot and Ankle Course

Orthopaedic Learning Center (OLC), Chicago, IL

To be waitlisted, please contact Maggie Hjelm at hjelm@acfas.org.

First Year of Membership for PGY-1 Residents

Residents, take your career to the next level with ACFAS! PGY-1 residents receive free membership through September 30, 2023. Apply today to take advantage of the perks of ACFAS membership.

Benefits of ACFAS

Discounted registration rate for ACFAS 2023 in LA 70+ hours of recorded clinical sessions on ACFAS OnDemand 15+ in-person CME opportunities each year

Listing of 60 fellowship programs

Monthly Scientific Literature Reviews

Growing podcast library with surgical and non-surgical topics

Join ACFAS and benefit first-hand from the College’s mission of empowering our members to be proven leaders and lifelong learners who positively impact the lives of their patients.

Visit acfas.org/skills for more information and to secure your spot at December's course.  from the american college of foot and ankle surgeons | www.acfas.org |

Live, Virtual Education You Can Use

Join us on Saturday, November 19 for the First Ray Virtual Symposium — where engaging sessions allow YOU to drive the discussion!

During this live, interactive event you’ll hear expert faculty discuss surgical options to correct first ray deformity, along with complication and revision options. After the

symposium ends, extend your learning experience as you interact with peers and faculty through the online discussion forum.

Can’t attend? Register now to access to on-demand recordings and earn 4 CME.

Visit acfas.org/firstrayvirtualsymposium for more information and to register today.

First Ray Virtual Symposium

research/health policy & advocacy

Advocating With the Alliance of Wound Care Stakeholders

As a member of the Alliance of Wound Care Stakeholders (Alliance), ACFAS is part of a collective voice, which includes other leading health care provider organizations and patient healthcare associations. ACFAS and the Alliance partners work to promote evi denced-based quality care and access to prod ucts and services for individuals with chronic wounds through advocacy and educational outreach with public and private sector health organizations and payers through legislative and regulatory advocacy.

ACFAS has participated in numerous public and private meetings with key stakeholders

and decision makers at the Centers for Medicare and Medicaid Services (CMS) and their contractors as well as the Food and Drug Administration (FDA). These meetings focused on regulatory and implementation of care issues as well as reimbursement issues.

The Alliance frequently sends advocacy and public comment letters on these topics to Congress and federal agencies, which are available on their Submitted Comments page.

Earlier this year, ACFAS participated in the Wound Care Evidence Summit 2022 hosted by the Alliance in Washington, DC (Bethesda, MD). The summit brought together federal

agency policymakers, payers, researchers, wound care medical specialty societies, patient and clinical associations to discuss wound care research and clinical trial design. The Summit also provided a forum for communicating directly with payer medical directors on the development of coverage policies and the use of clinical practice guidelines when making coverage decisions. Representatives from CMS, Aetna, Humana, UnitedHealthcare, and Blue Cross Blue Shield presented at the meeting. ACFAS continues to welcome the opportunity to engage with the larger wound care community.

Hear Practice Management Tips Everyone Could Use

ACFAS Practice Management Webinar

Wednesdays

Get expert advice and real-world tips when you join us this October 12, 19 and 26 for the new ACFAS Practice Management Webinar Wednesdays. Listen in to this three-part, CME-earning series to hear what insurance companies are looking for when submitting for reimbursement, how to know if your practice is hitting those important success indicators and how to prepare yourself for a malpractice case.

Insurance Reviews: Get the Inside Scoop for Proper Reimbursement

October 12 | 7-8:30pm CT | 1.5 CME

Moderator: Maryellen Brucato, DPM, FACFAS

Speakers: David Wander, DPM, FACFAS Kyle Berger, CPB

Don’t miss the behind the scenes look at the dos and don’ts of surgical billing from both the insurance reviewer and the biller’s sides. Learn some documenting pearls to help your surgeries get paid and what to do in an insurance audit.

How Do I Know If My Practice is Doing Well?

October 19 | 7-8:30pm CT | 1.5 CME

Moderator: Bela Pandit, DPM, FACFAS

Speakers: Bela Pandit, DPM, FACFAS Heraj Patel, DPM, FACFAS

Listen in as faculty show you how to do a deep dive analysis of your practice by accurately determining and measuring your top revenue makers…and losers…and how to adjust accordingly—all without hiring an outside consulting company!

Malpractice Preparation: Because it Happens to Everyone

October 26 | 7-8:30pm CT | 1.5 CME

Moderator: Ellianne Nasser, DPM, FACFAS

Speakers: Ross Taubman, DPM Al Ng, DPM, FACFAS

Barry Rosenblum, DPM, FACFAS

Maryellen Brucato, DPM, FACFAS

While nobody can fully exempt themselves from a possible malpractice case, experts share some tools to help you avoid getting into litigation with patients. You’ll also hear tips and pearls for documentation, peri-operative management and discussions on complications with patients.

New FootNotes Available

The Fall issue of FootNotes is here to give your patients timely tips to keep their feet and ankles healthy through another fall season. In this issue, you’ll find:

Keeping young athletes’ feet and ankles safe and injury free as they head into new fall sports seasons

Tips for making the switch from sandals to close-toed shoes without causing pain or other issues

How to keep your feet and ankles protected as you prepare your yard for winter safely during your fall yardwork

Use this issue of FootNotes however you want to help maximize your reach with patient education and marketing your practice. The cus tomizable second page is ready for you to add your practice information so you can keep copies in your office, post it to your practice website and share it on your social media ac counts. Access more free tools to help up your practice marketing game by visiting   acfas.org/marketing

Terminating a Patient Relationship

The doctor patient relationship is an impor tant one. As with any interpersonal relation ship, there may come a time when it is time to part ways for the benefit of one or both parties involved. While this can be difficult in any relationship, complications arise when medical care is involved.

Doctors are tasked with providing the best care possible to their patients, and on the rare occasion that this care is impossible due to patient or family patient or family be havior, providers have a difficult decision to make— terminating the patient relationship, providers have a difficult decision to make.

What are some reasons a practice may consider terminating a patient relationship?

Failure to pay medical bills

Not following treatment recommendations

Threatening to sue the practice or one of the physicians

Consistently missing appointments without warning or proper notice

Verbal abuse to physician or practice staff

Displaying drug-seeking behaviors

Refusing to leave the office Lying

ACFAS member and New Jersey-based foot and ankle surgeon Maryellen Brucato, DPM, FACFAS shares her experiences with having to address a problem patient and terminate care. “At least half of the time it has to do with a patient's family member being disruptive to the patient's care.” She adds, “We have also

had patients who were extremely late for their appointment and when informed they had to reschedule, they became disruptive and made a scene in the waiting room and were disre spectful to office staff.” Other instances include aggressive behavior around the office and patients who have tried to alter their medical records to have Medicare cover medical expenses. Any behavior that is destructive to the office, the patients’ care or disrespectful to office staff or other patients is unacceptable.

Dr. Brucato includes, “Accepting this behavior not only opens you up to liability by treating antagonistic patients, but the misbehavior is also extremely unproductive for the practice.”

She also shares, “It is your job to protect your staff. If you allow patients to abuse your staff, you are liable for that, too.” Adding, “I don’t tolerate this type of behavior in my office and no one else should either.”

She adds, “These patients take up so much of my and my staff's time and energy that it is simply not worth it, especially when 99 percent of my patients are gentle souls who absolutely deserve and need every iota of attention I can provide. When addressing a problem patient, think of it as appropriat ing your efforts to the patients who need it the most.”

Once a physician and practice staff have determined patient termination is necessary there are certain steps that should be followed. “Usually, it begins by giving the patient or the patient's family a warning. If they don't correct their course, the next step is to send a "firing letter" via certified mail.

The letter states we are unable to see the patient any longer and give them the reason.

We then provide the names of three other foot and ankle surgeons in the area and

Maryellen Brucato, DPM, FACFAS

“When addressing a problem patient, think of it as appropriating your efforts to the patients who need it the most.”

— Maryellen Brucato, DPM, FACFAS

let them know we can see them for up to 30 days, but on a completely emergent basis only.”

Dr. Brucato shares one main point to consider, “You have to be careful not to "abandon" these patients so taking all the proper steps will protect you from a poten tial abandonment suit.” While it differs from state to state, when considering terminating a patient it’s important to consult with a risk management or legal team to be sure you are following any state-mandated protocols to avoid any legal implications. All offices should start with responsibility of patient care to ensure you aren't abandoning them and handling it ethically.

As a new practitioner you never think about firing a patient, but it is important to have systems in place ahead of time to avoid any last-minute stress in case you find yourself in this situation. Consulting with a risk man agement professional or legal team can help to have everything in order in case a prob lem arises. The main goal should be to keep your practice staff, patient and yourself safe.

Another Jump in JFAS’ Journal Impact Factor for

More great news for The Journal of Foot & Ankle Surgery (JFAS) —The Journal Impact Factor (JIF) increased once again from 1.286 (2020) to 1.345 for 2021. The JIF is a journal metric measuring the success of a journal. Many factors are considered including the volume of publication and citations, character istics of the subject area and type of journal.

Our JIF is an exceptional number for a specialized journal, and as it keeps increasing, so will visibility and global interest in publish ing in JFAS Journal Editor Naohiro Shibuya, DPM, MS, FACFAS shares, “This Impact Factor is great for the profession as it’s

a direct reflection of the scientific interest in our profession.” He adds, “As the number of submissions increases, the editorial board has been able to be more selective in quality publications in turn increasing interest from researchers from around the world to publish in our journal.” These factors combined will keep improving visibility and take JFAS to the next level.

Thank you to past editor D. Scot Malay, DPM, MSCE, FACFAS, Dr. Shibuya, the entire editorial board, and the Council for Journal Management for their efforts to increase the value and visibility of the Journal!

Anthony G. Elliott, DPM, AACFAS Winfield,

Jonathon E. Scott, DPM, FACFAS Highlands Ranch,

Samuel S. Mendicino, DPM, FACFAS Houston,