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As 2016 comes to a close, ACFAOM wishes its members, educational partners and all members of our profession a safe and happy holiday season. As we reflect on the past year for the profession, we plan to provide the readers of the ACFAOM Foot & Ankle Weekly a look at the most accessed articles from the year. Our regular publication will resume Tuesday, Jan. 10.
The Washington Post
From Aug. 30:
Melissa Curley Bogner was baffled: Why did her feet feel suddenly hot — in January?
The 41-year-old management analyst for the Navy had grown accustomed to periodic bouts of neuropathy — numbness in her hands and feet — the apparent legacy of a severe allergic reaction to a drug she took in 2000 to treat a gynecological infection.
But this 2015 episode was different. Along with the sensation that her feet felt unusually warm, the skin on the second toe of her right foot looked inflamed. Weeks later, she noticed a small blister.
From Sept. 6:
Clinicians can consider the
differential diagnoses before
making a pair of orthotics
for plantar fasciitis
or after the orthotic fails
to relieve the symptoms. Before is
always better and more efficient, but
everyone must accept the premise
that there are zebras when treating
From April 5:
The Weil osteotomy has become one of the most commonly performed surgeries on the foot in the world. Lowell Weil Sr., DPM, started performing a distal oblique metatarsal osteotomy in 1984 to treat intractable metatarsalgia.
The procedures that surgeons commonly performed at that time for this problem had high complication rates associated with them, most notably transfer metatarsalgia. Some studies suggested that the transfer metatarsalgia rate were as high as 50 percent for the procedures performed at that time.
From June 7:
For podiatrists who treat
Medicare patients, value-based reimbursement
is about to get real. The
Centers for Medicare &
Medicaid Services is gearing up for
next year's launch of its Merit-Based
Incentive Payment System,
which will factor value, and not
solely services performed, into the
Medicare reimbursement a provider
that program is a success, other
insurers will likely follow
suit with pay-for-performance plans of their own.
"If there are cost savings
for the Medicare payers
through doing value-based
reimbursement, then you
can bet private insurers are
going to pick up on it as
well," said James R. Christina, DPM, executive director
and CEO of the American
Podiatric Medical Association. "Some are doing a type
of value-based reimbursement already."
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Lower Extremity Review
From Aug. 23:
Limb length discrepancies as small as 1.5 cm can significantly affect gait, and some clinicians choose to intervene in cases of even smaller discrepancies. Many LLDs can be addressed orthotically, but surgical techniques are becoming less invasive and more effective.
From July 5:
Recurrent sprains and long-term residual symptoms are fairly common in patients who suffer ankle sprains. With this in mind, this author provides a comprehensive review of the literature and a practical guide to conservative treatment at various stages for lateral ankle sprains.
From Nov. 1:
Although clinicians may assume plantar fasciopathy is always the cause of heel pain, the heel pain may be due to multiple etiologies. Citing the diagnostic advantages of ultrasonography, peripheral nerve blocks and neurosensory testing, this author says one can provide more tailored treatment for patients.
From Oct. 25:
When the painkillers stop working, arthritic joint damage in the big toe can make even the weight of a bedsheet agonizing.
Standard surgery eliminates that pain by removing the cartilage and fusing the bones, but at the expense of mobility.
Cartiva Inc's implant — made of the same substance used in contact lenses, called hydrogel — was approved for big-toe surgeries by the U.S. Food and Drug Administration in July.
From June 21:
Save for the daily interactions
that podiatric physicians
have with their patients involving
treatments and outcomes,
looks very little like it did a generation
ago. Sweeping changes in patient
insurance and reimbursement
models, influenced most notably by
the Affordable Care Act, have forced
practitioners to confront new realities
inconceivable in the past. In general,
faced with eroding reimbursements
and the overall decline in fee-for-service
payment, many podiatric physicians
have responded by seeking new
practice arrangements, forming both
small partnerships and regional super
From Jan. 5: In your perfect world, your practice operates seamlessly. The processes work together to provide a superior patient experience. Team members work together consciously and competently. Referrals come through word of mouth, and when a repeat procedure is necessary or desired, your patients return. The gap between the perfect world and reality is often miles apart, however: you lose patients to the competition, feedback is either nonexistent or negative, and your referral rate and return visits are low to average.
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