2025 AOFAS Annual Meeting-Symposium 3A: Practice Management Forum and Symposium 4A: Bunions Behaving Badly

Video Transcription

Video Summary

The symposium focused on practice management in the first 10 years, efficiency, and revision strategies for hallux valgus (bunions). Dr. Aaron Geier opened by encouraging attendance at coding and billing courses and introduced the session’s speakers. Dr. Pete Mangone presented top tips for new physicians, emphasizing professionalism, community involvement, proper coding knowledge, taking call to gain experience and referrals, and embodying the three A's of success: ability, affability, and availability. Dr. Thomas Wood shared personal experience on building efficiency in the first year of practice, highlighting the importance of credentialing, understanding group dynamics, adapting clinic workflow, and learning coding. Dr. Greg Lundin discussed clinic templating evolution, stressing the value of purposeful scheduling, managing patient volume, building a reliable team (especially medical assistants), and using two-room surgery setups for efficiency.<br /><br />Dr. Chris Stroud reviewed essential practice reports including accounts receivable, denial management, provider productivity, and profit/loss statements to optimize revenue and practice growth. Dr. Geier followed with the benefits of physician extenders (PAs and NPs), detailing how they enhance revenue, increase surgeon efficiency, expand practice outreach especially in rural areas, and improve patient satisfaction. Finally, Dr. David Pettis addressed work-life balance challenges, burnout, and generational differences, advocating for regular self-reflection, setting boundaries, teamwork with supportive staff, prioritizing personal well-being, and accepting balance as an evolving process rather than a fixed goal.<br /><br />The latter portion examined revision hallux valgus strategies. Speakers debated fusion (MTP joint) vs. osteotomy (lapidus or minimally invasive techniques). Dr. Manjur advocated for thoughtful osteotomy revisions when no arthritis or joint instability exists. Dr. Barreto endorsed MTP fusion for durability, especially in cases of arthritis or recurrent deformity, likening it to a loyal, dependable option. Dr. Easley emphasized correcting deformities at their origin—the TMT joint—with lapidus fusion, focusing on restoring three-dimensional alignment and rotation. The panel agreed that asymptomatic hindfoot flatfoot deformity often does not require correction during bunion revision. The symposium concluded with a lively discussion of complex cases, including minimally invasive revision options, hardware challenges, and the importance of individualized surgical planning to optimize outcomes in failed bunion surgery.

Keywords

practice management

hallux valgus

bunions

efficiency

revision strategies

coding and billing

physician tips

professionalism

clinic workflow

credentialing

clinic templating

physician extenders

work-life balance

burnout

MTP fusion