I’m here at the ACFAS Scientific Conference in Las Vegas, Nevada, and as the conference winds down, I can’t help but to think back on this week and reflect on my experiences.

For a variety of reasons, I’m attending almost all of the major conferences this year; the trip to Vegas is just the start of my conference season – and a good start it’s been. As always, our surgical college does an admirable job putting on the profession’s largest conference. For me, this event began with the first theme I’d like to discuss: education.

Education is my personal primary reason for attending the ACFAS Conference. Yes, I’m probably the biggest nerd in the podiatry world. Come to Vegas to learn? You must be kidding. Yes, it’s true. Brand a scarlet letter “N” on my forehead. I didn’t gamble, drink, or party (I’m not much for those things under normal circumstances anyway). I came to learn.

When I looked at the roster of topics, I saw a line-up of interesting speeches and strong, dynamic lecturers. But to be honest, many of the lectures I hear at any conference don’t provide me with anything new. Instead, I come to conferences like ACFAS for those very few epiphanic moments when a speaker describes an entirely new way of thinking, an alternative method to do a procedure, or a new research study that I didn’t know about. These moments are like diamonds that pop up and push me beyond my current knowledge into entirely new areas. That, my friends, is education!

I didn’t have one of those epiphanies this year, but I did appreciate something just as important: changing practice patterns. One of the important reasons to attend a national conference is to get a feel for the trends in how our profession is moving. For example, about two years ago at the ACFAS conference in Phoenix, I did receive one of those epiphanies when I heard about the work of Drs Paul Dayton, Mindi Feilmeier, and colleagues describing the new paradigm of frontal plane rotation in hallux valgus deformity. If you haven’t read their work, I strongly recommend it. I’ve summarized this paradigm shift in a previous Practice Perfect 453, The Next Paradigm Shift in Hallux Valgus Surgery – Addressing the Frontal Plane. But if you haven’t read the research, take the time to study their excellent article¹. It’ll change how you care for this clinical entity.

Now, what’s important here is that a few years ago, this was a new thing that hadn’t yet received its due. However, this year there were several lecturers that referred to their work, and it’s clear that this paradigm shift is becoming increasingly part of our normal thought pattern (as it should be). The fact that frontal plane rotation is now being applied to the 5th ray exemplifies how widespread this is becoming.

Similarly, it seems the profession is increasingly moving away from the old “arthroplasty/arthrodesis” model of hammertoe correction and is moving ever more towards addressing the plantar plate for metatarsophalangeal joint and hammertoe problems. This is an example of technology improvements helping us advance in the care of our patients, and the trend is clearly visible at this conference.

I want to take a second here to congratulate the conference’s leadership. One of the trends I heard more than once was the balance between technology and technique. I’m sure we all realize that these conferences – and much of our profession – is supported by relationships with various sponsors, and it would be easy for us to simply use more technology because of that relationship. Instead, I heard the mature, ethical, and responsible advocacy of technology use, with an emphasis on appropriate physician choice based on the science rather than the relationship. I also heard the same kinds of comments from various vendors I spoke with – demonstrating the maturity and ethics of our industry sponsors as well. Good on ya ACFAS and corporate sponsors!

Now, nothing’s perfect, and I’d be remiss if I didn’t have at least a few critiques. There were a few technology issues with poor sound quality ruining the keynote speaker’s talk (though I’m not sure good sound quality would have helped), and some computer issues during at least one of the lecture tracks.

More importantly, though, is content delivery. Despite the sound research that states passively listening to lectures at conferences does little to educate physicians,^2,3 the bulk of the content was delivered through lectures. Some of the lecture tracks did try to engage the audience with newer text- and Internet-based surveys, but they rarely, if ever, actually discussed the survey results. Additionally, some of the lecture tracks had so many speakers and topics that there was little time for discussion.

This is an incredibly challenging issue to fix, especially at a conference with somewhere around 1,900 attendees. But, in the spirit of trying to be helpful, here are a few suggestions:

As one final suggestion to make the conference even better, I ask that we bring back some topic tracts that were completely ignored this year: radiology and biomechanics. I understand this is a surgical conference, but that doesn’t change the need for a dedicated and detailed radiology discussion. As for biomechanics, why not spend some time on surgical biomechanics? It’s usually mentioned as part of the introduction to some lectures, but that misses the immense and fundamental importance of foot function on surgical decision-making. It deserves its own track.

I’ll end off with one final impression. Despite my desire to learn, the part of this year’s conference that makes it all worthwhile are my colleagues. This was the first year that I met up with students at all levels, from current 2nd, 3rd, and 4th year students, to residents and fellows, to prior students now in practice. It’s so rewarding as an educator to see our young colleagues grow from neophytes to the world’s best-trained foot and ankle surgeons. I’ve also met new friends and colleagues that make me excited to be a podiatrist. I’m excited for these new collaborations that will make this profession even more rewarding. A shout out to all of you, and my very best wishes to you all. See you at the next conference.