WisMed condemns surge in anti-Asian hate crimes; offers resources

The Wisconsin Medical Society (Society) issued a statement condemning the increase in anti-Asian hate crimes, including the murders of six Asian women (and eight victims overall) in Atlanta on March 16. The statement, released to media outlets statewide, draws attention to the 150 percent increase in anti-Asian hate crimes in major U.S. cities since the onset of the COVID-19 pandemic, and reminds the public how the Society stands with numerous national physician organizations in condemning racism as a public health crisis.

“We are deeply appreciative of our Asian-American members, for the vibrancy and value they bring to the American tapestry,” the statement reads. “We believe diversity is a strength of our community, and racism saps this strength to the detriment of the whole of society.”

While many statements regarding heinous acts are limited to the incidents themselves, the Society’s statement was crafted to also help educate the public. The statement links to resources members and the public can access to learn how to more effectively engage in the fight against racism while also connecting to organizations focused on racism perpetrated against Asian American and Pacific Islander communities – including in Wisconsin.  

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Foundation auction closes tomorrow at noon

Bid now! Check out the great items in the Foundation Mini Auction in conjunction with the Taste of the Foundation Series. If you couldn’t attend the event you still have a chance to enjoy the wine that we will be tasting – just bid on it! Want to take a trip to the Wild West once travel is safer? You could spend a lovely week in Missoula, Montana. Try your hand at fly fishing or just enjoy some great hikes. You might even see Yellowstone being filmed!

The auction ends at noon tomorrow (Friday March 26) so check it out soon. And sign up for the two remaining Tasting events.

Proceeds support the mission of the Foundation which is to advance the health of the people of Wisconsin by supporting medical education and health care initiatives.

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RFS and YPS nominations due April 11

Nominations are now being accepted for a variety of leadership positions within the Resident Fellow Section (RFS) and the Young Physician Section (YPS) of the Wisconsin Medical Society.

Both sections are accepting applications until April 11 and the nominees’ statements of interest will be posted to the respective WisMed Communities when voting opens.

Positions within RFS* include the following one-year terms:

• RFS representative to the Society’s Board of Directors
• RFS representative to the Society’s Nominating Committee
• Chair
• Vice-chair
• Secretary-editor
• At-large governing council member (two positions)
• American Medical Association (AMA) RFS delegate (13 positions)
• District regional councilor (eight positions—one from each Society-designated state region)

Click here to complete an RFS application.

Positions within YPS* include the following:

• Chair-elect
• At-large YPS governing council member
• American Medical Association (AMA) YPS Delegate

Click here to complete a YPS application.

*Please contact membership@wismed.org for assistance logging in to WisMed Community or with any questions. 

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Share your ideas at 2021 virtual Annual Meeting

WisMed Members are encouraged to share their ideas during the Wisconsin Medical Society’s 2021 Virtual Annual Meeting and Membership Briefing on Saturday April 17, 2021 from 8:00 a.m. to 10:00 a.m. This is an opportunity to chat with fellow members in small groups, pose questions to Society leaders and share your opinions regarding the strengths and weaknesses of the Society - all in just two hours!

More than a standard Zoom meeting, this format will be centered around conversations between Society officers and members in a way that will be engaging, inclusive and provide insights into what is most relevant and needed by members. To register, click here.*

The meeting is sponsored by WisMed Assure, the only Wisconsin-based insurance firm exclusively serving the health care community, and WisMed Financial. The Society created WisMed Financial to provide financial advice physicians can trust.

*Please note that Zoom may require you to sign up for a free Zoom account before registering for the event. You will receive a confirmation email once your event registration is complete. Please contact membership@wismed.org for assistance. 

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Survey to understand patients’ vaccine hesitancy

Vaccine misinformation is prevalent and easily accessible to parents and patients. This misinformation can impact parental attitude about vaccines. Immunization providers are encouraged to take the Wisconsin Immunization Neighborhood’s (WIN) survey regarding their perceptions of patients’ and parents’ vaccine attitudes to assist in the development of advocacy materials to improve vaccine confidence, recommendation practices and Wisconsin's vaccination rates.

WIN wants to know what clinicians are hearing in their practice to support in-practice conversations to address vaccine hesitancy quickly and effectively. Responses will help inform the creation of a short, effective toolkit vaccinators can use to help spur increased vaccine acceptance. WIN staff may reach out to immunization providers who identify their community as particularly challenging. A follow up conversation would take no more than 10 minutes and would be scheduled at the respondent’s convenience.

Please complete the survey, which will take about 2-5 minutes to complete, by March 29, 2021.

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Healing Arts: First phase of Healing Reflections Mural unveiled at Mayo Clinic Health System in Eau Claire

For close to a year, the Healing Arts committee at Mayo Clinic Health System in Northwest Wisconsin has been collecting and sharing stories of healing from employees and community members. The project pairs the stories with artists to create a Healing Reflections mural. The Healing Reflections mural focuses on the historic nature of 2020. Those themes are centered on healing, resilience, inclusion, diversity, hope and economic hardship. “People heal by gaining insight and understanding to another’s experience, and also by validating their own experiences,” says Todd Wright, MD, an orthopedic surgeon at Mayo Clinic Health System.

Dr. Wright and the University of Wisconsin – Eau Claire’s, Provost Patricia Kleine, developed the concept to pair stories with artists to provide inspiration. A key part of this project is to be able to view art and access stories on a website to read the story that inspired the art. “In telling, and then sharing these stories, healing moments occur,” says Dr. Wright. 

The project was supported in part by a donation in the amount of $2,250 from the Tri-County Medical Society (Eau Claire, Dunn and Pepin). "When we learned of this impressive project and the great need for financial support to keep the project alive, it was clear that this would be a good fit for the Tri-County Medical Society," says Donn Dexter, MD, society president and a neurologist at Mayo Clinic Health System in Eau Claire. "Our physicians are keen to help initiatives like this that recognize the work and sacrifice of our health care workers and others in our community. We are anxious to see this shared throughout the region to highlight the remarkable challenges we faced in 2020."

Once completed, the mural will be about 45 feet long. Sections of the mural will rotate throughout Mayo Clinic Health System sites in Northwest Wisconsin. "We are thrilled to see the project come to life as a beautiful work of art," says Dr. Wright. The first sections of the Healing Reflections mural are on display at the Mayo Clinic Health System Luther campus in Eau Claire, though with COVID-19 restrictions in place, the display is not currently open to public viewing.

Plans will be made at a future date for grand display showings in the Eau Claire community. The University of Wisconsin – Eau Claire is also collaborating on this project and will also showcase murals.

"It has been amazing to see the collaboration of our community partners on this project. Every partner was committed to promoting healing through the arts,” says Dr. Wright. 

Todd Comstock, a house supervisor and registered nurse at Mayo Clinic Health System — Northland in Barron, Wisconsin, along with his daughter and her family, started making masks for individuals at the beginning of the pandemic "I am so thrilled to see the mural is coming to fruition. My family and I are looking forward to seeing the mural," says Comstock. Comstock’s daughter’s story, "Behind Every Mask is a Story," is depicted in the artwork of Tracy Kennedy, a regional chaplain in Spiritual Care for Mayo Clinic Health System in Barron, Bloomer and Osseo.

"Just keeping her dad safe was not my daughter’s only mission," says Comstock. Comstock's daughter solicited help from her sister and together they began to make masks for the community, for individuals in the state of Wisconsin, for other states in the U.S., and eventually distributed masks worldwide. 

View a video with information about the Healing Reflections mural.

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Income-driven repayment plans

Looking forward to residency also means looking forward to repaying student loans. There are several things to consider to make the best choice for how to repay student loans.

Here are two important things to remember before considering the different types of repayment plans:

1. It’s critical to start loan repayment while in residency rather than use deferment or forbearance. This will save thousands of dollars.
2. In many cases, it is possible to switch repayment plans if one’s financial situation changes.

The basic premise of income-driven repayment (IDR) plans is simple; repay federal student loans based on ability to pay.

Here are the choices:

• Standard repayment plan
• Graduated repayment plan
• Extended repayment plan
• Income-driven repayment plans (Yes, there’s more than one!)

Seems complicated… and it is, but here are some basic definitions to help figure out how to best navigate the loan repayment landscape.

Standard repayment plan: Pay off loans in 10 years. Monthly payments are fixed based on adding the amount owed to the projected interest and dividing by 120. WARNING: This is the standard repayment plan if another plan is not chosen!

Because most residents can’t afford these monthly payments, this is not the way to go.

Graduated repayment plan: These also run for 10 years, but monthly payments start out low and increase every two years. But, as with standard plans, even the lower monthly payments are still likely higher than most residents can manage.

Extended repayment plan: This is a long-term repayment plan. With this type of plan, fixed or graduated payments will be made over 25 years. This type of plan is good for those who don’t qualify for an income-driven repayment plan. But, most residents do qualify for income-driven repayment plans.

Income-driven repayment plans (IDR): These plans base the monthly payment on income.

The four types are:

• Pay-As-You-Earn (PAYE)
• Revised-Pay-As-You-Earn (REPAYE),
• Income-Based Repayment (IBR)
• Income-Contingent Repayment (ICR)

Generally speaking, these plans cap monthly payments at 10% of one’s discretionary income. (Very simply, discretionary income is someone’s income minus whatever the poverty line is for their family.)

Low income = low payments. The payment size is recalculated every year based on filed taxes. The good (great?) news is that after 20 to 25 years, what remains of the student loans is forgiven. (Another topics is public service loan forgiveness; in which case loans are forgiven in only 10 years.)

IDR plans work well for residents who are trying to get by on a $60,000 salary and owe a lot of money (roughly $50,000 or more).

PAYE and REPAYE

PAYE differs from REPAYE in two significant ways.

First, to qualify for PAYE applicants have to prove they can’t afford to make the payments a standard 10-year repayment plan requires. REPAYE, however, doesn’t ask for this proof… with REPAYE, payments will never be more than 10% of discretionary income regardless of salary.

Secondly, PAYE is limited to the repayment of William D. Ford Direct Loans received after Oct. 1, 2007 and funds disbursed on or after Oct. 1, 2011. These loans include Direct Loans, subsidized and unsubsidized, Graduate PLUS loans and Direct Consolidation Loans made after Oct. 1, 2011, unless they include Direct or FFEL loans made after Oct. 1, 2007.

REPAYE is available to people who borrowed from the Direct Loan program, except for parents who took out PLUS loans. Borrowers qualify for REPAYE no matter when they took out their loan and as long as they borrowed from the list of qualified William D. Ford Federal Direct Loan programs.

A major benefit of REPAYE is borrowers remain eligible for the Public Service Loan Forgiveness program.

Payments on the REPAYE program are adjusted every year based on income and family size. If a couple files their taxes separately, PAYE won’t take a spouse’s income into account when calculating payments. With REPAYE, a spouse’s income is considered.

The best part of these programs is that after 20 years of on-time loan payments, the debt is forgiven.

Income-Based Repayment (IBR)

Income-based repayment (IBR) is another income-driven repayment plan that caps monthly payments at 10 to 15% of discretionary income. This type of plan is an option for those who don’t qualify for PAYE and don’t want to include their spouse’s income into their discretionary income. (That said, almost every resident qualifies for PAYE.)

Income-Contingent Repayment (ICR)

This type of repayment plan work well for those paying back student loans their parents took out on their behalf. They also work well for parents themselves who need an affordable way to pay back the loans they took for their kids. ICR is really only for paying back loans from one’s kids or loans from one’s parents.

A final word on flexibility
Borrowers can switch from on repayment plan to another. For example, recent graduates could choose REPAYE to take advantage of the government interest subsidy. Then, if they’re lucky enough to marry someone with a high income, they could switch to PAYE to avoid having their spouse’s income included in their monthly payment calculations. And, sometime down the road, they may quit their income-driven plan altogether because they want to make larger payments.

For help managing your debt, one of the best resources is a financial aid officer. And, visit the White Coat Investor website for more information. It’s a great source for guidance on how to acquire and manage the “good” forms of debt.

Rufus Sweeney
Original post from September 9, 2020

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Free continuing education credit available through WMJ

The Wisconsin Medical Journal (WMJ) has teamed up with the UW-Madison Interprofessional Continuing Education Partnership (ICEP) to offer continuing education credit for certain original research papers published in the journal. Visit wmjonline.org and look for articles with a blue “CE” button. To register, click on the “earn continuing education credit” link with each article or visit the ICEP website.

To date, credit is available for five articles and more will be available soon. There are no fees for participating in or receiving credit for this online enduring educational activity.

Please email wmj@med.wisc.edu with questions.