Time is right to contact legislators on independent nursing proposals

As the Wisconsin State Legislature readies for an active fall floor session beginning next month, now is a key time for physicians to contact their elected officials about proposed legislation that would allow certain advanced practice nurses to work independently – from pediatric and family care services to the potential creation of independent pain clinics, without needing any physician involvement.

Assembly Bill 396 and Senate Bill 394 are far-reaching companion legislation that create a new licensing process for certified nurse midwives, certified registered nurse anesthetists, clinical nurse specialists and nurse practitioners – grouping them all into the category of advanced practice registered nurses (APRN). Some of the more concerning elements of the 70-page bill include:

• eliminating the requirement that advanced practice nurses work in collaboration with a physician
• granting complete authority to the Board of Nursing to further define APRN scope of practice authority, including prescribing abilities
• defining APRN scope of practice to allow for independent diagnosing and treating capabilities that appear to be well beyond typical APRN education and experience

Simply put, the bill allows certain nurses to practice medicine without going to medical school.

While lobbyists representing a strong physician coalition have been very active in the state Capitol, nurses have been underselling the extent of the bill, calling AB 396/SB 394 a simple “APRN Modernization Act.” Now that the bills have received public hearings in their respective houses’ health committees and as State Assembly and State Senate leadership plan their fall floor agenda, now is an important time for all legislators to hear from the physicians in their districts, perhaps using the following points of emphasis:

• Physicians oppose AB 396 and SB 394 because the proposals could harm our state's current health care system that delivers great quality of care.
• The success of our nation-leading health care quality is rooted in physician-led, team-based care, and the bills could remove physicians from that care.
• Physicians want to keep working together with others on the health care team, which benefits patients. The bills move in the opposite direction by allowing nurses to carve out physicians from care decisions or input.

Please ask your State Assembly Representative and State Senator to OPPOSE AB 396/SB 394 as currently written and instead support the ability for patients to access the most experienced and highly trained health care professionals: physicians.

You can find your elected officials’ contact information on the State Legislature’s home page – input your voting address in the “Who Are My Legislators?” box on the right side of the page. Join the Advocacy in Action group in WisMed Community to stay up to date on important issues and contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

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Input needed to help guide Foundation initiatives

The Wisconsin Medical Society Foundation (Foundation) relies on Wisconsin physicians to share what they’re seeing in their clinics and communities as the most pressing population health and workforce issues - setting the Foundation apart from other public health philanthropy. Each year, the Foundation takes action based directly on the input received in the Physician County Survey.

The Foundation is dedicated to improving health in Wisconsin by supporting a strong physician workforce and increasing health access and equity. The Foundation works with the Wisconsin Medical Society at the statewide level and with community organizations and physicians in each county to support local efforts and provide resources.

Your input is vital to guide this work and to help identify local organizations that are truly making a difference to improve health.

Please take a moment to complete the survey answering these questions:

1. What are the most pressing health concerns in your community?
2. What are the most pressing physician workforce concerns in your community?
3. Which community organizations are making a difference to improve health in your community?

Feel free to contact Program Director Elizabeth Ringle to share feedback by email rather than by survey or if you have questions or would like additional information.

Thank you for sharing your experiences with us.

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WisMed members featured at OnRamp Healthcare Conference

Wisconsin Medical Society President, Alicia Arnold, MD, kicked off the morning plenary session of OnRamp Healthcare on Thursday, August 19. Welcoming nearly 300 attendees to the event, now in its third year, Doctor Arnold stated, “Physicians have spent the last several decades processing increasing amounts of medical data and navigating pressures to access updated information around the clock. We believe that OnRamp Healthcare will allow us to identify better ways to help physicians and help patients.”

In another session, two WisMed members, Tim Bartholow, MD, and President-elect Wendy Molaska, MD, participated in a Clinician Panel titled, How to Convert Good Ideas into Startups. Doctor Molaska participated as a direct primary care physician who recently started her own practice with the goal of being affordable and accessible to everyone and spoke of her ability to waive monthly fees for those in need. “They need care, and they don’t have access in other ways,” Doctor Molaska said.

This year’s conference drew almost 300 attendees, 418 startup tracks with over 500 pitch meetings to 76 suite holders. The Wisconsin Medical Society and WisMed Assure have been a presenting sponsor for the event since its inception in 2019.

If you are interested in participating in OnRamp Healthcare in 2022, please contact membership@wismed.org.

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Free MEB-approved opioid CME for Milwaukee County physicians

Wisconsin Medical Society (Society) members practicing in Milwaukee County are eligible for free registration for the highly rated on-demand webinar, Alternatives to Opioids in Treating Acute and Chronic Pain. This limited number of free registrations are available through a collaboration with Community Advocates Public Policy Institute and the Society.

Presented by Michael McNett, MD, this course meets the MEB’s two-hour continuing medical education opioid prescribing requirement for licensure and is also approved for AMA PRA Category 1 Credit™ and Maintenance of Certification Part II points for certain specialties.

To register, contact the Society’s Education Department at education@wismed.org. This free opportunity expires September 30, 2021 – register today! The Society’s full catalogue of CME can be found here.

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Disability insurance – I should have listened

One of the worst things for WisMed Assure advisors to hear is, “I should have listened to you years ago about purchasing personal disability insurance. I realize that it will now be very expensive, but I also realize that I need it. Can you please get some quotes for me?”

The WisMed Assure team makes great effort to educate Wisconsin medical residents on the importance of having personal disability insurance in place before finishing residency. At no other time will coverage be more affordable and easier to obtain. Our resident physicians are automatically entitled to a base benefit amount, and substantial discounts are offered by each of the five main personal disability insurers for physicians. Once coverage is in place, the cost for these base benefits is set for the life of the policy.

Premiums are based on age and medical health history, so get this coverage while young and healthy. WisMed Assure encourages physicians to add options like the Future Increase Option, which allows them to increase their coverage to keep up with their rising income, without any additional medical underwriting. They also advise implementing the Cost of Living Adjustment rider, which ensures that benefits received keep pace with inflation.

Career changes often result in loss of employer group disability benefits. Additionally, most employer group benefits coverage have limits, which is often much lower than a physician’s income.

Physicians work extremely hard to earn their incomes and most people don’t think twice about protecting their other valuable assets. Additionally, if student loans were incurred for this achievement, WisMed Assure can design coverage to make these payments in the event of a disability.

Please contact Tom Strangstalien, Insurance Advisor, to learn more about the best disability insurance options for physicians.

Originally posted July 9, 2021 in FYI: For Your Insurance

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Survey to inform dementia friendly toolkit

The Center for Aging Research and Education (CARE) at the University of Wisconsin-Madison School of nursing is working on developing dementia friendly training hospital materials. The purpose of this study is to understand the challenges faced by individuals living with dementia when they are seen in the emergency department or admitted to the hospital. This Dementia Friendly Hospital Toolkit will prepare hospital staff to address key challenges and opportunities identified via role play scenarios, short training videos, an organization implementation guide to help hospitals set goals and identify leaders to champion ongoing efforts and more.

CARE has identified relevant state and regional organizations as dissemination launch points for the Dementia Friendly Hospital Toolkit. The UW-Madison School of Nursing and CARE currently have established relationships with these organizations: Wisconsin Hospital Association, Wisconsin Nurses Association (WNA), Rural Wisconsin Health Cooperative (RWHC) and Wisconsin organization of Nurse Leaders (WONL).

An important first step to this work is circulating the Dementia Friendly Hospital Survey to as many different hospitals staff as possible. This survey will provide important information on hospital staffs’ interactions with persons living with dementia, specifically challenges faced in the hospital setting.

The survey is easily accessible here and takes about 10 minutes to complete. CARE greatly appreciates your help with this important research! Thank you in advance. 

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