Medigram, the Wisconsin Medical Society’s electronic newsletter for physicians, features timely news, upcoming events, answers to frequently asked questions and the information you need to make your practice run more efficiently. Topics include legislative updates, legal information, practice management information, government regulations, and much more. Medigram is delivered via email on Thursdays.

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Elizabeth Ringle named Foundation Executive Director
The Wisconsin Medical Society Foundation (Foundation) Board of Directors is pleased to name Elizabeth Ringle as its Executive Director. Ringle, long time Foundation program director, began her role as Foundation Executive Director on May 9, 2022 when Marje Murray, Executive Director since April 2020, accepted a new position.

On the Record with Wisconsin Medical Society CEO Chumbley
Wisconsin Medical Society (Society) CEO Bud Chumbley, MD, MBA, is set to retire this month. Chumbley joined the Society in November 2017, leading it through the COVID-19 pandemic.

HSA – the triple attack!
As many independent physicians know, health insurance costs are high – and keep climbing! To help alleviate some of these increases, WisMed Assure, the Wisconsin Medical Society’s insurance agency, suggests using strategies like Health Savings Accounts (HSA) and Health Reimbursement Accounts/Arrangements (HRA).

Share your experience treating chronic Lyme disease patients
In order to develop support for physicians who care for chronic Lyme disease patients, the AMA’s Chronic Lyme Disease Project is hosting a series of virtual focus groups. If you typically see 5-30 patients each year with persistent, prolonged symptoms contributed to Lyme disease, you are invited to spend one hour with other experienced physicians discussing your experience.

Chaperone rule economic impact period open through June
The State of Wisconsin’s Medical Examining Board (MEB) has opened another Economic Impact Analysis (EIA) period for physicians to weigh in on the potential costs of a proposed administrative rule designed to promote the use of chaperones when performing genital, breast and rectal exams (or when those areas might be exposed during other procedures).

May 12, 2022

Elizabeth Ringle named Foundation Executive Director

Elizabeth Ringle
Elizabeth Ringle

The Wisconsin Medical Society Foundation (Foundation) Board of Directors is pleased to name Elizabeth Ringle as its Executive Director. Ringle, long time Foundation program director, began her role as Foundation Executive Director on May 9, 2022 when Marje Murray, Executive Director since April 2020, accepted a new position. Ringle has managed the Foundation programs for nearly a decade and has 26 years of experience in nonprofit management.

As the daughter of a Mexican migrant worker, the Foundation’s work to increase health equity and access is very important to her and it is one of the reasons she is excited for the Foundation’s partnership with the Wisconsin Medical Society on the Justice, Equity, Diversity and Inclusion Task Force.

Ms. Ringle stated, “While at the Foundation I have been moved and at times awed by the tireless work of physicians across Wisconsin to welcome people into the profession and to do whatever it takes to make sure our physician workforce is supported and able to take on the challenges of making sure all have access to high quality health care in Wisconsin.”

As Program Director, she was particularly impressed by the physician and public members who serve on the Foundation’s boards and committees. The Scholarship Committee reads hundreds of personal statements from students each year, revealing the tremendous obstacles so many students face in life before they ever apply to medical school. This, she said, helped her to better understand the joy witnessed the very first time a student would put on their white coat and read a personal note of welcome from a Wisconsin physician. Also of note is the extensive work of the Foundation Grant Committee in reviewing the hundreds of grant applications that Wisconsin physicians champion every year. Through this work she has seen how deeply committed physicians feel to their communities and to improving the lives of their patients outside of the clinic. The results of the Annual Physician Survey lays bare the challenges our state faces in regard to health equity and physician job satisfaction. However, the Foundation Board and staff are optimistic those challenges can be addressed by supporting the work of the outstanding physicians who are actively engaged in their communities and with the Society.

“Seeing what I have of the profession over the past decade,” concluded Ringle, “I hope you can understand why I am humbled and grateful to continue serving the Foundation in this new role. I look forward to discussing how together we can build your Foundation to meet the needs of tomorrow.”

She can be reached at any time at elizabeth.ringle@wismed.org. If you haven’t already, please consider donating a White Coat for a first-year medical student here. If you would like to support physician-championed nonprofits in your community, please donate to our Around the State in 8 Districts campaign. 100% of your donation will go directly to support grants in your district.

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On the Record with Wisconsin Medical Society CEO Chumbley

Clyde Chumbley, MD, MBA
Clyde Chumbley, MD, MBA

Reproduced with permission from Wisconsin Health News.

Wisconsin Medical Society (Society) CEO Bud Chumbley, MD, MBA, is set to retire this month. Chumbley joined the Society in November 2017, leading it through the COVID-19 pandemic. 

He reflected on his time at the society in a recent interview with Wisconsin Health News. Edited excerpts are below.

What are your top accomplishments? 
Before the pandemic hit and changed everybody’s priorities, I spent a lot of time de-risking the Society. We owned an old building on the lake which was very dear to us, and the pension plan which had become somewhat archaic as a way to save for retirement. We also owned a captive in the Caymans, which served a purpose for physicians who needed malpractice coverage for a period of time until the market hardened. So I spent some time "de-risking" the Society. We downsized a little bit. Membership organizations such as medical societies and professional societies have lost membership over the years. However, over the last couple of years we have actually recovered some of our membership. We have 10,000 members again this year, which is good, so we’re kind of on the uptick there. 

Then COVID hit, and we concentrated on that. I think we had what I consider some very positive influence and help for the physicians of Wisconsin. We had a task force that met on a regular basis to provide physicians with information sheets and ways to reach patients on topics such as the benefit of vaccines. We joined a national group to bring PPE (personal protective equipment) into the state for physician practices when there was a shortage. We worked with the Injured Patients and Families Compensation Fund to have three years of premium holiday for both physicians and health systems, which I think saved everyone a fair amount of money during a time when finances were uncertain. So I think we had a lot of accomplishments. 

Physician burnout was a challenge before the pandemic. What do you see as possible solutions? 
Burnout is a term that certainly is descriptive, but it’s more than just burnout. I think it’s the well-being. We need to improve our public health system. If we had a robust public health system, I think we would have done better in the beginning. It’s unfortunate that the entire pandemic became politicized because it put physicians in the middle of some political battles and battles of philosophies, which really didn’t help morale for physicians, nurses or any other health care worker. 

As far as general solutions, not just the pandemic, you know physicians are not happy. That’s a multi-faceted problem, but it really comes down to a problem for Wisconsin. We have very good health care in Wisconsin, but we can’t continue that if we have a significant shortage of physicians, which people are predicting. It’s a very difficult job now due to how the electronic medical record is used. It’s used more as a tool for the finance department than it is to improve patient care. Although it’s had some positive effects on patient care, with the amount of time that it takes, pre-authorizations, interactions with the health care systems and disparities in health care, it can be very difficult to get yourself up to go into the office each day. Physicians also don’t have the flexibility that they used to have when they were in independent practice. They’re pretty much told where to go and what to do. They’re told to fill out the EMR. One big thing would be if they could have scribes so they didn’t have to focus on the EMR when they’re in the exam room seeing patients. 

I also think you can help physician well-being by having more physicians in the leadership of health care systems and what goes on in the state. We still do, but I think it’s been diminished during my tenure at the Society and my career here in Wisconsin. It’s interesting… we have this big infrastructure plan that we’re going to rebuild all the roads and we’re going to rebuild all the bridges for billions and billions of dollars. Not having physicians at the table in making health care structural changes is kind of like going to do that whole multi-billion dollar infrastructure without civil engineers. Physicians know medicine and they know how the system should work, and I’m disappointed that we don’t have as many physician leaders as we used to have. 

Another thing that we’re working on is a state-sponsored or Society-sponsored physician health program for physicians that need help, whether it's addiction or other behavioral issues. We’re one of only three other states that does not have a sponsored physician health program. We’re beginning to work with the Office of the Commissioner of Insurance a little bit on that. That would be nice if we could put that in place. We have put in programs for physician well-being so they can contact counselors through several County Medical Societies, and we’re about ready to sign a deal with a national company that could provide some counseling to physicians. I guess you have to treat the symptom and treat the disease, then try and go back and take care of the causes, which we’re trying to do. 

Forecasts show Wisconsin facing a shortage of doctors. What can address this?
There’s a state committee that’s looking at the challenges. I think it’s important that we keep the malpractice climate friendly to attract physicians, and that we look after their well-being. It kind of all ties together. If you’re going to meet the needs of physicians, you have to show that this is a good place to practice and with good health care systems that respect the physicians that make up those systems. 

Wisconsin’s health care environment is changing, with more consolidation and less independent practices. Is that changing the Society’s role in advocating for doctors, and how so? 
It does make it more difficult for us to get our message to the physicians in the state. This is because, for whatever reason, it’s difficult for us to get contact information once they become employed. Sometimes I can get a chief medical officer to send out some information about membership or something that we’re doing under his or her name, but many times they don’t want to do that. Because of this, they become somewhat invisible to us when they become employed by a system. This makes it more difficult to at least get to them and tell them what we do, why we’re doing it and perhaps why they would want to be members. 

I know you didn’t ask this, but there is no evidence that consolidation improves the cost of health care or the quality of health care. In fact, the evidence is that it overwhelmingly does not. But we will continue to consolidate. Maybe that’ll change, I hope. Maybe once everything’s been consolidated, those in charge will turn their attention to vastly improving the quality and reducing the costs of health care. 

What’s next for you? 
I don’t know. I’ve kind of failed at retirement three times prior to this. First, for me, is to try not to fail a fourth time and find enough to keep my mind active and my days filled. I’m sure I’ll stay active in the Society on committees or other things. I’m not one of those people who was smart enough to plan for retirement and develop hobbies or develop a decent golf swing. About all I’ve been able to develop is decent casting and fishing. So maybe I’ll have to perfect that more, do a little bit more fishing, spend more time with my wife.

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WisMed Financial - Meet your advisor

HSA – the triple attack!

As many independent physicians know, health insurance costs are high – and keep climbing! To help alleviate some of these increases, WisMed Assure, the Wisconsin Medical Society’s insurance agency, suggests using strategies like Health Savings Accounts (HSA) and Health Reimbursement Accounts/Arrangements (HRA).

The IRS recently published the approved contributions and plan allowances for HSAs in 2023, and things are changing. The biggest change is that plans that currently qualify for an HSA with a $1,400 deductible will no longer qualify for HSA contributions in 2023. To qualify, health insurance plans will be required to have a $1,500 deductible for an individual (or $3,000 for a family) to contribute to the HSA.

Reference Chart for High Deductible Health Plan (HDHP):

 

Recently, WisMed Assure's Chris Noffke worked with a physician who retired with more than $200,000 in his HSA. He stated that he was lucky to have listened to a professional to start this type of account. He now has an account to take tax free and penalty free distributions to pay for qualifying medical expenses at any age. Unlike many retirement accounts, HSA distributions are discretionary rather than required. Plus, after age 65, he can use the account for non-medical expenses penalty free. That means the HSA is taxed just like a traditional IRA, 401(k) or 403(b) for non-medical retirement income.

How did he build this nest egg? He used proper strategies which allowed him to take tax deferred dollars and invest them in mutual funds and other investment accounts.

WisMed Assure

Want to know more about how this strategy and other solutions help you plan for success? Click here to schedule a time to talk with Chris Noffke or give him a call at 608.442.3734.

Originally posted in The Antidote, May 12, 2022

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Share your experience treating chronic Lyme disease patients

In order to develop support for physicians who care for chronic Lyme disease patients, the AMA’s Chronic Lyme Disease Project is hosting a series of virtual focus groups. If you typically see 5-30 patients each year with persistent, prolonged symptoms contributed to Lyme disease, you are invited to spend one hour with other experienced physicians discussing your experience.

These focus groups will allow you to contribute your input, learn from other physicians and receive a $100 Amazon gift card for participation. If you would like to participate in any of the focus groups listed below, please email CLDProj@mathematica-mpr.com.

  • Primary care (family medicine, internal medicine, or pediatrics): June 13, 7-8 PM Eastern
  • Rheumatology: June 15, 7-8 PM Eastern
  • Infectious Disease: June 16, 7-8 PM Eastern
  • Psychiatry: June 21, 7-8 PM Eastern
  • Neurology: June 23, 7-8 PM Eastern

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