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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Around the State in 8 Districts
Listening to physicians about what matters most to you in your work and communities is the top priority for the Wisconsin Medical Society (Society) and the Foundation. We believe a strong, supported physician workforce leads to improved health equity and access and a healthier Wisconsin for all.

WisMed COVID-19 task force gets "long COVID" update
The Wisconsin Medical Society’s COVID-19 task force spent its June 16 meeting learning more about and discussing the implications of post-acute sequelae of COVID-19, or "long COVID." The comprehensive presentation from Nasia Safdar, MD, PhD, associate dean for clinical trials at the University of Wisconsin School of Medicine and Public Health, took the task force through various aspects of the still-developing condition, including the difficulties physicians and patients have in identifying it, evidence regarding its prevalence following initial COVID and the latest medical literature outlining studies undertaken so far.

Health coverage for physicians retiring early
The need for health insurance pushes some people to work to at least age 65, even when they can financially afford to retire much earlier. Let’s explore six ways to secure health coverage between early retirement and when Medicare starts at age 65.

Research study assessing racial disparities in pulse oximetry measurement requesting funding
The Wisconsin Medical Society and Foundation through the JEDI Task Force continue to look for opportunities to support research and efforts to increase health equity and access in Wisconsin. The COVID-19 pandemic has brought about a focus on health equity and, with it, a re-awareness of decades old data on racial disparities about the clinical accuracy of pulse oximeters among patients with darker skin pigmentation.

AMA webinar Racism in Medicine June 29
The American Medical Association (AMA) will host a 90-minute webinar Racism in Medicine: Historical foundations and strategies for advancing health equity from 6:00 to 7:30 p.m. CT on June 29. Emily Cleveland Manchanda, MD, MPH, the Director for Social Justice Education and Implementation at the AMA, will give a 60-minute didactic presentation followed by 30-minutes for Q&A.

Around the State in 8 Districts

Around the State in 8 Districts
Listening to physicians about what matters most to you in your work and communities is the top priority for the Wisconsin Medical Society (Society) and the Foundation. We believe a strong, supported physician workforce leads to improved health equity and access and a healthier Wisconsin for all. That’s why we’re so excited about our Around the State in 8 Districts campaign. We’re hoping to plan fun events for physicians and their families in every district in the state as an opportunity to listen to physicians and a chance for members to meet the Society’s CEO, Mike Flesher. Together, the Foundation, Society, WisMedPAC, WisMed Financial and WisMed Assure are your team, and we’re ready to act on what matters most in your district.

Around the State in 8 Districts is also a fundraising event. Through the Foundation’s annual Physician County Survey physicians recommended community organizations that are making a difference to improve health. Every dollar raised in the campaign goes directly to funding those organizations. Organizations like The Center for Suicide Awareness, which was recommended for funding by Jennifer Weibel, DO, a board-certified Family Medicine and Sports Medicine physician with Aurora Medical Center in Oshkosh.

“In the last 3 years HOPELINE, run by the Center for Suicide Awareness, has responded to 2,411 individuals and initiated 57 active rescues in Wisconsin,” stated Dr. Weibel as to why she championed this grant. “HOPELINE Responders are able to answer text messages 24/7/365 and all text messages receive a response within 2 minutes. This level of access is made possible by generous contributions such as that made by the Foundation.”

Text HOPELINE to 741741
The Center for Suicide Awareness is headquartered in Kaukauna, Wisconsin. They are dedicated to preventing suicide through proactive education, training, emotional support, collaboration and intervention. The vision of the Center is compassionate, readily accessible, barrier free and sustained support for any individual or entity in need, while free of any mental health stigma.

 

Of the many Center programs and initiatives, bringing HOPELINE™ to all of Wisconsin and beyond, has given individuals free emotional support anytime, from anywhere by simply texting HOPELINE to 741741. They are also proactive in the fight against Veteran Suicides. Every day approximately 22 Veterans die by suicide in the U.S. Veterans and service men and women deserve our help and support. As a result, they began the “I Challenge You to 22” program with all efforts focused on getting a Challenge Coin in the hands of a Veteran who is struggling. The Challenge Coin also has the number for HOPELINE™. Today, Police Departments across Wisconsin and beyond are equipping their officers with Challenge Coins to share with any Veteran who is struggling.

Jesse Ehrenfeld, MD, MPH

Jesse Ehrenfeld, MD, MPH

Suicide is complex, and so are its solutions. Skilled training is one of the most effective prevention approaches along with real life experience. They know that education and experience are the two factors that break stigma. Training empowers someone to recognize these signs and provide life-saving support to that individual. With the right knowledge and skills many suicides can be prevented.

The Foundation is grateful to Doctor Weibel for bringing the Center for Suicide Awareness to our attention. The funds granted to this organization will have a powerful impact. Help us fund other worthwhile programs that will improve health in Wisconsin. Every dollar you give to Around the State in 8 Districts will go directly to fund a grant in your district that was championed by one of your colleagues. We have a goal to raise at least $40,000 to fund more grants this year. Every dollar you donate makes a difference.

If you have an idea for a fun event in your district or if you would like to learn more about the many ways the Foundation and Society are working together to respond to physicians workforce and community health needs, please reach out any time to [email protected] or [email protected]

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WisMed COVID-19 task force gets "long COVID" update

The Wisconsin Medical Society’s COVID-19 task force spent its June 16 meeting learning more about and discussing the implications of post-acute sequelae of COVID-19, or "long COVID." The comprehensive presentation from Nasia Safdar, MD, PhD, associate dean for clinical trials at the University of Wisconsin School of Medicine and Public Health, took the task force through various aspects of the still-developing condition, including the difficulties physicians and patients have in identifying it, evidence regarding its prevalence following initial COVID and the latest medical literature outlining studies undertaken so far.

One of Dr. Safdar’s primary messages was that there are probably many more long COVID-related cases than we currently realize.

“We see a lot in the lay press, we see a lot in the medical literature about new and upcoming therapeutics for acute COVID, for vaccination and prevention,” Dr. Safdar presented to the task force. “But there is very little discussion of long COVID – and in part it has to do with the confusion surrounding the definitions and exactly the impact that it has.”

Physicians being aware of the possibility that a patient could be suffering from long COVID could more quickly help advance medicine’s understanding, leading to better, more efficient treatment for patients – including informing them about available long COVID clinical trials. WisMed members can view Dr. Safdar’s presentation and the ensuing question and answer period here.

The WisMed COVID-19 Task Force has been meeting regularly since June 2020 to help gather the latest information related to COVID-19 and create resources and materials physicians can use as they continue to fight the pandemic. For more information about the task force, contact WisMed Chief Policy and Advocacy Officer Mark Grapentine, JD.

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Health coverage for physicians retiring early

The need for health insurance pushes some people to work to at least age 65, even when they can financially afford to retire much earlier. Let’s explore six ways to secure health coverage between early retirement and when Medicare starts at age 65.

  • Retiree health insurance benefit – As part of your retirement benefits, your former employer provides health coverage for a length of time.
  • COBRA – This allows you to extend your employer’s coverage for up to 18 months. Not all employers are required to offer COBRA, some small employers are exempt. Pro tip: Evaluate dropping COBRA at the end of the calendar year rather than the 18-month expiration mid-year. Otherwise, you could pay two deductibles in the same year, one for the COBRA coverage and one for the replacement coverage.
  • Short term health insurance – This is month-to-month coverage and is usually limited to 12 or 18 months if renewable. It may not cover pre-existing conditions.
  • Health insurance marketplace – Also referred to as the Affordable Care Act and Obamacare, Wisconsinites use the federal marketplace at healthcare.gov. Many wealthy people qualify for health insurance subsidies because their income usually drops at retirement and the subsidy is based on household income not net worth.
  • Health insurance outside the marketplace – For those who don’t qualify for a government subsidy, other policies are sometimes available. Plans can be found at finder.healthcare.gov.
  • Health sharing plans – Although these plans look, act and feel like insurance, they are technically sharing plans, not insurance plans. Yet, their popularity grew rapidly last decade with about one million people covered by this type of plan in 2018.[1] The major draw is their low monthly cost as these plans are generally less expensive than unsubsidized marketplace health insurance plans.

With plenty of coverage choices, working to age 65 to maintain health insurance might not be necessary. If early retirement is in your plans, finding the right coverage will be one piece of the retirement puzzle.

Want more help? Download our guide, “The 3 Pillars of Successful Retirement Plans” for a 24-point checklist to prepare for retirement.

For personalized help eliminating debt, investing smart and securing retirement, please contact Mark Ziety, CFP®, AIF® 608.442.3750.

WisMed Financial

Mark Ziety, CFP®, AIF®
WisMed Financial, Inc. part of the Wisconsin Medical Society.



[1] https://en.wikipedia.org/wiki/Health_care_sharing_ministry

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WisMed Assure - Insurance Solutions for the health care community

Research study assessing racial disparities in pulse oximetry measurement requesting funding

The Wisconsin Medical Society and Foundation through the JEDI Task Force continue to look for opportunities to support research and efforts to increase health equity and access in Wisconsin. To support medical research please donate here.

The COVID-19 pandemic has brought about a focus on health equity and, with it, a re-awareness of decades old data on racial disparities about the clinical accuracy of pulse oximeters among patients with darker skin pigmentation. The differential accuracy of pulse oximetry may contribute to health inequities. Several studies have been published in the past two years about how the inaccuracy leads to differential rates in occult or hidden hypoxemia, or when the actual amount of oxygen in the blood is much lower than the amount detected by pulse oximetry, but none mention which pulse oximetry devices were used. Advocate Aurora Health’s hospitals in Wisconsin and Illinois exclusively use Masimo (one of the leading pulse oximetry manufacturers) devices. The technology that several decades old studies comparing the accuracy amongst races of different manufacturers of pulse oximetry were conducted on is no longer in use.

Masimo has provided researchers a small internal study published as a conference abstract (75 patients, 7,183 paired measurements made in a controlled setting) that indicates skin tone differences have not been shown to be clinically significant. However, multiple recent large studies using real-world evidence (using unspecified pulse oximeters) observed a higher rate of occult hypoxemia in those with darker skin tones (Sjoding et al, NEJM 2020; Wong et al, JAMA Network Open 2021; Fawzy et al, JAMA Int Med 2022). The mixed findings strongly suggest that additional evidence is needed to assess the clinical accuracy of Masimo pulse oximeters among diverse patients using real-world pulse oximetry readings.

This study hopes to leverage Advocate Aurora Health's retrospective electronic medical record (EMR) data to improve upon the knowledge base regarding this important topic. This would be accomplished by using a time interval of <1 minute between the SpO2 and SaO2 measurements and by reporting findings on one specific pulse oximeter manufacturer. Preliminary exploratory analyses indicate that there are more than 21,000 matched measurements that would meet the above criteria. Researchers also plan to analyze differences in outcomes (hospital length of stay and differences in treatments) between those with occult hypoxemia and those without.

For more information, please contact Eva Chang, PhD, at [email protected]

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AMA webinar Racism in Medicine June 29

The American Medical Association (AMA) will host a 90-minute webinar Racism in Medicine: Historical foundations and strategies for advancing health equity from 6:00 to 7:30 p.m. CT on June 29. Emily Cleveland Manchanda, MD, MPH, the Director for Social Justice Education and Implementation at the AMA, will give a 60-minute didactic presentation followed by 30-minutes for Q&A.

The presentation will include descriptions of:

  • Basic terminology around race and racism
  • Manifestations of racism in medicine at interpersonal, institutional, and systemic levels
  • Recommendations for additional reading and learning for physicians to continue their health equity education

Please register here to attend this webinar. Registration is required to access the Zoom link for this event. 1.0 CME credit will be offered for attending the event on AMA’s EdHub.

Note: The event is open to all individuals, including AMA members, non-members and staff. You will need an AMA account to register, which can be created free of charge. Please note that your username (not email address) must be entered in the account login page to reach the event registration.

If you have any questions, please do not hesitate to contact Kristina Hancock (Program Manager) at [email protected].

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