Elections bring more of the same in Wisconsin; national “Red Wave” fizzles

State Races
Incumbent candidates in Wisconsin’s major statewide elections November 8 fared well, regardless of political party. Democratic incumbent Governor Tony Evers will serve a second four-year term after fending off a challenge from Republican business owner Tim Michels. The current final tally was 51.2 percent to 47.8 percent – a raw margin of just more than 90,000 votes, and a different final result than what the polls had predicted would be a squeaker for Michels. The victory also bucked the usual trend for incumbent governors failing to win reelection when the sitting U.S. President is from the same party – Tommy G. Thompson was the last governor to accomplish that feat in 1990.

In the state legislature, a combination of significant Republican majorities in the State Assembly and State Senate coupled with favorable new district maps meant that the only question on election night would be the margins of majority control – and whether the GOP could reach “veto-proof” majorities that could override a Governor’s veto. While the State Senate reached that margin (22 out of 33 seats) with Republican Romaine Quinn flipping the open 25th senate seat into the GOP column, a united Assembly Democratic caucus will be able to sustain any veto issued by Governor Evers – but just barely. Democrats will hold 35 of the 99 Assembly seats in the 2023-24 biennium.

All legislators enjoy meeting their physician constituents – if you need help reaching out to a newly-elected state senator or state assembly representative, contact WisMed’s Heidi Green for assistance. And remember to save the date for Doctor Day 2023, scheduled to be held in person in Madison on June 15, 2023.

Incumbent Wisconsin Attorney General Josh Kaul continued the successful night for Democratic statewide incumbents, narrowly defeating Fond du Lac County District Attorney Eric Toney 50.7 percent to 49.3 percent (about 35,000 votes). While the Secretary of State race hasn’t officially been called, Democratic incumbent Doug La Follette holds a lead of more than 7,000 votes over Republican challenger Amy Loudenbeck.

Congress
The other major statewide race saw two-time incumbent Republican Senator Ron Johnson narrowly defeat Democratic Lt. Governor Mandela Barnes 50.5 percent to 49.5 percent, or just 26,500 votes among the more than 2.6 million votes cast in that contest. The race was a critical hold for Republicans seeking to gain a majority in the U.S. Senate – but those plans may have been thwarted by losing a previously-held GOP seat in Pennsylvania and watching a seemingly-winnable seat in Georgia slip to a December 6 runoff.

The Wisconsin delegation in the U.S. House of Representatives now has a more reddish hue following Republican Derrick Van Orden taking Wisconsin’s 3rd congressional district seat, which had previously been held for 26 years by longtime Democratic Rep. Ron Kind. Van Orden defeated Democratic State Senator Brad Pfaff by a closer-than-expected 52 percent to 48 percent margin, or a little less than 12,000 votes. Republicans Tom Tiffany, Mike Gallagher, Glenn Grothman, Scott Fitzgerald and Bryan Steil all handily won reelection, as did Democratic incumbents Mark Pocan and Gwen Moore.

Majority control of the U.S. House is expected to switch to Republicans, but the margin could be much smaller than what was expected as late as Tuesday afternoon, when both Republican and Democratic pundits were seeing signs of a “Red Wave.” But as results started to be tabulated, it became clear that the tsunami warning was a false alarm. Whatever the eventual margin, it appears likely that the federal government will join with Wisconsin’s state government in featuring split control – and likely gridlock.

What’s Next?
Your respite from campaign ads will be much like sunshine during Wisconsin’s winters: glorious but short-lived. A major race for the Wisconsin Supreme Court takes place in 2023, as Justice Pat Roggensack will be retiring from the state’s highest bench. If more than two candidates declare for the seat, a primary will be held on February 15, with the general election following on April 5. It will likely be the most expensive judicial race in state history. Set your DVRs accordingly.

Contact WisMed’s Mark Grapentine, JD for more information.

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Wisconsin Medical Society Foundation joins Winnebago County Medical Society meeting

Elizabeth Ringle, Wisconsin Medical Society Foundation Executive Director and Mikaela Powers, Director of Grants and Development joined the Winnebago County Medical Society meeting to share with members about the impact of the Foundation on their community this past year and to thank their County Medical Society for their ongoing commitment to support Fellowships. 

Members were encouraged to participate in the physician survey, which helps the Foundation understand what is most important to physicians in Wisconsin.

They were also encouraged to consider giving to the Foundation this holiday season for their charitable giving. When you give to the Foundation, you are impacting organizations in your community that are addressing health disparities and increasing access to care.

The Foundation wants to help as many organizations in 2023 as possible through their grant program and can’t do that without your input in the physician survey and donations to the Foundation.

Please fill out the survey here. Contact Elizabeth Ringle with any questions.

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“I’m a Doctor…Now What?” webinar series available on demand

The Wisconsin Medical Society recently concluded a series of six webinars with the theme of “I’m a Doctor…Now What?” This series was developed by the National Medical Health Collaborative, a non-profit organization established by the Wisconsin Medical Society, the Arizona Medical Association and the Missouri State Medical Association. The Collaborative has a mission to promote and advance the health care field by providing education, policy development and resources aimed at improving the delivery of patient care. The target audience for this series was early career physicians, residents and students and offered to all parties in all three states.

The six-part series featured the following topics:

• Managing Student Debt
• Employment Contracts
• Choosing a Specialty & Interview Tips
• Exploring Different Practice Settings
• Investing & Retirement
• Diversity & Health Equity

Each state contributed experts for the series. WisMed President Wendy Molaska, MD, FAAFP, served on the panel for Exploring Different Practice Settings and Mark Ziety, WisMed Financial presented Managing Student Debt.

The recordings for the full series can be accessed here.

Partnering with the excellent leadership and staff at Arizona Medical Association and Missouri State Medical Association was most rewarding. WisMed was honored to collaborate in this endeavor to assist our early career and future physicians.

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Interacting with the Drug-Seeking Patient available on demand

By watching the webinar Interacting with the Drug-Seeking Patient*, learners will review four functional pain disorder types (malingering, somatization, hybrid conditions and passive/dependent personality disorder) of the drug-seeking patient, and learn scripts that help clinicians treat the patient’s actual underlying problem. This session is presented by Presented by Michael McNett, MD, Medical Director for Chronic Pain, Aurora Healthcare, who specializes in addiction and pain management.

The Wisconsin Medical Examining Board (MEB) approved a rule requiring physicians with a DEA number to complete two CME credits on its Opioid Prescribing Guideline biennially. To help physicians comply with this rule, the Wisconsin Medical Society developed a series of on-demand webinars. This course will need to be combined with additional education to meet the two-hour requirement.

Learning objectives for Interacting with the Drug-Seeking Patient

• Describe the four functional pain disorder types that can result in drug-seeking behavior.
• Respond effectively to manipulation techniques often used by the drug-seeking patient.
• Describe the challenges, both clinical and personal, that prescribers often face when a drug-seeking patient behaves antagonistically.
• Identify steps in regular practice to mitigate the risks of opioid prescribing for a drug-seeking patient.

Click here to register for Interacting with the Drug-Seeking Patient or click here to learn about other courses that have been approved by the MEB. Wisconsin Medical Society Members get discounted registration on many of the courses. Please contact [email protected] with questions or for assistance logging in.

*Accreditation Statement
The Wisconsin Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

1 MOC Part II Credit
Application for MOC Part II credit has been filed with the American Board of Medical Specialties (ABMS) for approval by ABMS Member Boards. See course description for more information.

1 AMA PRA Category 1 Credit(s)™ (Enduring)
The Wisconsin Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Wisconsin Medical Society designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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National Injury Prevention Day, November 18

Guest article by George M. Lange, MD, FACP, Chair, Honoring Choices Wisconsin, Wisconsin Medical Society

National Injury Prevention Day (NIPD) was designated as November 18 in 2020. NIPD is designed to raise awareness about the burden of injury and violence and the need for change. It is dedicated to educating and empowering communities to make a difference in reducing injuries, deaths and disabilities.

Did you know that injuries and violence are the leading cause of death and disability for people ages one to 44? NIPD tries to reduce the burden you or others may encounter.

What can you do for NIPD?

• You can get or stay fit with regular exercise like walking for 30 minutes 3 to 5 times per week at a pace you’re comfortable with.
• Use your seatbelt when you’re traveling in a motor vehicle.
• If you ride a bike wear a helmet.
• If you own a gun, store it safely.
• Reduce your risk of falls with grab bars, no throw rugs or electric cords across walking areas and practice balance exercises available from your physician or on the internet.
• Make sure your immunizations are all up to date.
• Wash your hands after using the bathroom and before meals.
• Don’t smoke.
• Regular visits to your physician to screen for high blood pressure, high fats in your blood, obesity and diabetes. All of these, if untreated with increase your risk of stroke, heart attack and premature death or disability. All of these are treatable with lifestyle changes and/or medications.

It is strongly recommended you have a health care power of attorney.

What’s that, you ask? This is a document you create with the help of a facilitator, trusted person and witnesses. You may want to enlist the help of an attorney, but that’s optional. Health care power of attorney (POA) enables you to direct your health care even if the doctors can’t communicate with you. With this document you choose an adult person who is aware of your health care goals and wishes to speak for you. How does this relate to NIPD? Have you or someone you know had to make decisions concerning a loved one’s health care when they had to guess what the patient would want?

Wisconsin is not a next of kin state, so the spouse is not automatically the one to make decisions about their spouse’s health care. Maybe your spouse has parents or siblings who would vie to be the health care agent. This happened with a patient suffering dementia who was under my care. The patient’s dementia was severe enough that she could not make her own medical decisions and never completed a health care POA. The husband and daughter both applied to be her guardian. The Judge requested their plans to provide for this patient who now needed a nursing home. The husband and daughter both submitted plans, and the Judge felt both parties had great plans for the patient. The Judge couldn’t decide who had the best plan and appointed a guardian ad litem. This person didn’t know the patient, her husband or daughter. The moral of this story is, “It’s never too early until it’s too late to complete a health care power of attorney.” This did cause strife between the patient’s husband and her daughter.

NIPD also has recommendations for infant and child safety.

NIPD advises that an infant sleeps alone on their back and is in a car seat when in a car. Toddlers should be in car seat and, when older, a booster seat. You should never leave a toddler or infant alone in the bath, bathroom or around a body of water. When the child is older, they should wear a bike helmet when riding a bike. All children should receive their immunizations at appropriate ages. If there is a gun in the house, it should be safely stored, and the ammunition stored separately. The above advice is not a complete list of what can be done to prevent injuries and death, contact your physician for additional suggestions.

Visit the NIPD website to sign your organization up as supporter and join Milwaukee County and other organizations, put a green light on your organization logo, take a picture and send it to National Injury Prevention Day. May you reduce your risk of injury, disability or death.

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Thousands for year-end tax planning in 2022

Want to put thousands of dollars back into your pocket? Who doesn’t. Choices you make during your employer’s open enrollment period and for year-end tax planning can really add up.

Consider a married couple with $250,000 of income, two kids, a home and $100,000 in a taxable non-retirement investment account. What can they do?

• Add the maximum to a health savings account (HSA) if insured by a high-deductible health plan. Otherwise, adjust the 2023 contributions to efficiently utilize a flexible spending account (FSA). Approximate tax savings are $1,750 federal and $387 state.
• Time property tax payments. With the current $10,000 cap on federal deductions for state and local taxes (SALT) through 2025, most taxpayers don’t receive a federal deduction for paying property taxes. However, on the Wisconsin tax return, a tax credit worth $300 is available for paying $2,500 in property taxes each year. If last year’s property taxes were paid in December of 2021, pay up to $2,500 of this year’s taxes by December 31, 2022 and the remainder by the due date in 2023 to save $300 in taxes.
• Contribute to each child’s Edvest 529 college savings plan. The first $3,560 contributed per beneficiary for 2022 is deductible on Wisconsin income taxes for a tax savings of $377.
• Realize capital losses in the non-retirement investments. Tax savings could be up to $720 federal and $26 state for 2022 with additional losses banked for future tax years.
• Group charitable gifts into 2022 or 2023 if itemizing deductions is possible either year. Boost the charitable tax savings by giving appreciated investments instead of cash which avoids capital gain taxes. Use a donor advised fund (charitable account) to combine multiple years of charitable deductions into one tax year. Tax savings depend on individual circumstances.
• Increase 403(b) or 401(k) contributions to the maximum. Approximate tax deferral is $9,840 federal and $2,173 state.
• Transfer $12,000 from the taxable investment to backdoor Roth IRAs at $6,000 each. Tax savings depend on individual circumstances. For a 40-year-old couple, this annual strategy saves $96,740 in taxes through age 60.

The first four items reduce 2022 taxes by $2,910. Add in some of the longer-term strategies, and tax planning is easily worth more than $100,000 over time!

This is just part of the strategy for 2022, and we have two ways to learn more. First, download the 2-page year-end financial checklist. Next, consider registering for the year-end tax planning workshop on November 18 at 12:00 p.m.

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

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

Originally posted in the Antidote October 26, 2022

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Abortion law webinar recording available for WisMed members

Wisconsin Medical Society (WisMed) members can access the recording of the September 20 abortion law webinar, “Providing Patient Care Post-Dobbs: A Look at Wisconsin Abortion Law.” Developed to support WisMed members with questions surrounding the status of Wisconsin’s abortion-related law following the U.S. Supreme Court’s Dobbs decision in June 2022, legal experts from the Madison law firm Pines Bach discussed the current legal landscape.

Lisa Barroilhet, MD, Gynecologic Oncologist and a leader in preserving reproductive rights, also provided a medical perspective during part of the program. Click here to watch the recording. Member login is required.*

*Accessing the webinar requires your WisMed username and password. Click here to retrieve your username or password, or call 866.442.3800 or email [email protected] for assistance.

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