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.

If you have a Medigram story idea or would like to offer feedback, please email us or call 866.442.3800.

Participate in developing the Society and Foundation’s next strategic plan
The Wisconsin Medical Society and Foundation are undertaking a robust strategic planning process – guiding the organization in exploring where we are today, where we want to go tomorrow and how we will make the journey. The voices of our physician members are vital to this process!

Physician care team webinar for WisMed Members
Wisconsin Medical Society members are invited to attend complimentary one-hour loss prevention CME* on October 25 at 7 a.m. This virtual webinar, presented by risk and legal experts, will provide attendees with actionable guidance for improving care team relationships to optimize and mitigate liability in their practices.

Around the State in 8 Districts Touching Down in District 8
The Medical Society Foundation is encompassing the Around the State in Eight with NorthLakes Community Clinic based in Ashland.

Physicians 'between a rock and a hard place' when it comes to navigating abortion law
From the Wisconsin Health News daily email newsletter. In The U.S. Supreme Court’s overturning of a constitutional right to abortion has left Wisconsin doctors mired in legal uncertainty, panelists said at a Wisconsin Health News event Tuesday.

Last chance for I bonds 9.62% return
I bonds currently have a stated interest rate of 9.62% if the purchase is completed in October. Purchases in November are expected to earn 7.16%.

Choosing a specialty & job searching – free webinar for student and young physician members
The Wisconsin Medical Society partnered with the Arizona Medical Association and the Missouri Medical Association to develop a webinar series for student and young physician members.

Nominees sought for Society offices; deadline January 2
Nominations are now being accepted for several Wisconsin Medical Society (Society) offices, and all nomination materials are due to the Society’s Nominating Committee by Monday, January 2, 2023.

Interventional Approaches to Treating Acute and Chronic Pain available on demand
By watching the webinar Interventional Approaches to Treating Acute and Chronic Pain, attendees will learn about referrals for behavioral health services, prescribing pain medications and referrals for interventional pain management.

A higher level of caring for your medical office - click here - Society Insurance

Participate in developing the Society and Foundation’s next strategic plan

The Wisconsin Medical Society and Foundation are undertaking a robust strategic planning process – guiding the organization in exploring where we are today, where we want to go tomorrow and how we will make the journey.

The voices of our physician members are vital to this process! Please participate in the next listening session, which will take place on October 20, noon – 1 p.m. Register here.

The session will be facilitated by our planning partners Mary Ales and Shelly Rodrigues of Mosaica Solutions who will be posing questions, listening to feedback and digging deeper into the needs of Wisconsin’s physicians and patients.

Registration is required, participation is limited to 20 Society members per listening session. For more information, please contact [email protected].

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Physician care team webinar for WisMed Members

Wisconsin Medical Society members are invited to attend complimentary one-hour loss prevention CME* on October 25 at 7 a.m. This virtual webinar, presented by risk and legal experts, will provide attendees with actionable guidance for improving care team relationships to optimize and mitigate liability in their practices.

This presentation is appropriate for a wide-variety of audiences— including small, large, independent and system practices. Attendees will learn from real-life case studies and current Wisconsin law in order to mitigate risk and liability in their own practices.

Physician Care Team Collaboration Success: Understanding Current Requirements Under Wisconsin Law
Tuesday, October 25

7:00 - 8:00 a.m. CT
Register

Learning Objectives:

  • Understand the requirements for supervision and collaboration under current Wisconsin law.
  • Evaluate Physician and Advanced Practice Professional risk exposures while working together as part of the care team.
  • Implement risk reduction strategies to reduce the potential for harm and professional liability claims. 

*CME Information
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of NORCAL Insurance Company and ProAssurance Indemnity Company, Inc. The NORCAL Insurance Company is accredited by the ACCME to provide continuing medical education for physicians.

NORCAL Insurance Company designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Around the State in 8 Districts touching down in District 8: NorthLakes Community Clinic in Ashland

Around the State in 8 Districts

Through the Foundation’s Around the State in 8 Districts Campaign, the Foundation has funded grants across the state, including in Ashland Wisconsin to the NorthLakes Community Clinic (NLCC). Thanks to the grant from the Wisconsin Medical Society, leaders from NLCC honed their skills around crucial conversations and learned valuable skills to bring back to their teams.

Patient at Northlakes Community Clinic

“Communication is critical at all levels within our organization” says Reba Rice, CEO of NLCC. “For years, we’ve taught the principles found within the book Crucial Conversations because we believe conflict is actually a highly valuable asset to our organization–if done correctly. This book serves as the foundation for how to create a safe and productive environment for communication when stakes are high.” Other topics included personal assessments, conscious leadership, and community service. NLCC is a federally qualified health center located in northern Wisconsin. Led by a patient majority board of directors. They offer comprehensive primary care services to everyone regardless of their ability to pay.

NLCC addresses health inequities in the communities by implementing a team-based approach that focuses on both the clinical and social needs of patients.  Health outcomes for traumatized populations are poorer than for non-traumatized populations; both historical and childhood trauma are more prevalent among minorities, thus reducing health equity amongst that demographic.  NLCC is in the infant stages of a broad organizational culture shift that will place greater emphasis on trauma-informed care, which will guide all future clinic policy and increase health equity and access.  This transition aligns with their overall mission of responding to the health care needs of their communities with an integrated array of quality services and actively removing barriers to wellness.

With educating and building leadership among staff, the long-term benefits of this organizational culture shift have the potential to benefit many of the 21,000 NLCC patients living in their 20,000 square mile service area. Taking early steps toward an organizational shift focused on trauma-informed care will strengthen staffs relationships with patients.  NLCC will increase health equity by building a strong foundation that fosters empowerment through voice and choice, collaboration and mutuality, and strength and resilience. This, in turn, will improve health outcomes for more patients.

Please help the Foundation to support to support important community programs that are increasing health equity and access through. Through this campaign, every dollar will go directly back to your district to support programs that were championed by your fellow physicians. Help us improve health equity and access in your community by donating today to the Around the State in 8 Districts campaign. For questions or to learn more about the Foundation or our programs, please contact Program Coordinator Jaime Craig at [email protected] anytime. To learn earn more about NorthLakes Community Clinic, including how you can support them, visit nlccwi.org.

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Physicians 'between a rock and a hard place' when it comes to navigating abortion law

Panel speaking to room

From the Wisconsin Health News daily email newsletter. Sign up for a free trial.

In The U.S. Supreme Court’s overturning of a constitutional right to abortion has left Wisconsin doctors mired in legal uncertainty, panelists said at a Wisconsin Health News event Tuesday.

Physicians are working under the assumption that an 1849 law making it a felony to provide an abortion except to save the life of a pregnant person is in effect, said Wisconsin Medical Society President Dr. Wendy Molaska.

“We’re between a rock and a hard place here,” she said. “We would be criminally charged with a felony, go to jail, lose our medical license if we provide an abortion that’s found to be enforceable under this 1849 ban. On the other hand, we’re treading this very fine line of where is the life of the mother … at risk enough that we can perform an abortion to save her life and then not end up with a malpractice suit because we waited too long, based on current guidelines and standards, to provide this abortion.”

Angela Rust, a shareholder in the health law section of von Briesen & Roper, said there are split decisions by courts on whether federal law governing emergency departments preempts state laws surrounding abortion. Enforcement agencies have taken the position that it does, meaning that providers could be removed from Medicare and Medicaid programs for not providing timely treatment in an emergency setting.

Doctors could also face action against their license for misconduct, unprofessional conduct or criminal activity for violating the state law.

“While you can fall below the standard of care and thus have unprofessional conduct, you can also have unprofessional conduct for criminal liability,” she said. “It’s a position I don’t envy.”

Diane Welsh, a partner at Pines Bach, said whether the 1849 law is enforceable is the “biggest question” at this point. The Legislature hasn’t taken action to either reaffirm the old ban, pass a new one or amend the law in any way, she said.

No court has ruled on it either, although a lawsuit filed by Attorney General Josh Kaul is pending. She noted that local prosecutors in Wisconsin are divided on whether they’ll prosecute under the law.

“That leaves a predicament for healthcare providers who don’t want to be hauled off to jail and await a criminal trial while lawyers and judges or legislators figure out what the law is or what it means,” she said. “So, from a practical standpoint, it’s had a chilling effect, and most providers in the state that I’m aware of are trying to operate as if there might be criminal enforcement.”

Dr. Abigail Cutler, an assistant professor at the University of Wisconsin School of Medicine and Public Health, said that doctors can still provide guidance and make referrals for patients seeking care out of state.

“As an OB-GYN who is taking care of patients who are seeking abortions for all sorts of reasons, it is part of my duty, that I see, to help patients navigate that path forward and to provide clinical guidance, to answer questions, to ensure that where they’re going, they will receive safe, evidence-based abortion care, and to also be sensitive to and attuned to the barriers that so many patients are facing when trying to seek that care,” she said. “It is no small feat to seek an abortion in Illinois or Minnesota for someone in Wisconsin where the cost of travel, the cost of child care, the cost of the procedure itself, those are significant costs, financial, emotional, otherwise.”

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Last chance for I bonds 9.62% return

I bonds currently have a stated interest rate of 9.62% if the purchase is completed in October. Purchases in November are expected to earn 6.47%. 

How they work

I bonds are government issued and pay a fixed interest rate plus an inflation adjuster. The interest rate is announced every 6 months in May and November each year. However, each investor’s rate resets every 6 months from their purchase date. That means an investor today could earn 9.62% October to March then an anticipated rate of 6.47% April to September of next year. They are only available through treasurydirect.gov.

Sounds good, so what’s the catch?

  • You must hold them a minimum of 12 months.
  • Redeeming them between 1 and 5 years will cost you 3 months of interest.
  • The growth is taxed as ordinary income for federal purposes, but they are not taxable on your WI tax return.
  • Each person is limited to $10,000 per year with an additional $5,000 purchase available via tax refund.
  • I bonds cannot be purchased in retirement accounts.

When are they worth it?

For a guaranteed fixed investment, you really can’t beat an annualized blended compound return of 8.20%.

When are they not worth it?

Let’s take the math a step further to see what we really earn.

  • After subtracting the 3-month interest penalty for cashing in at 12 months, the return is reduced to 6.51%. Next, subtract federal income taxes on the 6.51%. At the 24% tax bracket, the net return is 4.94%. Still pretty darn good for a fixed investment.
  • What about just holding the bond for the full 5 years to avoid the 3-month interest penalty? Well, inflation for the next 5 years is projected to be 2.36%. So, that’s the 5-year before tax return expectation for I Bonds.

Ready to invest?  Not so fast, start here first.

  • Get your full employer matching contribution on your 401(k) or 403(b). A dollar-for-dollar match is equivalent to a 100% rate of return immediately.
  • Maximize your tax-free Roth and Health Savings Accounts. Long term investments can net more than 5.15% on an annualized basis and there’s no tax drag in these accounts. (Roth accounts are tax free after 5 years and age 59 ½. HSA has tax free withdrawals for qualifying medical expenses only.)
  • Have a proper emergency fund because you cannot redeem I Bonds for at least 12 months.
  • Pay off all high interest debt.
  • I Bond interest income can have side effects too since it increases your adjusted gross income (AGI).
    • Medicare premiums might be raised at higher income levels.
    • It may increase the taxation of Social Security benefits in some circumstances.
    • Families with kids attending college in 2025 could have financial aid reduced based on increased 2023 I bond income.
    • The capital gain tax rate could be increased on other investments.
    • Itemized deductions with an AGI threshold could be reduced.

If you have the cash, met the other criteria, and can make the purchase before the end of October, now may be a great time to purchase I Bonds at treasurydirect.gov.

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

WisMed Financial
Mark Ziety

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

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WisMed Assure - Insurance Solutions for the health care community

Choosing a specialty & job searching – free webinar for student and young physician members

Choosing a Specialty & Interview Tips webinar - Oct. 16 7pm CT

The Wisconsin Medical Society partnered with the Arizona Medical Association and the Missouri Medical Association to develop a webinar series for student and young physician members. Each one-hour webinar in this six-part series will air Sundays at 7:00 p.m. Participation is free, but separate registration is required for each session.

Register here for Choosing a Specialty & Job Search / Interview Tips, which will be presented by Raghu Adiga, MD, CEO of Liberty Hospital and Lisa R. Shah-Patel, MD, Director, Career and Professional Advising at University of Arizona, College of Medicine on October 16 at 7:00 p.m.

Register for these upcoming sessions:

Please contact [email protected] with any questions.

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Nominees sought for Society offices; deadline January 2

Nominations are now being accepted for several Wisconsin Medical Society (Society) offices, and all nomination materials are due to the Society’s Nominating Committee by Monday, January 2, 2023.

Candidates are sought for the following offices:

  • President-Elect for 2023-2024
  • AMA Delegate for 2023, 2024 and 2025 (three positions) – George Lange, MD, of River Hills (incumbent, eligible for reelection; 2024 and 2025)
  • AMA Alternate Delegate for 2023, 2024 and 2025 (five positions) – Don Lee, MD, of Franklin (incumbent, eligible for reelection; 2024 and 2025)

All candidates must submit:

The Nominating Committee will meet Friday, January 20, 2023, at 4 p.m. via Zoom. The Committee will interview and evaluate the candidates for Society offices and prepare a slate of nominees for presentation to the membership.

Those serving on 2022-2023 Nominating Committee are:

  • District 1—Arthur Angove, DO; Jesse Ehrenfeld, MD; David Galbis-Reig, MD; Joshua Gershtenson, MD; Cynthia Jones-Nosacek, MD; Anthony Rieder, MD; David Tylicki, MD
  • District 2—Lynn Broderick, MD; Michele Brogunier, MD; Amy Doherty, DO; Michael Grajewski, MD; Natalie Wheeler, MD
  • District 3—Hilary Bingol, MD; Michael White, DO
  • District 4—Lopa Kabir-Islam, MD; Michele Montgomery, MD
  • District 5—Joanne Pasiuk, MD
  • District 6—Bradley Burmeister, MD; Kenneth Pechman, MD
  • District 7—Alison Jones, MD
  • District 8—Leo Bay, MD
  • Specialty Sections—Leslie Abitz, MD
  • Resident/Fellow—Hannah Johnshoy, MD
  • Medical Students—Kyle Cass, Medical College of Wisconsin; Alyssa Fleischman, University of Wisconsin School of Medicine and Public Health

Communications to the Nominating Committee should be addressed to Mike Flesher, CEO, Wisconsin Medical Society, PO Box 1109, Madison, WI 53701. Communications also can be emailed to Stephanie Taylor. Access the candidate questionnaire for AMA Delegate and AMA Alternate Delegate or President-elect and the conflict of interest form.

Note: The Society will post the completed candidate questionnaire and cover letter on the Society’s website. The Society will post the conflict-of-interest form of all candidates selected by the Nominating Committee as nominees on the Society’s website after nomination by the Committee.

For questions or more information, email Stephanie Taylor.

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Interventional Approaches to Treating Acute and Chronic Pain available on demand

MEB-approved Opioid Prescribing Education

By watching the webinar Interventional Approaches to Treating Acute and Chronic Pain,* attendees will learn about referrals for behavioral health services, prescribing pain medications and referrals for interventional pain management. This session is presented by Kris Ferguson, MD, Pain Medicine Specialist at Aspirus, Vice President of the Wisconsin American Society of Interventional Pain Physicians, North American Neuromodulation Society Education Committee.

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.

Learning objectives for Interventional Approaches to Treating Acute and Chronic Pain:

  • Increase appropriate referrals to behavioral health and mental health services.
  • Promote appropriate prescribing practices for opioid and non-opioid pain medication.
  • Improve awareness and appropriate referral for interventional pain management to minimize pain and opioid prescribing.

Click here to register for Interventional Approaches to Treating Acute and Chronic Pain 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.

2 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.

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 2 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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