From WisMed President Wendy Molaska, MD, FAAFP – Dobbs update

Welcome to this week’s edition of Medigram – our most popular communication to Wisconsin Medical Society (WisMed) members. Because thousands of you receive this newsletter every week, I thought it would be a great chance to check in and let you know some of the latest happenings in our organization. Thanks for reading!

This week I wanted to update you on some of our work related to the fallout from the U.S. Supreme Court’s decision in Dobbs. That June decision not only overturned Roe v. Wade nationally but also resurrected a Wisconsin law first passed in 1849 that makes performing most abortions a felony. Originally, we considered commissioning a legal memo to help guide physicians in their care decisions, but concerns over the potentially changing legal landscape or that any written advice could become fodder in a future lawsuit made us pivot to alternate ways to help. On September 20 we presented a live webinar featuring legal and medical experts, which WisMed members can watch on demand here.* And next week I’m part of a Wisconsin Health News panel that will discuss the difficulties modern medicine has in interpreting a pre-Civil War, pre-germ theory, pre-women voting statute.

This is definitely a confusing and potentially scary time for some of our patients seeking reproductive health care, and they’re looking to us for answers. This is also a confusing and concerning time for us physicians, and while we don't have all the answers yet, WisMed will continue to lead the way forward. We will continue to work with legal experts and other specialists, such as physicians in the Wisconsin Section of the American College of Obstetricians and Gynecologists, to help provide guidance. Our main goal is to also continue to work to protect the sanctity of the physician-patient relationship.

Please don't hesitate to reach out to myself, or anyone at WisMed, with questions or concerns.

*Accessing the webinar requires your WisMed username and password. Click here to retrieve your username or password, or call 866.442.3800 or email membership@wismed.org for assistance.

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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 one of the listening sessions.

• October 12, noon – 1 p.m. register here
• October 20, noon – 1 p.m. register here

These sessions 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 membership@wismed.org.

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You have money in your WISMedDirect account, now what?

In recent months, and largely thanks to the GO PAC GO campaign, many physicians have added money to WISMedDirect, the Wisconsin Medical Society’s political conduit. Now’s the time to contribute it to the candidates of your choice at the state or federal level. Most polls show races are within the margin of error. Your contributions, along with your vote, do make a difference!

If you have a balance in your WISMedDirect account or would like to add to your account, contact Heidi Green and she can verify your balance and send off contributions to the candidates of your choice. If you've never given via WISMedDirect, contact Heidi as well and she will set up your account and send out your contributions! Her direct number is 608.442.3720.

Clearly, the gubernatorial and U.S. Senate races are front and center, but don't forget about the Attorney General and your local races for your State Assembly representative and State Senator.

To make sure you're registered, request an absentee ballot or to see what is on your local ballot on November 8, go to myvote.wi.gov. Feel free to reach out if you need more information and be sure to add "VOTE" to your calendar on November 8!

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Celebrate your colleagues – nominate a young physician and superhero of medicine

The Wisconsin Medical Society Foundation is seeking nominations for the Kenneth M. Viste, Jr., MD, Young Physician Leadership Award and the Superhero of Medicine Award which will be presented at the Foundation’s Annual Event on April 14, 2023, in Madison. The nomination deadline is November 1.

2022 Kenneth M. Viste, Jr., MD, Award Recipient Roger Kapoor, MD, MBA, FAAD

The Kenneth M. Viste, Jr., MD Young Physician Award was established in 2006 in memory of Kenneth M. Viste, Jr., MD, who was an active volunteer in his community and an advocate for patients and the profession of medicine at the state and national levels. Consider nominating a young physician from your area who has demonstrated a commitment to their patients, the community and the profession of medicine. A young physician is defined as a licensed Wisconsin physician, who is less than 40 years old or in the first eight years of practice after residency and fellowship training. The nomination form can be found here.

2022 Superhero of Medicine Patricia Téllez-Girón Salazar, MD

The Superhero of Medicine Award recognizes Wisconsin physicians who live out the mission of the Foundation to an exemplary degree, going above and beyond to improve the health of their patients and/or community. Superheroes of Medicine work passionately to help individual patients and/or fight to improve health by reducing barriers to care and improving health education, prevention or treatment. Preference is given to Wisconsin Medical Society member physicians involved in a program of the Foundation or a project supported by the Foundation through a grant or other partnership. Both the nominating physician and the nominee must be licensed Wisconsin physicians. To nominate a Superhero of Medicine physician, click here.

In addition to presenting the recipients with an engraved award, the Foundation will make a contribution to the charitable organization chosen by each recipient.

For more information on any of these awards, contact Elizabeth Ringle at 608.442.3789.

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Free employment contracts 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. 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 Employment Contracts – What You Need to Know, which will be presented by Kyle Claussen of the Resolve Agency on Sunday, October 9 at 7:00 p.m.

Physician burnout can be caused by various factors including the loss of autonomy and control of your career. Those problems often start by signing an unfair employment agreement. Attendees will learn the most problematic issues in physician contracts, including:

• compensation
• call coverage
• maternity leave
• non-competes
• side gigs
• intellectual property
• private equity buy-outs

Register for these upcoming sessions:

• Choosing a Specialty & Interview Tips, Oct. 16
• Private Practice vs. Employment, Oct. 23, presented by WisMed President Wendy Molaska, MD, FAAFP
• Investing & Retirement 101, Oct. 30
• Diversity & Health Equity, Nov. 6

Please contact membership@wismed.org with any questions.

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Nominate a 2023 Physician Citizen of the Year

The Wisconsin Medical Society (Society) is accepting nominations for its 2023 Physician Citizen of the Year Award. First established by the Society in 1982, the award recognizes and encourages Wisconsin physicians who volunteer their time and talents through civic and cultural activities—helping to improve the health and well-being of their communities.

Please nominate a friend, colleague or personal physician for this award. Click here to complete the nomination form. The nomination deadline is December 31, 2022.

Previous Physician Citizen of the Year recipients include Michelle Clark-Frosting, MD of Alma Center (2021); Jose Ortiz, MD of Eau Claire (2020); Kenneth Gold, MD of Beloit (2019); Gloria Halverson, MD of Milwaukee (2018); Paul Durbin, MD of Racine and Tim Westlake, MD of Oconomowoc (2017); Michael Ostrov, MD, MS of Madison (2016); Steven Manson, MD of La Crosse (2015); and Gordon Haugan, MD of Green Bay.

For more information, contact Stephanie Taylor.

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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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Important Moderna and Pfizer COVID-19 Vaccine Ordering Updates from DHS

As plans are being made for the availability of pediatric COVID-19 bivalent vaccine boosters in Wisconsin, the Wisconsin Department of Health Services (DHS) is providing COVID-19 vaccinators with the latest expected arrival and ordering information.

Pending CDC recommendation, pediatric COVID-19 bivalent vaccine boosters are expected to be available by mid-to-late October

It is expected that the Centers for Disease Control and Prevention (CDC) will soon recommend pediatric COVID-19 bivalent vaccine boosters for everyone 5 years of age and older.

Anticipated Use: Pending CDC recommendations, it is expected that Pfizer will receive approval for its bivalent vaccine booster for children 5-11 years of age, and that Moderna will receive approval for its bivalent vaccine booster for children and adolescents 6-17 years of age.

Pending Food and Drug Administration (FDA) action, it is also expected that the Pfizer COVID-19 monovalent (orange cap) vaccine will be removed from emergency use authorization as a single booster for children 5-11 years of age.

If this occurs, it will mean that the COVID-19 monovalent vaccines are no longer authorized as booster doses for any age group. The monovalent vaccines will continue to be authorized for use as primary series vaccines for individuals 6 months of age and older. Please do not waste out your on-hand inventory, as access to primary vaccination remains critical.

Pfizer updated bivalent booster: Similar look to monovalent

The Pfizer bivalent vaccine will be used as the booster dose in children 5-11 years of age. The vaccine will be supplied in multiple-dose vials with an orange cap and orange vial border. The Pfizer monovalent COVID-19 vaccine will continue to be used for the primary series in children 5-11 years of age. This vaccine has an identical orange cap and orange vial border as the bivalent vaccine for this age group.

It is important to differentiate between the two vaccine products to ensure children 5-11 years of age receive the appropriate vaccine at the appropriate time. The Pfizer bivalent vaccine vial for use as a booster for children 5-11 years of age is labeled “Pfizer-BioNTech COVID-19 Vaccine, Bivalent Original and Omicron BA.4/BA.5.” The Pfizer monovalent vaccine vial for use as a primary series for children 5-11 years of age is labeled “Pfizer-BioNTech COVID-19 Vaccine.”

Moderna updated pediatric bivalent booster: Same bivalent product, different dose based on age

Vial Presentation: The same Moderna bivalent vaccine vial labeled “MODERNA COVID-19 VACCINE, BIVALENT” will be used for both children 6-11 years of age and people 12 years of age and older. Vaccine vials specifically labeled for the age group 6-11 years of age will not be available. This presentation of the Moderna COVID-19 vaccine is supplied as multiple-dose vials with dark blue caps with gray borders.

The bivalent dose volume (0.25mL) for children 6-11 years of age is one-half the dose volume (0.5mL) of the bivalent booster vaccine for people 12 years and older. So, there may be up to 10 doses per vial when using the vaccine for children 6-11 years of age, and up to 5 doses per vial when using the same vaccine for people 12 years and older. To account for the maximum number of potential doses per vial, orders indicated for children 6-11 years old will receive double the number of ancillary kits.

Ordering Requirement: Vaccinators must select in the COVID-19 Vaccine Ordering Survey which age group they intend to vaccinate, so that the appropriate number of ancillary kits can be sent. In the survey, the Moderna bivalent vaccine booster for children 6-11 years old will be listed as “Moderna 6Y-11Y Bivalent BOOSTER ONLY” and the Moderna bivalent vaccine booster for people 12 years and older will be listed as “Moderna 12Y+ Bivalent BOOSTER ONLY.”

Ordering timeline for the pediatric COVID-19 bivalent vaccine boosters

Vaccinators will be able to place orders for the pediatric COVID-19 bivalent boosters by the afternoon of October 6. Vaccinators may place pre-orders by completing the COVID-19 Vaccine Ordering Survey. No orders will be shipped until the FDA issues Emergency Use Authorizations (EUAs) for the pediatric bivalent boosters.

Administration of pediatric bivalent boosters can begin only after the CDC recommends them, and the CDC publishes its clinical considerations. Local Health Departments (LHDs) must wait until DHS updates the Immunization Program Policy and Procedure (P&P) Manual on SharePoint before providing any recommended vaccine boosters.

Note: It is expected that the FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) and the CDC Advisory Committee on Immunization Practices (ACIP) will not meet to discuss the authorization and recommendation of the COVID-19 bivalent boosters. So, the expectation is the FDA will authorize them, CDC will recommend them and CDC will publish its clinical considerations all within a short timeframe.

Attend the October 11 DHS webinar and Moderna and Pfizer training sessions

As vaccinators prepare and plan for the availability of the pediatric COVID-19 bivalent booster vaccines, DHS encourages them to attend the upcoming Wisconsin COVID-19 Vaccine Program Webinar. It will be held on Tuesday, October 11 from 11 a.m. – 12 p.m. These updates are held monthly, on the second Tuesday of each month.

Moderna is hosting two types of events, which cover the same topics regarding their vaccine. National Educational Webinars (25-minute presentation followed by live Q&A) and Interactive Office Hours (Several 5-minute presentations with emphasis on live Q&A).

Pfizer Vaccines US Medical Affairs continues to lead Medical Updates and Immunization Site Training Sessions for all healthcare providers on the proper use of the Pfizer BioNTech COVID-19 vaccine. To access dates and links for upcoming training sessions, please visit pfizermedicalinformation.com/medical-updates.

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