Physicians renew call for needed changes to independent nursing bill

 

A strong alliance of physician specialty groups and the Wisconsin Medical Society (WisMed) urged members of a key state legislative committee November 15 to alter pending legislation that would allow advanced practice registered nurses (APRN) to work independently. Appearing at a hearing of the Assembly Committee on Health, Aging and Long-term Care in the State Capitol, the alliance shared stories of harrowing patient care situations requiring physician-level expertise and proposed amendments to the legislation, Assembly Bill 154/Senate Bill 145, that would establish basic amounts of experience and truth in advertising protections to better protect patient safety should independent nursing be allowed.

The current president of the Wisconsin Chapter of the American College of Emergency Physicians (WACEP), Kerry Ahrens, MD, FACEP, shared real-world experiences in her testimony to the committee, describing why WACEP and other physician groups saw merit in an earlier proposal from Governor Tony Evers to add a requirement into the APRN legislation that would ensure hospitals have a physician emergency medicine specialist available at all times in their emergency department. She also shared complex patient cases that have presented recently, showing how vital physician care can be in myriad situations.

WisMed’s Mark Grapentine, JD, also spoke on behalf of the physician coalition, describing how a reasonable compromise is likely needed in order for any legislation to merit Gov. Evers’s signature. That compromise, outlined by Gov. Evers and supported by the physician community, includes:

• Requiring nurses to have at minimum four years of team-based clinical experience before being allowed to practice independently.
• Establishing “truth in advertising” title protection for terms reserved for physicians, such as “anesthesiologist,”  “radiologist,” etc.
• Ensuring that APRNs practicing pain medicine remain in a collaborative relationship with a physician who is a pain medicine specialist.

You can view the hearing on WisconsinEye here. The APRN legislation testimony begins at 2:49:41 of the six-hour hearing, with Dr. Ahrens’s testimony at 4:23:00. Grapentine’s testimony begins around the 5:12 mark.

Both Republican and Democratic committee members seemed open to the idea of a compromise in order to gain the Governor’s approval, so physician constituents can help push that openness into action. See this Medigram story for more details on effective messaging tips and finding your legislator’s contact information.

Contact WisMed Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

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State Med Board elects new officers

Following the Wisconsin State Senate's rejection of Sheldon Wasserman, MD, as chair of the state's Medical Examining Board (MEB) October 17, the current MEB held elections at its monthly meeting November 15 to elect a new chair. The MEB elected longtime WisMed leader Clarence Chou, MD, as the new chair. As Dr. Chou had been serving as vice chair, the MEB then elected Sumeet Goel, DO, a family practice physician, to fill that vacancy. Dr. Goel had been Board secretary, so the MEB finished their reshuffling by electing orthopedic surgeon Gregory Schmeling, MD, as secretary.

The physicians will serve in their roles until January 2024, when the next round of annual elections are held. You can view the entire MEB roster here.

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A hopeful tomorrow for unhoused teens

Sixteen hours and 49 minutes is the time between school ending one day and beginning the next. It is also a long and difficult time for any young person facing homelessness. Project 16:49 is a program in Rock County that serves unaccompanied unhoused teens. The Wisconsin Medical Society Foundation (Foundation) was pleased to support the program with a grant. Foundation Program Coordinator, Jaime Craig, recently visited Project 16:49 to learn more about how Foundation grant funds are making a difference in Rock County. Project 16:49 Executive Director, Tammy DeGarmo, and staff welcomed Jaime warmly, just as they do for unhoused youth in the area.

Foundation grant funds were used to provide supportive services and case management for unaccompanied homeless teens. Many teens at Project 16:49 arrive after being abandoned by their families, loss of family members and unsafe situations. Project 16:49 ensures access to the services and support these students need to remain in school, graduate and become self-sufficient adults.

Project 16:49 case managers assess youth's needs, including:

• physical and mental health care needs
• provide appropriate referrals
• assist with scheduling appointments and arranging transportation to access services
• assist with obtaining immediate care, when necessary
• if youth do not have health insurance, assist them in enrolling in state health care; as well as
• assist with enrolling in Foodshare, if needed
• ·obtaining any required identification and/or documentation.

Youth can use the program’s address to receive mail. Youth who participate in ongoing case management or reside in transitional living homes receive assistance with establishing a primary care physician and other health professional relationships based on their needs. Part of the program’s life skills education includes learning how and when to use your primary physician versus urgent care versus emergency room care, and how to manage their own health and well-being. Many of the youth have grown up in generational poverty or with little to no parental involvement.  

One such teen is Allie. She was referred to Project 16:49 by her school social worker after she was kicked out of her family home. She was about to turn 17 and felt all her hopes for the future slipping away. She needed a place to sleep so she could focus on school and getting a job. Project 16:49 was able to get Allie into transitional housing. Now in her senior year, she loves theater and was cast in her school’s fall production. She got her driver’s license and attends counseling regularly. She has a job and is looking forward to graduating. She has been accepted at Milwaukee Institute of Art and Design and hopes to get a degree in graphic arts. Tammy DeGarmo sent the Foundation one of Allie’s images along with a note saying “Thank you for providing youth like Allie life-changing opportunities. We appreciate your trust and support of the work being done at Project 16:49.”

The Foundation learns about amazing programs like Project 16:49 through our annual Foundation County Survey. If you haven’t already, please complete the survey to help the Foundation prioritize our work throughout the state. If you would like to support important community health programs that increase health equity and access in Wisconsin, please consider donating to the Wisconsin Medical Society Foundation’s Mission Fund. If you would like to support Project 16:49 directly, they have an Amazon wish list here.

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WisMed Holdings Board honors board members’ service

The Wisconsin Medical Society Holdings Corporation, which oversees WisMed Assure and WisMed Financial, recently met to recognize four retiring board members for their dedication and service. Michael Foley, MD, Timothy Logemann, MD, Susan L. Turney, MD, and Stew Watson, MD were each presented a Meritorious Service Award for their valuable contributions to the WisMed Holdings Board of Directors.

Michael Foley, MD, is the President & CEO of Madison Emergency Physicians, Southern Wisconsin’s premier board-certified independent emergency medicine group since 1983. He is an experienced physician and CEO with demonstrated leadership in emergency medicine, passionate about personal development and skilled in finance, emergency medicine, leadership, health care, strategic planning and business development. Dr. Foley has been a member of the Holdings Board since 2021 and we very much appreciate his time, expertise and leadership.

Timothy Logemann, MD, FACC, FACP, is a non-invasive cardiologist and Medical Director. He specializes in cardiovascular disease and internal medicine and treats patients in Wausau. Dr. Logemann has more than 30 years of experience in the medical field. He has been a member of the Holdings Board since 2016 and has contributed significantly with vision, passion and support of the creation of WisMed Financial. 

Susan L. Turney, MD, FACP, is recently retired, after serving as CEO of Marshfield Clinic Health System. She is recognized as a national thought leader in health care and expert in strategic planning, executive management and external relations. She also served as CEO and executive vice president of the Wisconsin Medical Society from 2004-2011. Dr. Turney has been a member of the Holdings Board since 2004 and her time, expertise and leadership has very much been appreciated.

Stew Watson, MD, is a retired emergency medicine physician. Prior to his retirement he was the Regional Chief Medical Officer at Ascension from 2016-2021, President & CEO for Dean Clinic from 2014-2016, and President & CEO at Ministry Medical Group from 2008-2014. Dr. Watson has been with the Holdings Board since 2012, serving as Board Chair since 2018, and we have very much appreciated his time, expertise and most importantly his leadership.

The mission of the Wisconsin Medical Society Holdings Corporation is to provide innovative solutions to enhance the lives of physicians and health care professionals to help them provide outstanding and efficient care to their patients. As their current service and terms come to an end, we thank these four outstanding Board Members for contributing to our mission, and we look forward to welcoming and introducing our new members in the coming months.

WisMed Assure is the Wisconsin Medical Society’s insurance agency – profits earned support the mission of the Medical Society.

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Celebrate your colleagues – nominate a 2024 Physician Citizen of the Year

The Wisconsin Medical Society (WisMed) is accepting nominations for its 2024 Physician Citizen of the Year Award. First established by WisMed 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. Complete the nomination form here. The nomination deadline is December 31, 2023.

Previous Physician Citizen of the Year recipients include Douglas Davis, MD of Oregon (2023), William Finlayson, MD of Milwaukee (2023), Adedayo Onitilo, MD, PhD, MSCR, FACP of Weston (2023), 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 (2014).

For more information, contact Stephanie Taylor.

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WisMed beanie, tumbler now available; WisMed Perks to start your holiday planning

Get ready for winter with a Wisconsin Medical Society (WisMed) beanie, tumbler or fleece. Check out the new items in our apparel store here. Additionally, WisMed members can access vendor discounts on a variety of products and services, including technology, travel and more through WisMed Perks. Below are a few examples.

Tech and Electronics

Gifting season is here! Bring smiles with the best tech gifts from Lenovo’s Yoga, Legion, Tablets and IdeaPad laptops to headphones, webcams, portable speakers and more. Click here to learn more or if you need assistance with purchases, call 1.800.426.7235 (M-F: 8 am – 8 pm, Sat: 8 am – 5 pm). Be sure to check the website often – special offers change frequently.

Travel Savings Center

WisMed members have access to exclusive travel savings from car rentals, hotels, and ticketing discounts to condos, villas, cruises, guided tours and group travel packages. Find exclusive savings from brands like Avis and Budget, Wyndham, Collette and member-exclusive hotel discount aggregators.

Check back often for new providers and promotions! Whether you simply want to get from here to there or make your dream vacation a reality, WisMed members have all the tools right at your fingertips. Learn more here.

Car rental deals with Avis and Budget

Make the most of your summer travel plans with this limited-time offer on car rentals. Through July 31, WisMed members that spend at least $175 when booking a minimum consecutive three-day rental with Avis or Budget will save on base rates. Terms apply.

To make a reservation with Avis, click here and use your Avis Worldwide Discount (AWD) number A672086.

To book with Budget, click here and use your Budget Customer Discount (BCD) number B079592. 

Hotel Discounts

Planning your summer travel? Hotel Engine is a free and exclusive members-only hotel booking platform that connects WisMed members to deeply discounted hotel rates. Take advantage of an average of 26% off public rates at more than 150K+ hotels; no contracts, annual fees, or minimum spends; and superior 24/7, U.S.-based customer support. Sign up for free at members.hotelengine.com/join/wismed101.

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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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