Utilization of EMRs in rural Wisconsin as EMT and paramedic staffing shortages increase – a Foundation fellowship sponsored by Winnebago County Medical Society

“I feel more confident in working on research projects and I am even more interested in working in a rural community in the future,” reports Paige Titak, a Medical College of Wisconsin-Milwaukee student and recipient of a Wisconsin Medical Society Foundation fellowship sponsored by Winnebago County Medical Society. Paige’s research looked at the time of defibrillation by EMS for out-of-hospital cardiac arrest patients in Wisconsin based on population size.  

Along with mentor, Leslie Ruffalo, PhD, Mario Colella, DO, MPH, DHS, and the Wisconsin Office of Rural Health, Paige learned about EMS staffing models and challenges EMS agencies are facing in Wisconsin. She shared the following regarding her research:

In Wisconsin, 41% of EMS agencies report having periods of time where a legal ambulance crew was not available to staff an ambulance. Agencies that rely on volunteers are more likely to have gaps in service due to insufficient staffing and most volunteer-based agencies serve rural areas. Staffing shortages can lead to delays in patient care if a call is received when there is no staff available to keep an ambulance in service. Act 113 passed in 2015 addresses these staffing issues by allowing a legal crew to be defined as an Emergency Medical Responder (EMR) driver and Emergency Medical Technician (EMT) in agencies that serve municipalities with populations less than 20,000 people instead of requiring two EMTs. EMR is the first level of certification offered by the National Registry of Emergency Medical Technicians (NREMT). An EMR course is an average of 65 hours compared to an EMT course which is typically 120 hours of training. While the scope of practice of an EMR is more limited when compared to that of an EMT, they may help to meet staffing needs that can result in less delays when responding to 911 calls.

Since the passing of this Act, there have been no studies in Wisconsin to determine if allowing EMR drivers has decreased response times. We sought to study this by looking at patients who experience an out-of-hospital cardiac arrest and compare mortality outcomes between communities with EMR drivers versus EMTs as quick EMS response is associated with improved survival. There is a sharp increase in patient mortality if a first responder with a defibrillator does not arrive on scene in less than five minutes.

At present, the research team is working with the Wisconsin Office of Rural Health and the Wisconsin Department of Health Services to identify all variables that need to be included in the Wisconsin Ambulance Run Data System Elite data pull. Next steps include expanding the study to include calls that result in stroke alerts or trauma alerts.

The Wisconsin Medical Society Foundation is pleased to offer medical students these important research opportunities. The number of Fellowships we are able to award is completely dependent on yearly donations to our Fellowship Program. Please consider supporting important medical research of Wisconsin physicians and students with the Wisconsin Medical Society Foundation Fellowship Fund. If you are interested in becoming a mentor or applying for a fellowship, please contact Jaime Craig at jaime.craig@wismed.org. 

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Financial wizardry: increase your interest rate

Yields on cash are up – way up! – from even a year ago. However, many bank accounts haven’t kept pace. I regularly see banks paying less than half what they could. Since many people have their emergency fund sitting in the bank, it’s time to review your account yields.

If your bank is paying 4.75% or more, congrats, your yield is in the competitive ballpark and the time and hassle of switching may outweigh the benefit of a new account. The balance of the account matters too. An extra 0.5% on a $10,000 balance is only $50 per year, so it may or may not be worth the hassle to switch, but on $100,000, an extra 0.5% is $500 per year.

If your bank yield is low, checking for a higher yielding account at your bank is usually the easiest first step. Alternatively, here are four different products that typically pay more than your standard bank savings account as of November 8, 2023:

Of course, these are just examples and not a recommendation. You should always check the terms, conditions and risks before investing. With a little time shopping around, or a call to your financial advisor, you could see your cash yields jump.

For personalized help with your financial plan, please contact Mark Ziety, CFP®, AIF® 608.442.3750. 

Note: This article is for informational purposes only and should not be considered as financial or tax advice. Please consult with a qualified financial advisor or tax professional before making any financial decisions.

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Apply for a Wisconsin Medical Society office by January 3 - get involved

Applications are being accepted for several Wisconsin Medical Society (WisMed) offices, and all nomination materials are due to the WisMed Nominating Committee by Wednesday, January 3, 2024.

Candidates are sought for the following offices:

• President-Elect for 2024-2025
• AMA Delegate for 2025 and 2026 (two positions) – Tosha Wetterneck, MD, of Madison (incumbent, eligible for reelection; 2025 and 2026); Barbara Hummel, MD, of Milwaukee (incumbent, eligible for reelection; 2025 and 2026)
• AMA Alternate Delegate for 2024, 2025 and 2026 (three positions) – Corey Cronrath, DO of Eau Claire (incumbent, eligible for reelection; 2025 and 2026); Tony Thrasher, DO of Milwaukee (incumbent, eligible for reelection; 2025 and 2026); vacant position open for 2024 and 2025

All candidates must submit:

• a curriculum vitae not to exceed three pages
• a cover letter no longer than one page
• a completed candidate questionnaire for the office the candidate is seeking
• AMA Delegate and AMA Alternate Delegate
• President-elect
• a completed Disclosure of Significant Affiliations (conflict of interest) form

The Nominating Committee will meet Friday, January 19, 2024, at 4 p.m. via Zoom. The Committee will interview and evaluate the candidates for WisMed offices and prepare a slate of nominees for presentation to the membership.

Those serving on 2023-2024 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; Robert Ripenhoff; David Tylicki, MD; Katheryn Hope Wilkinson
• District 2—Delaine Anderson; Amy Doherty, DO; Michael Grajewski, MD; Sophie Kramer, 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—Brandon Hidaka, MD, PhD
• District 8—Leo Bay, MD
• Specialty Sections—Leslie Abitz, MD
• Resident/Fellow—Isha Jain, MD
• Medical Students—Andrew Labott, Medical College of Wisconsin; Greigory Dimailig, 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.

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

For questions or more information, email Stephanie Taylor.

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Low value care survey – share your thoughts

The Wisconsin Health Information Organization (WHIO) is co-leading a statewide initiative to raise awareness of low value care in Wisconsin. This work includes research on people’s perspectives about low value care. This research is being conducted by the Medical College of Wisconsin in partnership with WHIO through the “Eliminating Low Value Care in Wisconsin to Improve Quality, Safety, Health Equity, and Cost Efficiency” grant, funded by the Achieving a Healthier Wisconsin Endowment.

Low value care is defined as health care services that are:

• not supported by research;
• are duplicative or unnecessary; and
• may cause physical, emotional, or financial harm.

WHIO is asking you to share your point of view about low value care by completing this survey. The survey will take about 5 minutes. Your responses will remain anonymous and only aggregate results will be shared.

Thank you in advance for completing this important survey!

The survey will be available through December 8, 2023, so please share it with others who may want to give their perspective on low value care in Wisconsin.

Please contact rachelle.fenster@whio.org with questions about this survey or for technical difficulties.

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Leadership Academy – business-focused CME for physicians

Wisconsin Medical Society Members taking on new leadership roles or responsibilities within their practice or system or transitioning from a patient care role to an administrative role in leadership are invited to join the virtual leadership academy. Courses focusing on Emotional Intelligence and Impression Management cover cornerstones of emotional intelligence, provide tools to assess and improve EQ skills and will help you evaluate aspects of emotional intelligence and executive presence as it applies to leadership roles.

The Wisconsin Medical Society has partnered with Pennsylvania Medical Society to offer this program to help members achieve the foundational leadership skills you need to succeed in your new role. Enroll in these completely virtual mini courses focused on critical business acumen to set yourself up to be an effective leader and earn up to 14 credits of CME.

Courses include Ethical Decision Making, Health Care Finance 101, Project Management for Physicians, Strategic Thinking, and more.

This exclusive, member-only program has limited space available. Register today by emailing membership@wismed.org or calling 866.442.3800.

*The Pennsylvania Medical Society (PAMED) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. PAMED designates these enduring materials for a maximum of 14 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in these activities.

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