Latest News

  • March 08, 2018 8:23 AM | Deleted user

    Wisconsin Voices for Recovery at the UW-Madison Division of Continuing Studies will provide re-grant awards for organizations to employee Recovery Coaches and Certified Peer Support Specialists. Peer support providers will begin providing recovery support in the hospital-based setting (Emergency Department) with individuals who have survived an opioid overdose. This statewide peer support network will function as a portion of the State Targeted Response to the Opioid Crisis. The ultimate goal of the program is to create sustainable peer support models across the state that will:

    1. Increase treatment and recovery support service utilization of the target population
    2. Reduce Emergency Department recidivism
    3. Decrease the number of overdose fatalities in Wisconsin

    Read the article, Wisconsin Voices for Recovery receives $1.4 million grant to combat opioid abuse.

    Please consider applying for this amazing opportunity to help address the opioid crisis in Wisconsin! If you would like more information or have questions about this Request for Proposal, please contact wivoiceshn@dcs.wisc.edu.

  • March 07, 2018 10:14 AM | Deleted user

    March 7, Wisconsin Health News

    Wisconsin emergency departments saw suspected opioid overdoses more than double between July 2016 and last September, according to a report released by the Centers for Disease Control and Prevention Tuesday.

    The data show that the opioid epidemic hit the Midwest hardest among the country’s regions during that period. The Midwest experienced a 70 percent increase in opioid overdose emergency department visits, according to an analysis that covered 60 percent of emergency department visits in the United States. The average was 30 percent nationwide.

    The CDC also separately analyzed data for 16 states, including Wisconsin, which saw a 109 percent increase in suspected opioid overdose emergency department visits during that period. It was the highest increase among the analyzed states.

    “This fast-moving epidemic does not distinguish age, sex or state or county lines, and it’s still increasing in every region of the United States,” CDC Acting Director Dr. Anne Schuchat told reporters on a press call.

    Other Midwest states saw increases too, with Illinois reporting a 66 percent increase, Indiana a 35 percent increase, Ohio a 28 percent increase and Missouri a 21 percent increase.

    The findings show a need for better coordination between public health and public safety agencies to address overdose outbreaks. It also shows a need for more prevention and treatment efforts, according to the CDC.

    “Research shows that people who have had at least one overdose are more likely to have another,” Schuchat said. “However, if the person is seen in an emergency department, we are presented with an opportunity to take steps to prevent a repeated overdose.”
  • February 26, 2018 2:32 PM | Deleted user

    NOTE: Wisconsin ACEP President Lisa Maurer, MD was interviewed by NPR and featured in the following article. The article inadvertently shows Dr. Maurer's affiliation with Ohio rather than Wisconsin. 

    89.3 WFPL/HEALTH - February 21, 2018
    By Lisa Gillespie

    Starting July 1, some Medicaid enrollees could be fined for going to a hospital emergency room if they end up not actually having an emergency.  The new policy is part of bigger changes to the Medicaid program led by Governor Matt Bevin.

    The penalties apply to adults who gained coverage after Kentucky expanded Medicaid, such as adults without dependents, or some parents who are in families that make between 54 and 138 percent of the poverty line.

    “The intent of the policy is to reduce inappropriate emergency department use and educate individuals about the most appropriate setting for their health care needs,” Doug Hogan, a spokesman for the Kentucky Cabinet for Health and Family Services, wrote in an email.

    Medicaid, the state-federal health care program for low-income and disabled Americans, is paying for a bigger chunk of ER visits since the health insurance program expanded in 2014. In 2015, for instance, almost 47 percent of the ER visits in Kentucky were paid for by Medicaid, up from about 30 percent in 2012, according to a report by the Foundation for a Healthy Kentucky.

    Here’s how it’ll work: Enrollees will be given a “My Rewards” account. If the state deems an ER visit as unnecessary, My Rewards dollars will be deducted from that account, ranging between $20 to $75. That account will also be used to earn “dollars” for dental and vision services, since these Medicaid enrollees are losing automatic coverage of those benefits.

    Enrollees could also make a co-payment if they don’t have a My Rewards account.

    If an enrollee calls their insurance company nurse hotline before going to the ER, that penalty will be waived, even if the ER visit isn’t for an emergency.

    Here’s who could be affected:

    • Parents earning between 54 percent and 138 percent of the poverty line;
    • Adults without dependents.
    • Pregnant women, former foster care youth and enrollees who obtain a “medically frail” exemption will have access to a My Rewards account, but won’t face these penalties.  

    Determining A ‘Non-Emergency’

    There’s debate about what percentage of emergency room visits are unnecessary. The answer depends on where the information comes from.

    Health care researcher Truven Health Analytics analyzed millions of ER claims from 2010 and found 71 percent of visits were avoidable or unnecessary. The American College of Emergency Physicians, meanwhile, says only about 3.3 percent of ER visits are “avoidable.”

    There’s also a difference in how the state, an ER doctor and a patient define “non-emergency.”

    “There are very few patients who come to the ER who truly know that they didn’t have an emergency right up front,” said Dr. Lisa Maurer, an emergency room doctor in Wisconsin.

    Maurer understands that Kentucky’s new policy is supposed to discourage unnecessary ER visits but she worries it will deter patients who truly need to come.

    “We want to make sure that our patients feel that if they’re having an emergency, they can come to the emergency department,” Maurer said, who is also on the state legislative-regulatory committee at the American College of Emergency Physicians.

    Dr. Ryan Stanton works as a doctor in an emergency room in Lexington. He agrees with Maurer that people can’t always tell when something is an emergency. To regular people, conditions that a health insurer or an ER doctor might not see as an emergency, is to a patient, an emergency. Stanton used the example of patients with high blood pressure who fear they are on the verge of having a stroke. 

    “We’re hearing on the radio these ads about blood pressure causing stroke, and you need to go to the ER right away,” said Stanton. “But blood pressure is rarely an emergency. But to the lay public, blood pressure is a stroke waiting to happen.”

    A visit because of high blood pressure and fear of a stroke could be classified as a non-emergency if Stanton finds the patient wasn’t actually unstable or about to have a stroke.

    An Emergency In ‘Access to Care’

     “How many people do we have that call the family doctor, and the receptionist says, ‘If you can’t wait three days to get an appointment with us, then just go to the ER?’” asked David Wesley Brewer, former president of the Kentucky chapter of the American College of Emergency Physicians.

    Brewer said another reason people come to the ER, even if they know know it’s not an emergency, is because Medicaid enrollees have a hard time finding a primary care practice with immediate availability. The Truven Health analysis found that of the 71 percent of what it deemed “unnecessary” ER visits, more than 40 percent of those people could have been safely treated in a primary care setting.

    And locally, at the University of Louisville Hospital, two thirds of ER visits occur after hours, when cheaper alternatives like primary care offices or free clinics are closed. And the vast majority of visitors, the hospital said, have either been directed by their primary care office/insurance nurse line to go to the ER, or have a time sensitive medical need.

  • February 18, 2018 11:43 AM | Deleted user

    Lei Lei, MD
    WACEP Secretary/Treasurer

    I have been out of residency for five years, and it is remarkable that even in my relatively young career, I find myself and my colleagues all over the country burdened with burnout. After having kids and starting my life anew after almost a decade of the “it’ll get better” mentality, I sometimes wonder if I was overly optimistic about the practice of medicine. Though it seems like it is the current “hot topic,” it is becoming increasingly apparent that physician burnout is a persistent and growing issue in our profession which leads to significant downstream effects.  Burnout contributes to poor physician retention, which results in worsening physician shortages, which in turn will self-propagate as the remainder physicians struggle to fill the holes leading to medical errors, bad patient care, and of course more burnout. Physician burnout contributes to depression and one of the highest suicide rates of any profession.  

    Our profession is woven into our identities. Work is not just work; it comes home with us; and goes to sleep with us.  Physicians have been trained to project an indomitable image.  In reality the typical emergency physician statically does not sleep well, eat well, and doesn’t seek treatment for mental and physical ailments.  Our irregular schedules working holidays and weekends make it difficult to manage family life; our unwieldy student loans hold us financially captive to the medical field as we are often not in a position to replace our income by alternative means. Third shifters are at particular risk for metabolic syndrome and chronic sleep disturbance correlating with an increase incidence of hypertension, diabetes, and decreased lifespan.1 At the hospital we are charged with caring for our patients, striving to please exacting administrators, and being the stoic leader in the chaos of the ED. Self-care is always a peripheral after-thought. Even at home, we are often primary providers and our family members often view us as an endless resource for medical expertise. We care for others, but our own wellness is not a priority. 

    Physicians are leaving medicine or looking for alternative revenue streams for this reason. The Association of American Medical Colleges is projecting a shortage between 40,800-104,900 physicians by 2030. One third of practicing physicians will be of retirement age within the next 10 years. The younger physician cohort are suffering from burnout and cynicism not previously experienced by other generations of physicians.  A Facebook group “Physician Side Gigs” boasts twelve thousand members of practicing docs who looking to decrease clinical work and supplement their income. Our profession is facing some serious issues, but physicians can only affect part of a solution. Hospital administrations, medical educators, and federal and state regulators will have to prioritize physician wellness by addressing physician burnout. Many residency programs are enacting curriculum changes that build new physician resiliency and minimize burnout, but we should also ask ourselves: what can practicing docs do to improve their own resilience and what can hospitals and governments do to promote physician wellness. 

    My goal is to convince our collective profession that prioritizing our health and wellness needs to come off of the back burner. It is time to stop viewing self-sacrifice as a necessity in the culture of medicine. Hospital administrators will not do this for us. Hospital staff will not do this for us. Only we can advocate for ourselves.  This can mean telling your colleagues to take a break during a shift that allows for eating, pumping, or just a simple escape from the chaos of the department.  This can mean offering positive reinforcement for our colleagues who are making healthy choices. This can mean standing up for our colleagues who are being singled out. We need normalize these behaviors as the standard and not the exception. Let us be more honest with ourselves and in our daily interactions. The grumbling we hear during shift change and on our day-to-day exchanges with worn-out colleagues is a symptom of a larger problem.  We need to start and sustain these conversations. The more we passively absorb the stresses of this dysfunctional healthcare system, the more devalued we will be as doctors.  

    We must also focus on enacting changes across the system that favors sustaining physician wellness and changing the long standing cultural practices within medical communities that reinforce self-sacrifice as a necessity in medical practice. Healthy practices should be reinforced by our community and government. The biggest hurdle is simply making this a conscious priority in our minds as well as those of hospital administrators. This could mean framing the issue in terms of loss in productivity, physician retention, poor patient care, and mistakes in health care. As a member of professional organizations like WACEP and the Wisconsin Medical Society, you are supporting initiatives that benefit physicians and helping these issues to gain visibility and attention in legislation and policy. 

    With that I would like to announce that in the following months, WACEP will be starting a social media initiative to promote physician wellness. Please follow us on Twitter @WisconsinACEP or Facebook @WIACEP for updates.

    1. Wang, F., Zhang, L., Zhang, Y., Zhang, B., He, Y., Xie, S., Li, M., Miao, X., Chan, E. Y. Y., Tang, J. L., Wong, M. C. S., Li, Z., Yu, I. T. S. and Tse, L. A. (2014), Meta-analysis on night shift work and risk of metabolic syndrome. Obes Rev, 15: 709–720. doi:10.1111/obr.12194

  • February 15, 2018 11:54 AM | Deleted user

    WACEP 2018 SPRING SYMPOSIUM - HOTEL RESERVATION DEADLINE IS FEBRUARY 19th!

    Planning to attend the Wisconsin ACEP 2018 Spring Symposium next month?  Make your hotel reservations NOW! The deadline to receive overnight accommodations at the WACEP group rate of $149 is on MONDAY.

    Book your stay by calling The Edgewater directly at 1-800-922-5512 and request the Wisconsin Chapter, American College of Emergency Physicians room block. You may also book online using this direct link for WACEP's room block: http://theedgewater.link/WACEP2018. The cut-off date to book at the group rate is February 19, 2018. 

  • February 12, 2018 2:25 PM | Deleted user

    February 12, Wisconsin Health News

    The Joint Finance Committee signed off on two bills last week targeting the state’s opioid epidemic, teeing up the proposals for votes in the Assembly and Senate. 

    One of the bills would provide funding to combat drug trafficking, support substance abuse prevention efforts, establish treatment courts and provide medication-assisted treatment to inmates leaving jail. The other would make a series of changes to boost treatment and prevention efforts.

    The committee approved an amendment to the second bill, which aimed to address some concerns raised about the bill streamlining the process for people to become substance abuse counselors.

    “Wisconsin already has a pretty high threshold for requirements, both from an educational standpoint and from a clinical standpoint,” said bill author and JFC Co-Chair Rep. John Nygren, R-Marinette. "Even with these changes, we are still on the high end of all our neighboring states.”

    The amendment also changed a part of the bill mandating that the Department of Health Services remove prior authorization requirements for prescribing buprenorphine combination products, a treatment for opioid addiction. Instead, DHS would have to report back to the Legislature every six months until the requirements change.  

    The amendment didn't include a request by the medical community to remove parts of the bill requiring some healthcare providers take continuing medical education credits on prescribing opioids.

    The Wisconsin Medical Society, which supported the bills, said in testimony that the proposal is unnecessary for the Medical Examining Board, which has issued rules requiring such education through 2019. Nygren praised the Medical Examining Board’s work.

    “This is not a move to be punitive,” he said. “The Medical Examining Board has actually taken steps. Others haven’t.” 

  • February 06, 2018 10:08 AM | Deleted user

    February 1, WMS Medigram

    Doctor Day 2018 brought more than 450 physicians and medical students from across the state to Madison to meet with legislators and their staffs on Tuesday. Key issues included a proposed Worker’s Compensation fee schedule, a bill allowing chiropractors to perform comprehensive sports physicals for high school and college athletes, and legislation removing the requirement for certain nurses to work in collaboration with a physician. 

    Prior to meeting with legislators at the State Capitol, attendees heard from speakers including Gov. Scott Walker, who highlighted his Health Care Stability Plan to lower individual health care premium costs, provide seniors with greater health care stability, and protect those with preexisting conditions. He also discussed recent initiatives to combat the opioid crisis in Wisconsin. 

    “Addiction knows no boundaries. It involves all of us,” he said. “Over the past four years I’ve had the honor of signing 28 pieces of legislation that have come out of the HOPE agenda, but there is still more work to be done. 

    “We can’t afford to have anybody on the sidelines, and that includes those suffering from addiction today,” he continued. “We need to get them healthy, back up on their feet again, and right back into the workforce where they can lead strong and healthy and safe lives and be a part of making this state even better going forward.” 

    In addition to hearing from Governor Walker and other speakers, attendees participated in an issue briefing before heading to the State Capitol to meet with lawmakers. 

    Now in its fifth year, Doctor Day is a partnership among the Wisconsin Medical Society and other key physician groups and physician-led organizations. The day-long event provides a unique opportunity for physicians from across the state to collaborate and share with policymakers facts and data on timely health care issues. 

    “As physicians, we have the privilege of caring for patients every day, and when we come together for Doctor Day, we are reminded how important it is to also have a voice outside the exam room,” said Society President Noel Deep, MD. “Doctor Day continues to grow each year, and it’s incredibly gratifying to see physicians from all specialties and practice types united to advocate on behalf of patients and the medical profession.” 

    Today’s participants represented 24 different physician organizations and partners: the Wisconsin Medical Society, Medical College of Wisconsin, University of Wisconsin School of Medicine and Public Health, Axley Brynelson, Association of Wisconsin Surgery Centers, Brown County Medical Society, Waukesha County Medical Society, Wisconsin Academy of Family Physicians, Wisconsin Academy of Ophthalmology, Wisconsin Association of Hematology and Oncology, Wisconsin Chapter American College of Emergency Physicians, Wisconsin Chapter of the American College of Physicians, Wisconsin Council of Child and Adolescent Psychiatry, Wisconsin Dermatological Society, Wisconsin Neurological Society, Wisconsin Orthopaedic Society, Wisconsin Psychiatric Association, Wisconsin Radiological Society, Wisconsin Section-American College of Obstetricians and Gynecologists, Wisconsin Society of Addiction Medicine, Wisconsin Society of Anesthesiologists, Wisconsin Society of Pathologists, Wisconsin Society of Plastic Surgeons, and Wisconsin Surgical Society. 

  • January 31, 2018 12:19 PM | Deleted user

    January 30, Wisconsin Health News

    The Office of the Commissioner of Insurance is drafting a proposal that would update state law and regulations on network adequacy for health insurers. 

    Spokeswoman Elizabeth Hizmi said in an email that the agency anticipates working on the proposal through summer. 

    Deputy Commissioner J.P. Wieske said the bill is based on work the agency did with the National Association of Insurance Commissioners to create model legislation that had the support of consumers, the medical community and the insurers. 

    “We felt that modernizing our network adequacy procedures to reflect that model made some sense,” he said at a Wisconsin Health News event last month. He said current rules are “very complicated” and that the legislation would simplify the process. 

    The legislation would ensure that insurers have adequate networks to provide care and that consumers have access to care they need in-network, he said.

  • January 17, 2018 11:24 AM | Deleted user

    Lisa Maurer, MD, FACEP

    If you’re reading this newsletter thinking, “Sure I’m a WACEP member, but that doesn’t really impact my daily grind,” this President’s Message is for you!

    Over the course of 2017, the WACEP board led by Bobby Redwood as President brought amazing structure and focus to our activities, ensuring that our resources are being used to help our patients, our profession and our physician workforce. Building on the excellent content now established, I intend to focus this year on the theme of our Spring Symposium: Building Connections. I hope to connect members to the value that already exists and may not be taken advantage of, and to connect with underrepresented members to ensure our work reflects what you value.

    Our average member is a pit doc like me, and on last year’s membership survey, you told us you want WACEP’s priority to be advocacy above all else. We listened: our top advocacy issues are to 1) improve the care for our patients with psychiatric emergencies by decreasing their length of stay in the ED and 2) improve reimbursement for emergency care by our Medicaid department. What’s more, our organization is working to increase outpatient treatment for our patients struggling with opioid addiction, leading a multispecialty group of physicians advocating to restore medical malpractice caps, and ensuring Wisconsin regulators have a fair reimbursement system in place for our patients forced onto narrow-network insurance plans. 

    But for the average pit doc, we may represent your practice with our advocacy issues, but does the diversity of the WACEP Board of Directors represent you?  We have a great opportunity to broaden the scope of the voices in our leadership, and this year we will be actively looking to do so. Case in point: all members are welcome at Board meetings, and in fact, I would LOVE for you to come. Please consider joining us on March 14 from 3-5:30 pm just before the Spring Symposium kicks off. Let us know if you will join us!

    After last year’s amazing Spring Symposium, we are looking to this year’s event to further integrate the academic emergency physicians and residency programs into our organization. With huge thanks to Drs. Hamedani and Hargarten, we are excited to partner our annual conference with the decades-long tradition of the UW/MCW Emergency Medicine Research Forum as it alternates between Madison and Milwaukee each year. In addition to bringing back the popular LLSA course, simulation session and roundtable discussions on hot topics in EM practice, attendees will now have access to ground breaking research happening right here in our state. 

    But what about the residents at those academic programs? Those who are deepest in the trenchiest of trenches? We want to improve how we support you! For those of you interested in policy, please come to Doctor Day on January 30th, where I’ll host a policy primer to get everyone up to speed on how policy is affecting your career and practice. We also have plans to visit both residency programs every year to discuss how we can help on issues that are meaningful to you. Lastly, we want to recognize our resident members. The WACEP Board of Directors includes three resident representatives from each program, who can be great resource for anyone looking to learn more. At the Spring Symposium, one resident from each program will be recognized with the WACEP Resident Advocacy Award celebrating how our WI EM residents advocate for important issues, for their patients, and for each other every day.

    Another important theme reflected in our membership survey last year was the importance of education and information sharing among Wisconsin emergency physicians. Our Spring Symposium will alternates between Madison and Milwaukee, as do our board meetings.  It is not lost on me that access to this valuable resource can be difficult for many of our members in the other 90% of the state.  As WACEP certainly prioritizes Wisconsin residents’ access to amazing emergency care, we plan on taking advantage of the great opportunity to develop increased opportunities for cutting edge education for all our colleagues practicing emergency medicine in Wisconsin, WACEP members or not, Emergency Medicine trained or not. We are looking for feedback on how to make this a realistic, enduring, valuable resource. One great way to discuss this as well as other WACEP activities would be to attend a Listening Tour event near you. Look for information about upcoming stops on the Tour, when our board members will come to an ED break room or department meeting near you.  Please let us know if you’d like a visit in your neck of the woods!  We’ll supply the board member and the pizza.

    If these above opportunities would bring value to your practice, take advantage! Follow along and stay updated via social media, check us out on Facebook or Twitter (@WisconsinACEP).  Join us for Doctor Day in Madison on January 30th.  Let us know if you’d like to come to our board meetings. Attend our Spring Symposium on March 14th-15th in Madison. And perhaps most importantly, if you have a different point of view, let’s CONNECT!  Drop me a line and let me know how we would be valuable to you.

  • January 11, 2018 5:21 PM | Deleted user

    ACEP wants to recognize innovative and successful approaches to managing two of the most vexing issues facing emergency departments across the country: end-of-life care and opioid use.  

    ACEP’s Leadership and Advocacy Conference in May 2018 will feature a day-long Solutions Summit in which select success stories in these areas will be highlighted.  Any physician or emergency department that has developed a new approach to better address these problems is encouraged to submit their story. Some of the successes submitted will be recognized in the Summit program.  A few who submit notable success stories will also be given an opportunity to present live at the Summit.  

    For end-of-life care, examples of innovative programs could include expanded use of POLST, enhanced coordination with hospice, palliative care initiatives, etc.   For opioids, we’re interested in recognizing programs designed to curtail the use and prescribing of opioids in the emergency department as well as programs to help treat patients of opioid abuse.

    To submit your story, go to https://www.acep.org/solutionssummitideas to fill out the brief online submission form. And please feel free to share this e-mail with others you think might have a success story to share.

    The deadline for submissions is February 10th.