Latest News 


  • February 08, 2019 9:18 AM | Sally Winkelman (Administrator)

    Julie Doniere, MD
    WACEP Board of Directors

    I know… another article about opiates.  Bear with me, I am writing this because I am anxious to start some conversations about treatment of opiate abuse.  Specifically, I am eager to hear about what is happening in the ED’s across Wisconsin.  

    In my practice, I feel like the biggest challenge is finding treatment for those patients that are seeking help with their opiate abuse.  Current practice is often symptomatic treatment, a referral list, and a “good luck!” We see people at their most vulnerable. We are either taking care of them after overdose, identifying their abuse disorder by looking at old charts, or being there when they realize they have a problem and present themselves to the ED. 

    There are some caveats to opiate treatment. Opioid addiction does not respond to the same treatments as alcoholism.  Abstinence therapies do not typically work.  These patients have a desperate need to avoid withdrawal. 

    This is where buprenorphine can be helpful.  While incorporating bup into my treatment in the ED, I have encountered multiple misconceptions about the drug:

    Myth #1: You can’t administer Buprenorphine in the ED without an X-Waiver. 
    BUSTED:
    Any ED physician or midlevel provider can use buprenorphine in the ED to treat opiate withdrawal.  The patient can return to the ED for 3 days In a row to get buprenorphine. 

    Myth #2: Buprenorphine is a scary drug and will throw my patient into withdrawal.
    BUSTED:
    Well, kind of busted.  Buprenorphine will cause withdrawal symptoms.  It should be given only to that subset of patients who are already in withdrawal; the COWS scale can measure this, I use MDcalc.  When a patient has a COWS scale of 8 or greater, buprenorphine can be given.

    Myth #3: Every opiate addicted patient in the county will be inundating my ED for buprenorphine.
    BUSTED:
    ED’s that have initiated buprenorphine have seen a decline on drug seeking behavior. 

    Myth #4: We are trading one addiction for another.
    BUSTED:
    The goal of medical assisted treatment is to trade addiction for dependency.  Abstinence from opiates is the goal.  While buprenorphine is an opiate agonist, it works primarily to control withdrawal symptoms so that individuals have more control over their cravings and avoid the risky use of opiates. 

    By no means is this article meant as a fully informative review of buprenorphine in the ED.  I am not smart enough for that!  If you are interested in a deeper dive into the role of buprenorphine in the ED, please view one of these two webinars:

    • Developing an ED Initiated Buprenorphine Program (View
    • Buprenorphine 101 - Demystifying Medication Assisted Treatment in Wisconsin (View)

    The following information about ED dosing concepts is thanks to Dr. Donald Stader, an ED doc in Colorado:


  • January 21, 2019 10:42 AM | Sally Winkelman (Administrator)

    In a news feature aired last summer on WEAU Channel 13 in Eau Claire,  new WACEP Board member Nate Blankenheim, MD  was interviewed in an exclusive look inside the new Marshfield Medical Center Eau Claire Emergency Department. Doctor Blankenheim talked with the reporter about the new facility and tried to teach him how to put on a cast. Watch video.

  • January 18, 2019 8:09 AM | Sally Winkelman (Administrator)

    January 17, WMS Medigram

    The State of Wisconsin Medical Examining Board modified the Opioid Prescribing Guideline at its monthly meeting in Madison on Wednesday. Expressing a desire to be less proscriptive in the “Discontinuing Opioid Therapy” section of the guideline, the Board has removed specific clinical suggestions for situations when opioid therapy leads to evidence of addiction risk or is proving ineffective.

    The section’s first two subsections have been shortened, while the third section remains the same:

    Discontinuing Opioid Therapy
    a. If lack of efficacy of opioid therapy is determined, safe discontinuation of opioid therapy should be performed.
    b. If evidence of increased risk develops, safe discontinuation of opioid therapy should be considered.
    c. If evidence emerges that indicates that the opioids put a patient at the risk of imminent danger (overdose, addiction, etc.), or that they are being diverted, opioids should be immediately discontinued and the patient should be treated for withdrawal, if needed. Exceptions to abrupt opioid discontinuation include patients with unstable angina and pregnant patients. These patients should be weaned from the opioid medications in a gradual manner with close follow-up.

    The Board also added a new general provision near the top of the overall guideline:

    2. It is best practice for a practitioner to consider guidelines within their specialty when prescribing opioids.

    The remaining guideline provisions were renumbered to reflect this addition. The new guideline became effective upon Wednesday’s vote approving the changes.

    In other action, the MEB elected its leaders for 2019. They are the same as in 2018, with Ken Simons, MD, reelected chair, Tim Westlake, MD, as vice chair and Mary Jo Capodice, DO, as secretary.

  • January 16, 2019 12:47 PM | Sally Winkelman (Administrator)

    Jeffrey Pothof, MD, FACEP
    WACEP President

    Dear WACEP members,

    Thank you for everything you do day in and day out to ensure our communities, our families, and our patients in Wisconsin and beyond have access to great emergency care.  I’m humbled to be your president and commit to working hard to ensure you are supported in your professional practice and that we, collectively, advocate for high quality emergency medical care.

    I wanted to take a moment to introduce myself to all of you.  My hope is that during the next year I’ll be able to meet many of you in person through our mutual involvement in the things that matter most to us as emergency physicians.  I grew up in Randolph, a small town in rural Wisconsin.  I attended Edgewood College and subsequently the UW School of Medicine and Public Health for my doctorate degree.  I completed residency at the University of Michigan.  While in Ann Arbor I finished a medical education scholars program in healthcare administration and served as chief resident during my fourth year of residency.

    I came back to Madison after residency as faculty at the University of Wisconsin.  I had developed a strong passion in health system operations as well as patient safety and quality while in residency that spilled over into my early professional career.  I held various leadership roles over the last decade including Service Chief of Emergency Medicine for the William S. Middleton VA Hospital, Clinical Service Chief for the UW Division of Emergency Medicine, Vice Chair of Quality and Operation for the UW Department of Emergency Medicine, and most recently a health system role now serving as Chief Quality Officer for UW Health.   I continue to work shifts both at our University Hospital emergency department and at the smaller emergency department at our American Center campus.  I’ve been a flight physician with UW Med Flight for the last 8 years and still enjoy it as much today as I did back then.

    My interest in organized medicine began early in my career.  I joined ACEP’s Quality Improvement and Patient Safety Section in 2012.  I served the section in many roles culminating as chair of the section in 2015.  I was also a member of the Quality and Performance Committee from 2013-2017.  More recently my interests have shifted from the national level to the local level.  In 2016 I began serving as a board member for WACEP and have enjoyed working on issues that impact the physicians and patients in my own back yard and being able to represent our interests at the annual ACEP council meeting.

    I want to encourage all of you no matter what your background to attend our Spring Symposium.  Registration is currently open and can be found here.  There has been tremendous effort expended by our team to provide a very valuable experience for those in attendance.  I really think all of us no matter our practice environment will take something away from this year’s conference.

    I’ll have more updates as we move through the year, but WACEP has its hands in many pots.  We are committed to being good partners in the fight against the opioid crisis.  We are devoted to improving both the patient and provider experience when it comes to navigating our mental health system.  We are eager to develop initiatives to assist providers in finding meaning in their work, and we continue to advocate for fair Medicaid reimbursement for the care you deliver.   My hope for this year is that we become closer as physicians who provide emergency care without any additional qualifiers.  Whether in democratic groups, national group practices, small rural practices, or large academic practices there is more that holds us together than pulls us apart.

    I’m excited to embark on this journey with you and look forward to WACEP’s accomplishments in 2019.

    Sincerely,

    Jeff

  • January 16, 2019 12:33 PM | Sally Winkelman (Administrator)

    Jamie Schneider, MD
    EM3, MCW Emergency Medicine Residency
    WACEP Alternate Delegate to WMS and ACEP

    As the end of residency nears I have noticed a subtle shift in my education. Until recently, I had been focused on how to treat patients; medical school taught me disease and diagnosis and the broad strokes, and the first years of residency honed my treatment of crashing patients and worried well.

    It’s only in the last year that I’ve really started learning what it means to be a physician in the real world.  This includes billing workshops, applying for jobs, reviewing contracts, and engaging in philosophical discussions on management of our profession.

    To this end, I had the awesome opportunity to join the WACEP delegation at the ACEP 2018 Annual Meeting last fall as an alternate delegate. Where the ACEP Scientific Assembly adds to our education and tools for treating patients, the Annual Meeting gives us a venue to shape the practice and profession of Emergency Medicine.

    ACEP, as with seemingly every other organization in America, spent much of its time at the Annual Meeting on opioids. Just as interesting, however, was the vast amount of discussion about what Emergency Medicine is, and how we as a profession should manage and advance it. We heard keynotes on how to tackle the lack of trained EPs in rural areas, bylaws amendments on who should be a part of ACEP, and resolutions on topics from protecting physicians’ mental and physical health to ensuring fair and appropriate remuneration to appropriately training future EPs.

    As a physician early in my career, these debates were valuable in shaping my understanding and views, and for our more experienced members gave a forum for sharing their wisdom. It can be argued that Emergency Medicine attracts one of the most diverse groups of practitioners, caring for the most diverse group of patients in the most diverse environments in all of medicine. There is clearly no “one best way” forward for our profession, but forums like the ACEP Annual Meeting are invaluable for allowing us to find common ground.

    With that in mind, I am looking forward to the Wisconsin Medical Society’s Annual Meeting coming up on April 7. Representatives from each Wisconsin specialty society (including WACEP) and from all geographic districts of the state will gather in Madison to discuss topics relevant to the entire house of medicine of Wisconsin. Resolutions this year will include at least two that are sponsored by WACEP. If you don’t happen to be sleeping off a Saturday overnight shift, consider joining us for what is sure to be interesting and enlightening discussion.

  • January 16, 2019 10:49 AM | Sally Winkelman (Administrator)

    ATTENTION MEDICAL STUDENTS! If you're considering Emergency Medicine for residency the April 13th Midwest Medical Student Emergency Medicine Symposium is for you!

    We know the residency match process can be overwhelming. That's why Wisconsin-ACEP is teaming up with the MCW and UW Emergency Medicine Residency Programs to co-sponsor the event alongside Ohio and Michigan Chapters of ACEP, EMRA, and some of the top residency programs from around the country.

    This event will show medical students the ropes on choosing the right residency, rocking your interview, and standing out from the competition! Don't miss out on this one-of-a-kind event with a dynamic agenda designed to maximize your participation.    

    Midwest Med Student Symposium & Residency Fair

    April 13, 2019
    Hilton Garden Inn Toledo/Perrysburg, Ohio

    Learn more and register online. Registering by phone? Call Monday-Friday, 1-888-642-2374 between 7am and 4pm CST.

  • January 15, 2019 1:36 PM | Sally Winkelman (Administrator)

    A recent article in the USA Today quoted WACEP leader Bobby Redwood, MD, MPH, FACEP, and highlighted over a year of work being done by Wisconsin ACEP, the Wisconsin Hospital Association, and other organizations in regards to initiating Medication Assisted Treatment (Buprenorphine), in the Emergency Department.

    Redwood points out a few of the efforts to date: 1) WACEP surveyed the EM workforce in Wisconsin on MAT; 2) WACEP developed an infographic on MAT & the ED; 3) WACEP and other organizations scheduled and promoted X-waiver training opportunities in Wisconsin; and 4) WHA developed a webinar to encourage MAT cooperation between primary care and emergency physicians.

    WACEP's next steps are to work with key stakeholders to secure funding and develop regional streamlined care processes to make sure patients get the coordinated care they need.

    "While WACEP will continue its efforts in 2019," says Redwood, "I am really hopeful that we will start to stem the tide of morbidity and mortality from opioid overdoses in Wisconsin. Thanks to all who contributed to this important work."

  • January 11, 2019 1:36 PM | Sally Winkelman (Administrator)

    A monthly webinar series, Health Care Workforce Resilience, jointly sponsored by the Wisconsin Medical Society and the Wisconsin Hospital Association, is offered the second Tuesday of each month throughout 2019.

    Each month will focus on a unique topic. Participants will receive one hour of continuing education credit, as well as practical and easy-to-implement tools for dealing with burnout in health care.

    Resources and the recording of the January webinar, Prevalence & Severity of Burnout: Workforce Resilience as Care Quality, are available online.

     The next monthly webinar, Enhancing Resilience: The Science and Practice of Gratitude, will occur on February 12 and will demonstrate a simple, enjoyable and effective tool for improving well-being by cultivating gratitude. Learn more and register.

  • January 11, 2019 1:03 PM | Sally Winkelman (Administrator)

    Eric Jensen, Jensen Government Relations, LLC

    After what feels like a never-ending election cycle, the 2019-20 Session of the Wisconsin Legislature is finally under way.  Dominating early news following the election:

    Governor Tony Evers’ victory in November changes the partisan political dynamic in Madison for the first time in nearly a decade.  While Republicans maintained wide majorities in both the Assembly and Senate, they do not have sufficiently large majorities to override gubernatorial vetoes on their own, meaning as a general rule legislation will need bipartisan support to ensure passage.

    The “Lame Duck” (post-election) Legislative Session in December set a contentious early tone to the 2019-20 Session.  However, as Inauguration Day approached, and in speeches given on Inauguration Day, Senate Majority Leader Scott Fitzgerald, Assembly Speaker Robin Vos and Governor Evers all spoke to a desire for cooperation, bipartisanship and civility.

    The coming Budget Debate.  Prior to his inauguration, Governor Evers announced a variety of items he intends to include in his 2019-21 Budget Proposal (generally announced in Mid-February).  Of particular interest, the Governor made clear he intends to include a Medicaid Expansion proposal based on the original Affordable Care Act’s MA Expansion program.  While Republicans have historically and openly opposed MA Expansion, Senator Fitzgerald has signaled that the Senate will remain open-minded heading into the Budget process.

    Typically, the Governor introduces the Budget in mid-February in a speech to a Joint Legislative Session.  Once introduced, the Budget Bill moves on to the Joint Finance Committee (currently made up of 8 Assembly Representatives – 6 GOP and 2 DEM, and 8 Senators – 6 GOP and 2 DEM).  JFC’s work on the Budget includes informational hearings, a period of research and analysis by the non-partisan Legislative Fiscal Bureau, a period of hearings during which the Budget is debated and voted on piece-by-piece, and finally passage of a recommended Budget Bill that moves on to the full Legislature.  While the Wisconsin Constitution requires the Budget to be signed by July 1, if that does not happen the State government does not shut down, rather all agencies continue operating at the prior Budget’s funding and programming levels.

    This year, it is widely anticipated that rather than working from Governor Evers’ Budget proposal, the GOP-led Legislature will write their own version starting from scratch.  But because the Wisconsin Governor has the power of the line-item veto when it comes to the Biennial Budget, the final product will be one of negotiation – but we may be waiting well into the Fall of 2019 before a final Budget deal is reached.

  • January 11, 2019 8:30 AM | Sally Winkelman (Administrator)

    The ACEP Nominating Committee is accepting individual and component body recommendations for Board of Directors, Council speaker, and Council vice speaker candidates. 

    A true measure of a leader is knowing when it is time to accept the challenge of leadership. One must carefully consider their education, life experiences, and potential to determine when they are ready to lead. If you know you are ready to lead, don't wait for a phone call to determine your interest in seeking nomination! Take the initiative to contact your component body president or section chair to express your interest in nomination, and ask that a letter of support be submitted on your behalf.

    To qualify for a Board position or Council office, a candidate must:
    be highly motivated to serve ACEP and be committed for three years for a Board position;

    • be an ACEP member in good standing with no delinquent dues;
    • be an ACEP member for at least five years;
    • show evidence of ACEP involvement in both national and chapter activities (such as current or past chapter officer, current or past national committee leadership, current or past service   as a councillor or alternate councillor, or current or past section leadership);
    • show chapter and/or section support for candidacy. 
    Criteria for nomination to Council office include:
    • nominees must be active members of the Council (presently or recently); 
    • nominees must be active nationally (presently or recently); and 
    • there will be no exclusions because of past service.

    Nominations must be received by March 1, 2019 and may be emailed to John G. McManus, Jr.. MD, MBA, FACEP and copied to Sonja Montgomery.

    Elections for the Board of Directors will occur on Saturday, October 26, 2019, during the Council meeting in Denver, CO. Please contact Sonja Montgomery at 800-798-1822, ext. 3202 with questions about the nomination process.