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  • November 12, 2019 8:29 AM | Sally Winkelman (Administrator)

    ACEP has developed new resources specifically to benefit small groups.  A new Small Group Advisory Group is a team of seasoned small group members who have volunteered to support the small group practice model by sharing their expertise with other small group members who are looking for guidance or wanting to tap into the experience of others as they face various challenges unique to small groups. If your small group is dealing with an issue that you’d like to ask the advisory group about, just send us an email at smallgroups@acep.org.

    ACEP has also developed an online community for small group members to share ideas and discuss issues. To joint that group and see the other small group resources available, go to www.acep.org/smallgroups.

  • November 12, 2019 8:27 AM | Sally Winkelman (Administrator)

    ACEP’s new first responder training program, Until Help Arrives, was officially unveiled during ACEP19 in Denver with a series of events to highlight how emergency physicians can positively impact their communities by conducting training sessions to teach the public basic life-saving skills. Learn more.

  • November 04, 2019 5:11 PM | Sally Winkelman (Administrator)

    New ACEP member benefit now available

    ACEP members care for their patients 24-7-365… but are you are taking care of yourself?  At ACEP19 in Denver, ACEP launched the ACEP Wellness & Assistance Program., a service available to all members that provides access to three confidential counseling or wellness coaching sessions, free of charge.

    Call 1-800-873-7138 to register and receive support whenever, however iyou need it.

    • Counseling is available 24 hours a day, 7 days a week
    • Sessions can cover stress, anxiety, depression, family issues, drug and alcohol abuse, relationships, death, grief, and more
    • The service is strictly confidential and can be scheduled face-to-face, over the phone, via text, or through online messaging 
    • Wellness coaching sessions are 30-minute phone calls to help reach your personal wellness goals which can include weight loss, nutrition, healthy habits, stress, caffeine reduction, injury recovery, relationships, sleep, smoking cessation, and more

    Members may choose three free sessions in any combination of counseling and wellness coaching, up to the session limit.

    An additional resource is available at a nominal fee of $15/year that will help members manage legal and financial issues through ACEP’s partner, Mines & Associates. Participants will have unlimited access to an extensive online resource library and unlimited 30-minute in-person consultations for each individual legal or financial matter and a 25% discount on legal and financial services within the Mines network. 

  • October 31, 2019 5:22 PM | Sally Winkelman (Administrator)

    During Tuesday’s Public Hearing for the Assembly Committee on Health, emergency physician and vice-chair of the Medical Examining Board Tim Westlake, MD, testified against Assembly Bill 526 on behalf of the Wisconsin Medical Society.

    This bill is one of nine bills produced by the Speaker’s Task Force on Suicide Prevention. The first draft of the bill would require two credits of CME every two years on the topic of suicide prevention for all physicians, psychologists, social workers and several other professions. The Wisconsin Medical Society raised concerns to the Speaker’s office, the chair of the Speaker’s Task Force and the bill author, and an amendment was offered by Rep. Tony Kurtz (R – Wonewoc) that would only require the two hours once upon the next renewal.

    The Wisconsin Medical Society opposes the legislation (even with the amendment) for the following reasons:

    • Suicide prevention and mental health treatment are already part of best practices for physicians.
    • Physicians are the best judges of what education they need to serve their patients, and the CME requirement is another example of government interference and regulation in medicine.
    • The recent Opioid CME requirement was successfully created through the action of the Medical Examining Board, not through legislation.
    • Physicians already take significantly more education than is required under state law to maintain Board certification.

    Doctor Westlake stressed that all physicians care deeply about preventing suicide, mentioning that he treated four suicidal patients in the ER the night before. He then pointed out that a requirement of CME is unlikely to impact patient care. “A responsible physician will make sure they are up to date on all aspects of their practice,” Westlake said, “but requiring CME won’t change behavior. You can’t legislate responsibility.”

  • October 24, 2019 3:10 PM | Sally Winkelman (Administrator)

    The Wisconsin Chapter, ACEP Nominating Committee is now accepting nominations of any member in good standing interested in serving in WACEP leadership.

    WACEP's Board of Directors meets quarterly and provides ongoing strategic oversight as the organization works to advance the effectiveness, sustainability and mission of the Chapter. Board members are expected to participate in all Board meetings, the annual Spring Symposium, and various other activities related to the organization's strategic priorities.

    Nominations are being accepted for the positions listed below (terms begin January 1, 2020):

    • (2) Directors-at-Large on the Board of Directors (4-year term)
    • (4) Councillors to ACEP (3-year term)
    • President-Elect (this is a 3-year commitment, one year each as President-Elect, President and Immediate Past President)
    • Secretary/Treasurer (1-year term)

    If you or any of your colleagues are committed to serving in a leadership capacity and being a resource for information, education, networking and advocacy, we encourage you to get involved Nominations close November 25, 2019. Submit nominations here.

  • October 21, 2019 4:02 PM | Sally Winkelman (Administrator)

    President's Message, October 2019
    Jeff Pothof, MD, FACEP
    WACEP President

    It was well over a year ago when one of my colleagues and fellow flight physician, David Hindle, launched a new conference at our staff meeting.  Entitled “Awesome and Amazing,” it was a case conference that highlighted some of the best medical care teams in the flight program delivered to critical patients.  It seemed like such an obvious thing to share and an effective tool to promote learning and collaboration on our teams, but also 180 degrees opposite from what we as clinicians typically experience.

    I think it’s just human nature to focus on those things that aren’t quite perfect or still need a little fine tuning.  I postulate the rigors of medical education and the hoops we all jump through predispose us to being hypercritical of ourselves.  I’ve been to many a lecture hall to discuss cases at the monthly M&M case review conference.  Most cases would not be well described by the “awesome” adjective.  I’ve looked at the blinded data during performance reviews and must secretly admit that there is a twinge of self-disappointment when I’m not a top performer on any single metric.  I’m not arguing that we shouldn’t learn from our mistakes, and I’m not saying that we shouldn’t continue to hold ourselves to a very high standard.  I do think we’d all be well served by just as frequently looking back to those awesome and amazing moments that seemingly come out of nowhere during our careers.

    I encourage you to take a moment to reflect back to a time when you were part of something that was “awesome and amazing.”  Think about a time when you added immense value and where your presence on a shift or in a room made an inflection point in someone else’s life trajectory.  Anyone who’s committed themselves to a career in emergency medicine has these moments.  I find that looking back to those times helps make that overnight shift that just won’t end a little shorter, or that case where you wish you could have a do-over sting just a little bit less. 

    So, without overly inflating our egos, I embolden all of you to spend a little more time thinking about the awesome and amazing things you’ve done in addition to the things you strive to be better at.  It’s an important balance that paints a more accurate portrait of who we are as emergency physicians.

  • October 18, 2019 4:17 PM | Sally Winkelman (Administrator)

    Editor’s Note: This article appeared in the August 2018 issue of Medigram, a monthly publication of the Wisconsin Medical Society

    Physicians are required by law to report information to entities or individuals such as county health officials or law enforcement in certain situations. Most recently, that includes threats of school violence, which was enacted as part of a school safety law earlier this year.

    Both HIPAA and Wisconsin confidentiality laws allow disclosure of protected health information where such disclosure is required by law. Failure to report as required can result fines, civil or criminal liability and/or professional discipline. Physicians should check with their legal counsel or risk manager if they have questions about when they are required to report information to others and how to do so.

    The following is a summary of some of the more common mandatory reporting obligations applicable to Wisconsin physicians.

    Threats of School Violence—Physicians and other health care professionals who believe in good faith, based on a threat made by an individual seen in the course of professional duties regarding violence in or targeted at a school, that there is a serious and imminent threat to the health or safety of a student or school employee or the public must “immediately inform, by telephone or personally, a law enforcement agency of the facts and circumstances contributing to” that belief. (Wis. Stat. § 175.32)

    Child Abuse and Neglect—Physicians and other health care professionals who have reasonable cause to suspect that a child seen by them in the course of professional duties has been abused or neglected or has been threatened with abuse or neglect must “immediately inform, by telephone or personally,” the county department or local law enforcement of the facts and circumstances giving rise to that suspicion. (Wis. Stat. § 48.981)

    Conduct of Colleagues—Physicians must make a written report to the Wisconsin Medical Examining Board if they have reason to believe a Wisconsin licensed physician:

    • Has engaged in acts constituting a pattern of unprofessional conduct under Wis. Admin Code § MED 10.
    • Has engaged in acts that create an immediate or continuing danger to one or more parties or to the public.
    • Is medically incompetent.
    • Is or may be mentally or physically unable to safely to engage in the practice of medicine or surgery. (Wis. Stat. § 448.115)

    Elder Abuse—Physicians and other health care professionals must file a report with the county department, elder-adult-at-risk agency, local law enforcement, the Department of Health Services or the state board of aging and long-term care if they have reasonable cause to believe that an individual over the age of 60 seen in the course of professional duties, or another elder-at-risk, is at imminent risk of serious bodily harm, death, sexual assault or significant property loss, or if requested to make such a report by the patient. (Wis. Stat. § 46.90)

    Sexual Contact by a Therapist—A therapist who has reasonable cause to suspect a patient or client he or she has seen in the course of professional duties is a victim of sexual contact by another therapist must ask the patient if he or she wants them to report the information and must, if authorized by the patient, report the suspicion to the Department of Safety and Professional Services or the local district attorney within 30 days. (Wis. Stat. § 940.22)

    Danger to Others—Physicians, like all individuals, have a duty of reasonable care in light of foreseeable harm. This may, under certain circumstances, require physicians to warn or take reasonable actions, such as notifying law enforcement or potential targets, if they believe a patient, individuals or the public is at risk of serious and imminent harm as a result of information obtained in the course of providing professional services. Where such a duty may exist, Wisconsin law specifies that it is satisfied by doing one or more of the following: contacting law enforcement, contacting the applicable county department or taking other action a reasonable health care professional would consider as fulfilling a duty to warn a third party of substantial probability of harm under the circumstances (Wis. Stat. § 51.17). Physicians are encouraged to discuss such matters with their legal counsel or risk manager.

    Other—Physicians are required by law to report certain other events or acts to state or local officials, including the following:

  • October 14, 2019 11:00 AM | Sally Winkelman (Administrator)

    Wisconsin ACEP is pleased to be partnering with Hubbard, Wilson & Zelenkova LLC (HWZ) for lobbying and legislative services. The firm is led by seasoned lobbyists with vast experience and exceptional relationships with policymakers across the political spectrum and on both sides of the aisle.  HWZ represents groups and organizations including trade associations, healthcare interests, Fortune 500 companies, trade unions, and state and national non-profits. 

    Greg Hubbard has over 15 years experience representing a wide range of interests and has successfully lobbied on landmark issues in energy, telecommunications, taxation, natural resources and land use.  Formerly, Greg worked for several republican legislators including as Chief of Staff to former Senate Majority Leader Mary Panzer.  During contentious legislative redistricting efforts in 2001, he provided analysis and advice to Assembly and Senate Republican leadership.  Greg is a graduate of the University of Wisconsin-La Crosse. 

    AJ Wilson is a principal at Hubbard Wilson & Zelenkova with nearly two decades of experience in and around the Wisconsin State Capitol. AJ represents clients ranging from trade associations and national non-profits to trade unions and Fortune 500 companies on legislative, regulatory, and procurement issues.  Prior to lobbying, AJ was Chief of Staff to Assembly Democratic Leader Jim Kreuser and spent over seven years in the Wisconsin Legislature developing strategy, crafting legislation, and maintaining critical relations between legislative leadership, members, state agencies, and the Governor's office.  AJ is a graduate of the University of Wisconsin-Madison and earned his JD from the University of Miami School of Law. 

    Ramie Zelenkova has over a decade of experience in lobbying and grassroots advocacy and has worked to maintain strong relationships with legislative members on both sides of the aisle.  Ramie represents a variety of clients including nonprofits, professional associations, trade associations and Fortune 500 companies in areas such as healthcare, long-term care, education and child welfare.  Ramie’s experience includes an extensive background representing client interests before the Wisconsin Department of Health Services with particular experience representing client interests related to the delivery of Medicaid programs. Ramie is a graduate of the University of Wisconsin- Madison.  

    Katie White is Associate at HWZ with ten years of combined government affairs and legislative experience. Katie has crafted and advanced policies and political strategies for diverse clients and interests ranging from education, healthcare, and long-term care to agriculture and energy.   She provides extensive knowledge of the legislative process and excellent relationships with policymakers.  Prior to lobbying, Katie worked for Wisconsin Senator Rob Cowles.  She received her Bachelor’s degree in Political Science from the University of Wisconsin-Madison. 

  • October 03, 2019 2:09 PM | Sally Winkelman (Administrator)

    Annual turnover rate for nurses is 17.5%, and while limited department-level data exists, annual RN turnover rate in the Emergency Department is estimated at 21.5%, the second highest of any medical specialty.  

    To better understand department-level data on turnover rates and the factors associated with them, the Studer Group, together with representatives from ACEP and ENA, have created the 2019 Emergency Department Nurse Retention Study.

    Please ask your ED RN Managers to complete a brief, 90-second survey to help with the study. Responses will be confidential and aggregate data will help gain better insight into the problem and gather solutions.  Begin survey.

  • September 27, 2019 2:59 PM | Sally Winkelman (Administrator)

    Outbreaks of hepatitis A virus (HAV) have been reported across the U.S., with Minnesota being the most recent state affected. During these outbreaks, 24,952 individuals have become ill, and 60% of them needed to be hospitalized.

    As of this writing, the Department of Health Services (DHS) has not detected HAV outbreaks in Wisconsin. However, most Wisconsin adults are not immune to HAV, making the state vulnerable to an outbreak unless HAV vaccination is scaled up. Because the current outbreaks of HAV are predominantly impacting communities with identifiable risk factors, including unstable housing, recent incarceration, and injection drug use, targeted efforts to vaccinate high-risk individuals could substantially reduce the risk of HAV outbreaks in the state. A single dose of HAV vaccine has been shown to control outbreaks of hepatitis A and provides up to 95% seroprotection in healthy individuals for up to 11 years.

    Emergency departments are a critically important partner for providing HAV vaccine to patients in need because this setting provides care for many high-risk individuals who may not seek routine preventive care elsewhere.

    We are asking you and your staff to work with your patients and clients to reduce the spread of hepatitis A infection. Please share the following information widely.

    What can you do to help prevent hepatitis A infections?

    1. Check the immunization history of at-risk groups: Many individuals who are at risk of HAV have no consistent medical home. Checking their immunization history in the Wisconsin Immunization Registry (WIR) or in your organization’s Electornic Health Record (EHR) is a good way to make sure they are up-to-date on their vaccines, including HAV vaccine and influenza.
    2.  Provide HAV vaccine to patients who are unvaccinated and at-risk in the emergency department and urgent care clinics. Providers who do not have available vaccine may direct patients to local health departments or tribal health care clinics. Homeless individuals and injection and non-injection drug users are also at higher risk for other vaccine preventable diseases and should be brought up-to-date per the relevant CDC immunization schedule.
    3. Consider HAV infection in individuals, especially the homeless and those who use illicit drugs, with discrete onset of symptoms and jaundice or elevated liver function tests. Symptoms include nausea, vomiting, diarrhea, anorexia, fever, malaise, dark urine, light-colored stool, or abdominal pain.
    4. Promptly report all confirmed and suspect HAV cases. Please contact your local health department by telephone IMMEDIATELY upon identification of a confirmed or suspected case and report through the Wisconsin Electronic Disease Surveillance System (WEDSS) within 24 hours upon recognition of a case.
    5. Provide post-exposure prophylaxis (PEP) for close contacts of confirmed HAV cases. Susceptible people exposed to hepatitis A virus (HAV) should receive a dose of single-antigen HAV vaccine or intramuscular (IM) immune globulin (IG) (0.02 mL/kg), or both, as soon as possible within 2 weeks of last exposure. The efficacy of combined HAV/Hepatitis B virus (HBV) vaccine for PEP has not been evaluated, so it is not recommended for PEP.
    6. Ensure that all health care workers use standard precautions in patient care to protect themselves against HAV. HAV, like norovirus, is a non-enveloped virus, and it may be similarly difficult to inactivate in the environment. Alcohol-based hand rubs and typically-used surface disinfectants may not be effective.
    7. Work with community partners for a second vaccine dose as needed. Many local health departments and pharmacies have the second dose in the Hepatitis A series. Find out where the second dose can be given so you can recommend your patient seeks out their services after they leave your care.

    Who is at high risk for getting hepatitis A?

    • People who use drugs, whether injected or not (for example, cigarettes, joints, vaping products, pills)
    • People who have experienced unstable housing or homelessness
    • People who have sexual contact with someone who has hepatitis A (for example, engaging in oral-anal sex, also known as “rimming”)
    • Men who have sex with men
    • People who have close person-to-person contact with someone who has hepatitis A (for example, those who share bathroom facilities or a cell)
    • People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C
    • Individuals in correctional and jail settings, due to the close living conditions which allow the virus to spread easily

    What is hepatitis A and how is it spread?

    Hepatitis A is a highly contagious disease that is spread from person to person and is found in the feces (poop) of people with hepatitis A virus. Hepatitis A can be easily spread if someone does not wash their hands properly after using the bathroom.

    How is hepatitis A different from other types of hepatitis?

    Hepatitis A is different from hepatitis B and hepatitis C. While all three can damage the liver, they are caused by different viruses and are spread in different ways. Most often, hepatitis A is spread by eating or drinking food or water with the virus in it. In recent outbreaks, hepatitis A has been spread by sharing drugs or drug products, or having sexual contact with someone with hepatitis A.

    What are the signs and symptoms?

    Symptoms usually start four weeks after the individual has come in contact with the hepatitis A virus. However, they can start as early as two and as late as seven weeks after the virus enters the body. Symptoms can start quickly and can include:

    • Fever
    • Fatigue
    • Loss of appetite
    • Nausea
    • Vomiting
    • Abdominal pain
    • Dark urine (pee)
    • Diarrhea (loose stools)
    • Clay-colored stools
    • Joint pain
    • Jaundice (yellowing of the skin and eyes)

    What should you know about the hepatitis A vaccine? 

    The hepatitis A vaccine is safe and an effective tool for preventing the spread of disease. It is important to use the single-antigen hepatitis A vaccine when vaccinating staff.

    One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A. It provides up to 95% protection against hepatitis A in healthy individuals for up to 11 years.

    What resources are available to order from DHS?

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