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  • September 03, 2025 3:57 PM | Anonymous

    Sen. Rachael Cabral-Guevara (R-Appleton) and Rep. Nancy VanderMeer (R-Tomah) began circulating to their colleagues in the legislature a bill draft relating to physician assistants. Please see below a memo to the legislature from the Wisconsin Medical Society asking legislators NOT to sign on as cosponsors. Included in this email is the memo and bill draft from Cabral-Guevara and VanderMeer.

    Be assured that our coalition of the Wisconsin Medical Society and physician specialty organizations continue to work on these scope issues.

    Please contact your state legislators asking them not to sign on to this legislation. Find your Legislator Here: WSL - Find Your Legislator

    Members of the Wisconsin State Legislature: 

    On behalf of the Wisconsin Medical Society – the state’s largest physician membership organization representing more than 10,000 physicians statewide – we respectfully urge you not to cosponsor LRB 0509/1 and instead oppose. This proposal would create a path for physician assistants (PAs) to practice independently, which we believe is not in the best interest of Wisconsin patients.

    Patients receive the highest-quality care when they have access to physician-led health care teams, which include physician assistants and other professionals. Unfortunately, this bill would further fragment those teams, weakening the collaborative model that best serves patient safety and outcomes.

    Physicians undergo the most rigorous education and training of any health care provider. By contrast, PAs complete shorter educational programs (typically 2-2.5 years compared to physicians’ 4 years of medical school) and are not required to complete residency training. Physicians, on the other hand, complete 3-7 additional years of residency after medical school before practicing independently. Clinical experience requirements also differ significantly: approximately 2,000 hours for PAs versus 12,000 - 16,000 hours for physicians. These differences are appropriate because PAs are valued members of physician-led teams – not independent practitioners.

    This proposal is an outlier nationally: 45 states currently require physician supervision or collaboration for PAs. Eliminating that requirement in Wisconsin would move us away from the proven team-based model that benefits patients.

    Finally, the bill proposes changing the title “physician assistant” to “physician associate.” If the goal is independence from physician-led care, why maintain the term “physician” in the title? This risks confusing patients who reasonably assume that the word “physician” indicates someone who has completed medical school and residency.

    There are additional concerning elements within the bill that we would be happy to discuss in detail with you or your staff. Please feel free to contact us with any questions.

      

    Mark Grapentine, JD

    Chief Policy & Advocacy Officer

    Wisconsin Medical Society

    mark.grapentine@wismed.org

     

    CO-SPONSORSHIP MEMORANDUM

     

    TO: All Legislators 

    FROM: Sen. Rachael Cabral-Guevara

                   Rep. Nancy VanderMeer

    DATE: September 2nd, 2025

    RE: Co-Sponsorship of LRB-0509/1 relating to: adopting the title of physician associate for physician assistants, independent practice of certain physician associates, extending the time limit for emergency rule procedures, and providing an exemption from emergency rule procedures.

    DEADLINE: Wednesday, September 10th, 2025 at 3:00 P.M.

    The Physician Assistant/Associate (PA) profession was established over 50 years ago in response to a critical shortage of physicians, particularly affecting underserved rural and urban communities — a challenge that remains relevant today. This proposal offers a valuable opportunity to ensure that these vulnerable populations throughout Wisconsin continue to have access to high-quality, cost-effective healthcare.

    Currently, PAs in Wisconsin are licensed and regulated by the Physician Assistant Affiliated Credentialing Board. There are over 4,600 licensed PAs practicing across the state in diverse medical specialties. All PAs receive comprehensive education and training, earning a Master’s degree through rigorous didactic coursework and more than 2,000 hours of supervised clinical rotations. Wisconsin is home to four accredited PA educational programs. Upon graduation, PAs must pass the Physician Assistant National Certifying Exam (PANCE) administered by the NCCPA before obtaining licensure. To maintain certification, PAs must complete at least 100 hours of continuing medical education every two years and pass a recertification exam every ten years to demonstrate continued medical knowledge in all areas of medicine, regardless of the specialty in which they may practice.

    A PA’s scope of practice includes conducting physical examinations, diagnosing and managing illnesses, assisting in surgery, and prescribing medications. Presently, Wisconsin law requires PAs to practice pursuant to a collaborative agreement or under the overall direction and management of a physician.

    This bill aims to modernize the PA practice in Wisconsin by allowing PAs who have completed four years of clinical practice with a physician to apply for autonomous practice outside of a formal collaborative agreement — largely mirroring recent changes signed into law for advanced practice registered nurses (APRNs). Importantly, PAs will continue to be restricted to practicing within the bounds of their experience, education, and training to ensure patient safety and would continue to be legally required to consult with or refer to another healthcare provider when a patient's care needs exceed the physician assistant's experience, education, or training. Furthermore, similar to APRN regulations, PAs would be required to collaborate with a physician when using invasive techniques to treat pain syndromes, except when working in hospital or hospital-affiliated clinic settings.

    Additionally, the bill updates the professional title from “Physician Assistant” to “Physician Associate.” From the profession’s inception, PAs were never intended to be mere assistants but largely autonomous healthcare providers. The current title has often caused confusion about their role. Adopting the “Physician Associate” title aligns Wisconsin with the national standard used by the AAPA and reflects the terminology embraced by a growing number of countries worldwide, providing clarity and consistency about the important role PAs play in modern healthcare.

    We encourage you to join us in co-sponsoring this legislation to support Wisconsin’s healthcare workforce and improve access to care for all communities.

    If you would like to cosponsor this legislation, please contact Sen. Cabral-Guevara’s office at 6-0718 or Rep. VanderMeer’s office at 7-9170, or by email.

    Analysis by the Legislative Reference Bureau 

    This bill adopts the term “physician associate” for “physician assistant” in the statutes, changes the title of the credentialing board that licenses physician associates to “Physician Associate Affiliated Credentialing Board,” allows physician associates to assume the title “physician associate” in addition to other titles allowed under current law, and allows a physician associate to practice independently from physicians if the physician associate satisfies certain criteria.

    Under current law, a physician assistant who provides care to patients may provide the services of a physician assistant only if there is a physician who is primarily responsible for the overall direction and management of the physician assistant’s professional activities and for assuring that the services provided by the physician assistant are medically appropriate or if the physician assistant has entered into a written collaborative agreement with a physician that describes the physician assistant’s individual scope of practice and includes a protocol for identifying an alternative collaborating physician for situations in which the collaborating physician or the physician’s designee is not available for consultation.

    To qualify to practice independently under the bill, a physician associate must satisfy certain criteria, including that the physician associate has completed 7,680 hours of clinical practice as a physician associate while practicing with a physician who is primarily responsible for the overall direction and management of the physician associate’s professional activities and for assuring that the services provided by the physician associate are medically appropriate or while practicing under a written collaborative agreement that satisfies the requirements under current law. In order to qualify to practice independently, the physician associate must maintain certain evidence that, during the 7,680 hours of clinical practice, the physician associate maintained a mutual, professional relationship with at least one physician; maintained documentation indicating the relationships the physician associate had with one or more physicians to deal with issues outside of the physician associate’s knowledge, training, or experience; and maintained evidence that he or she was subject to a quality assurance program, peer review process, or other similar program or process that was implemented for and designed to ensure the provision of competent and quality patient care and that also included participation by a physician. The 7,680 hours of clinical practice may include the lawful practice of the physician associate outside this state or the lawful practice of the physician associate in this state prior to the effective date of this bill, the lawful practice of the physician associate as an employee of the federal government as a civilian or as a member of a uniformed service while performing duties incident to that employment or service, including hours of independent practice outside of a supervisory or collaborative relationship with a physician, and any clinical hours completed pursuant to an educational program that qualifies an individual for licensure as a physician assistant under current law.

    The bill provides that, regardless of whether a physician associate has qualified to practice independently, a physician associate may provide treatment of pain syndromes through the use of invasive techniques only while practicing with a physician who, through training, education, and experience, specializes in pain management and who either is primarily responsible for the overall direction and management of the physician associate’s professional activities and for assuring that the services provided by the physician associate are medically appropriate or is under a written collaborative agreement with the physician associate. However, the bill provides that a physician associate may provide treatment of pain syndromes through the use of invasive techniques if the physician associate has qualified to practice independently under the bill and provides treatment of pain syndromes through the use of invasive techniques in a hospital or a clinic associated with a hospital. Further, the bill provides that a physician associate may provide treatment of pain syndromes through the use of invasive techniques if the physician associate has qualified to practice independently under the bill and has privileges in a hospital to provide treatment of pain syndromes through the use of invasive techniques without a collaborative relationship with a physician.

    Finally, the bill adds physician associates who have qualified to practice independently as mandatory participants in the Injured Patients and Families Compensation Fund. The Injured Patients and Families Compensation Fund provides excess medical malpractice coverage for health care providers who participate in the fund and meet all other participation requirements, which includes maintaining malpractice liability insurance in coverage amounts specified under current law. Under current law, no physician assistant may practice as a physician assistant unless they maintain such medical liability insurance.

    For further information see the state fiscal estimate, which will be printed as an appendix to this bill.


  • June 24, 2025 4:35 PM | Anonymous

    WACEP’s Rural Outreach Procedure Day, held at the Mid-State Simulation Center in Wisconsin Rapids, brought attendees together for a focused day of hands-on training tailored to rural practice needs.

    Participants sharpened essential skills through five high-impact stations:

    • Ultrasound-Guided Nerve Blocks – For advanced pain control in low-resource settings.

    • OB Procedures – Boosting confidence in obstetric emergencies.

    • Chest Tube Insertion – Managing pneumothorax and pleural effusion.

    • Cricothyrotomy – Emergency airway access when intubation fails.

    • Fiberoptic Intubation – Handling difficult airways with advanced tools.

    Attendees enjoyed event’s practical value and expert instruction. WACEP is proud to support rural physicians and looks forward to hosting more training opportunities in the future.




  • June 04, 2025 11:44 AM | Anonymous

    WACEP members Dr. Lisa Maurer and Dr. Brad Burmeister met with Representative Barbara Dittrich during Wisconsin Doctor Day to discuss critical legislation impacting Emergency Department staffing requirements. Physician advocacy in action — thank you for representing the voice of emergency medicine at the Capitol!


  • June 04, 2025 10:57 AM | Anonymous

    Wisconsin Health News
    June 4, 2025

    Aspirus Wausau Hospital has finished its emergency department expansion, which will support its work as a regional referral and tertiary care center.

    Eight new patient rooms came online Tuesday, boosting the department’s capacity to 30 treatment spaces. When work on the expansion began in 2022, the department had 18 beds.

    The additions include enhanced trauma and critical care rooms.

    Aspirus is seeing a growing demand for emergency and trauma care.

    “This final phase is about more than just physical space,” said Mason Lucca, director of the hospital’s emergency department. “It represents our ongoing commitment to providing timely, high-quality emergency care to people throughout our service area.”


  • May 20, 2025 10:00 AM | Anonymous

    Wisconsin Health News May 15, 2025

    Nursing independence bill receives support, but concerns raised over ER care

    A compromise bill that would allow some nurses to practice independently of physicians received support at a public hearing Wednesday. But a doctors’ group raised concerns about emergency rooms operating without emergency physicians. 

    Advanced practice nurses have pushed for more than a decade for independence. They’ve faced opposition from doctors and Gov. Tony Evers, who vetoed their last two proposals. 

    The latest plan would allow advanced practice nurses to work independently of doctors after four years, with restrictions around practicing pain management and title protections for physicians. 

    “We're confident the bipartisan bill before you — a compromise reached between our offices, so many stakeholders and the governor's office — will make it across the finish line,” bill author Rep. Tony Kurtz, R-Wonewoc, told the Assembly Committee on Health, Aging and Long-Term Care. 

    “This legislation is long overdue,” said Terri Vandenhouten, a nurse practitioner in New Franken in northeast Wisconsin. “I look forward to my colleagues providing the best care possible to those in need of care.” 

    Dr. Aurora Lybeck, an executive board member for the Wisconsin Chapter of the American College of Emergency Physicians, testified for information only. She said the bill has a “major deficiency” by not having physician staffing requirements for emergency rooms. 

    Lybeck said emergency physicians are trained to handle complex medical cases and provide life-saving treatment based on minimal medical information. They’re seeing trends like for-profit microhospitals with minimal staffing as well as emergency departments without emergency physicians, particularly in rural areas. 

    “I'd argue that an emergency department without an emergency physician is really just an urgent care,” she said. 

    Lybeck acknowledged the Legislature may be concluding the discussion on advanced practice nursing independence, but said that conversation — and potentially legislation — on emergency department staffing may follow. 


  • June 05, 2024 11:18 AM | Anonymous

    Regional centers will serve those with mental health and substance use needs

    Wisconsin has taken another step forward to help people with mental health and substance use emergencies with the opening of five crisis stabilization centers for adults. Crisis stabilization facilities support people who can't stay in their community safely, but don't need to be hospitalized. Funded by the Department of Health Services (DHS), the centers provide a dedicated location for this level of care for most counties.

    "Whether it's been declaring 2023 the Year of Mental Health, securing new investments for school-based mental health and other initiatives, or supporting the launch of the state's 988 Suicide & Crisis Lifeline contact center, we've been working to find solutions to the burgeoning mental health crisis facing our state since 2019," said Gov. Tony Evers. "This includes bolstering our state's crisis care infrastructure so that folks can access the care and support they need when and where they need it—especially in an emergency. While the opening of these new facilities is a tremendous step forward, we know there's far more to do, and we're committed to building on these efforts to ensure every Wisconsinite has access to mental and behavioral health care regardless of their ZIP code."

    "The need for services for people experiencing mental health and substance use emergencies has been rising steadily over the past several years," said DHS Secretary-designee Kirsten Johnson. "Our investment in these five crisis stabilization facilities for adults is a commitment to ensuring the right care is available at the right time in the right place for all state residents who need help."

    DHS set aside $10 million in 2021 to support the development of five crisis stabilization facilities for adults, with each location serving multiple counties. The funding is part of Wisconsin's share of American Rescue Plan Act (ARPA) funds reserved for mental health and substance use services. Today's announcement represents the work of four providers who each received a share of the funding in 2022 to establish these home-like centers. The services areas are based on partnerships the providers have set up with county agencies providing mental health and substance use services.

    Read More

  • February 28, 2024 3:32 PM | Anonymous

    Wisconsin Senate Bill 145 – the “APRN bill” - has again passed both houses of the legislature. Far beyond licensure, this bill expands scope of practice and eliminates current law physician collaboration requirements for nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists.

    Last legislative session, Governor Tony Evers vetoed this legislation. Despite his previous veto, the bill was not improved significantly and still lacks provisions and guardrails that WACEP and other physician groups consider vital. So again, our last hope to protect patient safety in Wisconsin is another veto by Governor Evers.

    Far beyond creating an APRN license, this bill takes physicians out of patient care and jeopardizes patient safety. From independent practice without any physician involvement to prescribing privileges that are regulated solely by the state’s Board of Nursing, this bill disrupts the cooperative and collaborative team-based model of health care that makes Wisconsin a leader in patient care. WACEP believes that emergency care is best led by an emergency physician and that the best solutions to increase access to care in rural areas does not include complete advanced practice nurse independence. Passage of this bill will translate into nurse practitioners working independently in your local urgent care or an emergency department with no physician involvement or backup.

    Urge Governor Evers to veto this ill-advised legislation.

    Your advocacy is needed now!

    Contact the Governor Now


  • September 20, 2023 3:25 PM | Anonymous

    Dear Member,

    I am writing to request your preferred contact information for a study led by Dr. Angie Ingraham at the University of Wisconsin-Madison. Dr. Ingraham is conducting the Support Interhospital Transfer Decisions (SITe) study. Through this study, Dr. Ingraham seeks to understand providers’ experiences communicating during calls about interhospital transfers for older adults with emergency general surgery (EGS) diagnoses.

    Emergency medicine physicians play a critical role in the transfer of EGS patients. Dr. Ingraham seeks to gather contact information for emergency medicine physicians now, so that you can be reached quickly if you participate in a transfer call that meets study criteria. If you call the UW Health-Meriter Access Center regarding an older EGS patient, you may be contacted about this study. Your contact information will be kept confidential and only used to invite you to complete a 3-minute survey each time you make an eligible call. Participation in the study will not affect transfer requests.

    Please take one minute to share your contact information here: https://go.wisc.edu/egs

    This study has been funded by the National Institute on Aging and approved by the University of Wisconsin Institutional Review Board.

    Thank you for taking the time to support this important effort.

    Please email egstransferstudy@surgery.wisc.edu with any questions. 

    Best regards,
    Dr. Kerry Ahrens

  • September 20, 2023 3:21 PM | Anonymous

    Dear Wisconsin ACEP Member,

    You are invited to take part in this research project entitled “Effects of Legislation on Workplace Violence in Emergency Departments Across Wisconsin.”

    You will be asked to complete a survey to evaluate your experiences surrounding workplace violence. The survey will take about 10-15 minutes to complete.

    More information is provided at the link to the survey below.

    Link: bit.ly/45xFQT0

    You may forward the survey to any colleagues (MD/DO, NP, PA, or RN) who practice in an emergency department in Wisconsin who did not receive the survey.

    Sincerely,

    Corey Sell, MD and Matthew Chinn, MD

    Principal Investigators

    Department of Emergency Medicine

    Medical College of Wisconsin

    Department Phone: 414-955-6450

    E-mail: csell@mcw.edu; mchinn@mcw.edu


  • August 10, 2023 10:37 AM | Anonymous

    The WACEP Spring Symposium Planning Committee is opening a call for presentations for the 2024 Spring Symposium! We are looking for topics you are interested in presenting and you think others will enjoy learning more about! This could include clinical topics, hot topics, interesting cases and more.


    Submit your Presentation Here


    Time slots will range from 15-min to 1-hour sessions. The Spring Symposium will take place March 6-7, 2024 at the Brookfield Conference Center in Brookfield, WI. You must be available to present in-person.


    Presenters will be selected based on topic of interest and brief description of the presentation. Please submit your presentation proposal no later than September 30, 2023 for consideration. If you have questions contact the WACEP office at WACEP@badgerbay.co.


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