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  • June 20, 2018 1:27 PM | Sally Winkelman (Administrator)

    Join the Wisconsin Society of Addiction Medicine on Saturday, September 29, 2018 in Madison for a high-impact workshop day designed to provide education on high quality, evidence-based practices.

    The case-based learning format is designed for front line clinicians and trainees who have faced and will face the challenge of helping patients with substance use disorders. Clinicians who will benefit include nurse practitioners, physician assistants, primary care providers, emergency room providers, and other sub-specialists. Two morning and one afternoon options are available, including:

    • The ASAM Treatment of Opioid Disorder Course: Focus on Buprenorphine
    • Naltrexone in Treatment for Alcohol and Opioid Use Disorders: Case Studies and Practical Applications
    • Buprenorphine 2.0: I Have My X-DEA, So Now What? Case Studies and Practical Applications

    Learn more and register.

  • June 19, 2018 11:25 AM | Sally Winkelman (Administrator)

    FitWell is a wellness initiative of the Wisconsin Chapter, ACEP, that encourages members to exercise and share their successes. The contest is open to Wisconsin EM physicians, EM residents, medical student members of an EMIG, and APPs. One contest participant will be randomly selected to win a WACEP braded fleece, and $200 to be applied toward a gym/club membership of their choice. Contest Guidelines include:

    • On Twitter or Instagram using hashtag #fitwellWACEP, post pics of yourself being active, during a workout, or tips on how to squeeze physical activity into your busy day. Make sure your posts are public!
    • Tag your EM friends on your posts and your entries will count double!
    • One entry per post with unlimited entries.
    • All entries must be posted by August 31, 2018. Winner will be chosen by random drawing on September 1st.

    Questions? Contact us at WACEP@badgerbay.co.

  • June 19, 2018 10:27 AM | Sally Winkelman (Administrator)

    Suzanne Martens, MD
    State of Wisconsin EMS Medical Director

    The Advancing a Healthier Wisconsin Endowment has awarded funding to the Wisconsin EMS Association, which will help expand a Milwaukee County pilot project for dispatcher-assisted CPR instructions statewide. 

    The Milwaukee County Dispatcher Assisted Bystander CPR program was created to increase the overall cardiac arrest survival rate within the Milwaukee County. Through the program, dispatcher assisted bystander CPR pre-arrival instructions are made available to all callers in the County. 

    Out-of-hospital cardiac arrest is a significant health problem. In Milwaukee County, only 10% of out-of-hospital cardiac arrest patients survive to hospital discharge. When CPR is started by bystanders, the odds of survival double, however, bystander CPR is attempted on only 19% of cardiac arrest victims in the County. This rate could be improved if every 911 caller received CPR coaching. With the implementation of dispatcher assisted CPR instructions in Seattle, Washington, the rate of bystander CPR doubled and survival rates for the entire County increased. 

    2017 Wisconsin ACT 296Dispatcher Assisted CPR, mandates that by May 21, 2021, every Public Safety Answering Point (PSAP) will provide dispatcher assisted CPR in one of two methods, either by dispatcher training or call transfer to a trained PSAP. This program will also include monitoring and continuous quality improvement. Act 296: 

    • affords protection from civil liability in performance of dispatcher assisted CPR;  
    • provides $250,000 for fiscal year 2017-18 in funding for emergency dispatcher CPR; 
    • specifies that DHS must include a proposal for funding an emergency dispatcher CPR training in its 2019-21 biennial budget request; 
    • creates a 0.5 full-time equivalent position in DHS to administer the emergency dispatcher CPR training grant program. 

    The bill was strongly supported by members of the WI EMS Advisory Board, as well as representatives from the American Heart Association, and its enactment was recognized on the HeartRescue Project website

    The Milwaukee County EMS dispatch pre-arrival instructions for CPR are freely available. PSAPs that pursue training will require assistance and medical oversight. EM and EMS physicians will be asked to support these programs and their community. Start asking questions and becoming involved now. Three years is not a lot of time to enact this vital public safety program, and sooner is better.

  • June 18, 2018 2:32 PM | Sally Winkelman (Administrator)

    Lisa Maurer, MD, FACEP

    At the risk of addressing a sensitive topic perhaps not ideally discussed via email newsletter, WACEP needs feedback from our members on how, or if, we should be involved in possible future Wisconsin firearm regulations.  

    Inspired by Dr. Stephen Hargarten’s presentation at WACEP Spring Symposium 2017, I believe there is room for growth in how physicians discuss firearm safety from a health perspective while steering clear of political biases.  Who better to give input than my colleagues working in Wisconsin’s EDs every day? 

    This will be a timely legislative topic for Wisconsin in the near future, judging by the fact that the Wisconsin Legislative Council released an Information Memorandum on Firearm Regulation this last session.  If we should be involved in possible future regulations, it is useful to learn about the regulation currently in place in Wisconsin.  The memorandum summarizes that Wisconsin’s constitution gives people have the right to keep and bear arms for security, defense, hunting, recreation, or any other lawful purpose.  Current regulations (including pertinent federal laws):

    • Prohibit possession of a firearm by individuals who are: convicted of a felony or domestic violence crime, involuntarily committed under chapter 51 statute, adjudicated incompetent, addicted to any controlled substance, or under the age of 18;
    • Permit background checks in specific scenarios such as purchasing a firearm from a federal firearm licensed dealer or to apply for a license to carry a concealed weapon;
    • Impose penalties for transferring firearms to an ineligible person or providing false information;
    • Provide geographic restrictions on carrying a firearm.  For example, a person may not carry a firearm onto a public or private property if the owner has notified the person not to enter while carrying a firearm, into a school zone, or in a vehicle for the case of loaded long guns; and
    • Regulate certain devices such as fully automatic firearms, armor-piercing ammunition, and special processes for obtaining silencers. 

    Our country has seen growing momentum for a particular type of firearm regulation known as “red flag laws,” where courts and police may temporarily seize an individual's firearms if they are thought to be a threat to self or others.  This type of regulation now exists in six states and is being considered in 20 more, including Wisconsin.  The specifics of the “red flag” laws vary from state to state.  Generally, police may only seize firearms owned by the individual in question, even if there may be other firearms in the home owned by others.  The individual typically has an annual opportunity to petition the court for return of their firearm, although that time interval may be shorter in some states.  Also, the definition of “thought to be a threat” can be described as “substantially likely to harm” or the more difficult to prove, “imminent danger.”  Likewise, the type of individuals permitted to make this judgement of threat varies among states.  Some states specify that immediate family members may be the ones to notify police, whereas other states include household members or other close contacts.

    To my knowledge, no state includes physicians in the list of specific contacts that may alert law enforcement for the purpose of firearm possession regarding an individual thought to pose a threat to themselves or others.  Should Wisconsin include physicians as they consider “red flag” laws?  This is ironically reminiscent of our statutes regarding involuntary holds for psychiatric disease that may render an individual an imminent threat to themselves or others.  Seeing as our state’s process of placing and removing Emergency Detention holds is so unique, should we be the pioneers of implementing a similar system for physicians alerting officers when it may be indicated to remove someone’s firearm?  On the other hand, many emergency physicians in Wisconsin suggest that the Emergency Detention process in our state should be completely revised.  Perhaps we should avoid reinforcing that system by mirroring it in another statute. 

    In summary, WACEP is looking for your opinion: if Wisconsin decides to proceed with a “red flag” firearm regulation, should physicians be among the individuals who are allowed to make the determination of threat to self or others?  Please do send us your thoughts!

  • June 07, 2018 5:17 PM | Sally Winkelman (Administrator)

    Rosalia Holzman, MD
    Univ. of WI Emergency Medicine Residency, Class of 2020

    As I have progressed through my training, I have realized more and more that I cannot expect things to change just because I believe something is wrong or unfair. It takes initiative from those who identify different issues to work towards a solution. It finally occurred to me that this includes myself. I need to speak up for what needs to change. My residency program passed along information about the ACEP Leadership & Advocacy Conference (LAC) and I knew immediately I wanted to go.

    It was an amazing experience (especially for my first national conference as an emergency intern) and I cannot wait to go back again. I met so many motivated and passionate emergency physicians that are going to change our practice and our country for the better. I sat through different sessions on the opioid epidemic, medicare reimbursement, drug shortages, and more. There was an amazing panel discussing women in leadership in emergency medicine and how women like myself need to step up to the table and make ourselves heard. We also had the opportunity to listen to the Surgeon General as our keynote speaker! 

    On top of conference sessions and discussions, we spent an entire day on Capitol Hill advocating for 3 particular issues: the opioid crisis, drug shortages, and disaster preparedness. It was an eventful day working alongside fellow Wisconsin EM physicians. This conference really opened my eyes as to everything that is being done and all of the opportunities there are for me to really advocate for my patients and my profession. I would like to thank WACEP for helping me attend the conference, and I cannot wait to get more involved!

  • May 15, 2018 10:05 AM | Sally Winkelman (Administrator)

    Lisa Maurer, MD, FACEP

    One of WACEP’s three priority issues this year is to improve Wisconsin's Medicaid reimbursement for emergency care.  For many of you who are seasoned members of this organization, you know that this is not a new goal.  Before your eyes glaze over and you scroll on, know that this is now a truly re-energized movement for the last few years, and we are closer than ever.  We are currently having active meetings with the decision makers within DHS, who now recognize that as our emergency physicians are being reimbursed worse than any other state in the nation, our healthcare safety net is not sustainable.  Record-low reimbursement for federally-mandated care is making it hard for our physician groups and hospitals to compete with Illinois and Minnesota for quality emergency physicians. 

    Perhaps we are getting such a captive audience within DHS because we come with solutions on how to trim unnecessary costs from the Medicaid budget, which funds could then be used for proper reimbursement.  It makes sense, right? We are emergency physicians, we are the solutions people. Our board has been working for years on gathering data on several ideas of how the state might not only maintain or improve quality of care delivered in the emergency department, but how they can save money doing it.

    What would you do?

    Looking at Medicaid waiver demonstrations in many states, the current trend to save money i state budgets is to implement work requirements as a condition of eligibility for Medicaid, increase cost-sharing for Medicaid enrollees, and - right in our backyard - add ED copays.  In fact, Wisconsin DHS has applied for a waiver demonstration in our state that would implement work requirements, impose drug screening, and also add copays for ED care.  To clarify, whereas traditionally allowed ED copays for Medicaid enrollees are applied to visits determined to be “non-emergent,” the proposed ED copays in Wisconsin would be for any ED visit.  This does sound appealing at first glance, but history has proven that states that implement ED copays do not actually reduce non-emergent visits to the emergency department nor save money on their Medicaid budgets.

    So again, if our state is currently using the above-mentioned methods for saving money and attempts at decreasing non-emergency visits to the emergency department, but perhaps will not be very successful, what should we tell them to do instead? Is there a certain health system flaw in Wisconsin that leads patients to your ED unnecessarily?  Have you found a practice pattern that helps Medicaid beneficiaries to get plugged into the appropriate outpatient resources in your community?  Do you think that if EM physicians participate more actively in determining which visits were non-emergent, then the ED co-pays would be more effective?  I sincerely believe that emergency physicians are unavoidably systems-minded physicians and have many solutions to offer that might be more insightful than what the agency professionals can see from the outside. Let's help them, let's be part of the solution. Let's get this system change done this year to bolster our state’s emergency medicine network.  Send me your ideas!

  • May 15, 2018 7:59 AM | Sally Winkelman (Administrator)

    Wisconsin ACEP is proud to announce the conclusion of our EATWELL contest, the first of many wellness topics we will tackle in the upcoming months. Thank you to all who posted pictures of your health conscious meals and amazing eating tips to inspire your colleagues to take care of themselves. We will announce the winner via Facebook, Twitter and Instagram soon, so stayed tuned!

  • May 03, 2018 11:04 AM | Sally Winkelman (Administrator)

    The ACEP Council meeting is YOUR opportunity to influence the ACEP agenda. If you have a hot topic that you believe ACEP should address, let your Wisconsin ACEP Councillors know! Resolutions must be written ans submitted by July 1. Your WACEP Councillors for 2018 include:

    • Howie Croft, MD
    • William Falco, MD
    • William Haselow, MD
    • Jeff Pothof, MD
    • Bobby Redwood, MD, MPH
    • Mike Repplinger, MD, PhD
    • Alternate Councillors: Lisa Maurer, MD and Jamie Schneider, MD

    It takes just two members to submit a resolution. Contact any of the Chapter Councillors us through the WACEP office. Learn more about the process of submitting resolutions here.

  • May 03, 2018 11:00 AM | Sally Winkelman (Administrator)

    Eight hours of training on medication-assisted treatment (MAT) is required to obtain a waiver from the Drug Enforcement Agency to prescribe buprenorphine, one of three medications approved by the FDA for the treatment of opioid use disorder. Providers Clinical Support System (PCSS)offers free waiver training for physicians to prescribe medication for the treatment of opioid use disorder. 

    PCSS uses three formats in training on MAT:

    • Live eight-hour training  
    • “Half and Half” format, which involves 3.75 hours of online training and 4.25 hours of face-to-face training.
    • Live training (provided in a webinar format) and an online portion that must be completed after participating in the full live training webinar (Provided twice a month by PCSS partner organization American Osteopathic Academy of Addiction Medicine) 
    Trainings are open to all practicing physicians. Residents may take the course and apply for their waiver when they receive their DEA license. For upcoming trainings consult the MAT Waiver Training Calendar. For more More information on PCSS, click here
  • May 03, 2018 10:57 AM | Sally Winkelman (Administrator)

    Don’t Miss the Premiere Event for Emergency Medicine Advocates and Leaders!

    Attendees at ACEP's annual Leadership & Advocacy Conference will advocate for improvements in the practice environment for our specialty and access for our patients. First-timers will receive special training on how to meet and educate your Members of Congress while seasoned participants will build upon valuable Congressional connections. A new “Solutions Summit” has been added on May 23 where attendees will discover innovative solutions on key topics such as opioids and end-of-life issues that demonstrate emergency medicine's value and leadership. CME credit will be given for the Summit.

    Confirmed Speakers Include:

    • U.S. Surgeon General Vice Admiral (VADM) Jerome M. Adams, M.D., M.P.H. 
    • HHS Assistant Secretary for Preparedness and Response Bill Kadlec, MD will be presenting during the Public Policy Town Hall on Emergency Preparedness.
    • Amy Walter, National Editor for The Cook Political Report, will offer her predictions for the mid-term elections. 
    • Senator Bill Cassidy, MD (R-LA) 
    • Representative Kyrsten Sinema (D-AZ) 
    REGISTER TODAY!
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