The University of Wisconsin School of Medicine and Public Health (SMPH) is one of four sites awarded a total of $7.5 million from the National Institutes of Health (NIH) to conduct research that could lead to improved care in emergency departments for people with dementia.

The effort aims to leverage expertise in emergency medicine, geriatrics and Alzheimer’s disease and related dementias to identify gaps in emergency care for people with dementia and address those gaps, according to Manish Shah, MD, MPH, professor of emergency medicine and co-principal investigator.

For example, many commonly used medications are problematic for people with dementia.  Better understanding which medications are safest for this vulnerable population would help clinicians better care for them, he said.

“The emergency department is not an ideal care setting for people with dementia,” Shah said. “What we want to do is find better ways to care for one of our most vulnerable populations, namely older adults with cognitive impairment.”

The funds will support Geriatric Emergency Care Applied Research Network 2.0 – Advancing Dementia Care (GEAR 2.0 ADC), which is a collaboration between SMPH, Yale School of Medicine, Feinberg School of Medicine at Northwestern University and Washington University School of Medicine in St. Louis. All four institutions are home to an NIH-National Institute on Aging-designated Alzheimer’s Disease Research Center.

WACEP President's Message
October 2020
Ryan Thompson, MD, FACEP

Another election cycle is upon us, in case that wasn’t already abundantly apparent by the barrage of political ads that have taken over our televisions and airwaves! Ahh, the joys of living in a swing state.

Despite the commercial fatigue, the outcome of this election will no doubt shape the future of our specialty for years to come. Both state and federal elections have significant impacts on health and fiscal policy, as well as the potential to upend legislative priorities. Of course, WACEP does not endorse any specific candidate or party, and we are committed to working with whoever is willing to help us to better the care of WI patients and make the state a more appealing place for emergency physicians to practice. That being said, we do necessarily shift our strategies and priorities to what we can most effectively get done with any given group of legislators in power.

This promises to be a unique election, with the COVID pandemic raging all around our state. Many people have likely already voted absentee, but if you haven’t, there are still a lot of options open to you. If you are already registered, you can request an absentee ballot online at myvote.wi.gov by October 29th, although be aware they have to be returned by November 3rd at 8pm in order to be counted. If you aren’t interested in voting by mail, early voting starts on October 20th and runs until November 1st in most areas. Early voter registration can occur in-person until October 30th. And of course, you can always both register and vote on election day at your local polling place, although be aware that long lines may be expected at some polling places.

Depending on where you live in the state, there may still be a need for poll workers to assist on election day. Who better than emergency physicians to don PPE, stay on their feet all day, and manage large volumes of people? If you are interested in signing up to be a poll worker, you can learn more here.

Vote your conscious, vote for the candidate who will help your patients, vote your party, vote on a single issue, vote on many issues, vote of the candidate with the best hair, it doesn’t matter. Just VOTE!

Looking for a new EM Career Opportunity?  Be sure to visit WACEP's online Career Center where you can sign up for new job alerts, upload your CV, filter your search criteria by desired function, browse existing jobs and apply with fewer clicks. Create your job search strategy today.  

Wisconsin ACEP has joined the Vote Safe Wisconsin 2020 coalition. We are committed to sharing information and resources with our community partners on how to safely vote. We encourage everyone to vote absentee, vote early, or vote at the polls with a mask and socially distancing. Learn more. 

The Wisconsin Chapter of the American College of Emergency Physicians (WACEP) released a statement in support of the Governor's temporary restriction on indoor gatherings announced on Tuesday. 

Gov. Tony Evers directed Department of Health Services (DHS) Secretary-designee Andrea Palm to issue Emergency Order #3 limiting public gatherings to no more than 25 percent of a room or building’s total occupancy. See full the order and list of exemptions here.

This directive is effective at 8 a.m. on Oct. 8, 2020, and will remain in effect until Nov. 6, 2020. It applies to any gatherings at locations that are open to the public such as stores, restaurants, and other businesses that allow public entry, as well as spaces with ticketed events. A frequently asked questions document is available for review here.

“We’re in a crisis right now and need to immediately change our behavior to save lives,” said Gov. Evers. “We are continuing to experience a surge in cases and many of our hospitals are overwhelmed, and I believe limiting indoor public gatherings will help slow the spread of this virus. Folks, we need your help and we need all Wisconsinites to work together during this difficult time. The sooner we get control of this virus, the sooner our economy, communities, and state can bounce back.”

WACEP is pleased to share these updates from our partners at the WI Medical Society

As Governor extends statewide mask order, the Society urges proactive public behaviors

As Governor Tony Evers declared a new public health emergency and issued a new face covering mandate on September 22 due to increases in the state’s COVID-19 case rate, the Wisconsin Medical Society (Society) took the opportunity to remind the public how they can take proactive measures to help reduce the spread of the virus, regardless of any government action related to the pandemic.

In a media statement sent statewide the afternoon of the Governor’s announcement, Society CEO Bud Chumbley, MD, MBA, emphasized how mask wearing, physical distancing and regular hand washing are proven effective strategies to reduce the spread of COVID-19. “If we all agree to take simple steps, we can reduce the spread of the pandemic and protect our state’s physical and economic health,” Dr. Chumbley said in the statement. “We strongly urge everyone to wear masks, maintain social distancing and continue to wash hands often and thoroughly,” Dr. Chumbley said. The statement also emphasized that with seasonal influenza season looming, getting a flu vaccination is another action individuals can take that helps protect themselves and the public.

The statement is the latest in a series of actions the Society has taken to help remind the public of their important role in helping stem community spread, including three public service announcements that have been aired on statewide television and on the Society’s various social media channels.

Contact Mark Grapentine, JD for more information.

Medical Examining Board concerned over possible proposal to change nursing collaboration requirement

Many physician members of the state’s Medical Examining Board (MEB) raised concerns at its monthly meeting on September 16 over a potential Board of Nursing (BON) proposal that would repeal a requirement that Advanced Practice Nurse Prescribers (APNP) work in collaboration with at least one physician or dentist. While the MEB does not have jurisdiction over how nurses are regulated, numerous MEB members were concerned that such a proposal would have negative impacts on Wisconsin’s high-quality health care system.

The MEB’s concerns rose from a BON meeting on Sept. 10, which included initialization of the process used to change the administrative code: preparing a proposed “Scope Statement” laying out the desired change. The specific scope statement proposal, which requires approval from the Governor before it can be developed further, was included in yesterday’s MEB agenda for discussion.

State MEB administrative staff indicated that the BON may be withdrawing or further modify the scope statement and said a BON subcommittee will be discussing the issue Sept. 18. The Society will attend that subcommittee meeting and has already been in contact with other physician-centric advocacy organizations to ensure all are aware of the possible attempt to alter the collaboration requirement.

In other action, the MEB unanimously approved its own scope statement for a regulatory update that would extend the current requirement for physicians holding a U.S. Drug Enforcement Administration number to complete controlled substance education as part of the 30 hour biennial license requirement.

That statement will now be sent to the Governor for review; the Board will further develop the rule following the Governor’s likely approval.

Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

Society's COVID-19 Task Force asks physicians to review DHS alert on antigen testing

The Wisconsin Medical Society’s (Society) COVID-19 Task Force recommends that Wisconsin physicians review a COVID-19 Health Alert on antigen testing issued today, September 24, by the state’s Department of Health Services’ (DHS) Bureau of Communicable Diseases.

Calling this testing an “important and evolving topic,” DHS Chief Medical Officer and State Epidemiologist for Communicable Diseases Ryan Westergaard, MD, PhD, MPH, provides important information regarding various aspects of this type of testing, including considerations for using antigen tests in symptomatic vs. asymptomatic patients, the characteristics of the antigen tests for SARS-CoV-2 currently available and a list of antigen tests currently authorized for use in the U.S.

The Society’s COVID-19 Task Force continues to meet biweekly as Wisconsin battles the pandemic, and regularly updates relevant information on the Society’s COVID-19 Resources webpage.

Contact Society CEO Bud Chumbley, MD, MBA with any questions for the COVID-19 Task Force.

Virtual trivia – October 8

Join your fellow Wisconsin Medical Society members for a virtual WisMed Meet Up! Trivia nights provide an opportunity to connect with your peers across the state from the comfort of your home.

The Society will create trivia teams, or you are welcome to invite colleagues to create a team of your own by emailing Jess. (Maximum of 4 people per team).

Date: Thursday, October 8, 2020
Time: 6:00-7:00 p.m.
Register here!

Gift cards will be awarded to the winning team! Please contact our Membership Specialist at jessica.schreiter@wismed.org with any questions.

Thanks to Exact Sciences for sponsoring this member exclusive event!

Lisa Maurer, MD, FACEP
WACEP Legislative Chair

Wisconsin ACEP continues to advocate for the practicing emergency physician and your patients with the state’s legislators and regulators.  In the last year, we supported EM physicians as COVID-19 hit, and we’ve also continued important work in our ongoing priorities of Medicaid reimbursement and psychiatric care. 

Even though March seems lightyears away, I’ll never forget that overwhelming feeling of the unknown as we started to see patients with COVID.  There was little to no research to support best practices, and even our patients without COVID feared hospitalization for concern of having an exposure.  In times of such uncertainty, WACEP fought to bring medical liability protection to the physicians on the front line.  Wisconsin now provides civil liability immunity for care provided during the Public Health Emergency pending “actions or omissions do not involve reckless or wanton conduct or intentional misconduct.” 

We also heard from our members that independent EM physician practice groups should be eligible for state distributions of CARES Act financial support, just as hospitals were, for lost revenue and increased expenses due to COVID.  In September, DHS announced that emergency physician practice groups could apply for those funds, and they will be distributed before the month is over. 

WACEP will continue its focus on improving Medicaid reimbursement rates, especially as we expect post-pandemic Medicaid enrollment to rise and our state budget to be squeezed.  We absolutely must improve our worst-in-the-nation Medicaid fee schedule for emergency services.  Our state values the expertise of emergency physicians standing by to save lives, and this is not accurately reflected currently as Medicaid reimbursement does not even pay for half of the cost of providing emergency care to its enrollees.  We are honored to have Wisconsin Medical Society also name this as a priority issue as we craft the next state budget.  Of note, our state passed a bill last November that would ensure all services covered under Medicaid would be equally valued if provided via telehealth, including consultations and home monitoring.

WACEP also recognizes that we continue to have room to improve our care for patients with psychiatric emergencies, and oftentimes that necessitates progress in legislation.  We continue to actively participate in the Wisconsin Emergency Psychiatric Task Force, partnering with our colleague psychiatrists as well as other stakeholders such as law enforcement, the Attorney General, WI Counties Association, and others.  We have agreed and published a SMART protocol for risk-based medical evaluation of patients with emergent psychiatric conditions, and look forward to upcoming projects and bipartisan legislation regarding increased transparency in bed availability, regional approaches to stabilization, and pilot projects for novel admissions procedures.  We supported legislation that was already passed in March 2020 whereby law enforcement agencies may contract a DHS-approved third-party vendor to transport an individual for emergency detention.

Thank you to all WACEP members for your support and engagement in grassroots advocacy over the last year.  Without you, none of this would happen.  Please continue to stand together as we anticipate a busy legislative session in the upcoming year, including bills on physician assistant scope of practice, balanced billing for out-of-network care, and much more. 

The Wisconsin Elections Commission encourages every eligible citizen to vote and to become involved in the election process. One way to get involved is to become an Election Day poll worker, also known as an election inspector).  

Citizen involvement is essential to conduct open, accurate and fair elections in Wisconsin. And, Emergency Physicians as well as other healthcare providers are uniquely positioned given the comfort level with PPE.

There are several different jobs at polling places in Wisconsin, all of which are appointed by municipal clerks. Learn more at elections.wi.gov.

In response to the increasing COVID-19 cases, Governor Evers announced a new Emergency Order—EO-2.  Included in this new order are new provisions applicable to health care providers including interstate reciprocity, credentialing, and Telemedicine.  

In addition, the provisions from previously released EO-16 related to physician assistants and nurses are included by reference.  The new order is effective immediately and unless suspended by the legislature or the courts, will remain in effect for the duration of the federal declared public health emergency.  

View the Governor's press release. 

The ACEP20 countdown is on. This year's conference is October 26-29 and has much to offer!  Watch this short video that will surely get you pumped up to attend and take part in the innovative features and creative programming of this year's virtual experience.  Everyone has their reasons: The education, the community, the career advancement opportunities. Maybe it's the chance to break from the daily grind and treat yourself to some “me time.” Whatever your reason, register today!