The competition for physicians among the 50 states is fierce, but a new Web site could put the Badger State in the lead. Developed by the Wisconsin Hospital Association for the Wisconsin Council on Medical Education and Workforce (WCMEW), www.wisconsinphysiciancareers.org was eagerly embraced by physicians, hospitals and clinics alike.

In less than a month, hospitals, clinics and academic medical centers posted over 500 physician vacancies. As The Valued Voice went to press, family medicine topped the list for the number of positions posted with 100, followed by 60 positions in internal medicine. Psychiatry, a specialty that has been identified as severely short, had nearly 30 positions posted at press time and 20 hospitalist positions were listed on the site.

WHA President Steve Brenton said the Web site has been a hit with both hospitals and clinics.

"We can hardly believe how quickly this Web site caught on with our hospitals, clinics and even with physicians. The WHA staff that developed this site for WCMEW went to great lengths to find out what resources physicians value in their job searches. They also met with in-house recruiters to determine the tools they would find useful in reaching physicians," Brenton said. "This Web site should give Wisconsin a leg-up on the competition for physicians."

Rob Fishman, MD, a resident in the Wausau-based UW Family Medicine Residency Program, and Eric Johnson, MD, a resident at the University of Wisconsin School of Medicine and Public Health in Madison, both were impressed with the completeness and capabilities of the new Web site.

"It is very detailed and well-organized with a high degree of transparency and honesty. I like the fact you can search for positions on your own time, send an email directly to the hospital or clinic that has an opening, and maintain control of who contacts you and when," Fishman said.

Johnson said the Web site has the advantage that "you don’t have to wonder about the motivation of the recruiters."

"It is not like they are reading off a piece of paper about a community. They really know the position, and they live and work in the community where you would live. They have more at stake. It is an issue of trust and credibility," Johnson said. "The positions listed on the Web site really emphasize community and lifestyle and for most residents, that is near or at the top of our list," Johnson added.

The physician recruiters employed by Wisconsin hospitals and clinics were equally impressed with the site. Richard Lynch, medical staff recruiter for Fort Memorial Hospital and UW Health Partners Watertown Regional Medical Center, has listed several positions on the Web site and termed the site "exceptional."

"This is an ideal way to get our career opportunities in front of physicians in a user-friendly environment that they can access 24/7. It is easy to post positions and tailor the descriptions that will interest physicians in contacting you for more information. Being in-house and as employees of the hospital or health system ourselves, we are very honest in our presentation of our opportunities," Lynch said. "Ultimately, they can find us right down the hall. There is no hiding or hard sell…that is not how we operate."

"The new Web site is a great tool that puts physicians in direct contact with the in-house recruiter to talk specifically about our position and nothing else. Another plus is that with all the positions listed in one place, if I’m working with a physician and we don’t have a match but they want to stay in Wisconsin, I can put them directly in contact with a recruiter in another hospital or clinic and hopefully keep that physician in Wisconsin," Lynch added. "First and foremost, we want to fill our own positions, but if it doesn’t work out, then we just try to keep them in Wisconsin."

Next week WHA will work directly with WCMEW and the Wisconsin Medical Society in launching a national communications and marketing campaign.

A business paper in northern Wisconsin this week, while reporting about a Wisconsin Supreme Court decision from the Court’s most recently concluded term, showed the importance of Wisconsin’s peer review statutes. The case involved a physician who was employed by a hospital on a contractual basis. At the behest of the hospital, the physician underwent diagnosis and treatment for alcohol dependence. During that time, the physician’s privileges at the hospital were suspended.

The physician brought an action alleging medical negligence against the addiction treatment provider and filed claims of defamation and negligent communication of false information against the hospital staff. The Supreme Court, recognizing the importance of the protections provided by the peer review statutes, emphasized that the purpose of the statutes is, "to encourage hospitals to perform quality-control reviews aimed at improving, prospectively, their services. [The peer review statutes] were enacted to protect the confidentiality of the peer review process, in the hope that confidentiality would encourage free and open discussion, among physicians knowledgeable in an area, of the quality of treatment rendered by other physicians."

The Court also recognized that peer review must consider issues of future performance, "Realistically, however, a review of [the physician] and his services would be incomplete if it focused solely on past performance. The [hospital] Board convened to review [the physician’s] ability to perform as an on-call physician [.] The Board’s concern was understandably focused on the surgeon’s future performance. The actions of a hospital governing body in reviewing the ability of a physician to perform services, especially a physician who is frequently on call 24 hours per day, qualify for the immunity contemplated by [the peer review statutes]."

The Wisconsin Department of Health Services on October 3 released a new guidance document that discusses recent changes to Wisconsin’s confidentiality and patient health care record statutes under 2007 Wisconsin Act 108. A copy of the memo can be found at http://ehealthboard.dhs.wisconsin.gov/Guidance%20Memo%20Act%20108%2010.06.08.pdf.

In an effort to further advance the development of electronic medical records and electronic health information exchange in Wisconsin, Act 108 reduced barriers related to re-disclosure of health care records, disclosure of mental health care records, and removed burdensome documentation requirements. The Act also reduced barriers to the disclosure of health care records to family and friends of the patient.

The new guidance from DHS in particular focuses on changes to §51.30 of the Wisconsin Statutes that became effective on October 1. Those changes permit a limited amount of mental health care information to be shared between health care providers and were identified as necessary to better coordinate care between physicians.

"Physicians have expressed a need to have quick and ready access to clinical information to make well-informed decisions about the best way to care for a patient," states the guidance document. "By allowing the specified health information data elements to be shared with providers outside a related health care entity, subsequent providers can have access to information that is important to their assessment and care of the patient presenting to them."

WHA actively participated in the workgroups that developed Act 108 and were convened as a part of the Governor’s eHealth Initiative.

The Wisconsin State Health Plan, Healthiest Wisconsin 2010, has been in place for nearly a decade, and it’s time for an update. The Department of Health Services (DHS) is now in the process of creating the next State Health Plan, Healthiest Wisconsin 2020 (HW2020.) We need your help in creating HW2020, which will become the policy roadmap to protect health and safety, eliminate inequalities in health, and transform our public health system to achieve our shared vision of healthy people living in healthy and safe Wisconsin communities.

I was honored to be asked to represent the Wisconsin Hospital Association and provide a hospital perspective on the Leadership Planning Team that was formed to help guide the development of HW2020. Now, I’d like to ask you, my health care colleagues, to provide feedback on the proposed plan.

Please plan to attend and/or designate individuals from your hospital to attend one of the Community Engagement Forums being held in six locations around Wisconsin in October and November, 2008. Information about the forums is included with the registration form: http://dhs.wisconsin.gov/statehealthplan/hw2020/forums.htm.

The forums will be hosted by the Healthiest Wisconsin 2020 Strategic Leadership Team, and the University of Wisconsin Partnership Program. Many of you will remember similar forums when HW2010 was developed. The purpose of the Community Engagement Forums is to tap the wisdom of Wisconsin communities and the public health system partners to:

• Respond to the proposed Healthiest Wisconsin 2020 framework (vision, mission and principles)
• Make recommendations for the Healthiest Wisconsin 2020 priorities
• Create opportunities to work together to implement Healthiest Wisconsin 2020
• Develop a Healthiest Wisconsin 2020 network
• Stand on the principle that collaboration is the key to success

The dates of the forums by region are:

• Western: Eau Claire, October 14, 2008 (10:00 a.m. – 2:00 p.m.)
      Sleep Inn (Grand Valley - Rooms 2 and 3)
      5872 33rd Avenue, Eau Claire, WI 54703
  
  

• Northern: Woodruff/Minocqua, October 22, 2008 (10:00 a.m. – 2:00 p.m.)
      Woodruff Town Hall (Will also be Webcast via Mediasite)
      1418 1st Avenue (Hwy 47 - next to the Post Office), Woodruff, WI 54568
  
  

• Northeastern: Appleton, October 29, 2008 (1:00 p.m. – 4:00 p.m.)
      225 N. Oneida Street, Appleton, WI 54911
  
  

• Southeastern Forum 1: Milwaukee, October 31, 2008 (9:00 a.m. – 1:00 p.m.)
      (meeting site to be decided)
  
  

• Southeastern Forum 2: Racine/Kenosha, November 6, 2008 (12:30 p.m. – 4:30 p.m.)
      Kenosha County UW Extension Center, 19600 75th Street, Bristol, WI 53104
  
  

• Southern: Madison, November 13, 2008 (2:00 p.m. – 6:00 p.m.)
      (meeting site to be decided)

For more information about the Engagement Forums, contact Jennifer Potts, ASB, BSM, chair, HW2020 Community Engagement Forums, Division of Public Health, Wisconsin Department of Health Services, 414-227-4922 or jennifer1.potts@dhs.wisconsin.gov.

It is my privilege to serve on the Healthiest Wisconsin 2020 Planning Team on behalf of Wisconsin’s hospitals. I will continue to keep you apprised of our progress throughout the development of Healthiest Wisconsin 2020.

Frank Byrne, MD,
President, St. Mary’s Hospital, Madison

Hospital leaders in Green Bay recently met with Rep. Jim Soletski (D-Green Bay). It was an opportunity for individuals from local hospitals – Aurora BayCare, Bellin Hospital and St. Mary’s/St. Vincent Hospitals – to learn more about a local elected official. It was also an opportunity to provide Rep. Soletski insight into issues impacting his area’s hospitals.

Issues discussed included the hospital assessment, health care reform and raiding segregated funds among others.

On the hospital assessment, Rep. Soletski said: "My bottom line is I want to see all hospitals on a healthy footing…I don’t want to see one hospital close because of reimbursement. Where are those patients going to go?"

On the Senate Democrats’ "Healthy Wisconsin" plan: "There were some problems. Here in Wisconsin we’re doing a pretty good job at taking care of the uninsured. It’s the people who have insurance but are constantly afraid of losing it."

On raiding segregated funds: "My distaste for the use of segregated funds knows no bounds."

On the importance of constituent-legislator relationships: "I know some of you already, but I’m hoping you feel comfortable coming to me…I gladly receive input from you on health care issues."

Heidi Selberg of St. Mary’s/St. Vincent in Green Bay talked with Sen. Rob Cowles about Medicaid underfunding and its negative impact on Green Bay hospitals and the health care system in general. Selberg spoke specifically to the previously proposed hospital assessment and the potential it would have to bring some measure of relief to Wisconsin hospitals.

On October 3, President Bush signed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which added new federal mental health parity requirements to group health plans. The parity act was a part of the package of legislation included in the Emergency Economic Stabilization Act of 2008.

Generally, effective October 2009, group health plans will be prohibited from maintaining cost sharing requirements such as copays, limitations on treatment such as limits on days of coverage, or restrictions on access to out of network providers for mental health and substance abuse coverage that are different than for medical and surgical coverage. These new requirements are in addition to existing federal parity requirements concerning annual and lifetime dollar limits that were enacted in 1996.

The new parity requirements do not require a health plan to provide any mental health benefits or require coverage of any specific mental health treatments. However, if a mental health treatment is covered by the health plan, the coverage for the treatment must meet the new parity requirements.

Also, the new parity requirements only apply to group health plans sponsored by employers with 50 or more employees. The parity requirements also will not apply to health plans maintained pursuant to collective bargaining agreements until the date on which the last of the collective bargaining agreements relating to the health plan terminates, or January 1, 2009 whichever is later.

In addition, a group health plan may exempt itself from the parity requirements if the actual total costs of coverage with respect to medical and surgical benefits and mental health and substance use disorder benefits under the plan increase by two percent in the first plan year in which parity applies or by one percent in any subsequent plan year.

The Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative (RWHC) recently met with representatives from the Wisconsin Office of the Commissioner (OCI) of Insurance. The meeting dealt with numerous billing issues Wisconsin hospitals are having with health insurance companies. Many of these issues relate to claims submitted to large national health insurance companies. While the OCI doesn’t have any authority over self funded plans or Medicare Advantage plans, they do play a role in regulating commercial health insurance companies conducting business in Wisconsin.

Representatives from OCI stated that they act on behalf of both beneficiaries and health care providers relating to the performance and activities of insurance companies. They stressed that hospitals and other providers need to let them know if the insurers aren’t paying claims appropriately.

Working directly with the insurance company is always the first option, but if your hospital is seeing an undesirable pattern of behavior from a commercial insurer on billing issues, it is important for you to also inform the OCI. On the OCI Web site, information is available about filing a complaint. An electronic complaint form is also available online. This information can be found at www.oci.wi.gov/com_form.htm.

WHA and RWHC will continue to monitor commercial health insurer performance and will work with the OCI to try and remedy known billing issue problems.

The Rural Wisconsin Health Cooperative Information Technology Network (RWHC ITN), based in Sauk City, has become the first FCC Rural Healthcare Pilot Program network to receive a funding commitment letter (FCL). The FCC Pilot Program, a first-of-its-kind federal health care network initiative, will be distributing up to $400 million dollars over three years.

This announcement comes nearly a year after the FCC released the Rural Health Care Pilot Program Selection Order, which identified 69 projects from 43 states that qualified for funding based on Pilot Program goals to stimulate deployment of broadband networks necessary to support innovative telehealth and, in particular, telemedicine services to areas of the country that need them most.

The RWHC ITN FCC project provides high speed, redundant broadband connectivity initially to four critical access hospitals (CAHs), two physician clinics, and two collaborative datacenters that are participating in a cooperative hospital information system (HIS) and electronic health record (EHR) initiative.

"By collaborating on health IT," says Louis Wenzlow, ITN’s chief information officer, "the participating facilities are able to work together to implement EHR systems, to share their server and datacenter costs, and to benefit from the expertise of a pooled support staff. Ultimately, the communications infrastructure supported by the FCC Pilot Program is what makes our shared datacenter model possible."

Vendors that will be providing aspects of the ITN FCC project include CenturyTel, Charter, and Digicorp. "We’re managing the network ourselves," Wenzlow said, "so we don’t need to rely on a single vendor for the entire project. As we build and expand, the vendor selection question will always be who can provide the most appropriate and cost effective solution for the location being added."

The hospitals and clinics participating include: Boscobel Area Health Care, Memorial Hospital of Lafayette County, St Joseph’s Community Health Services, Tomah Memorial Hospital, and two physician clinics in Wonewoc and Elroy. Wenzlow hopes the Pilot Program, which pays for 85 percent of eligible costs, will eventually be expanded to provide funding for additional participants.

The issues surrounding health literacy and programs that are making an impact on improving patient outcomes will be explored at a conference in Madison October 28 sponsored by the Southwest/South Central Regional Health Literacy Committee.

Christina L. Cordero, PhD, MPH, project manager in the division of standards and survey methods at JCAHO, will address their recommendations for culturally and linguistically appropriate services and how to implement practices that support health literacy.

The free, half-day conference is presented by Wisconsin Literacy’s SW/SC Regional Health Literacy Committee with support from its members representing the Southwest Area Health Education Center, Wisconsin Department of Health Services, Confident Conversations, LLC, and Enlace. It will be held in Madison from 8:30 a.m. to 1:15 p.m. at American Family Insurance, 6000 American Parkway, with lunch provided. Other presenters include Brenda Gonzalez, deputy director of New Routes to Community Health, a national program of the Benton Foundation funded by The Robert Wood Johnson Foundation; and Marsha Connet and Margarete Cook, both regional literacy consultants with Wisconsin Literacy.

There is no cost to attend the conference, but pre-registration is required. To pre-register call 608-257-1655 or email events@wisconsinliteracy.org. The registration deadline is October 24.

It happens all too often—an employee becomes injured at work and a workers’ compensation claim incurs. The severe claims can have a dramatic, detrimental affect to your premium and, ultimately, your bottom line. And it means that a great deal of human suffering is probably occurring, too.

How can you address costly injuries? Of course, injury prevention—preventing injuries from happening in the first place—is key, but once they occur, the impact can be minimized. Since up to 50 percent of workers’ compensation costs depend on how injuries are responded to and managed after the injury occurs, one effective strategy is to implement a stay-at-work program. The concept is simple: keep injured workers at work as they recover, once they are medically able to be there. Where physical limitations are provided, real tasks and contributions can still be made. Keeping active also promotes healing, putting employees back to normal capacity in shorter periods of time. Other benefits experienced include reducing workers’ compensation costs, maintaining employees’ skills, and minimizing the potential for a secondary disability or re-injury.

For assistance mitigating the impact of severe workers’ compensation claims, contact Matt Wahoske at mwahoske@fincorsolutions.com or at 608-469-8590.

Where do you go for preventive care if you are Latino, have no health insurance and live in Green Bay? This group of people had no preventive care until St. Mary’s Hospital Medical Center began offering Hispanic Health Education and Screenings at local churches. Three area churches are convenient sites where people congregate to worship. After church, free health information and screenings are making a difference in improved health for this population.

Maria had never had her blood sugar tested before and when she made an appointment for the free screening, her blood sugar was elevated. She picked up information on the disease of diabetes and was also referred to the Northeast Wisconsin Community Clinic. Had she not had this screening done, her condition would not have been treated until more serious health problems developed. Now Maria is learning more about diabetes and changing her diet; and she started a walking program. The preventive screenings not only improve the health of Latinos by catching health problems early, but health care dollars are saved with early treatment.

Carlos also made an appointment at the free health screening to have his blood cholesterol checked. The results showed he had high cholesterol and triglycerides; he was also referred to the Northeast Wisconsin Community Clinic where he was examined and put on medication.

Susan’s blood cholesterol was tested and she presented with other symptoms. After being referred to the community clinic, she learned she had a more advanced stage of heart disease. This screening saved her life with early detection.

Screenings for arthritis are also offered; Carisa and Augustin came to a screening to find out why they had joint pain. Again, they were referred to the community clinic. They had no idea there were treatments to help them feel better. They joined an exercise class and also attended a free public forum on arthritis and back pain.

Aerobic exercise and nutrition classes as well as public forums of health information are held regularly for all age groups. For each of our screening patients, exercise was suggested and now they are learning how to improve their cardiovascular health and feel better overall.

Dozens of cases of diabetes have been detected through this program and many others are having heart disease identified early so that treatment can begin earlier. Access to care is a right for all to have and because of the Hispanic Health Education and Screening program, at St. Mary’s Hospital in Green Bay, hundreds of Latinos are living healthier lives.

On Tuesday nights from 5-7 pm, Franciscan Skemp Healthcare Sparta Campus is a very busy place. The St. Clare Health Mission of Monroe County opens its doors and sees patients on a walk-in basis. Service is limited to Monroe County residents who are ineligible for public or private insurance. The name "Clare" comes from the Latin word for "bright." In the 16th century, an Italian woman named Clare of Assisi established a contemplative religious order, which came to be known as "The Poor Clares." St. Clare, who did much of her teaching from a window in the convent wall, was sought out by the sick because of her powers of healing.

The St. Care Health Mission of Monroe County opened in 1996 with the support of Franciscan Skemp Healthcare La Crosse Campus, Sparta Campus, and Lake Tomah Campus; Gundersen Lutheran Medical Center in La Crosse and Sparta and Tomah clinics; Scenic Bluffs Community Centers in Cashton and Norwalk; and the Monroe County Department of Health and Human Services.

The Health Mission is staffed by an all volunteer staff including: physicians, physician assistants, nurse practitioners, nurses, certified medical assistants, pharmacists, laboratory and X-ray technicians, patient advocates, social workers, clerical personnel and transcriptionists. Spanish speaking interpreters serve the Hispanic community.

A Monday morning chronic clinic was added to the services of the Mission clinic in September, 2007. This clinic serves diabetic patients on referral from the regular Tuesday evening clinic.

Prescriptions issued by the Health Mission providers can be filled at the Health Mission pharmacy. A contribution of $1 per prescription is requested, not to exceed $5 for multiple prescriptions. The cost of medications provided by the Health Mission pharmacy averages $60,000 per year. In addition, Franciscan Skemp Healthcare Sparta Campus absorbs tens of thousands of dollars annually in technical services. In 2007, the hospital posted charity contributions of $83,900 and the clinic absorbed $4,757.

More than 47 million Americans lack health insurance. While some qualify for medical assistance programs, many others "fall through the cracks." In Monroe County‘s population of 41,000 people, there are over 900 families (8.4 percent) living below the national poverty level, defined in 2007 as a single person or family of four living on less than $22,650. Many low-income working people cannot afford private health insurance, nor qualify for public aid.

The St. Clare Health Mission provides basic health care which, if neglected, can result in even more costly long-term care. Since 1996, over 25,000 hours of professional volunteer services have made possible more than 11,000 patient visits. The focus of the Health Mission is on treatment of acute and chronic problems, as well as preventive care. Educational materials are also available.

The Sparta St. Clare Health Mission of Monroe County is a much appreciated and widely supported clinic by both local patients and also health care providers throughout the region. The appreciation can be seen in the faces of the patients that have been helped. What started in the 16th century with Clare of Assisi is still going strong through the work of the St. Clare Mission Clinic of Monroe County.

Submit hospital community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Froedtert Hospital in Milwaukee, ThedaCare in Appleton and University of Wisconsin Hospitals and Clinics in Madison have earned National Research Corporation’s 2008-2009 Consumer Choice Awards. The award recognizes hospitals across the United States that health care consumers consider to have the highest quality and image.

The organizations selected for the Consumer Choice Awards are chosen by people who live in the communities the hospitals serve. To determine the winners, NRC conducts an annual Healthcare Market Guide survey of more than 400,000 consumers throughout the United States. Nationwide, 3,200 hospitals were named by consumers who participated in the survey.

For more information, visit http://hcmg.nationalresearch.com.

Top of page