Having trouble viewing this email? View it as a Web page.

October 2022

You are receiving this update as a licensee of the Wisconsin Medical Examining Board or as a subscriber to this communication.

Quick Links

• Board Landing Page
  • Meetings and Agendas
  • Statutes and Rules
  • Pending Rules
• ePDMP Quarterly Reports

Chair's Corner

By Sheldon Wasserman, MD Chairperson, Wisconsin Medical Examining Board      While attending the Federation of State Medical Boards’ Annual Meeting in April, I listened to a presentation by Corey Feist, the brother-in-law of Dr. Lorna Breen. Dr. Breen, an emergency room physician in New York City, took her own life on April 26, 2020, as the COVID-19 pandemic had begun to stress the health care system and providers of care as never before, exacerbating the existing suicide, burnout, PTSD, anxiety, and depression challenges that were already facing the medical profession. Her death followed her recovery from COVID-19 in the midst of working extended shifts treating COVID patients.      Mr. Feist and his wife, Jennifer Breen Feist, created the Dr. Lorna Breen Heroes’ Foundation in Dr. Breen’s memory to advocate for support of health care professionals’ mental and behavioral health, reduce the stigma that is associated with the need for mental wellness care, and to increase funding for research and programs aimed at reducing burnout and improving mental and behavioral health. (https://drlornabreen.org/)      The Heroes Foundation achieved a major success recently in its advocacy for national legislation to address mental and behavioral health concerns among health care providers. On March 18, President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667). The Act provides grant funding through the Department of Health and Human Services (HHS) to the health care workforce, hospitals, medical professional associations, and other health care organizations aimed at improving mental and behavioral health among health care providers. It also directs HHS to conduct a three-year root cause study (e.g., the increasing role of systems issues contributing to burnout), a campaign to encourage providers to seek support and treatment, and to disseminate best practices to prevent suicide.      The results of the Feists’ call to action are long overdue. We have learned that, compared to the general population, suicide is disproportionately high among physicians, residents and medical students. The scope of the suicide problem is alarming. Each year approximately 400 physicians nationally take their own lives. That is more than one physician suicide each day, and roughly the equivalent of the combined graduating classes of the two medical schools in Wisconsin-the Medical College of Wisconsin and University of Wisconsin Medical School. Suicide’s lead progenitor, burnout, is also increasingly a concern:  physicians are at a 40% higher risk of occupational burnout than other workers. In turn, there is an impact on patients. One finding indicates that between 210,000 and 400,000 deaths associated with preventable harm occur each year, and many may be due to physician burnout.        These figures are difficult to take, but solutions are within reach. Seeking care is essential not only for ourselves but our families, our friends and our patients. As we in this profession know, compromised physician wellness may also compromise the quality of the medical care provided.      Corey Feist’s talk spoke to me personally as the Chair of our Wisconsin Medical Examining Board. He noted that one of the primary factors contributing to physician suicide, including Lorna Breen’s, is fear that physician regulatory boards across the country will take an action against a medical license due to the act of a physician seeking mental health care. This is wrong. That perception prevents physicians in Wisconsin from seeking out the care they need. So let me clarify: As it states in our license renewal application, treatment for medical conditions is not in itself a basis on which an applicant is ordinarily denied licensure when the applicant has demonstrated personal responsibility and maturity in dealing with a mental health issue. The Board encourages applicants who may benefit from treatment to seek it. In addition to focusing on their own well-being and quality of life by seeking care, the mental illness may not lead to functional impairment, physicians may be less prone to harming a patient, and they may be more prepared to provide care with reasonable skill and safety. As for the physician duty to report (s. 448.115, Stats.), it exists to protect patient safety, not to target physicians for taking steps towards their own wellness. To underline the main point, care of the patient requires care of the provider.      Following the Heroes presentation, I requested discussion about mental health challenges among physicians and how the Wisconsin Board might support physicians who need assistance. I am pleased to report that we have made some progress. At our June 15 meeting, the Medical Board unanimously moved to support the expansion of the state’s Professional Assistance Procedure (PAP) program to address licensee mental health issues (in addition to its current focus on substance abuse issues). The PAP is a non-disciplinary program for licensed professionals with substance abuse issues that are committed to their own recovery. It is designed to provide an opportunity for qualified participants to continue practicing without public discipline while complying with the terms of a contract. Unfortunately, the Medical Board is unable to expand the program on its own. A state statute change is necessary, and the authority to change statutes resides with the state legislature and the Governor. So I intend to work with the Board to explore what role it might play in advancing its support for an expanded PAP going forward.      In addition, I want to emphasize the importance of physicians playing a leadership role in reducing stigma. Dr. Breen received some care, but it was brief. She confided to those close to her a fear of being ostracized by her colleagues and a downward career spiral due to a mental health episode. She felt exposed and embarrassed. This is what stigma does. Can anyone say that these stigma-driven fears are uncommon in the House of Medicine, reinforced and perpetuated by the traditions and norms we grew up on, or deny that the prevailing belief is that you will be perceived as unfit to practice or weak if you seek care?      Finally, on a more personal level, after exploring the topic of physician mental health and wellness with some of my OB/GYN residents, one of them, Dr. Alexandra Levy, volunteered to write a letter discussing the issue from a young physician’s perspective. Her letter is included (below). I commend Dr. Levy for having the courage to share her personal experience.

“Physician, heal thyself” - Luke 4:23

By Alexandra Levy, MD OB/GYN PGY4

     The vast majority of physicians, at one time or another, have found ourselves sitting across from a patient who has confessed that they are feeling down, hopeless, and suicidal. They are bravely reaching across the aisle for help – and seeking out a healer for it. They believe in us and expect that we can set them on the path for healing.

     I’ve spent hours holding hands and exploring fears, pain, and anxiety that have led my patients to such a dark place. I don’t judge them. I know that life is hard, that obstacles can feel insurmountable, that sometimes you’re looking from so deep within the chasm that you can’t really see where you fell in in the first place. And I know this because I’m just like them.

     I was diagnosed with depression in 2018. I had a series of really devastating personal events that I did my best to ignore. Externally, I tried my hardest to project a competent intern who was unaffected by her surroundings. Internally, I felt ashamed that I was a fraud. I struggled with the same feelings of hopelessness, loss, and the accompanying shame of “not being strong enough” to solve my own problem. However, under no circumstance would I have ever turned to my supervising physicians for help – because I was deathly afraid of the consequences.

     Medscape published a survey of 13,000 physicians this year, and the results are heart-wrenching. Thirty three percent of our colleagues report depression; ten percent report thoughts of suicide without attempt; one percent have attempted. It is not stratified by gender. Both male and female physicians report similar feelings.

     When asked by Medscape to self-report why they have not sought help, the quotes all follow the same theme. “I’m afraid that if I spoke to a therapist, I’d have to report receiving treatment to credentialing or licensing boards,” wrote one physician. “Physicians cannot seek help for these issues because if we do that, these temporary issues will follow us for the rest of our careers,” echoes another.

     The culture of medicine is not kindness to one another. My colleagues and I don’t mock patients for their weaknesses. We recognize that depression, bipolar disorder, anxiety disorders, and all other mental health problems are generally the result of organic issues and trauma, which is not the afflicted person’s fault. Yet who hasn’t witnessed a relentless verbal beating from attending to resident, senior to junior resident, or junior resident to medical student? Most of us in surgical specialties wear our tears as a badge of honor. Learning to become stoic in the face of horrific trauma, terrible outcomes, and public embarrassment is expected – or you are weak. And everyone will make that very, very clear.

     The time for stoicism is over. Mental health is just as important as physical health. Seeking help for any ailment takes bravery and strength. One-third of your colleagues are struggling too. You are not alone. Therapy and anti-depressant medication will not prevent you from keeping your job and medical license. You have worked tirelessly to become the person you are. You matter to so many people.

     Your patients need you to be healthy, your family needs you to be healthy, you need you to be healthy.

     We need to talk about this. A third of us are struggling in the shadows. We can’t let one more student, one more resident, or one more attending take their own life because they are afraid to get help.

Be the change.

Get Help Now: Suicide Prevention Resources

Professional Assistance Procedure (PAP) Information

General Information

     The Professional Assistance Procedure (PAP) is a non-disciplinary program for credentialed professionals with substance abuse issues who are committed to their own recovery.  The procedure is designed to protect the public by promoting early identification of chemically dependent professionals and encouraging rehabilitation. It is also designed to provide an opportunity for qualified participants to continue practicing, without public discipline, while complying with the terms of a contract that is closely monitored by the Department. 

     If you are a credentialed professional struggling with substance abuse issues, we encourage you to review the PAP Instructions and submit an application:

PAP Instructions

Application

Contact Information

Professional Assistance Procedure
Department of Safety and Professional Services
PO Box 7190 Madison, WI 53707-7190

Email: DSPSImpairedProfessionalProcedure@wi.gov
Phone: (608) 267-3817 (Press 6 for PAP/Monitoring)
Fax: (608) 266-2264

Please note that participation in PAP will not exempt a credential holder from discipline.  It may be used in conjunction with the formal disciplinary process in situations where allegations of misconduct, negligence or violations of law exist, other than practicing while impaired by alcohol or other drugs.

Information About Administrative Rules

Click to edit this placeholder text.

Pending Rule Changes

Keep current with any pending rule changes affecting your profession by visiting the DSPS website to view the Pending Rules listing.

Administrative Rulemaking Process

Please review the Rulemaking Process page of the DSPS website to learn more about the promulgation of Administrative Rules.

Board Membership

The Medical Examining Board consists of 9 licensed doctors of medicine, 1 licensed doctor of osteopathy, and 3 public members members. The Board's membership also includes the Chairperson of the Injured Patients and Families Compensation Fund Peer Review Council who serves as a nonvoting member of the Board.

Sheldon A. Wasserman, M.D., Chairperson - Physician Member (Milwaukee, WI)
Clarence P. Chou, M.D., Vice Chairperson - Physician Member (Milwaukee, WI)
Sumeet K. Goel, D.O., Secretary - Physician Member (Plover, WI)
Milton Bond, Jr. - Public Member (Milwaukee, WI)
Kris Ferguson, M.D., Physician Member (Wausau, WI)
Diane M. Gerlach, D.O., Physician Member (Kenosha, WI)
Carmen Lerma, Public Member (Milwaukee, WI)
Michael A. Parish, M.D., Physician Member (Milwaukee, WI)
Rachel E. Sattler, Public Member (Madison, WI)
Gregory Schmeling, M.D., Physician Member (Hartland, WI)
Derrick R. Siebert, M.D., Physician Member (Wausau, WI)
Lemuel G. Yerby, III, M.D., Physician Member (Barron, WI)
Emily S. Yu, Physician Member (Milwaukee, WI)

Information on how to apply for appointment to the Wisconsin Medical Examining Board, or other gubernatorial appointments, can be found through the Office of the Governor using the link below: https://evers.wi.gov/Pages/Application_Process.aspx

Enforcement Actions of the
Board

     The Medical Examining Board, in collaboration with staff at the Department of Safety and Professional Services, can take action against its licensees to help protect the profession and the citizens of Wisconsin. You may search for any of the Board Orders listed below on the Department’s website by using this link:

Board Order Search:

https://dsps.wi.gov/Pages/SelfService/OrdersDisciplinaryActions.aspx

Disciplinary options available to the Board

Disciplinary actions are reported to the National Practitioners Data Bank. Available options to the Board include:

Reprimand: A public warning of the licensee for a violation.

Limitation of License: Imposes conditions and requirements upon the licensee, imposes restrictions on the scope of practice, or both.

Suspension: Completely and absolutely withdraws and withholds for a period of time all rights, privileges and authority previously conferred by the credential.

Revocation: To completely and absolutely terminate the credential and all rights, privileges and authority previously conferred by the credential.

Non-disciplinary options available to the Board

Non-disciplinary actions are not reported to the National Practitioners Data Bank. Available options to the Board include:

Administrative Warning: Issued if violation is of a minor nature, a first occurrence and the warning will adequately protect the public. The issuance of an Administrative Warning is public information, however the reason for issuance is not.

Remedial Education Order: Issued when there is reason to believe that the deficiency can be corrected with remedial education, while sufficiently protecting the public.

Board Orders

April 2022-August 2022

A wealth of useful information is available on the Department of Safety and Professional Services website at: https://dsps.wi.gov/pages/Home.aspx

Do you have a change of name or address?

Licensees can update name or address information on the Department website at: https://dsps.wi.gov/Pages/SelfService/Default.aspx. Please note that confirmation of change is not automatically provided. Legal notices will be sent to a licensee’s address of record with the Department.

Telephone Directory:

Call the Department of Safety and Professional Services toll-free (877) 617-1565, or (608) 266-2112 in the Madison area to connect to the service you need.

CONTACT US

Email: dsps@wisconsin.gov  |  Phone: (608) 266-2112  |  Office Hours: 7:45 a.m.- 4:30 p.m.

The mission of the Department of Safety and Professional Services is to promote economic growth and stability while protecting the citizens of Wisconsin as designated by statute.