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President’s Blog

Posted By Jeff Britton, Wednesday, March 15, 2017

On February 28 I had the opportunity to join other AAP Chapter Presidents in Washington, DC for a day of advocacy on Capitol Hill. We started the day with a briefing from Mark DelMonte and Jamie Poslosky of the AAP Washington Office. They summarized for us the Academy’s current strategy related to health care coverage for children. We then left for hill visits to bring that message to our legislators and their staff.

Essentially our “ask” was to make sure that kids are not hurt by any changes made in the Affordable Care Act or in Medicaid/CHIP. For the ACA piece I focused on essential health benefits. The preservation of essential health benefits, such as coverage for well child visits, immunizations, screening tests recommended by Bright Futures, and the ability to see pediatricians and pediatric subspecialists, is of utmost importance to the children of our state and country. I came armed with stories about how, before the ACA, major employers in my area like Kohler Company and Acuity Insurance would not cover immunizations, shifting the cost to the taxpayers through the Vaccines for Children program.  There was also a time that Kohler covered well exams only every other year.

Regarding Medicaid, I focused on the financial facts (in Wisconsin, 47% of people on Medicaid are children, but they make up only about 20% of the cost) and on the importance of Medicaid as an entitlement. Proposals to block-grant or cap Medicaid payments to states would work in economic good times, but would put children in danger of being uninsured or underinsured during the next economic downturn. At such a time, more children would likely need Medicaid, but the State would be unlikely to be able to provide the additional needed funding – and with the Federal portion capped, the only option would be to cut services or not add members to the roles. Again, I came armed with a personal story – in 2007 my practice was about 27% Medicaid, but by the end of 2009 it had jumped to 37% as the unemployment rate in Sheboygan County rose to around 10%. (Unfortunately it remains around 36%, despite record low unemployment now, due to erosion of benefits and the hiring of temp workers without benefits).

I met with Representative Glenn Grothman and with staff from the offices of Senator Baldwin, Senator Johnson , and Speaker Ryan. Each conversation was cordial and interesting, and I believe that there is agreement that we don’t want to hurt children.  However, unless we pediatricians continue to speak up for our patients, that message could easily get lost. The volume of other groups also visiting the Hill last week was astounding, causing long lines at every office building as people waited to go through security.  

Obviously a single hill visit is just the start of a relationship. However, if all of us can bring forth to our representatives a uniform message about coverage for children in our state, I think we have a chance to have that message heard.

It is a wild time in Washington right now. It’s also a great time to get involved. Right or call your Congressman. Send an email. Write an op-ed for your local paper. Tell the stories of your patients, and your practice, that illustrate how important health benefits and health coverage is to the children you serve. Tweet about it using the hashtag #docs4coverage. Feel free to contact us, or the AAP Division of Federal Government Affairs, for guidance. 

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I Have Narcolepsy, but Narcolepsy Doesn't Have Me

Posted By Lukas Hunter, Wednesday, February 15, 2017
Updated: Monday, February 13, 2017

When you look at me you can’t see it. You see a student who gets tired and sleepy if the lights gets dimmed, puts his head on the desk if the lecture is slow or quiet, and nods off from time to time.  No, I did not stay up too late last night. In fact, I take a nap or two after school; I go to bed at 10:00 pm every weeknight and wake up four times a night to take medicine to put me back to sleep. 

I have narcolepsy with cataplexy, an invisible neurological disorder in which my sleep wake cycles are really mixed up because my brain doesn’t produce enough of the neurotransmitter called hypocretin. You will see my cataplexy, a sudden loss of muscle tone, when I experience extreme emotions like laughter, anger, and fear. Unlike some of my friends who fall to the ground, my symptom appears as facial muscle drooping and weakening of the knees.  These attacks last just a few seconds. 

It took my doctors four years to diagnose my condition, better than the national average of seven years, but that is still a long time. Many of my friends with narcolepsy were diagnosed as schizophrenic, depressed, ADHD, epileptic to name a few.  The symptoms of narcolepsy mimic these diseases (hallucinations, withdrawn, fidgeting to stay awake, and cataplexic episodes).

Luckily for me, I did get the correct diagnosis and with medications I lead a very active and fulfilling life of a high school junior. I have narcolepsy but narcolepsy does not have me.

Lukas Hunter is Youth Ambassador for the Narcolepsy Network.  He has available to give a slide presentation or table top display concerning narcolepsy in youths with a focus on school participation and accommodations necessary for the student with narcolepsy to reach his/her highest potential. Please contact Mary Hunter at for more information on this program.

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I Did It - So Can You

Posted By Ellen Schumann, Sunday, February 12, 2017

As our state and federal policy efforts begin ramping up with the new budget and administration changes, WIAAP will be calling on member pediatricians to contact legislators to provide expertise in making policy decisions.


Back in September 2016, the chapter sent out an appeal for members to contact their congress member to urge passage of the Mental Health Reform Act of 2016. The chapter asked if I would share the letter I sent to Senators Baldwin and Johnson in support of that bill. I'm happy to report that this legislation was passed. I hope you will consider taking similar action as new proposals arise.

Dear Senators Baldwin and Johnson:


As a concerned constituent, pediatrician, mother,  and aunt, I am writing to urge your support for the bipartisan Mental Health Reform Act of 2016 which includes a groundbreaking provision to invest where the foundations of strong mental health are laid - with very young children and their parents, starting from birth.


By beginning at birth this legislation will open the doors for more effective prevention of severe mental health disturbances later in life saving families, communities and our country billions of dollars in the long run.  The need for reform is urgent. You have the opportunity to act now to improve the lives of tens of millions of Americans, their families, and our communities.  Please urge your colleagues to bring mental health reform to the floor for a vote this year and vote "yes."  


Please remember by attending to infant/early childhood mental health, it is possible to change the trajectory of a child's life to reduce the need for treatment later in life, decrease incarceration rates and to grow healthier and happier communities.


Wisconsin’s families are counting on you!


Ellen M. Schumann, MD, MS, FAAP

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Combatting Opioid Addiction in Wisconsin

Posted By Kia LaBracke, Thursday, December 15, 2016

WIAAP testified at a recent hearing of the Governor's Task Force on Opioid Abuse (view here, around minute 200:00) and participated in the latest meeting of the Wisconsin Coalition for Prescription Drug Abuse Reduction, convened by Dr. Timothy Westlake of the Medical Examining Board. Lt. Governor Rebecca Kleefisch and Rep. John Nygren, co-chairs of the Task Force, and collaborators from most health systems, public health and other advocates discussed electronic Prescription Drug Monitoring Program (e-PDMP), medication-assisted treatment (MAT) and models for expanding treatment options in the medical home.

Wisconsin stands at the forefront of actionable solutions to the alarming and deadly opioid addiction epidemic. Thanks to the dogged efforts of state Rep. John Nygren and the legislation known as the H.O.P.E. Agenda (Heroin, Opioid Prevention and Education), since 2013 our state has passed a remarkable 17 proposals dealing not only with heroin but prescription drug use and addiction. Attorney General Brad Schimel has bolstered Wisconsin Department of Justice efforts through the successful "Dose of Reality" campaign, focusing in on the dangers of prescription painkillers.

We bring a valuable pediatric perspective to state efforts, including a focus on infant and early childhood as well as school-based mental and behavioral health interventions, and are exploring a pediatric-focused CME curriculum for satisfying the new educational requirement on opioid prescribing.

There is no one solution, but to see the vast array of stakeholders who are not only taking an interest but taking a responsibility to attack this problem is impressive. The medical community is embracing the opportunity to improve their practices - not just in prescribing but in first line treatment of patients with addictions. As with any other mental or "brain" health disorder, primary care clinicians are seeing more and more of their patients needing this type of care and possible referral and therapies. Only can communities can knit together resources to ensure those supports are in place. Our job is to make sure the best practices for kids, and their caregivers, stay at the forefront of the discussion.

Tags:  advocacy  legislation  opioids  substance use disorders 

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Pediatricians and HPV Vaccine Reluctant Parents

Posted By Eyla Boies MD FAAP FABM, Friday, July 29, 2016

Parents who are otherwise on board with routine childhood vaccines balk when I recommend the HPV vaccine along with the Tdap and meningococcal vaccine at the 11 year check-up. A recent survey found only 38% of adolescent girls and 14% of adolescent boys complete the three dose series of HPV vaccine. There are currently 12,000 new cases of and 4,000 deaths attributable to just cervical cancer each year in the US.

Research has shown that pediatricians are part of the problem. Why? Either we do not perceive the HPV vaccine to be as necessary as other vaccines, and/or our messaging is not as effective for the HPV vaccine.

Funded through an AAP Educational Grant supported by Merck, the AAP CA Chapter 3 teamed up with San Diego physicians to produce a video and webinar to help pediatricians better communicate to parents the importance of immunizing against HPV at 11 or 12 years of age. 

The video includes eight vignettes with local San Diego pediatricians. It shows mock clinical encounters with patient/parent actors, with role playing ways to recommend the HPV vaccine and strategies to respond to concerns. Dr. Maya Kumar, an adolescent medicine specialist at UCSD, moderates the videos and provides a treasure trove of information regarding HPV infections and the vaccine.

Key takeaway messages:

  • 40% of HPV related cancers occur in males
  • Lifetime probability of contracting HPV is 85% for females and 90% for males.
  • 50% of HPV infections are with serotypes associated with cancer
  • 80 million doses of HPV vaccine have been administered
  • HPV vaccine has been around for 10 years
  • No serious side effects
  • More effective immune response when give early rather than mid or late adolescence

The webinar includes four presentations covering up-to-date information about the burden of HPV-related disease, vaccine uptake, strategies for counseling parents and patients about the vaccine, HPV disease from the gynecologic perspective and utility of reminder recall systems. 

Dr. Mark Sawyer, an infectious disease specialist at UCSD School of Medicine and Rady Children’s Hospital and member of the AAP Red Book Committee, discusses the epidemiology of HPV-related disease and vaccine efficacy and safety.  Dr. Kumar, the video series moderator, reviews effective, evidence based counseling strategies to address the concerns of vaccine-hesitant parents, such as: 

“Why does my 11 year old need to be vaccinated against an STD?”

“I am worried about the side effects of such a new vaccine.”

“Why would my son need a vaccine that prevents cervical cancer?”

Dr. John Willems, senior consultant in the department of Obstetrics and Gynecology at Scrips Clinic Medical Group in San Diego discusses not only the burden of cervical and related cancers but the burden of screening for cervical cancer. Dr. Sawyer presents the work of Ms. Heidi DeGuzman, Chief of Community Pediatrics and Program director for the San Diego Immunization Partnership with UC San Diego, on HPV uptake in San Diego County, reminder recall, and the San Diego County immunization registry.

The webinar provided valuable information allowing me to educate parents better about the burden of HPV disease and the safety and efficacy of the vaccine.  I am convinced that medical history will show HPV vaccine as one of the most significant medical advances of first decade of the 21st Century, with the potential of dramatically reducing the incidence of HPV related cancers.

Tags:  cancer  hpv  vaccines 

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