February 2010 • Volume 109 • Issue 1 Official publication of the Wisconsin Medical Society Intervention through prevention: Effective for workers and employers ® Uncommon Insurance® IS YOUR DATA PROTECTED? Healthworks® from Society Insurance®, a comprehensive property and casualty insurance package specifically designed for the needs of the medical community, now offersS ecurity Breach Services™ through Identity Theft 911®. This new service could save you a lot of money and your reputation in the event that sensitive patient and /or employee information is compromised. Security Breach Services delivers a multifaceted solution for an information security breach incident that exposes any personally identifiable information from your clinic’s patients and /or employees. Designed by the nation’s leader in identity management and fraud education, Security Breach Services offers a comprehensive solution that enhances any incident response plan-ready to be mobilized at a moment’s notice. To learn more simply call 866.442.3810 and talk to one of our agents about obtaining Healthworks with Security Breach Services from Society Insurance, or visit www.wisconsinmedicalsociety.org/insurance. Official publication of the Wisconsin Medical Society EDITORIAL Changes in store for the Wisconsin Medical Journal ...................5 John J. Frey, III, MD ORIGINAL CONTRIBUTIONS A Cost-Benefit Analysis of Wisconsin’s Screening, Brief Intervention, and Referral to Treatment Program: Adding the Employer’s Perspective ..............................................9 Andrew Quanbeck, MS; Katharine Lang; Kohei Enami; Richard L. Brown, MD, MPH A Study of Clinician Adherence to Treatment COVER THEME Guidelines for Otitis Media with Effusion ................................15 Intervention through Stella U. Kalu, MD; Matthew C. Hall, MD prevention: Trends in Bariatric Surgery for Morbid Obesity Effective for workers in Wisconsin: A 6-Year Follow-Up ............................................21 Dana S. Henkel, MS, PA-C; Patrick L. Remington, MD, MPH; and employers Jessica K. Athens, MS; Jon C. Gould, MD This issue of the Wisconsin BRIEF REPORT Medical Journal features an Pilot Study of Adolescent Attitudes Regarding article that evaluates how Ski or Snowboard Helmet Use ....................................................28 employers might benefit from Andrew R. Peterson, MD; M. Alison Brooks, MD, MPH paying for screening, brief CASE REPORT intervention, and referral to All Red is Not Always Bacterial Cellulitis: treatment (SBIRT) services A Case of Löfgren’s Syndrome....................................................31 Gagan Kumar, MD; Nilay Kumar, MD, MPH for all employees. The authors determined that providing SBIRT services would be cost-effective overall by aiding worker attendance and productivity. Cover design by Mary Kay Adams-Edgette. The mission of the Wisconsin Medical Journal is to provide a vehicle for profes- sional communication and continuing education of Wisconsin physicians. 2 Wisconsin Medical Journal • 2009 • Volume 109, No. 1 The Wisconsin Medical Journal (the Journal) (ISSN 1098-1861) is the official publication of the Wisconsin Medical Society and is devoted to the interests of the medical profession and health care in Wisconsin. The managing editor is responsible for overseeing the production, business operation and con- tents of the Journal. The editorial board, chaired by the medical editor, solic- its and peer reviews all scientific articles; it does not screen public health, socioeconomic, or organizational articles. Although letters to the editor are reviewed by the medical editor, all signed expressions of opinion belong to the author(s) for which neither the Journal nor the Wisconsin Medical Society take responsibility. The Journal is indexed in Index Medicus, Hospital Literature Index, and Cambridge Scientific Abstracts. Send manuscripts to the Wisconsin Medical Journal, 330 E Lakeside St, Madison, WI 53715. Instructions to authors are available at the Wisconsin Medical Society Web site: www.wisconsinmedicalsociety.org, call 866.442.3800, Volume 109 • Issue 1 or e-mail [email protected]. MEDICAL EDITOR SOCIETY OFFICIALS John J. Frey, III, MD Robert J. Jaeger, MD, FACOG, YOUR PROFESSION EDITORIAL BOARD President Proceedings from the 2009 Annual Meeting of the American John J. Frey, III, MD Thomas Luetzow, MD, President-Elect Philip F. Giampietro, MD College of Physicians, Wisconsin Chapter .................................34 Steven C. Bergin, MD, Mahendr S. Kochar, MD, MACP Immediate Past President Kathleen R. Maginot, MD Susan L. Turney, MD, Joseph J. Mazza, MD YOUR SOCIETY Executive Vice President/CEO Thomas C. Meyer, MD Society’s ‘Leadership 15’ using WHIO data to find John W. Hartman, MD, Treasurer Richard H. Reynertson, MD Charles J. Rainey, MD, JD, Speaker areas to reduce cost, improve quality ............................................7 Sarina B. Schrager, MD Michael Miller, MD, Vice Speaker Tim Bartholow, MD Peter Sigmann, MD Geoffrey R. Swain, MD BOARD OF DIRECTORS Darold A. Treffert, MD George M. Lange, MD, FACP, Chair The CHILD Project: Connecting Health Insurance Steven H. Yale, MD Kevin A. Jessen, MD, Vice Chair with Lunch Data ...........................................................................49 Evidence-Based Medicine District 1 Michelle Yang, Medical College of Wisconsin Consultant Mark E. DeCheck, MD David A. Feldstein, MD Barbara A. Hummel, MD Lowell H. Keppel, MD STAFF Mahendr S. Kochar, MD Kendi Parvin Kesavan Kutty, MD 2009 WisMedPac Donors ...............................................................4 Communications Director George M. Lange, MD Kristin Knipschild Michael Lischak, MD Call for Papers, Reviewers .............................................................6 Managing Editor George Morris, MD Mary Kay Adams-Edgette Rosanna Ranieri, MD Thank You to Our Reviewers ........................................................8 Layout and Design Sri V. Vasudevan, MD Merry Earll District 2 2009 Foundation Donors .............................................................50 Administrative Assistant Jay A. Gold, MD, JD Jessica Steinhoff Norman M. Jensen, MD Classified Ads ................................................................................56 Editorial Consultant David Murdy, MD Rachel Berens-VanHeest Martha (Molli) Rolli, MD Editorial Consultant Tosha B. Wetterneck, MD ADVERTISING Kurt Wilhelm, II, MD Heidi Koch, Slack Attack District 3 Advertising, 608.222.7630 or Eric A. Gundersen, MD [email protected]. David M. Hoffmann, MD SUBSCRIPTION RATES District 4 Members: included in member- Richard A. Dart, MD ship dues. Non-members: $99. Mary Jo Freeman, MD Current year single copies, $12 Jean C. Montgomery, MD each. Previous years single cop- William E. Raduege, MD ies, when available, $10 each. District 5 Periodical postage paid in Terry L. Hankey, MD Madison, Wis, and additional Kevin A. Jessen, MD mailing offices. Karen L. Meyer, MD District 6 Published every other month, John W. Hartman, MD beginning in February. Bruce M. Neal, MD Acceptance for mailing at special Nicky Plementosh, MD rate of postage provided for in Section 1103, Act of October District 7 3, 1917. Authorized August 7, Arne T. Lagus, MD Daniel R. Sherry, MD 1918. Address all correspon- dence to the Wisconsin Medical District 8 Journal, PO Box 1109, Madison, David M. Saarinen, MD WI 53701. Street address: 330 E Medical Schools Section Lakeside St, Madison, WI 53715; Yolanda T. Becker, MD e-mail: [email protected] Young Physicians Section POSTMASTER Andrea Hillerud, MD Send address changes to: Resident Fellow Section Wisconsin Medical Journal, Claudia L. Reardon, MD PO Box 1109, Madison, WI 53701 Medical Student Section ISSN 1098-1861 Cory Hartman, Medical College Established 1903 of Wisconsin William Ragalie, UW School of Medicine and Public Health © 2010 Wisconsin Medical Society Thank you to WISMedPAC and WISMedDIRECT 2009 contributors–2010 efforts underway! Thanks to the support of the following individuals, Society physicians continue to build their political activism. By contribut- ing to WISMedPAC, you help support legislative and judicial candidates with a strong commitment to health care. WISMed- PAC pools members’ resources, thereby increasing physicians’ ability to influence public policy. Join your colleagues statewide in contributing to WISMedPAC. You will be investing in your future, the future of your patients, and the future of medicine. Champions of Medicine Robert J. Jaeger, MD, FACOG Todd R. Peebles, MD ($1000 or more) Kevin A. Jessen, MD Sarah J. Pratt, MD David H. Klehm, MD David M. Saarinen, MD John F. AufderHeide, MD Chris N. Larson, MD Evan K. Saunders, MD Timothy L. Bartholow, MD Paul A. Larson, MD Peter N. Smith, MD, FACC Steven C. Bergin, MD Scott Linton, MD Jeanine M. Swenson, MD, FAAP Richard A. Dart, MD William J. Listwan, MD Thomas J. Wilkins, MD, FAAPMR George M. Lange, MD, FACP Timothy G. McAvoy, MD Friends Robert H. Lehner, Jr, MD Edith A. McFadden, MD, MA, FAAOA Kenneth J. Pechman, MD, PHD George C. Mejicano, MD, MS (Up to $149) Susan L. Turney, MD, MS, FACP, FACMPE Karen L. Meyer, MD Arthur E. Angove, DO Sridhar V. Vasudevan, MD Michael M. Miller, MD Calvin S. Bruce, MD Jean M. Riquelme, MD Henry Ta-Shen Chang, MD Ambassador’s Club Fernando A. Riveron, MD Noel N. Deep, MD ($500-$999) Jeffrey E. Rodzak, MD Carl S L Eisenberg, MD John T. Bolger, MD Martha (Molli) Rolli, MD Jay A. Gold, MD, JD, MPH Timothy T. Flaherty, MD Thomas D. Sandager, MD Erik A. Gundersen, MD, MA John W.