Speaker: Jeremy Fisher, DO, FACOFP

In this episode, listeners will learn how to:

· Recognize the key components of effective and actionable clinical feedback.

· Seek, receive, and apply feedback to support continuous improvement.

· Develop communication skills that foster productive feedback conversations.

· Build stronger educational and professional relationships through meaningful feedback exchanges.

Resources

• Dillon’s Tragedy Becomes Dillon’s Law
• Dillon's Law at OMED '24: Training and Visibility

Transcript

This transcript was created with the aid of automatic speech recognition technology.

Steve Legault: Hello, and welcome to the ACOFP DO.FM Advocacy podcast. I'm Steve Legault, the Director of Knowledge, Learning and Assessment and host for this episode.

Today, we're going to talk about an impactful story that began with tragedy, but transformed into an advocacy movement which has resulted in Dillon's law in Wisconsin, and with continued advocacy may find its way to the national level.

We're welcoming Lenard Markman, DO onto the podcast today as he was integral in getting this legislation passed.

Dr. Markman is a retired Osteopathic family physician in Wisconsin, and a member of ACOFP, welcome to the podcast Dr. Markman.

Dr. Markman: Thank you. It's great to be here.

Steve Legault: Alright. So for those that don't know about Dillon and why this began, can you give us some background on who he was and what happened to him?

Dr. Markman: Sure, actually, it's almost 10 years to this date. Dillon Mueller was a very healthy 18 year old young man in rural Wisconsin. He was an eagle scout and captain of the football team. He never had any health problems. He was actually helping one of his friends with yard work when he gets stung by a bee, a single bee. He got short of breath. Developed hives. He got weak. He had his friend call 911, and the first responders were there right away. But they did not have epinephrine. They did not have the medication they needed to save his life. By the time paramedics came from the nearby city. It was too late, he did not survive. His parents are very proud that he was an organ tissue donor, and over 30 people have benefited from his final gift.

Steve Legault: Thank you for that recap and background on the story. Can you tell me a little bit about how this evolved from like such a tragedy, and moved into a movement to make sure epinephrine is easily or more easily accessible.

Dr. Markman: Sure Wisconsin, Osteopathic association connected with Dillon's parents and we worked on creating what's called Dillon's law in Wisconsin.

This law lets anybody take an anaphylaxis training course get certified, take their certificate directly to the pharmacist and obtain epinephrine and use it wherever they go, and they're covered under state Good Samaritan law. This has been very popular legislation went through a hundred percent bipartisan.

We then created what's called the do it for Dillon anaphylaxis training program to date. We've trained over 5,000 people in Wisconsin, and 15 lives have been saved by people who've taken our course.

Steve Legault: You mentioned the State Society. How did you personally get involved in, you know, moving that legislation forward?

Dr. Markman: So I was actually president of the Wisconsin Osteopathic Association at that time and we decided we were the 1st professional organization to actually offer full support for to Dillon's parents, and we weren't sure exactly what to do and Dillon's parents actually had been thinking about trying to make epinephrine available over the counter and that didn't seem like a good possibility. We talked and decided that creating a law that simply lets anybody who's trained use. It makes more sense. Currently a school teacher in any state, a teacher, somebody at school who's trained to use epinephrine can save a child's life at school. But that same teacher or trained individual cannot save a child a block away at the city park or the community swimming pool. So we have trained people who aren't able to use their skills. And that doesn't make sense and that's what our state legislators decided. We worked with them. We discussed how we could best prevent these kind of tragedies from happening, and that's how we came up with Dillon's law.

Steve Legault: During the legislative process, did you run into any resistance in trying to get this passed? Did you have to convince any lawmakers why this made sense? And are there any tidbits you can kind of share with the audience?

Dr. Markman: Sure. So we were the 1st state to really create Dillon's law. So we actually had to create 3 separate laws. I call it Dillon's law. But there's Dillon's law, 1.0, 2.0 and 3.0. So we did it in stages because we weren't sure and didn't want any resistance to any part of the law, and a lot of people thought, oh, you can't have epinephrine, It's an injection. And really it just took a lot of educating personally with our legislators; and it makes sense. Almost everybody has somebody in their family or a friend who has anaphylaxis. So once people start really start thinking about it. It's like, Yeah, we can. We can do a lot better. We can get prepared for this.

Steve Legault: This is a great example of physicians being advocates and taking a grassroots movement, and really moving it along and being champions. So is there anything that you've experienced or learned during the process that you can share with other physicians? If they have a passion project or something, they've identified that they would like to solve in their communities? How would how would they go about that?

Dr. Markman: Yeah, actually, it's a lot easier on a state basis than I thought. Once you have a good idea of what you need to accomplish, like getting epinephrine more available, if you sit down and talk with your state legislators they have people who are bill writers. And they'll say, yeah, this is a good idea let's see how we can form this into a law and then it's just getting more people to join on board. Our bill was supported by all the health organizations in Wisconsin. And again, it's nice to be passing a bill that goes a hundred percent bipartisan.

Steve Legault: This is on the state level, I think you're looking to get this into the national conversation as well. Have you run into anything there? Is there anything that somebody listening to this could do to potentially help that effort?

Dr. Markman: Yes. So once we passed our law, one of the Osteopathic physicians from Minnesota knew a senator in Minnesota. It took one phone call to their Senator and Minnesota passed our form of Dillon's law in Minnesota within like 2 months, without any testifying or work at all.

We then shared it with Indiana. The executive director of IOA was the executive director of Indiana and Indiana Osteopathic physicians ran with this, and they got their Dillon's law passed in Indiana also.

So it's something that every State can do. We decided to take it on national level, just so we could get this all done at once. It's kind of like the School Epinephrine Bill. It really is a grant preference law that just says, if States pass Dillon's law then they'll be given higher preference for Federal grants that become available.

So it's nothing where there's any opposition, everybody's really in favor of it. It's just hard to get Congress and the Senate to move forward. So we have companion bills. We have a bill in the House and a bill in the Senate Companion bills that are both bipartisan.

So it just takes a little more push from people in each state to get their Congressmen and their Congresswomen and Senators on board. So in Wisconsin every single Congressman and Congresswoman has co-sponsored Dillon's law, HR. 3910.

This last week Senator Baldwin from Wisconsin co-sponsored Dillon's law, SB. 3575 in the Senate. So we only have one more Senator in Wisconsin, and he's already said when it comes out on a vote he'll definitely vote for it, but we want him to co-sponsor it now.

So it is getting people just to hear about it and talk to their Congressmen, Congresswomen, and Senators, and getting them to sign on to it.

Steve Legault: Well, thank you for sitting down and talking to us. And this is a great story of how physicians can be advocates. You're not only helping patients, but helping the entire country through legislation. So thank you so much for all the work you've done on this.

Dr. Markman: Okay, thank you.

Dr. Shubrook discloses relationships with Abbott, Bayer, and Novo Nordisk as a non-CE consultant and AstraZeneca, Eli Lilly, and Novo Nordisk as an advisory board member. This podcast has been reviewed by non-conflicted physicians to ensure any potential conflicts are mitigated.

Dr. Pennings discloses relationships with Medifast as an independent contractor and Abbott as a consultant. This podcast has been reviewed by non-conflicted physicians to ensure any potential conflicts are mitigated.