All About Access

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Episode Transcript

(00:08):
Eight seven thirteen ten. WIV Afull scope with doctor nicolehem Kiss, Wisconsin's
directcare doctor. Of course, DoctorNicolehemkiss comes to us from Advocate MD,
a direct primary care practice. You'renot familiar with direct primary care, so
an amazing model. It's a greatresource if you're looking for some options for
primary care for yourself, your family, your employers, if you're an employee,

(00:32):
looking to maybe offer up some ideasto your employee or talk to them
about direct primary care. Of course, you can learn more online Advocates DPC
dot com. That's Advocates DPC dotcom. The telephone number six O eight
two six eight sixty two eleven.That's six O eight two six eight sixty
two eleven. If you have questionsfor doctor Nicole Lampkiss, love to get
you on the air this morning atsix O eight three two one thirteen ten.

(00:54):
That's six O eight three two onethirteen ten. If you have any
questions about direct primary care, greatopportunity to get on the show right now
with doctor nicolehemkis speaking of the doctor, Doc. How you're doing this morning?
I'm doing well, Sean, howare you? I'm doing really really
good? And uh and we've gotWe've got a really interesting and a lot
of stuff to get to this morning, important stuff to get to this morning,

(01:15):
and kind of right off the bat, doctor. One of the things
people often wonder about to say,well, I have like insurance, I
have insurance through my employer or somethinglike that. Why would I need direct
primary care? Why would that besomething I should look into? What's what's
kind of the answer to that?And why do people I know a lot
of people that see you also eventhough you don't build insurance and don't go

(01:37):
through insurance, people have both Uand insurance. Why is that? Oh
did we lose you doctor? Ohno, oh no, I think we
lost doctor hem kiss may have gotand it looks like got disconnected. We'll
do is we'll get an answer tothat question and so much more this morning
here on Madison The Morning thirteen ten, Wiba mentioned the website advocate DPC dot

(01:57):
com. That's advocates DPC dot com. Tell full number six O two six
eight sixty two eleven. That's sixO eight two six eight sixty two eleven.
Again, you can always as wellif you've got a question about direct
primary care, doct Nicole is here. She loves taking questions, love answering
them. Tell full number here atstation six O eight three two one thirteen
ten. That's six O eight threetwo one thirteen ten. And doctor,

(02:20):
we were talking about why somebody mighthave both insurance and a direct primary care
membership, and a lot of yourpatients do just that, don't they.
Yes, you know, in anideal situation, you know, you have
the direct primary care membership, youhave better access to care, more time
with the doctor, more direct communicationwith the doctor, and you use that
for you know, ninety ninety fivepercent of your healthcare needs. Some people,

(02:44):
you know, we can take careof one hundred percent of their healthcare
needs. Maybe if if you havemore complicated issues, maybe we can take
care of eighty percent of your healthcareneeds. But then you're really just using
insurance for the big stuff, youknow, the catastrophic things, if you
need to be hospitalized, you needmajor surgery. But the idea would be
that if you can choose like ahigh deductible healthcare plan, you're using us

(03:05):
to kind of fill that gap sothat hopefully you're not having to pay towards
your deductible which might be very high, and then you're not having to use
your insurance, but it's still therein case you were to need it.
So when we think about this too, about you know, I don't go
I don't think most of us seeour doctor every month, though some people
may. That's a lot of questionpeople sometimes wonder about, well if I,
if I'm not using it monthly,why would I why would I pay

(03:28):
for a monthly doctor. Yes,this this question comes up sometimes. It
actually I came up with a patient, you know, in the last week
or so where uh, you know, a patient either emailed or came in
and they You're like, well,I hadn't hadn't really been going to in
the last couple months, so youknow, can you just you know,
not charge me for those months thatI wasn't coming And it's like, yeah,

(03:50):
I'm sorry, it doesn't work thatway. In the same way that
you know, you're you're basically you'repaying for access to care right sometimes you
need it. Sometimes you might notneed it, but you're paying for the
fact that it is there for youwhen you need it. In a similar
way, you know, I don'tlike to necessarily compare us to insurance because
that's that's like a four letter wordbut insurance is something that you're paying for

(04:10):
every month. You pay your monthlypremiums, and you most likely are not
going to the doctor every month.I mean, maybe there's a small percentage
of the population that does, butI would say the average person goes to
the doctor two or three times ayear. So you're paying that monthly you
know, premium. You're going tothe doctor two or three times a year.
And I don't know many people thatare calling a Blue Cross Blue Shield

(04:30):
and saying, hey, can Iget the last you know, twelve months
and premiums back because I didn't usethe doctor. No, because you had
access to care, you know,whether it was something little or something big,
you had access. And in thesame way, we look at direct
primary care as access and not notthat you're paying for utilization. And that's
why I don't like the comparison.Sometimes people compare a direct primary care membership

(04:53):
to a gym membership, and Idon't think that's a good comparison because with
a gym membership, you actually dowant to you know, you do want
to go as much as possible,hopefully, you know, within reason,
to a gem. But it's notlike, yeah, I haven't been using
this gym membership for two years,so I'm going to cancel it. That's
not the same as as a directprimary care membership. Talking this morning with
doctor Nicolehemkiss, she is with AdvocateMD, a direct primary care practice.

(05:15):
You can learn more about Advocate mD as well as Direct Primary Care on
the website Advocates DPC dot com.That's Advocates DPC dot com. Telven number
six O eight two six eight sixtytwo eleven. That's six O eight two
six eight sixty two eleven. Anddoctor, you talk about that access and
having access, being able to getin to see your doctor when you need
to see a doctor, and yourdoctor, that's a very important aspect of

(05:38):
all of this, isn't it?Yes? You know, I hear this
also kind of brought up sometimes withthe larger companies that we have. You
know, some of the companies thatwe work with are self funded, so
that means they are paying out theirclaims. You know, they don't have
it necessarily a traditional insurance policy,and so again for them, the question
is why are we going to paythis, you know, sixty or seventy

(05:59):
dollars a month for employees who maybethey never come and see you, or
maybe you know fifty percent of ouremployees come and see you. And my
response to that is all it takesis you know, one time where you
need a doctor and you can't accessa doctor in an outpatient setting. You
know, there's many examples of this. I like to use the emergency room
example, where you know it's aFriday night and you sprain your ankle and

(06:20):
you're not sure if if there's abreak there or not. What are you
gonna do. You're gonna maybe callyour primary care doctor, but you're not
going to reach your primary care doctor. You're going to reach the nurse triage
line or maybe the doctor who happensto be on call who's covering for thirty
doctor's patients, so that that doctorcould be covering for thousands of patients.

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And what happens in the system isthat a lot of times, you know,
there's many reasons for this. Theydon't know you that well, they're
they're unsure if they can actually giveyou the advice over the phone without examining
you. And also there's the kindof medical legal reason of they'll direct you
to go to an er or anurgent care. You know, ending on
if there's an urgent care that's openum. So a lot of things are
directed to go to an EAR thatdon't need to be you know. Another

(07:06):
another example might be, you know, you have a sick child or a
sick baby. It's a weekend.You know, you're not quite sure if
it's something that you know, canyou get to some advice over the phone,
And it's very reassuring when it's yourphysician again. You know, I
take care of families and babies andlittle kids. And if a family texts
me or calls me over the weekendand they describe what's happening, and I

(07:27):
ask a few questions and then theygive me the answers to those questions,
and and I'm able to kind ofsort through the information and advise them.
You know, it sounds like thisis a virus. Let's let's you know,
watch them tried this over the countermedicine. Um. You know,
if you start to see these thesethree things, let me know. But
I don't think that you need tobe seen right now, or the child
doesn't need to be seen right now. But again, in the system,

(07:48):
you're going to be directed to goto an EAR or an urgent care um
you know, which which obviously there'sa large cost associated with that. It's
inconvenient. Most people don't like sittingin an ear waiting room for hours.
But so I like to say topeople in businesses when they say, why
am I paying this sixty dollars amonth, Well, all it takes is
one er visit, and that ervisit is you know, the minute you

(08:09):
walk into an er it's a thousanddollars no matter what they do to you,
and then you know, anything elsethey do, X rays, cts,
medications labs. You're looking at probablyfour or five thousand dollars for that
er visit. So that five thousanddollars would have then paid for, you
know, six years of a directprimary care membership six years. So it's

(08:30):
like this is this is there's nocomparison, you know, of the amount
of access that people have in thisdirect primary care system, and when you
look at costs just from a it'sit's a very kind of a short sighted
way to look at it when youjust look at the monthly and say,
well, if I'm not using itevery month, like do I really need
this? Well, yeah, youdo need it, because you can't anticipate

(08:50):
for the same reason that we needto have insurance or some form of catastrophic
coverage. We can't anticipate what thefuture will bring, right, So it's
it's nice to have that access.And again that access isn't happening through the
system right now. Think of likecar insurance, Like none of us would
ever dream of driving our car withoutinsurance. Yet the reality is, I

(09:11):
think most of us have probably beenpaying for our insurance for our car for
our entire lifetime and maybe we've usedit once maybe, And so you think
about that stuff and it's and that'sand that's again going back to back to
your point doctor about you know you'repaying for access and having that when you
need it, and when you talkedabout how it works with direct primary care,

(09:33):
that access when you need to seeyour doctor, your doctor being available
to you and not having to godown that urgent care route, not having
to go down the way. Thatis an amazing thing about direct primary care.
Not only is it affordable, notonly is it high quality primary care
for you, you also actually getto meet with your doctor when you need
to see your doctor. You canlearn more on the website. Advocates DPC

(09:56):
dot com. That's Advocates DPC dotcom. They're telephone number six O eight
two six eight sixty two eleven.That's six O eight two six eight sixty
two eleven. Pick up the phone, make an appointment this morning and become
a member at Advocate MD six Oeight two six eight sixty two eleven,
or of course learn more online AdvocatesDPC dot com. We'll continder our conversation
with the doctor next as Full Scopewith doctor Nicolehemkiss continues here at thirteen ten

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WIBA, A twenty thirteen ten WUIBAand full Scope with Doctor nacolehem Kiss Madison
in Wisconsin's directcare doctor. You canlearn more about doctor Nicolehemkiss all three locations
of Advocate MD. Also all thedoctors on staff for you at Advocate MD.

(10:41):
All at the website Advocates DPC dotcom. That's Advocates DPC dot com.
Also a great thing there to learnabout direct primary care and how it
works. All on that website andthen become a member. Pickup phone Gi
McCall six O eight two six eightsixty two eleven at six O eight two
six eight sixty two eleven. Andbefore we talk a little bit as we're
talking access this morning about if youare in that insurance system getting into see

(11:05):
a doctor, and the doctor shortageand the problems that that is causing.
Um, I want to really quicklythough, just talk about a little bit
more doctor as we discuss access,the investment and the importance of seeing your
doctor. Oftentimes, you know,but the studies have shown people who see

(11:26):
their doctor regularly for checkups and appointmentsand have that good doctor patient relationship,
they get sick, they have issuescome up far less often because oftentimes things
that start out little can be preventedfrom becoming something bigger, can't they true?
Um, they have done studies thathave shown that when you see a
primary care doctor on a regular basis, that you live longer and you're healthier.

(11:48):
In general, there is a lotof debate, you know, as
to well I feel good, youknow, why should I go in and
see a doctor? Well, partof what family medicine doctors do is preventive
care. So we do screening tests, we do exams, we do blood
work, We check your blood pressure. Even though maybe you've never had an
issue with your blood pressure, butyou know, all of a sudden,
you know, you come into thedoctor's office and it's it's running high.
Figuring out what's causing that, andagain that doesn't necessarily mean, I know,

(12:11):
sometimes there's a perception that you know, Western medicine trained doctors will push
pills on you of like here's yourbloodressure medicine, here's your cholesterol medicine.
A lot of what we try todo is lifestyle medicine, so kind of
educating and discussing how things like dietand exercise play such a role in health,

(12:33):
along with stress and sleep and youknow, alcohol use and drug use
and all these other things that contributeto our health besides the pharmaceutical part of
this. So the goal is reallyto try to keep people off of meads,
right, and as much as wecan get people to change their lifestyle
and get healthier and lose some weightand you know, eat less salt and
eat less processed foods, that's reallythe goal. And then if we can

(12:56):
prevent them, you know, soif we can better control your blood pressure,
better control your cholesterol, and thenthat prevents you, you know,
ten years or fifteen years down theline from having a heart attack or a
stroke or things like really really terrible, um, you know, episodes like
that, then we will do that, try to do that while you're you're
healthy and before you develop symptoms.So I think, you know, in

(13:18):
our current healthcare environment, unfortunately,a lot of what we do is,
you know, people say sickcare ratherthan healthcare. So we wait until a
person develop symptoms. We wait untilthey're having the chest pain or the shortness
of breath or you know that,you know, they can't walk because they
can't catch their breath, and thenwe try to figure out, oh,
wow, what's what's causing us?Well, what if we could prevent those

(13:39):
things from developing because we caught youearlier on and we were able to kind
of make those changes earlier on,then that really pays off, you know
later in later years. Or peoplesometimes surprised you mentioned that, you know,
we talk about about about that lifestylemedicine. Are people sometimes surprised at
like some of these small changes andadaptations to lifestyle. Are people sometimes surprised

(14:01):
at some of the significant and profoundeffects they can have on our overall health?
Yes, I think that it's somethingthat's hard to explain or to just
you know, say express in words. I almost feel like you have to
experience it. You know, forthose of us, including myself, that
have lost a good amount of weightsand you know, that's kind of made

(14:22):
it easier to exercise. It,you know, made you kind of more
motivated to eat healthier. It's it'sa lot of things, Like a lot
of things in life. You know, these things happen in cycles. Right.
We get in a bad cycle.We don't feel very good, we
don't you know, our mood isbad. We eat worse. When we
eat worse, we don't feel likeexercising or getting out and taking a walk.
When we start eating healthier, whenwe lose a little bit of weight,

(14:45):
our mood is better, we feellike exercising more. So it's kind
of a cycle that people go through. But yes, I think that having
a doctor that's willing to sit downand take the time with you, because
these conversations don't happen in five minutes. These conversations take, you know,
thirty minutes or longer. I mean, I've had patients where I've talked to
them for an hour just about dietand it's something that I enjoy doing.

(15:07):
So if you have a doctor who'sable to take the time to have these
conversations and to answer your questions andto really discuss these issues in detail,
and then you know you kind ofhave a support person or a point person
that you're not kind of doing thisby yourself. That's really a cool thing.
And it always gets me when Ihear I mean, obviously there's tons

(15:28):
of people in the healthcare team andthey all you know, have a contribution
to make you know. I hearabout things like health coaches, and I
think, well, your doctor couldbe your health coach, right, ideal,
your doctor would be your health coach. Right. We're supposed to be
here to support you and encourage patientsand help them when they have questions or
struggles. So you should have adoctor that you views as a support person
for those things. Talking this morningwith doctor nicolehem Kiss of Advocate MD.

(15:52):
Online Advocates DPC dot com. That'sAdvocates DPC dot com. Great website to
learn more about the practice and directprimary care telphone number. Make an appointment
to become a member at Advocate MDsix two six eight sixty two eleven at
six O eight two six eight sixtytwo eleven. Five Fantastic doctors at Advocate
MD and people say, doctor Nicole, how were you able to assemble such

(16:14):
a great team of doctors? Andone of the reasons one obviously, direct
primary care is not only amazing forpatients, but also amazing for doctors as
well, and a lot of doctors, really good doctors in these insurance systems
are just being just being burnt outbecause there's such a shortage. Is that
right? Yes, you know,again, like many things, like I

(16:34):
said, in cycles, you know, this is kind of a perpetually worsening
cycle where as the system gets worseand doctors are kind of pushed to see
more and more patients and their panelsget larger. You know, they say,
a traditional family medicine doctor in aninsurance space system might have a panel
of twenty five hundred patients, threethousand patients, and to give you a

(16:56):
comparison to a direct primary care practicelike ours, our doctors when they're full,
they might have five hundred patients intheir panels, so, you know,
less than a quarter of what afee for service doctor has in their
panels. What we're seeing. Soas these doctors are, you know,
seeing more and more patients and kindof pushed more that you know, they're
burning out at increasing rates, andso they leave the system, they retire

(17:18):
early, they start working part time, so they work two days a week
instead of four days a week,and so then it becomes harder to see
a doctor, right, So thenyou know, you have less access within
the system. And also, obviouslythe really good doctors, the doctors that
like talking to their patients and takingthat time with them and they have a
good relationship with their patients, thosedoctors will be sought out and they will

(17:41):
have larger panels, and it willbe harder to get into those doctors.
So, yes, it's kind ofa vicious cycle. But in our model,
again, this is somewhat good forus when this happens, because these
doctors leave the system and come andwork for us with us. And so
I think that what we are seeinghappening is that they're is going to be
more of an access issue as timegoes on and patients will need to have

(18:04):
access to a doctor. So ifyou if you think that it's important to
you know, be able to seea doctor when you need to and make
an appointment easily and have somebody that'sgoing to spend time with you, I'd
really encourage you to look into thedirect primary care model. What an amazing
idea of seeing your doctor when youneed to see your doctor exactly and as

(18:25):
we're seeing as as we mentioned,of course, Advocate MD expanded from one
clinic now there's three area locations,one from one doctor, doctor Colehempkiss,
to an entire team of doctors onstaff at Advocate MD. You can learn
more about it online. Folks areabsolutely responding and loving it. Learn more
online your Advocates DPC dot com.That's Advocates DPC dot com. The telephone

(18:48):
I'm making appointment to come remember sixo eight two six eight sixty two eleven
at six eight two six eight sixtytwo eleven Doctor Hempkiss. You enjoy this
beautiful day and have a great weekend. You two Sean, thank you.
Certified Financial Planner Trade se Anton joinsus next to here on thirteen ten WI B eight