C-Level Staff & Wearables

Episode Transcript

Speaker 1 (00:00):
Eight oh seven thirteen ten WIBA and full scope with
doctor Nicole Hempkiss, Wisconsin's direct care doctor. You can get
no doctor Hempkiss and all eight physicians as well as
learn more about Advocate MD all on their website Advocates
DPC dot com. That's Advocates DPC dot com. Not only

(00:20):
eight physicians at Advocate MD four locations, very convenient Westside
and Middleton east Side. Right on one fifty seven South
Feroks Avenue, Fitchburg, right on the Madison Madison Fitchburg line.
Now right on Sien Road and down in Janesville, right
near the hospital at ten twenty one Mineral Point Avenue.
Of course, if you're in southern Dane County or in

(00:41):
Rock County, that clinic is perfect for you. Again, you
can learn more online the website Advocates DPC dot com.
That's Advocates DPC dot com. Telph number six oh eight
two six eight sixty two eleven. That's six oh eight
two six eight sixty two eleven. And joining us this
morning as mentioned is doctor Nicole Hempkiss. Doctor. How you
doing this morning?

Speaker 2 (01:01):
I'm doing great, Sean, how are you?

Speaker 1 (01:02):
I can't complain, it's it's you know, ready for the weekend,
and looks like it's going to be a good one.
We've got an important conversation. Has always fun stuff to
talk about. We start talking about technology and wearables. I'm
gonna I'm gonna get into that a little bit, which
as soon as you sent that over this morning, I
got all giddies talk at a little bit about and

(01:23):
we'll also talk about the C suite, which is like
CFO COO CES, something's like the big money people when
it comes to health systems. We're gonna get some get
some insight into what's going on with their roles. But
first let's talk a little bit about direct primary care
and a little one what it is, and I think
the other big question is when can I enroll? What

(01:45):
do folks need to know in those areas? Doctor?

Speaker 3 (01:48):
Yeah, so you know, direct primary care is a model
of care where the premise behind it is that, yes,
there are some aspects of healthcare that can be very expensive.
I think all of us have experienced going into see
a primary care doctor or maybe a specialist, or going
to get a test or a procedure or a blood
test at the at the healthcare system and coming back
and getting a huge bill afterwards and not understanding, you know,

(02:11):
why wasn't this covered by my insurance?

Speaker 2 (02:13):
Why is it so expensive?

Speaker 3 (02:15):
And the idea behind direct primary care is that we
are separating out, separating out primary care from all the
rest of healthcare. So primary care is the things that
we can do in the clinic setting. That would include,
you know, urgent care, your annual exams, your chronic disease
management for blood pressure and cholesterol and thyroid diabetes, the
minor procedures we can do in the office. And then

(02:37):
the rest of healthcare, you know, the things like you know,
major surgeries, emergency room visits, you know, cancer treatments, all
of these things that can be very expensive, you know,
those things that we do want to have some.

Speaker 2 (02:49):
Form of a like a catastrophic coverage.

Speaker 3 (02:51):
That could be a high deductible insurance policy, that could
be a health share. Again, that's up to your personal preference,
your financial situation. But for the vast majority of people,
you know, we can take care of ninety percent, ninety
five percent of your health care needs. For some people,
one hundred percent of their health care needs in our clinic.
So when we do it that way, it all of

(03:13):
a sudden becomes much less expensive. Uh, it's you have
much better access to care. You get a doctor's appointment
in a few days or a week rather than you know,
six to nine months. You have a doctor that's going
to spend forty five minutes to an hour with you
rather than ten or fifteen minutes. You have the ability
to text or call that doctor after hours when there's
something urgent going on. Again, the reason we can do

(03:34):
that is because we've separated out, you know, all these
administrative costs that are associated with not only insurance billing,
but also you know, large healthcare systems and all the
layers of bureaucracy they have, which you know that will
kind of bring us into our next topic. But yes,
if anybody can do direct primary care. You know, this
is not a system for people that don't have insurance.

(03:55):
That's one of the common misconceptions. You know, ninety five
percent of our patient population has some form of healthcare coverage.
But again, they're using us for all of those reasons
I mentioned, the cost savings, the access, the quality of
the care. And I'm sure you've probably experienced similar situation Sewn,
or have you ever experienced when you went into the

(04:16):
doctor and get this bill in the mail two or
three months later and like, why I didn't realize how
it was going to be built for that?

Speaker 1 (04:22):
Well, yeah, yeah, I've experienced that, and I think for
a lot of folks that is one of their big
dreads is not knowing what it's going to cost. And then,
you know, we hear stories of you know, of people
getting these bills and they're just shocked and what exactly,
you know, I thought this was going to be like
my free are included with my whatever, my my wellness

(04:43):
visit or whatever, and they end up getting They're like, wait,
what's this all about? That's one of the cool things
and doctor. I know, folks that have had a chance
to listen to the show for a while are familiar
with this, but for folks that are new to the program,
one of the things they may not know is not
only is membership very affordable, well, everything is spelled out
in black and white as far as if you do
need tests or if you do need certain things that

(05:06):
there is an added cost to. It's very clear, very transparent,
and very upfront about it as well.

Speaker 3 (05:13):
Exactly, you know, that's the other big thing that separates
us from the large healthcare systems. I think, you know,
and what we've talked about on the program many times
is there is really no transparency. Even if you want
to be a really educated healthcare consumer and call ahead
of time and figure out, you know, what the cost
of something is going to be, there's really not a
good way to do that. Systems in many cases will

(05:34):
you know, keep these costs kind of hidden from patients
because they don't want them to know the cost of things,
or they'll make it, you know, overly complex to be
able to figure that out. In our system, all the
visits are included, so you'll never get any any bills
in the mail for a visit. Things like lab work
or medications, all of those costs would be told to

(05:55):
the patient ahead of time. And you know, our labs
are typically five to ten dollars are generic. Prescription medications
might be you know, five to ten dollars for a
ninety day supply, so it's much much lower cost, and
all of those costs would again be known to the
patient that you know, we don't have any surprise medical bills.

Speaker 1 (06:14):
It's pretty cool too, as we talk about talk about
the great things offered at Advocate MD, and what membership includes.
And it's such a really really great model for you,
great opportunity to day to learn more. If you haven't
been to the website recently, head on over Advocates DPC
dot com. That's Advocates DPC dot com even better, what
a great data Make an appointment to become a member
at Advocate MD. All you've got to do is pick

(06:34):
up phone, give them a call six oh eight two
six eight sixty two eleven. That's six h eight two
six eight sixty two eleven and doctor. One of the
areas that Advocate MD and direct primary care, one of
the areas that that really helps you keep things more
affordable is there's not all of the bureaucratic layers at
Advocate MD. There's not you know, there's it's literally you

(06:57):
and a staff of seven other physicians. It's it's really
kind of good old traditional medicine relationship doctor patient relationship.
Don't have the insurance and other things in there, and
that's one of the big ways you can keep costs down.
Let's talk about some of the big systems that we're
kind of alluding to earlier, about some of those surprise
bills and the amount of revenue coming into these they've

(07:19):
all got you know, they've got all certain you know
wings of their of their buildings that are just offices
and get up towards the top of those those wings,
up to those those rooms with great views overlooking the
lake and other things. Uh, there's there's a lot of
really nice, nice offices that cost a lot of money.
Let's talk about some of those roles and what's going

(07:41):
on in healthcare systems when it comes to like CFO, CEO,
CEOs and all those other other folks.

Speaker 3 (07:48):
Yeah, you know, I think there's a lot of parallels
with you know, large healthcare systems and even our government. Right,
so government doesn't tend to contract and get smaller. It
gets bigger and bigger, and you know, you you they
have new committees and new positions and you know, more
layers of bureaucracy as time goes on, as opposed to

(08:09):
getting smaller. And I think hospital systems are the same way.
Or you know, now when I kind of use the
term hospital systems synonymous with healthcare system because hospitals own
you know, all the layers of healthcare. Now, they own
the primary care doctors, the specialists, the surgery centers, the
radiology facilities. That's definitely true in our local area here
of Madison, as we have very few independent you know,

(08:33):
doctors and independent surgery centers and things that that's changing things,
you know, thankfully. But so when you look at healthcare
systems or hospital systems throughout the years, they have expanded
and expanded their administrative costs. You know, so they have
all these vice presidents and all these you know, different

(08:54):
layers of nursing administration, and there's a cost associated with
all of that because right that those people are not making.

Speaker 2 (09:02):
A little bit of money, they're making a lot of money.

Speaker 3 (09:05):
There was something recently post on LinkedIn by some of
my colleagues that was talking about one of the local
hospital systems down in Janesville that many of us are
familiar with, and many of us are familiar with the
president and CEO. But they listed all of their you know,
the CEO, the vps. You know, there's a VP of revenue,

(09:27):
the VP of operations like all these you know, many
of these hospital systems have twenty or thirty vps. But
so they listed their comps from twenty twenty three, so
almost two years ago, and you know, the CEO is
making eleven million dollars, and that also probably doesn't include
all of his you know, his other you know, bonuses

(09:49):
and you know, all of these other things that he gets.
But they also and then at the bottom of it,
they put tax exempt nonprofit status since May of nineteen
seventy two. So this is a tax exempt nonprofit healthcare
system that pays their executives multiple millions of dollars, you know.
And then yeah, as we've talked about, in the meantime,
they will send their patients to collections if they don't

(10:11):
pay their you know, a couple hundred dollars you know,
medical bill for some necessary medical treatment. So that that's
a whole nother story. But but so you have all
these layers of within healthcare systems. And this was brought
to my mind because you know, I think I sent
you the article Sean about It's in the Becker's Hospital Review,
and the title of the article is c Suite roles

(10:33):
Fewer health systems are prioritizing. And it's funny to me
because and I think, you know, there are many corporations
that have these similar titled executive roles, but you know,
chief learning officer, Like what does that mean, I don't know,
you know, chief experience officers. So it's almost like they're
thinking of their thinking of titles to give to people,

(10:54):
to put them into positions, you know that the you know,
chief strategy officer.

Speaker 2 (10:59):
You know.

Speaker 3 (10:59):
So again, it used to be that there was maybe
a couple different layers of bureaucracy, and you know, there
was somebody obviously that ran the hospital, and you know,
there was different leadership roles. But that has you know,
exploded over the last you know, ten fifteen years, and
I think, now, what what hospitals and healthcare systems are

(11:20):
finally recognizing, hopefully slowly, is that, uh, you know, maybe
all these these people aren't necessary.

Speaker 2 (11:28):
What exactly do all these people do? You know?

Speaker 3 (11:31):
I think we need to look at you know, as
we look at things like efficiencies within healthcare systems, and
many of it, much of it is put on the
shoulders of doctors, like well, what just see more patients,
you know, like Seid of seeing twenty patients today, you
see twenty five patients today. You generate more revenue. Let's
you know, nurses, instead of taking care of four patients

(11:52):
at the bedside, take care of six patients at bedside.
You know, instead of instead of pressuring doctors and nurses
to do more and more and more when they're already stretched,
then why don't we look at ways to decrease the
administrative cost within these large healthcare systems so that they
can actually function you know, at a lower cost, more

(12:13):
lean functioning, and then pass that savings you know, of
course onto the patient, which they never do, but in
an ideal world, that would be what would happen.

Speaker 1 (12:22):
Well, the other thing that I think too, that would
be really nice if they were to able to like
you know, hire you know, more doctors and you know,
maybe use some of that money for that. So at
least if you're you know, if you're selling out all
this money, at least it's a good experience. I think
what that's part of the other other big frustrations for
folks is, you know, healthcare is is you know, in
that system is so dang expensive, so many unknowns, but

(12:46):
you're also treated so poorly. Like I think that's a
you know, you're waiting months, if not you know, half
a year to get in to see to see somebody,
and when you are, you're kind of you know, treated
like chattel where you're just kind of pointed this, So, yeah,
it's such a mess and doctor when we talk about
these about these different things and kind of the the

(13:06):
reshuffling of the deck of you know, kind of roles
that are being that are being absorbed into other roles.
And again, I think that the frustration is always how
does this make the patient experience better? And the answer is, unfortunately,
always it doesn't. And that's one of the cool things
about Direct Primary Care and Advocate MD. It's all about patients,
it's all about you. It's all about your relationship with

(13:28):
your doctor. You can learn more online the website ADVOCATESDPC
dot com. That's ADVOCATESDPC dot com. Great option for you your family. Also,
if you're an employer looking for some great options for employees,
direct Primary Care and Advocate MD is a huge benefit.
It's a really really good thing to offer your employees. Again,
you can learn more online ADVOCATESDPC dot com. That's ADVOCATESDPC

(13:52):
dot com. Tellfh number to make it a point and
become a member at Advocate MD. Give McCall six oh
eight to six eight sixty two eleven. That's six oh
eight two six eight two eleven. We'll continue our conversation
with doctor Nicole Hempkiss of Advocate MD. Talk a little
bit about wearables. What are wearables? We'll find out from
the doctor. We'll also find out what implications they might have.
We'll get those details next as Full Scope with doctor

(14:12):
Cole Hempkiss continues right here on thirteen ten Wi B A.
Thirteen ten Wi B A and Full Scope with Wisconsin's
direct care doctor, doctor Nicole Hempkiss. Of course, doctor Hempkiss
comes to us from Advocate MD, a direct primary care
practice with four area locations Eastside, west Side, Southside, Jamesville
as well right don Mineral Point Avenue. Great great clinics,

(14:35):
great great doctors. Eight doctors at Advocate MD, eight physicians
there for you. You can learn more online the website
ADVOCATESDPC dot com. That's Advocates DPC dot com. Telphon number
six oh eight two six eight sixty two eleven that's
six oh eight two six eight sixty two eleven to
make an appointment, become a member at Advocate MD. And
doctor technology is super cool, and I know that Rob F.

(15:00):
Kennedy Junior is is talking wearables and really trying to
promote them and uh, it's I always find this this
kind of area to be very interesting as somebody who
loves tech for the tech of it all, but finding
different ways to make them technology useful. And there's always
kind of that that back and forth is more data

(15:22):
is good, more accurate data is even better, but sometimes
these technological advances are used to kind of cut off
that human interaction. And and as much as as again
I love technology, there is really no comparison for you know,
having some you know, whether it's a watch or a
ring or or I see people with now with like

(15:44):
monitors that are like actually like in their arm that
actually are are doing things. It's still not it's still
no replacement for a good old fashioned medicine and meeting
with your primary care doc.

Speaker 2 (15:54):
Is it very true?

Speaker 3 (15:57):
And you know, I think as we hear more and
more about AI and computers and and I think, you know,
AI obviously is being used now within healthcare systems to
increase efficiency and and you know, even dealing with messages
from patients and things like that. But I think that
the technology is obviously it has good aspects, and having

(16:17):
data and knowing what's going on in your body, there's
you know, some really positive things about that. For me,
I see the downside being also though, you have to
have the knowledge and kind of the awareness of how
to process that information, right. So I definitely have experienced
patients where they wear you know, the the Apple watch
or they have the ring, and so you know, they're

(16:39):
they're kind of constantly looking at you know, how their
heart rates fluctuating and their oxygenation level or their sleep
patterns or all these things, and in some ways it
can almost feed into a cycle of making you more
anxious or more ocd about it, which we don't want that,
but it also you have to have. This is why
I definitely recommend that people that are you using these

(17:01):
fitness tracking type devices. I remember when it used to
just be remember the old fashioned sean like pedometers that
people used to wear, like I remember my mom used
to she probably still does, but you know, the old
pedometers that would just tell you, like register how many
steps you were taking and stuff. But so we've we've
obviously improved upon that a lot, and I do think

(17:21):
there's a value to knowing some of that information. But again,
you know, things like for example, you know the common
thing that you know, we look at.

Speaker 2 (17:29):
In the Apple Watch and the ring and everything is
heart rates.

Speaker 3 (17:32):
So you know, it's it's important for people to understand
that it is one hundred percent normal to have, you know,
fluctuations of your heart rate throughout the day, depending on
you know, of course, your activity level, whether you're anxious,
you know, the position that you're in, whether you're laying
down or standing up. You know, all of these things
can cause heart rates to change.

Speaker 2 (17:51):
You know.

Speaker 3 (17:52):
Sometimes I think people will again get a little bit
too fixated, fixated on like you know, short little blips
that they see and you know, you know obviously versus
like the overall patterns that are happening. But it can,
you know, I mean we've had patients where it can
diagnose things, you know, like if if you're persistently have

(18:12):
an elevated heart rate and you know, or if you're
feeling something going on in your chest and it feels
like your heart's fluttering or it's pounding you know, hard
in your chest. Those are things again you should talk
to your doctor about. But I do see that, you know,
in the future, I think this the tracking devices and
everything will only become a bigger and bigger deal and

(18:35):
a bigger part of our you know, healthcare journey. You know.
The other thing that that article mentioned, so this was
also in the Becker's Hospital Review, and it was the
title of that was, well, RFK Junior's wearables push work.
So he's pushing that everyone should have every American should
have access to one of these devices. Within the next

(18:55):
four years. I'm assuming there's going to be some government
program to subsidize that or some thing, but you know.

Speaker 2 (19:02):
I think that we will see more and more of this.

Speaker 3 (19:04):
So the other big thing that we're seeing now is
continuous glucose monitoring, so where people stick.

Speaker 2 (19:09):
That on their arm, and you know, not just for
diabetic people.

Speaker 3 (19:12):
We used to do this obviously with diabetics, especially type
one diabetics, but now even people that are very you know,
want to be very aggressive about their their their intake
of food or you know, their how their insulin is
reacting to what they're eating and things like that. So
they'll wear these in it will monitor their glucose, you know,

(19:32):
over time, and they'll be able to see those patterns
and see how the glucose rises after they eat certain
types of foods. And again I think that that is
all very helpful information. As long as we're able to
patients are able to look at it and process it
and not become fixated on it or anxious about it.
And obviously, if you have you should have access to

(19:54):
a primary care doctor that can help you interpret that information.
You know, you shouldn't be interpret it all by yourself
because you need the broader context of what that means.
You know physiologically, and you know what are normal vile signs,
and you know why why is your body reacting in
this way? So I think that again that kind of
just brings it back to, like you said, Sean, having

(20:16):
access to a doctor, uh, you know, a face to
face doctor that they're going to help you kind of
understand what those what that data means.

Speaker 1 (20:24):
And now you and I were talking during the break
I had recently, I've got a couple of smart watches
that do some of the some of the tech stuff,
and but I recently switched to to wearing a ring
and it's a really it's it's very cool. I love
the having the access to the data. I love that
I don't have to wear one watch. I can because
I'm a nerd about watches. I can wear other watches.
This thing just looks normal with whatever I wear. But

(20:47):
I was telling you one of the things that I
fret about is it tells me that I need more sleep,
and it's like kind of already know just kind of
adds adds more, adds more to it. And uh and
with that technology to doctor, are you seeing more patient
that are that are you know, bringing in whether it's
it's reports from there on their iPhone or android. Are
you seeing patients kind of bring that stuff to you

(21:09):
and saying, hey, here's what I see. Can you help
me understand this stuff?

Speaker 2 (21:14):
I see some of it.

Speaker 3 (21:15):
Yes, I mean I think that there's obviously a section
of the population that is very much into these you know,
maybe it's you two Sean like very much into having
all of this information, you know. And I think sometimes
people go through phases I would include myself in this too,
where maybe you wear the watch all the time for
a few weeks or a few months and then you

(21:35):
kind of, you know, like fall back a little bit
and you're not as much into it as you were before.
But yes, I think definitely there's a cool factor to
it right where it's like, oh my gosh, like I
could see like, oh I woke up you know, five
times last night and I didn't even realize it or like,
oh my my heart rate you know, got really fascin.
So there's there's that part of it that I think

(21:57):
is interesting. And again it's I think there's a lot
of positives for patients to be interested in what their
body's doing and want to you know, understand it better
and figure out answers if things are you know, if
they're having symptoms of something. I think there's a lot
of positives to that. So yes, I do have patients
that will sometimes bring it. You know, I have a

(22:18):
few patients that have the ring. And you probably know
more about the ring than I do, Sean.

Speaker 1 (22:24):
Yeah, they And what's like, I'll tell you. One of
the reasons too, I switch is because that they charge
it takes like thirty minutes to fully charge it in
the last for twelve days, so it's uh oh it's yeah.
And so what I do is I just each morning,
just while I'm in the shower. It's waterproof, but I
set it on the charger. I've never so it's cool
and it continually does that. The one that again, this

(22:45):
is I don't have to make it all about it.
I don't want to all about me, but I will
tell you, doc, one of the reasons why I liked
it is it is it tracks like not just sleep,
but alerts for like sleep apnea. It'll it'll do like
a cycle where like it'll monitor very detailed over I
think it's three or four nights where it and it
tracks all that stuff. And I just to me, I'm like,
that's a really cool thing because with the watches, they

(23:08):
they you know, they work great. They got the e
kg a kg or whatever those things are, which I
find just fascinating watching the graphs and seeing how the
ticker's going, but they don't do it is like they
don't track like the the some of the sleep stuff
that I wanted. So I'm like, I'll check this thing out.
So it's yeah, it's it's cool. And I know also doctor,
and you would know this better than anyone around, but

(23:31):
like you got to take it also with a bit
of a grain of salt, as these are not you know,
there's a big difference between what what I buy as
a consumer and the tools and the and and and
that that are available to you as a doctor.

Speaker 2 (23:45):
Yes, very true.

Speaker 3 (23:46):
Yeah, I mean, especially like what you mentioned that example
of there's a one lead EKG option on the Apple Watch,
and and and again I think it's it's overall basically
pretty reliable, but it doesn't replace like getting an EKG
in a doctor's office. So so yeah, I think these
things might be good, good ways to kind of like
trigger something to where you then you know, get a

(24:07):
further work up with a doctor. But again just reiterating
that I don't think people should fixate on on you know,
like looking at it all the time and letting it
worry you. If you're if you're concerned about something, you know,
go into the doctor and talk with them about it.
But I use my Apple Watch too a lot for
the fitness tracking, like the you know, if you're walking
or running or swimming. It's really cool that it can

(24:29):
like record all of these things and know what activity
you're doing even if you don't you know, type it
into the watch. So I think there's a lot of
really interesting, you know, options that are available.

Speaker 1 (24:40):
It is great stuff. It's a great day to start
that conversation we talk about talk about cool options. One
of the great options for you your family if you're an employer,
direct primary care and Advocate MD. As we talk about
all the different things going on in the medical world.
It's a great day to kind of get back to
those basics. Actually have a great relationship with your doctor,
getting in to see your doctor when you need to.
And of course I'm very, very affordable, amazingly affordable, shockingly

(25:04):
affordable Advocate MD. You can learn more online the website
ADVOCATESDPC dot com. That's Advocates DPC dot com. Telphy number
six soh eight two six eight sixty two eleven. That's
six oh eight two six eight sixty two eleven.

Speaker 2 (25:16):
Doctor.

Speaker 1 (25:16):
It's always great chatting with you. Have a great weekend
and we'll talk soon you too, Sean, Thank you. News
is next right here on thirteen ten wib A