Dr. Hemkes Answers Your Questions About DPC

Episode Transcript

Speaker 1 (00:00):
Eight O four thirteen ten wib A full scope with
doctor Nicole Hemkiss, Wisconsin's directcare doctor. If you have not
had a chance to check out the website Advocates DPC
dot com. That's Advocates DPC dot com. I would tell
you definitely need to check out the website Advocates DPC
dot com. Doesn't matter who you are, how you feel

(00:22):
about your current healthcare, all that stuff. I have a
pretty good feeling on how you do. Actually, if you're
not a member of Advocate MD, but you should definitely
learn more about it. It's a really really cool model,
a great opportunity for you your family. If you're an
employer looking for some great options for primary care, make
sure you head on over the website Advocates DPC dot com.

(00:42):
That's Advocates DPC dot com. Membership costing it's sixty eighty
dollars a month somewhere and there about seventy eight thing
on average. If I remember right, telphe number six oh
eight two six eight sixty two eleven, make nake a
point become a member at Advocate MD six oh eight
two six eight sixty two eleven. Doctor Hemkiss, how you doing?

Speaker 2 (00:57):
Was I?

Speaker 1 (00:58):
Pretty close on my on my figures there numbers my uh.

Speaker 2 (01:01):
Yes, yes, I'm doing well, Sean. How are you?

Speaker 1 (01:04):
I'm doing great. It's so great to talk with you
each and every week, and you know, I always kind
of hog the conversation. And one of the things I
feel bad about is I haven't mentioned to folks one
of the great things about having you on on Fridays
as we're live this morning is the opportunity for folks
that have questions about direct primary care, have questions about
kind of about the healthcare system. You're an amazing resource

(01:27):
and I always forget and I should do this. And
I'm going to make a note that phone lines are
open six oh eight three two one thirteen ten. That's
six oh eight three two one thirteen ten. If you
have questions for doctor Hemkis, we'd love to have you
join us.

Speaker 3 (01:39):
Now.

Speaker 1 (01:39):
Obviously we're not going to do medical diagnosed Caesar medical
questions on air. This is definitely more of a forum
prof You've got questions, and I know sometimes people wonder
things that maybe I overlook as far as asking questions
about like hey what about this? What about that? Oh
my goodness, what a great what a great opportunity is
to get on the air with doctor Hemkiss this morning again.
Who wonder about direct primary care and surants are just

(02:00):
kind of healthcare in general. We'd love to hear from you.
Six eight three two one thirteen ten. That's six eight
three two one thirteen ten. And before we get rolling
on this week's overall topic, about just a little bit
about some of the some of the things going on.
Actually it's just stuff right out of the news as
a matter of fact. We'll get to that in just

(02:20):
a moment. But first, doctor, let's talk a bit about
Advocate MD, the four clinics, the eight physicians that at
Advocate MD, and specifically two about direct primary care for
folks that aren't familiar with it. Let's talk about the
practice and what you guys are doing at Advocate MD.

Speaker 2 (02:38):
Yes, we are a cash based, membership based primary care practice.
We currently are the largest physician only direct primary care
in Wisconsin. We are one of the largest physician only
direct primary cares in the Midwest. Our model is unique
in the way that we only have physicians. So right
now we have eight physicians in our practice. When you

(03:02):
come in and see us, each of the doctors spends
forty five minutes to an hour. With patients, you typically
get an appointment in you know, sometimes a few days,
sometimes maybe most at most would be one to two weeks.
We get you in the same day for urgent care.
And then the other unique thing is that you do
have access to your physician after hours. So if it's
a night or a weekend, you have a number where

(03:24):
you can text or call them. So this is almost
like a concierge type level of service. You know. The
question that we get after that is well, how can
you do that and how can you still have a life. Well,
the way we can do that is because our doctors
have panels of usually four hundred to six hundred patients
and their panel versus two thousand to three thousand patients

(03:47):
of what mini doctors in the large health systems here
locally you have two to three thousand patients in their panel.
So we have, you know, less than a quarter of
that in our patient panel. So that's what allows us
to have better access, more time with the patient after
hours availability.

Speaker 1 (04:03):
And what's funny about it is as you talk about
well how are you able to do that? The other
thing that I always get is people are like how
is she able to do that at such an affordable right?
Like what's the you know? And I think I think
I've heard you use this phrase as well, like what's
the catch? And that's the cool thing about direct primary
care is the catches. There's no insurance involved, which means
there's no crazy costs, there's no middlemen. It's just a

(04:24):
great relationship between you and your doctor. And I know,
one of the big important things about direct primary Care
and Advocate MD as well is transparency. Everything is spelled
out black and white. If you've got a question for
doctor Hemkis about direct primary care, I'd love to hear
from you this morning. Six SO eight three two one
thirteen ten. That's six SO eight three two one thirteen
ten and Susie joins us this morning. Susie, welcome to

(04:45):
the program here on the air with doctor Nicole Hempkiss
of Advocate MD.

Speaker 3 (04:48):
Awesome, thanks well your question questionnaire. My question is what
other health? Basically, what what are the coverage should you
get beside with Nicole Hempsons.

Speaker 2 (05:05):
Yeah, it's a great question, and there is a section
on our website that says pair with But in general,
what I recommend is that people have some sort of
a high deductible insurance policy to pair with us. So
you're going to use direct primary care for you know,
most people ninety to ninety percent of their healthcare needs.
So you know, whether it's urgent care, if it's preventive care,

(05:27):
if it's your kind of follow up visits for blood
pressure or whatever the chronic medical needs you have, you
can use our clinic for that. But we don't, you know,
obviously do surgery. We aren't specialist, we don't do emergency
room care. So those sort of things. You want to
have what we used to call catastrophic insurance policies. Now
that name has kind of fallen out of favor after

(05:49):
the Affordable Care Act, but you want to have a
high deductible insurance, and that kind of varies depending on
what people's comfort level is. You know, some people have
a five thousand dollars deductible nowadays go all the way
up to you know, fifteen thousand dollars deductibles. So that
would be something that we're keeping on the back burner.
Hopefully never have to use it, but it's there in

(06:09):
case something major were to happen. But yes, so mostly
a high deductible insurance if you have an high deductible
that's paired with an HSA. That's also great because now
due to the new big beautiful Bill, they are allowing
people to use HSA money for direct primary care memberships
and all the other ancillary services like labs, meds. So

(06:31):
you can take that HSA money that you're putting in
and again this is kind of like a tax uh,
you know, pre tax savings account that rolls over, so
you can use your HSA funds to also pay for
your direct primary care membership.

Speaker 1 (06:45):
Pretty amazing stuff, Susie, thank you for the call. Great
question this morning, and that and and uh, and that's
one of those questions I know a lot of folks wonder,
is like, because we're so conditions for like follow like
systems and you know all these and I think we've
been marketed to so much like everything under one roof,
and people are sometimes nervous about about making that change.

(07:06):
They're saying, well, if I step away from that system,
how does the process work? How does direct primary care work?
And it works. It works the same, except with transparency.
It works the same, except you kind of understand, like
when you go to see your doctor, as you mentioned.
You know, like ninety percent of your health care is

(07:26):
seeing your primary care doctor. That's all covered by your
direct primary care. It's if you have like a catastrophic issue,
you have an injury, gosh forbid, develop cancers and other things,
then you've got that insurance or that health shared to
pick up that it's once, I think for a lot
of folks, and I've got the chance for meet with
people that have been patients of yours for many, many

(07:48):
many years. Doctor talking about like once they're in, they
just don't even think about it other than the fact
that it's convenient to them. It's not a thing that
they even think about, if that makes sense. So one
of the things too, I want to ask you two doctors,
when Susie called in one of the notes that make
the change to DPC, and I was hoping she would
ask this, and but her question went a little bit different.

(08:09):
But that is something I do sometimes wonder about, is
if you're making the change to a DPC, how does
how does that work logistically? Like let's say somebody were
to sign up today, are you you're able to get
all their you know, their medical informational type of things
from their current primary care physician or how does how
does that part work?

Speaker 3 (08:25):
Doctor?

Speaker 2 (08:27):
Yes, that's a great question. You know. So most people
are making this change during this kind of open enrollment
period which we're about to enter into. For most people,
that's like the October to January part of the year,
the end of the year, the beginning of next year.
Many times maybe they're either uh during doing their open
enrollment through work. So again, if they have an employer

(08:48):
that's providing them with health insurance options, again, you know,
my recommendation would be to choose a high deductible policy.
And we do also again work with a lot of
employers who provide direct primary care. Logistically, they can enroll
with us at any time, so we do not have
an open enrollment period. You know, any day of the year.
They can enroll with us. The way that process is

(09:10):
typically started is they either call the office or they
email us through the website. Through that contact us, we
then send them an enrollments link in a scheduling link.
So once they complete that online enrollment, technically they're in
our system. They are patients of our practice. They can
schedule an appointment at any time. The enrollment begins then,
and so then they have access to the scheduler and

(09:32):
and you know, coming in for a new patient visit,
and so that kind of starts the ball rolling in again.
Usually it's anywhere from maybe a couple of days to
at the tops maybe a couple of weeks, which you know,
again is shocking compared to what we hear about in
the systems right now. That it is it is, you know,
six months, nine months a year to get in and

(09:54):
there's one local system that is telling patients that they
are not taking on new patients, one of the large
So it's it's scary in a way when when you
can't see a doctor. So we are definitely taking on
new patients. We have four out of our eight physicians
that are actively taking on new patients are four newer doctors,

(10:15):
so that would be doctor Quality, doctor Dan's, doctor Philben,
and doctor Di Giovanni. They have a little bit more
space in their panel. And part of this model is
that you know, once we get to that you know,
five hundred and six hundred patient mark, most of our
docs will stop taking on new patients, so we can
still provide that same level of access and care and time.

Speaker 1 (10:35):
You can talk about that that I've heard from folks
who are telling me like the I got a message
on my on my what's the there's some app out
there that the healthcare systems use saying you're overdue for
an appointment, and they're like, I went on to make
an appointment and now I'm really overdue because it's like
a year out and it's like that is I I mean,
think about how much you're paying for for for that inconvenience.

(10:58):
There is a convenient, better way, a fantastic way that
is Advocate MD and Direct Primary Care. Learn more online
Advocates DPC dot com. That's Advocates DPC dot com. We'll
talk about a story in the news in just a moment,
but first one of the things too, I want to
ask you about doctor Hemkis. By the way, if you
have questions for the doctor, love to have you join
us this morning six eight three two one thirteen ten.

(11:18):
That's six oh eight three two one thirteen ten. If
you've got questions about direct primary care, insurance, healthcare general questions.
There not going to do medical advice, that's that's not
what we do here. But we'll definitely talk about if
you've got questions about Advocate MD or direct primary care.
We'd love to have join us six oh eight three
two one thirteen ten. That's six oh eight three two
one thirteen ten. I talk about the and you mentioned

(11:39):
the doctors at Advocate MD. Eight physicians at Advocate MD.
The doctors include obviously we could talk with you, but
the other doctors as well. You guys absolutely love this
model too. I think as we talk from as a
patient perspective, how much people enjoy and how much we
love that as doctors. As physicians, you guys really enjoy
this model as well, don't.

Speaker 2 (12:01):
Yes, it is a very different way of practicing than
what all of our doctors experienced in the large systems,
where they were seeing usually fifteen to twenty patients a day.
Our doctors now see usually you know, that many in
a week, so fifteen to twenty patients in a week.
And again it's just a it's a as a family

(12:24):
medicine doctor, you know, we didn't go into this because
you know, we went into it for the relationships and
because we like taking care of people. We like talking
to people. When you have a seven to ten minute
rushed visit where you kind of are sticking to the facts,
like okay, what meds you need refilled. Okay, yeah, let's
schedule you for this this lab appointment. There's not a

(12:45):
lot of time for chit chat or getting to know
that person, finding out what's happening in their life. And
that's part of it, right, Like if if I know
more about you know, your family dynamic, and the stress
is happening at work, and maybe the stress is happening
in your relationship or whether you're not sleeping, and you know,
all of these things contribute to your health. So when
I have forty five minutes to an hour, I really

(13:06):
can delve into that along with all the lifestyle medicine
stuff that I really enjoy talking about. You know, how
you're eating, how you're moving, you know, if you're consuming
too much alcohol or other substances. You know, all of
those again are kind of the pillars of our health.
So we have the time to talk about that in
a forty five minutes to an hour appointment. And I

(13:27):
remember thinking, you know, when I first started the practice
and had never had these kind of visits before, thinking
this is the way it's supposed to feel like. I
never knew that it actually could feel like that. Many
of us experience as physicians after you go through years
and years of training. So I know we've talked about

(13:47):
this sean On. The program for most of us medical
training is approximately I think it's like nine to twelve
years total if you count undergraduate medical school residency. Actually
maybe it's it's closer to eleven to fifteen. So right, yes,
I know I'm trying to add the person in my head,

(14:07):
but yeah, depending on what you go to, you know
how long the residency is. Again, for family medicine docs,
it's four years of undergrad four years in medical school,
and three years of residency, so that's eleven years. But
so you get to the end of this point and
you you know, you've been working towards this goal for
you know, half of your life, and then you you
graduate and you start working and sometimes you have this

(14:30):
kind of experience where you you realize this is not
what I thought it was going to be, like like,
I am not as satisfied with this as I thought.
And and so direct primary care kind of brings us
back to this point where we we actually are practicing
medicine the way we envisioned it could be. And and

(14:51):
if you talk to any of the docs in the
practice that will tell you that they have never worked
in a practice like this, that it's the best job
that they've ever had, the they could never go to
work an your health after this basically as the sentiment, yeah,
it is.

Speaker 1 (15:06):
It's it's such a rewarding as we think about as
patients getting a chance to actually get to know our
doctors and actually doctors being able to like the old
day is when you get to actually know your doctor,
your doctor knows you, and it's a it's a great
opportunity each and every appointment to learn more and of
course make sure you know ultimately live healthy and longer.
And what a great benefit to a direct primary care

(15:29):
and Advocate MD. And today's a great day if you've
been thinking about it, Today's day to learn more or
make that appointment. Become a member at Advocate MD six
oh eight two six eight sixty two eleven. That's six
eight two six eight sixty two eleven. The website Advocate
DPC dot com. That's Advocate DPC dot com. GI do
our conversation with doctor Nicole Hemkiss. You've probably seen the headlines.

(15:49):
If you have, and I hope you're sitting down, expect
another nine to ten percent bump in health insurance costs.
Talk a little bit with doctor about that and take
your call as well. Next as Full Scope with doctor
Nicole Hempkiss continues here on thirteen ten w u I
b A, thirteen ten wui BA and full scope with
Wisconsin's directcare doctor doctor Nicole Hemkiss. Great calls this morning.

(16:12):
Don't forget if you've got a question about direct primary
care healthcare in general. Love to have you join us
this morning. Still got time for your question your call
six oh eight three two one thirteen ten. That's six
eight three two one thirteen ten. A lot of a
lot of you know, really really good opportunities and great
information from doctor Nicole Hemkiss again about direct primary care, insurance,

(16:32):
healthcare in general. Love to have you join us. Of course,
no medical advice and not that type of show, but
questions about how how direct primary care works. Again a
fantastic uh fantastic website also ADVOCATESDPC dot com or you
get right on the air at six oh eight three
two one thirteen ten. That's six oh eight three two
one thirteen ten. Speaking of phone numbers, tellfuh and I'm gonna
make a point. Become a member at Advocate MD six

(16:53):
oh eight two six eight sixty two eleven. That's six
oh eight two six eight sixty two eleven and doctors.
So much stuff in the news. I was, I was,
you know, we were talking obviously we talk each week
and kind of go over what we're going to talk about,
and I'm like, there's just so much stuff out there.
What is I mean as we talk about things in
the news, what for you is is kind of that

(17:14):
that big story right now currently that that's kind of
maybe off the radar currently, but maybe folks will will
start to q in on it or something that people
need to be aware of. What's kind of that that
story right now that's got that's got your attention?

Speaker 2 (17:28):
Doctor? Yeah, I had posted I believe I posted this
on our Facebook and the LinkedIn. But there was an
article that came out that was talking about how much
increase in premiums that people can be expecting for next year,
and so they're projecting. I mean, you know, every year,
health insurance costs go up, usually exponentially higher than the

(17:51):
other cost of everything that's going up. You know, your groceries,
your electricity, your gas, but health insurance always increases by
a higher, higher margin and you know, as part of
the overall healthcare increase. But they're saying that nine to
ten percent increase in health insurance by next year. And
the really staggering part was, you know, so a lot

(18:13):
of people after the Affordable Care Act was passed or Obamacare,
which now has been about fifteen years ago. You know,
part of the promise of this was that more people
were going to have access to healthcare. And again, many
people equate health insurance with health care, and you know,
we've talked about those things are not necessarily synonymous with

(18:35):
each other. It's interesting in this article it said that
only thirty six to thirty eight percent of Americans wanted Obamacare.
But part of what Obama promised was that health insurance
premiums for everyone would go down. Basically, what they were
doing in a way, the federal government was kind of
stilting up these insurance companies. The health insurance companies were

(18:57):
not saying, you know what, we're charging too much money
for health insurance. We're going to lower all of our costs.
You know, we're going to start charging fifty percent of
what we used to charge. Know, what they were actually
doing is they were getting subsidies or you know whatever
they call them vouchers. They were getting subsidies from the
federal government so that they could artificially lower these premiums
over over years, and then depending on your income, you know,

(19:20):
you could get subsidies based on that. But slowly they
started to increase these prices, and you know, now there's
less of the federal government's assistance with this, and you know,
the people that really won and all of this were
the insurance companies. But the article mentions that in two
thousand and nine, so let's say, fifteen years ago, approximately

(19:40):
the average monthly cost of a health insurance plan for
an individual a single person was ninety two dollars a month,
and now the average cost is six hundred and twenty
one dollars. So what is that I don't know, is
that like a three hundred percent or five hundred percent
increase and the end so so similarly, fifty years ago

(20:00):
the average cost of health insurance for a family was
three hundred and fifty dollars. And I don't know, they
don't really mention if this was like people that are
having to pay for their health insurance on their own
versus like if they have a company that's paying for
a part of it, and then this is their portion
of the cost. They don't really give details on that,
but so three hundred and fifty dollars for a family coverage.

(20:23):
Now the average cost is twenty three hundred, two thousand, yeah,
two thousand dollars a month. So again that has gone
up exponentially. Think about that. So that is twenty six
thousand dollars a year that a family, average family is
spending on health insurance. You know, that's that's probably the

(20:45):
biggest chunk other than maybe for some people their mortgage payments.
I mean that might be more than that. So I
mean it's almost making health insurance you know, cost prohibitive.
And so now they're saying that that's going to go
up by another ninety to ten percent. And just to again,
you know, kind of circle back to the fact that
you don't have to be locked into a specific health

(21:06):
insurance plan or a specific deductible. There are other options
out there. You know, whether you're if your employer is
offering you a good health insurance, meaning you know, a
low cost health insurance that has good coverage that you're
not paying a lot out of pocket take advantage of that,
again with the caveats that you might not still be

(21:26):
able to see a doctorary often. But I mean, if
they're going to pay for a large portion of your
health insurance, you know, take advantage of that. But if
you have a if you work for a company that's
either your health insurance premiums the portion that you're responsible
for is very expensive, or they don't provide health insurance premiums,
you know, you should look at the options on the
marketplace and see if there are affordable options that are

(21:49):
higher deductibles. If you don't see affordable options there, you
can go to you know, individual insurance companies, websites. You know,
obviously there are brokers in town that will will help
assist you in finding health insurance options. You know, you
have to keep in mind that sometimes brokers are paid
based on commission. There's all different payment structures for insurance brokers,

(22:10):
but sometimes they are paid on a commission basis for
selling particular brands of insurance or a percentage of the
insurance premium. So just keep that in mind. So sometimes
you can do a lot of research on your own.
It is good sometimes to get a you know, advice
from a professional person. But I would say take advantage
of whatever programs you could get through your employer, you

(22:32):
know again, or if you do based on your income,
if you're able to get a subsidy through the marketplace,
you should obviously take advantage of that. But it is
it is disheartening to see that, you know, the health insurance,
that the solution that we were promised with Obamacare has
actually for many people increase their health insurance cost and

(22:56):
you know, actually made insurance less afford and you know,
made care less accessible.

Speaker 1 (23:03):
You know. One of the things that I remember is,
you know, his business tries to tries to manage costs
and profits those type of things. There used to be
a term called shrink flation that you hear, and thing
is getting smaller and costs going up, and I feel
like with health care it's not just and it you know,
we talk about nine to ten percent increase in that

(23:25):
same time over the same in one year's time, the
quality has gotten worse. I mean, your access has got
it's i'd be one thing and not to say that
would even be acceptable if like if you were paying more,
but we're still receiving the same thing year after year.
You're paying more and getting less and being more inconvenienced.
And we're not talking about you know, this is not

(23:48):
like oh, I'm going to the movie theater, We're going
to the amusement park. It's literally your healthcare that every
single year, your own health is costing more to do
things basic things to make sure that you are healthy.
It's costing more, and you're losing access, you're losing relationships,
you're losing quality of care vice, being less likely to
see an actual physician. It's it's such a such a

(24:11):
frustrating thing. And you know, as we get the opportunity
to talk with you doctor each and every week, for
folks like me that are talking about that frustration, if
you experience it, direct primary care and Advocate MD. It's
an amazing option for folks. And as we talked about
some of the great benefits of direct primary care today
is that day. I mean, it's real easy to do
make an appointment six oh eight two six eight sixty

(24:32):
two eleven. That's six oh eight two six eight sixty
two eleven. The website advocates DPC dot com. That's Advocate
DPC dot com. Doctor. I know there's a to stuff
we could talk for hours about about these things, and
I will tell tell folks and doctor you know you
and I've been doing this show a number of years
and the podcast is up for people that want to
kind of kind of hear how things have progressed. I

(24:55):
would encourage them to listen back to the podcast, share
the podcast as well, and of course share information about
Direct Primary Care an advocate MD with their friends and
family again Online ADVOCATESDPC dot com. That's ADVOCATESDPC dot com.
Doctor Hemkiss, it's always great chatting with you. You enjoyed
this great weekend and we'll.

Speaker 2 (25:11):
Talk real soon you too, Shaw, Thank you.

Speaker 1 (25:14):
News comes your way next right here on thirteen ten
wuib a