How do We Value Our Health

Episode Transcript

Speaker 1 (00:00):
Thirteen ten Wi BA and full scope with doctor Nicole Hemkiss,
Wisconsin's direct care doctor. Of course, doctor Hemkiss comes to
us from Advocate MD, a direct primary care practice with
offices four. As a matter of fact, tell you about
two here three here in Madison. Goodness, I've got the
west side, we got the east side, we've got the
south side. Got the Jamesville location as well. You can

(00:22):
get more information about all the clinics online at ADVOCATESDPC
dot com. That's ADVOCATESDPC dot com. To make an appointment
to become a member at Advocate MD. It's real easy
to do well. I gotta do this. Pick a phone,
give a call six oh eight two six eight sixty
two eleven at six oh eight to two six eight
sixty two eleven and doctor four clinics eight doctors, which
means you've got a couple of new doctors starting soon,

(00:44):
don't you.

Speaker 2 (00:46):
Yes. Doctor Gina DiGiovanni started with us about a month ago,
and then doctor Jennifer Philbin is starting with us in
just a few weeks. So we're very excited about the
two new doctors.

Speaker 1 (00:57):
That is really exciting and one of the great things
about Advocate MD and direct primary care is you have
access to your actual doctor when you need to see
your actual doctor and communicate with your actual doctor. It's phenomenal.
And as we talk about the eight physicians now at
Advocate MD across four locations. Part of the reason why
there are a new doctors coming on is as more

(01:17):
people learn about Advocate MD and direct Primary Care, more
patients are coming on board, which means to keep keep
those panels small, they add more doctors. So it's a
really really great benefit to direct primary care. Again, you
can learn more online Advocates DPC dot com. That's Advocates
DPC dot com. Now that we are early into the
new year, Doc, I know a lot of folks are

(01:37):
are kind of assessing things, right, We've just had our
resolutions and other things, and I think for a lot
of folks is they kind of go over things like value,
what's you know, what's what's important to us, Things that
are that that we really want to make make sure
that we highly prioritize and value. Health is one of
those areas that that I think a lot of us do,

(01:59):
but we don't always see that put into action. Let's
talk about why we don't prioritize our health as much
as we probably should.

Speaker 2 (02:07):
Yeah, you know, it's something that I think about a lot,
and I would just happen to be doing my household budget.
Do you ever do those?

Speaker 1 (02:14):
Sean Christina does.

Speaker 2 (02:17):
Okay, Yeah, it's kind of one of those things you
hate to look at it and figure out where all
the money is going. But you know, it made me
think about, you know, how we view you know, a
lot of times we get patients that will contact us
and they might want to join the practice or be
interested in joining, and then you know, on average, our

(02:39):
prices are around seventy to eighty dollars per month, you know,
depending on a person's age. And sometimes I will hear
people say things like, oh, you know, this sounds really great,
but you know, I just don't have that much money,
and I totally feel for that, you know. I mean,
I know a lot of people are right now are
in very strict financial cases. But you know, I think

(03:00):
it also kind of goes back to looking at where
we do spend our money. And it's interesting how most
of us, you know, including myself, at times, will we'll
try to skimp on things like healthcare. Yet you know,
we we do spend money on the luxury items and
the things that necessarily are not essential to life, but
are you know, fun things or you know, entertainment type expenses.

(03:25):
So it makes you wonder, you know, why do we
not prioritize our health more than we do? Like, why
is this not the first thing that we're spending our
money on? Right, and then everything else is additional. You know,
you obviously have necessities, things like, you know, your mortgage
and your groceries and your utilities. You have to pay
those bills. But then why isn't healthcare kind of almost

(03:46):
considered close to that, like a necessity because your health
right is important, you know, it probably should be, you know,
the most important thing, or maybe one of the most
important things. If if you're a religious person, maybe your
spirituality obviously is very important, family and all those things,
but maintaining your health I would say, should be up
there on the list of one of the most important things.

(04:09):
But unfortunately, in the current culture of health care, I
think that we kind of make health insurance synonymous with
health care, and those two things are very different. And
you know, we've talked about it, Sean, that health insurance
is not the same thing as healthcare. Many people have
health insurance and they have very poor access to care.

(04:29):
So it's kind of goes back to how do we
separate out those two things and how do we kind
of look at this from a different perspective and think
how can we spend our money more wisely to have
a better level of care?

Speaker 1 (04:42):
Just some thing when you think about too, like what's
what is another day of spending time with friends and family?
What's the value on then? And to think that that day,
things that we do during our lifetime impact how many
days we have here on earth, is you know, the
kind of not to get too like fel esophagal and stuff,
but it is the reality is we have an impact

(05:04):
on our health and not just our overall longevity, but
our quality of while we while we are mortals, how
do we take care of ourself and how do we
how do we reward ourselves through that and and prioritizing
health is a big thing and one of the things
doctor that is interesting and since getting the chance to
know you over the years and what you guys do

(05:25):
at Advocate MD is you don't have to compromise with
healthcare per se, especially when it comes to primary care.
We think about what you guys are able to do
at Advocate MD and really provide high quality healthcare and
primary care to people. And really for I was looking
the other day and at what like averages like seventy

(05:46):
dollars a month, which is you think about what does
it again? Talk about like spending another day or you know,
having that good you know that that one more memory
with your with your friends and family, what's that worth? Well,
little little type of steps can definitely go a really
really long way. Let's talk about how then the kind
of that insurance system is designed. And you mentioned insurance

(06:10):
is not healthcare and that I think for some folks
that's a profound statement, and it's sadly very true, isn't it.

Speaker 2 (06:18):
Yes? And I think you brought up another great point Sean,
that you know, I think sometimes we look at the
cost of something or the price of something, and you
know the price of direct primary care, and it seems
so low. So I think sometimes there's almost a misconception
that one of two things, either there's got to be
something weird going on here, like how can you keep

(06:39):
the prices that low?

Speaker 1 (06:40):
Right?

Speaker 2 (06:40):
Because there's many people out there that are paying you
five hundred dollars to one thousand dollars a month just
for health insurance again which they don't use, which we'll
talk about more. But so there's kind of a one thought,
one school of thought where it's like, how are they
able to do this? I don't understand it, so I'm
kind of suspicious of it. And then the other school
of thought is if something has a lower price, that

(07:02):
must mean that it's lower quality. And both of those
things are not correct, right because in healthcare, unlike I
would say a lot of other industries, you know, there
are many things where you know quality is not necessarily
correlated with price. But you know, in healthcare, we've actually
found they've done studies, you know, looking at things like
surgeries and procedures, and they found that in many cases,

(07:25):
the lower cost surgery or procedure is actually the higher quality.
Some of this goes back to like the skills and
the experience of the doctor, and when you have access
to care and they're able to perform more of these,
they become more skilled at that. So again you can
look at places where there's monopolies and certain healthcare systems

(07:48):
and they have only a couple of systems and they
raise their prices up a lot. And those those places
can be in you know, rural areas of the country
where they maybe don't have the most specialized doctors and things.
So again that just goes back to this misconception that
quality is not correlated with price in healthcare. So that

(08:10):
should not let somebody look at the price of direct
primary care and think, oh, there must be something wrong
with this or the doctors there must not be the
highest quality. I like to I just did a presentation
yesterday to business and I always put up all the
faces of the doctors in their names, and I usually
mentioned a couple of the doctors, and I always mentioned
that doctor Adam Balen, who was one of our docs,

(08:34):
was at SSM Health for twenty five years, and during
part of that time he was the director of primary
care for SSM Health in the Southern region, right, I
think it was a period of five years or something,
so all the docs that were primary care docs were
under him. And then doctor Karen Schulman. They came to
us for Marshall Clinic. She was the director of their
primary care division for a number of years. So again

(08:56):
these are our highly skilled, experienced and well you know
well known doctors that have decided to make this leap,
and I do that to prove that point of you know,
we have great doctors in this system and the reason
that they decided to leave is because they just wanted
to be able to practice medicine in a different way.

Speaker 1 (09:17):
And having had a chance to meet many of the
doctors at Advocate Amity, doctor Bayalen, doctor Karen Shulman as well,
and and others obviously getting to know you over the years, doctor,
it's amazing we talk about not just the you know,
obviously to become a doctor as a very eyebar, as
it should be. It's a it's a very intensive and
very important role, but also you learn more about about

(09:40):
some other things you mentioned both doctor Shulman and doctor
Adam Balen and some of their experience. These are these
are people that are that are very very talented medically,
but also have a very profound understanding, just like you,
of how the healthcare system works. And and you see
a lot of frustration and anger for people that that
worked really really hard and did a lot of studying

(10:02):
and did all sorts of took all sorts of steps
in order to help people finding out that there's barriers
out there. And speaking of those barriers, when it comes
to like insurance, I know, for a lot of folks
when they get there, you know, when they first get
that job that offers insurance, they feel like it's a
golden ticket, and like all of a sudden, they quickly
realize it actually hinders oftentimes getting care and getting into

(10:25):
see a doctor and those type of things that that
insurance system isn't set up to really be as a customer,
as a patient. It's not really set up to benefit
the patient, is it.

Speaker 2 (10:39):
Yes, you know, it's funny because I heard somebody say
this insurance is one of the only things we buy
and hope that we never have to use. Right, It's
kind of an interesting concept. And the same is true
of health insurance. I mean true of many different types
of insurance. But health insurance, again, we buy it, and theory,

(11:00):
the reason for it should be that we need help
paying for the very expensive parts of healthcare. But the
reality is that health insurance has morphed into this thing
where we use it for every part of healthcare. But
as you mentioned, Sean, what we found is that health
insurance actually creates barriers because it creates barriers for cost,
right because it increases the cost of care, which makes
it harder to access that care. It creates more bureaucratic

(11:23):
red tape. So when you do need something, that health
insurance company is functioning as an intermediary and they are
deciding are you allowed to get this procedure? Are you
allowed to get this medication. We're going to make your
doctor fill out all this additional paperwork to be able
to approve it, so we're going to make you wait
longer for it. So it's denying access to care, delaying care.
So it creates those kind of barriers, you know. It

(11:45):
creates barriers between the doctor and the patients because again,
sometimes a doctor might recommend something and the insurance can
step in and say that they're not going to going
to approve it. So there's many reasons why health insurance
has become actually not a great thing. I think the
reason it was originally designed was for a good reason

(12:06):
to help people pay their medical bills, but it has
kind of turned into something, you know, different than that,
and that's why I always kind of urge people to
view it as kind of a last resort and not
something that you're utilizing on a regular basis.

Speaker 1 (12:20):
Talk this morning with doctor Nicole Hemkiss of Advocate MD.
You can learn more online about Direct Primary Care and
Advocate MD all on their website Advocates DPC dot com.
That's Advocates DPC dot com. Four locations of Advocate MD
Westside and Middleton east Side in Madison right on Fair
Oaks have Jamesville at ten twenty one Mineral Point Avenue,
the newest clinic right and Fitchburg right on Madison, Fitchburg

(12:43):
right on the line there right at thirty two to
twenty sign road right and a beautiful nature Preservatis are
really really all the clinics are very very nice at
Advocate MD. And fabulous doctors eight of them. Eight physicians
at Advocate MD. You can learn more online ADVOCATESDPC dot com.
That's Advocates dp C dot com. It's a great day
to make that appointment to become a member at Advocate
MD all. I get to just pick a phone, gimme

(13:04):
call six oh eight two six eight sixty two eleven.
That's six oh eight two six eight sixty two eleven.
If you're looking for some great options as well for
your employees, or if you want to suggest to your
employer Advocate MD let them know about it. Of course,
more information available at Advocates DPC dot com. That's Advocates
DPC dot com. More a full scope is next right
here on thirteen ten Wi B A, thirteen ten Wi

(13:36):
B A and full scope with doctor Nicole Hemkiss, Wisconsin's
directcare doctor. You can learn more about doctor Hemkiss all
the doctors at Advocate MD as a matter of fact,
as well as direct primary care on the website Advocates
DPC dot com. That's Advocates DPC dot com. Tell forh
number six O eight to two six eight sixty two eleven,
that's six oh eight to two six eight sixty two

(13:56):
eleven to make an appointment to become a member at
Advocate MD. The website is a really good resource, a
really good starting point. I've got great information about direct
primary care. Also, as we're talking this week about insurance,
what direct primary care pairs well with in those in
those whether it's a high deductible or a health share,
you can learn more about that all online at Advocates

(14:17):
DPC dot com. That's Advocates DPC dot com. So doctor,
let's kind of talk about we had mentioned, of course,
one of the great benefits of advocate MD and direct
primary care is when folks make an appointment to see
their doctor, they can get in to see their doctor
and actually see their doctor, not not somebody else, actually
see their their primary care physician. That is that that

(14:39):
used to be the way things work. That is a
very rare thing these days, is as people rarely get
a chance to see their doctor. What are we seeing
as far as the process in the kind of that
current system when you do need an appointment, how does
that work for me? For people? Doctor?

Speaker 2 (14:56):
Yeah, you know, the situation has almost become kind of
loud sometimes and our expectations or the bar is set
so low now that you know, when you need to
see a doctor and you call into one of the
large healthcare systems here locally in town, I'm sure people
would not be shocked to hear them say that it'll
be six months or nine months or a year to

(15:18):
get in with that doctor. So then you know, you
might be directed to an urgent care clinic if you
have something more urgent. But for most medical conditions, like
by the time you wait six months or nine months,
either the condition has improved or it's worsened, right, So
it's worsened to the point where you have to then
go into a higher level of care or it's gone
away and you know, or it's causing you some sort

(15:40):
of damage because of the prolonged effects of it. But
that's really not acceptable, and I'm I'm always kind of
surprised that people are willing to accept that, But I
think we've just become kind of so indoctrinated to like
this is the way it is, Like there's nothing else
I can do, you know, I just have to pay
my health insurance every month, and when I actually need
to use the health insurance to see a doctor, they

(16:03):
don't have appointments available. So it's almost really sort of
a scam when you think about it, that you're paying
for something that you then cannot utilize. And again, you
would you would think that more people would be would
be in an uproar about this, but but I again,
I think that they're just so kind of desensitized to it.

Speaker 1 (16:24):
It feels like I think for a lot of folks
is fingers crossed. It's it's hopefully I never get in
that situation. And I know for a lot of a
lot of people that have have joined Advocate MD, they
unfortunately had gone through an experience that was quite trying
for them, and they said, all right, enough of this,
I am, I'm going to look for an alternative. And

(16:44):
they found direct primary careen Advocate MD, where you actually
have affordable access to your doctor. And and with that
situation about about actually getting in to see a doctor,
and you work through that system you mentioned, folks, let's
say you get sick or you have an injury, there's
no way that in that insurance system you would ever
get in to see your doctor. Why you're sick, They're

(17:06):
going to send you to like an urgent care or
something else like that, where you're going to see some
doctor or probably not even a doctor, like a PA
or something else. Instead. Advocate MD works a bit different.
Let's say you know, I come down with a cold,
I call in a doc, I'm not feeling well. How
does that process then then work?

Speaker 2 (17:27):
Yes, so if they if they join as a member,
So we have to have people join as members to
be seen. And so once they join, it's very easy
to get an appointment. They can either call in to
get an appointment, they can do it online for normal
routine appointments. If it's just like established care, that might
take you know, sometimes it's a few days a week,
maybe two weeks at the most. But if it's an

(17:49):
urgent care, we get people in the same day.

Speaker 1 (17:51):
It's pretty amazing. And that is an important distinction. Is
as as we talk about seeing your doctor. That's why
it's so important call today become a I'm an Advocate
MD because you'd never know what's going to happen later.
And of course it's a really really great model direct
primary care. You can learn more online at ADVOCATESDPC dot com.
That's ADVOCATESDPC dot com telphon. I'm going to make that

(18:11):
appointment six o eight to two six eight sixty two eleven.
That's six oh eight two six eight sixty two eleven
and doctor. Before we wrap up this week, I didn't
just want to talk about you know, we mentioned the
doctors at Advocate MD. Eight physicians at Advocate MD across
the four clinics. Let's talk about what brought them to
Advocate MD and also what made you decide, you know what,
I'm going to step out of out of the system

(18:34):
and I'm going to create something unique. There's obviously you know,
a great reward that you're seeing now back of the day,
though when you first started, that was a pretty bold step.
Let's talk about kind of what drives you and the
rest of the doctors at Advocate MD.

Speaker 2 (18:50):
Yeah, So, as a as a typical primary care doctor,
when you're working in a large health system, like the
large systems that we have here locally, you know, there
are very different expectations and values placed upon you know,
how much time you spend with the patient and the
quality of carer you're providing. Much more of the emphasis
is being placed on how many patients you can see

(19:11):
in a day, you know, and you could write up
those notes and code and build for those patients. And
that has kind of over the last ten or fifteen
or twenty years progressed to the point where now primary
care doctors are being expected to see maybe twenty to
twenty five patients a day, so on average they might
spend ten to fifteen minutes with each of those patients.

(19:34):
And so that on the patient end obviously doesn't lead
to great care. On the doctor ends, that leads to
a lot of burnout, a lot of frustration that they
can't spend enough time with the patient and really be
able to hear what they're saying and you know, manage
multiple issues, whether acute or chronic issues, and rather they're

(19:55):
sending them to specialists for these things that they're sending
them to an urgent care care for things that they
could take care of if they had the time. So
our doctors all worked at large health systems for years
and kind of came to the point where, you know,
again it had nothing to do with taking care of patients.
It was just frustration with the system and what we

(20:17):
the better term. We don't really like to use the
term burnout because that, to me implies there's something wrong
with the doctor. But I think the better term that
a lot of us have used is moral injury. Basically,
like you're being asked day after day to do this
thing that you no longer agree with or value, or
you know, you think it's actually in some cases harmful

(20:37):
to the patient. So that's why they leave the big systems.
And you know, that's part of the reason that I
started the.

Speaker 1 (20:44):
Practice Happier Doctors, Happier patients a really really great model
at Advocate MB. It's a really important day to start
that journey, start that conversation. It's really easy to become
a member. Pick up phone gammacall six oh eight two
six eight sixty two eleven. That's six h eight two
six eight sixty two eleven. Of course you want more information,
there's a great website for that. That's Advocates DPC dot com.

(21:04):
That's Advocates DPC dot com. Great place to start. You've
been listening to the program for a while and thinking,
you know, I should really give them a call at
Advocate MD and make that appointment. Today is the day
to do just that. Six ' oh eight two six
eight sixty two eleven. That's six h eight two six
eight sixty two eleven. And don't forget. If you're an
employer looking for something great to offer your employees, definitely
check out Advocate MD and Direct Primary Care Doctor Hemkiss.

(21:26):
It's always fantastic chatting with you. Have a good weekend,
and we'll do.

Speaker 2 (21:29):
It all again real soon, you too, Sean, Thank you

Speaker 1 (21:32):
And again the website Advocates DPC dot com.