Keep It Up

Today, Dr. Hemkes talks about why it's important to stay in a direct primary care program, even if you don't see your doctor regularly.

Episode Transcript

(00:03):
Eight away thirteen ten WIBA Madison inthe morning in full scope with doctor Nicole
Hemkiss. Of course, doctor Colehemkissis Madison's directcare doc and she comes to
us from Advocate MD, a directprimary care practice. If you're not familiar
with Direct Primary Care DPC, checkthem out on the website Advocates DPC dot

(00:23):
com. That's Advocates DPC dot com. You can learn more about direct primary
care. You can also learn aboutthe three locations of Advocate MD, west
side of Madison, in Middleton,round on Glacier Ridge Road, east side
Madison, right on South fair Oaksapp and in Janesville right on right across
from the hospital ten twenty one MineralPoint Avenue. As a matter of fact,
we're gonna talk about a cool eventcoming up on just a few days,

(00:47):
coming up next week Thursday and openhouse at the new at the New
Place. And of course joining usthis morning is doctor Nicole Hempkiss from Advocate
m D. Doctor, how areyou doing this morning? I'm doing very
well, Sean, how are you? I'm doing a really, really great
and we've got got some great questionsto talk about this morning about things like
what a primary care doctor does whyfolks should have one. Of course,

(01:08):
I know you get a lot ofquestions from businesses. We'll talk a little
bit about that, and of course, if anyone's got a question about how
direct primary care works are about directprimary care, doctor Nicole is here this
morning to answer your question at sixO eight three two one thirteen ten.
That's six O eight three two onethirteen ten. We get you on there
with doctor nicolehem Kiss. Don't forgettingto learn more about Advocate MD on their

(01:30):
website Advocates DPC dot com. That'sAdvocates DPC dot com and the telephone number
six O eight two six eight sixtytwo eleven that's six O eight two six
eight six two eleven, and makean appointment to become a member at Advocate
MD. So let's start off talkingabout, of course, the big news
third location of Advocate MD. Ofcourse everyone's familiar at the Middleton location and

(01:52):
the east side of Madison location,the newest one on Mineral Point AV in
Janesville. And you're gonna be doingan open house next week, aren't you
do. Yes, you know we'vebeen seeing patients now for a few weeks,
and you know the office we hadsome finishing touches that we needed to
put on, but I think it'sready to show to the to the rest
of the world. So we're excitedto show people the space. It's it's

(02:14):
a really I would say it's probablythe nicest of our clinics. It's the
largest UM. So people can comein, take a walk around and see
what a direct primary care clinic lookslike, you know, meet some of
the doctors. Um. I knowthe majority of the doctors in the practice
will be at the open house,so they'll get to, you know,
meet them, talk with them,ask questions that they have about direct primary

(02:36):
care. Hopefully they're interested in joining. If you have a business and you're
interested in potentially signing up employees forthis model, you know, we'd be
happy to talk with you. Youknow. It's it's one of the really
neat things about direct primary care.And I know you and I have talked
about this before, but this isthis is something that's important to highlight in
that there is no other at leastI've never seen anything like this where you're

(02:58):
able to actually meet a doctor beforeyou become their patient. And one of
the great things about the open housesthat you do doc is you have other
doctors from the from Advocate MD onsite, they're hanging, if they're mingling,
chatting with folks. It's a reallycool opportunity that you really just don't
get anywhere else to actually meet thedoctor. You really don't. I mean

(03:22):
I think, you know, maybeten twenty years ago these sort of things
happen, but I think in thebig systems right now, I mean,
obviously we've we've talked about doctors arevery burnt out, you know. I
mean, if you're seeing fifteen totwenty patients a day in a normal insurance
based slash, you know, welike to call factory line medicine practice,
you know, you don't really havetime to do meet and greets in there.

(03:42):
So because we kind of allow forthat, you know, block off
some time, you know, patientscan actually if they're interested in joining.
You know, this would be forpatients that want to join the practice and
just want to meet the doctor inperson to you know, make sure it's
a good fit. You know,they do have the opportunity to call us
and schedule a you know, fifteenminute appointment to come in and meet that

(04:03):
doctor. And like you said,Sean, I don't know of any other
practice. It used to be that. I remember pediatrics practices, like when
you were getting ready to have ababy, you could like interview the pediatrician.
I don't really think that that happensmuch anymore either, But we do
want to obviously differentiate ourselves from thesystem and provide that kind of level of

(04:23):
you know, what we're looking todo is provide very personalized patients center care,
So we want to make sure thatyou like the doctor that you're coming
to see. And for the docsin our practice who are still building their
panel, a couple of us areno longer really taking on a lot of
new patients, but the other doctorsin the practice are, so those doctors
are still doing the meeting grief.You mentioned the doctors at the practice of

(04:44):
course, doctor mccolehemkiss, doctor atAdvocate Emdy, as well as medical director
doctor Adam Baal and doctor Michael Augie, doctor Karen Shulman and now on board
doctor Christina Quality. And that's anotheropportunity. So we talk about the Janesville
location, doctor Quality will be willbe available and she'll be working, I
know, spending a lot of timeworking out of the Janesville location. It's

(05:04):
a great opportunity for folks who maybethey've met doctor Balin before, met doctor
Shulman, met you in the past. Doct's a great oportunity to meet the
new doctor as well, isn't it. Yes, we feel very fortunate to
have doctor Christina Quality join our practice. She's been with us now for about
a month. She's a local galthat grew up in Stoughton, so knows

(05:26):
the area well. It was previouslyworking at SSM Stoughton. Very caring,
personable, you know, smart doctor. So if if people are out there
looking or you know, if herformer patients are looking for her, she
will be at the Advocate indeed JamesWill Clinic, and she also rotates up
at our other two clinics, soshe is accepting new patients. So we

(05:48):
are very excited to have her andyou know, have her be part of
our team. Should be an excitingopen house again. Mark your callenders Thursday,
May fourth, from noon until fivepm. I'll be stopped by as
well. A couple of reasons.I've seen the pictures, doc, and
I really really want to see thenew clinic because it looks you did some
great work and there it looks phenomenal. I can't wait to see that,

(06:09):
and of course a great opportunity tomeet with the doctors as well. So
again I can learn more on theFacebook page for Advocate MD or note down
Thursday May fourth, from noon untilfive chance to meet the doctor. Check
out the newest Janesville location of AdvocateMD, right at ten twenty one Mineral
Point Avenue. As we talk alsowith doctor Colhem Kiss, I mentioned their
Facebook page. Haven't mentioned the websiterecently, I got to reinforce that because

(06:31):
Advocate DPC dot com is an amazingwebsite to learn about direct primary care also
some really good options for you,your family and your employees if you're an
employeer, an employer, and thetelephone number six O eight two six eight
sixty two eleven. That's six Oeight two six eight sixty two eleven.
Let's talk about the importance, doc, of why we need a primary care
doctors. What's kind of the valueto to actually having a primary care doc.

(06:59):
Yeah, you know, this issomething that's discussed a lot, and
you know that you know, they'vetried to do studies in terms of,
you know, do people need tosee a primary care doctor if let's say
you're you're a well person middle age, You're not do for any test,
you're feeling good. You know,is there a value in that? And
you know, again, I thinkfrom what we see in the literature,
many people don't have a primary caredoctor, right, I can't remember the

(07:21):
numbers, forty percent, fifty percentof people, or or let's say they
do have a primary care doctor onpaper, but they see that person,
you know, they haven't seen themin five years, they haven't seen him
in ten years, or you know, what happens frequently is you if you
do have a primary care doctor andyou are in a big system, you
call to make an appointment with thatperson, and their books so far out
that you have to make an appointmentwith somebody else unfortunately. So I think

(07:45):
that definitely part of the value ofyou know, having a primary care doctor,
and just the whole idea of primarycare is that the idea behind a
lot of what we do as familyphysicians is that we really want to focus
on preventive care. Right. So, um, you know, I've heard
our current system referred to as sickcare versus healthcare. Right. We have

(08:05):
this kind of reactionary system. Sopeople go to the doctor when they're sick.
They go to the doctor when they'renot feeling good, they're having symptoms
of something, they're diagnosed, they'retreated right. Um, as opposed to
a system that kind of focuses onpreventive care and trying to you know,
catch something before it gets to thepoint where you're having symptoms. That's that's
the true meaning of preventive care.So um, that's why we do things

(08:26):
like you know, mammograms and colonoscopiesand and different sort of early screening tests.
That's why we do things like floodwork because you know, there might
be things that show up in yourbloodwork that you know, you're feeling great
and you know you didn't you don't. You don't feel like you have high
cholesterol, right, you don't.You don't feel like there's something abnormal in
your labs. But we can pickthat up. But even more so going

(08:48):
in to see a doctor and youknow, again establishing that relationship and then
in the field of direct primary careas opposed to in the big box system
that we talk about a lot,where in the big systems, you know,
they they AFP a few years agodid a study that showed the average
primary care physician the time that they'respending actually in front of that patient as

(09:09):
opposed to you know, all theback office stuff that they have to do.
You know, you review the patient'schart, you look at their old
previous medical records, you review thelabs. Before you walk into the room,
you know, you kind of prepareyourself and then you know there might
be orders you have to enter andall this kind of you know office you
know, administrative stuff that you haveto do on the back end. But
the actual time that you're spending sittingin front of that patient talking to them,

(09:31):
examining them, UM, on averagein the system is seven minutes.
And I bring this up a lotwhen I do presentations to you know,
groups and employers, because I say, you know, seven minutes. So
you know, my patient walks inand you know, I'm a family medicine
doc, so I must like talkingto people at least a little bit,
right, or else I would notgo into this field. I had,

(09:52):
you know, go into radiology orsomething else. Um. But they walk
in and it's like, how howare you, how's it going, what's
it's new in life? You know, how are your kids? You know,
what you know, how's work bythe time you do that, and
then maybe ask you know, whatprescriptions you need refilled? I mean,
you've already exceeded the seven minutes.So it's like, where do we you

(10:13):
know, how do we find thetime to talk about the things that are
truly preventive preventive medicine and lifestyle medicine, which is, you know what I
like to think of as as thecomponents of you know, the basis of
our care, of our healthcare andthe foundation of health is to really focus
on how are you eating, areyou getting enough activity, how are you

(10:33):
sleeping? What's your stress level?Like how much alcohol are you drinking?
Are you smoking? These sort ofthings that are are the basis of everything
else. Right, So if wedon't have a strong foundation, then kind
of all the other stuff is notgoing to be as good. And yes,
no, it's gonna say, well, that's an interesting perspective too,
doc is is when we talk about, you know, the lifestyle medicine is

(10:56):
so much of this stuff is UM. If it's something you can you can
be educated about or make some smallchanges UM early on, it can really
change that. You know, youthink about that about that courses. You
know, is maybe some modify modificationsto diet or exercise. Little tiny things
can have a huge impact when itcomes to overall overall health and overall longevity.

(11:22):
It can make a huge difference definitely. Um. I was gonna add
to what you're saying and say,you know, it's not an uncommon thing
where you know, we have prettyhealthy people and middle aged people, let's
say, in their in their midforties, and they feel good and they're
active, and they you know,don't really have any chronic medical issues.
They don't take any prescriptions, sothey don't go to the doctor a lot

(11:43):
um. You know, let's saythey go to the doctor. You know,
especially you know, males tend togo to the doctor even less than
females usually, um, So theymight go to the doctor every five years
or when they're actually sick. Um. But you know, they come in
for a visit and it's like,well, oh, your your blood pressure
is a little bit high, andyou get some lab work. You're lestrol
is also a little bit high.Maybe you're you're fasting. Blood glucose is

(12:03):
a little bit high. Um.So all of those things contribute to our
health and in the short term,those things might not make a big difference.
I like to talk to patients aboutkind of short term you know what,
things like blood pressure due to ourbodies. But the long term is
what we're looking at. So ifwe don't do something now, you know,
whether that's modifying your diet, modifyingyour activity, you know, starting

(12:26):
a med which I like to say. You know, there's a perception amongst
you Western medicine doctors that were kindof pill pushers and that the solution to
everything is to give you a prescriptionfor a pharmaceutical drug. And I don't
believe in that. I mean,I believe that the basis is your diet,
exercise, and if we can modifythose things in you know, ninety
five percent of cases, hopefully Ican keep you off of drugs. But

(12:48):
but if we did have to starta prescription drug, that's also an option.
But yes, you're right, Sean. I think that if we can
catch people to where we are findingthese things like you know, high pressure,
high cholesterol, you know, prediabetes, diabetes, then we are
preventing them from five years down theline, ten years down the line having
things like heart attacks, strokes,you know, major medical issues and that's

(13:13):
that's the goal of all this.It's it's pretty amazing too when you talk
about having the opportunity to spend timewith patients to get to know them,
and you talk about, you know, making those modifications and doing that lifestyle
medicine. It's a it's a greatopportunity. With Advocate MD, and we
talk about options for yourself, optionsfor your family, and they've got great
stuff there. They've also got greatoptions if you are an employer looking for

(13:35):
things for your employees or you're involvedin helping with those decisions at your office,
you definitely want to check out AdvocateMD and Direct Primary Care to learn
more about some of those great options. 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

(13:56):
two eleven to make an appointment tobecome a member Advocate MDUM. We're gonna
talk a little bit about speaking ofsome of the businesses out there, some
of the questions doctor Nicole gets frombusinesses. We'll talk about that. We'll
also take your call next as fullscope with doctor Nicole heem Kiss. Madison's
directcare doc continues right here on thirteenten WIBA in twenty five thirteen ten WIBA

(14:28):
Madison in the Morning and full scopewith doctor Nicole hem Kiss. Of course,
Doctnicol mkiss comes to us from AdvocateMD, a direct primary care practice.
Learn more online the website Advocates DPCdot com. That's Advocates DPC dot
com. Before we talk about somebusiness stuff with doctor Nicole. One of
the things too, I think alot of times you hear from folks about
direct primary saying I don't really goto my doctor very much, and that's

(14:54):
and that's a problem, isn't adoctnicol? Yes, you know, I
think some people kind of equate,well, I'm paying for this thing,
and if I'm not going to thedoctor every month, you know, like
should I keep paying for this thing? And it always kind of bothers me
a little bit. The analogy thatsome people use, the analogy of direct
primary care to a gym membership andthey say, well, you pay for

(15:15):
your gym membership every month, andyou might not go every month like most
of us would pay for gym membership. We rarely go but I don't like
that analogy because I think a gymmembership, you obviously the goal is to
go more right within a within reason, and it's not necessarily that the goal
of you know, having a directprimary care membership is that you go to

(15:35):
the doctor more. But the goalis that when you do need a doctor,
you have access to care, right, because that is something that is
currently lacking in our system. Soin the state of Wisconsin, for example,
where we are, you know,we rank very highly for quality of
care. So we are fortunate tolive in an area, especially in the
Madison area, where we have reallygood hospitals, high quality docs, access

(15:58):
to pretty much any kind of surgeryspecialists that we need. The problem,
though, is that the availability ofappointments and the availability of testing is not
great. Right. So it almostI was having the same conversation with someone
the other day, and it's like, it almost doesn't matter how great the
system is and how great the doctorsare if you can't get an appointment with
them, right, Like if everybody'sbooked out for a year, you know,

(16:21):
it doesn't really matter. So whatwe are lacking in Wisconsin is access
to care and also the care thatwe get here. The healthcare here is
very expensive compared to other states,so we have good quality, poor access,
and high cost. And high costalso create an access problem, right
because with the higher the cost ofhealthcare, the more people will avoid it

(16:42):
because they're scared to get a bigbill. So these are the things that
Direct Primary Care are looking to solve. So we can solve the access problem
because you've got a doctor that's accessibleto you now today, if you made
an appointment, if you're a memberof our practice, we get you in
the same day when you need tobe seen. If it's something non urgent,
it might be one week or twoweeks, not six to nine months

(17:04):
to see your doctor you're a doctor. And then of course the affordability part.
You know, our our model makeshealthcare very affordable. You know,
everything is transparent, so patients don'thave to worry about, you know,
getting huge bills afterwards, whether they'regetting medication from US labs, from US
radiology, everything is transparent and theyknow the price of everything ahead of time.

(17:26):
So these are the problems that DirectPrimary Care solving. And again you're
paying that monthly membership fee because youwant to have access to care, and
I always find it a little bitironic because I don't hear that same question
come up with insurance, right,So you know, many people have health
insurance and we pay monthly a lotof money. Some people, you know,
five hundred to one thousand dollars amonth for their health insurance. And

(17:48):
I don't know that I've ever heardsomebody say, well, you know,
I haven't used the insurance and afew months, so can I just get
a refund on that, you know, what I paid to you guys like
to Blue Cross, Fluciold or whatever. You don't hear people say that you
don't And it's it's an interesting,interesting respecting when we talk about direct primary
care, what you're able to dosimple, better, more affordable. It's
an amazing option for you, yourfamily, businesses, and I know you

(18:11):
get a lot of questions from businessesand you've been meeting with a lot of
area business leaders as well. It'sa great model direct primary care. It's
a great practice. Advocate MD threelocations Madison West and Middleton right at Glacier
Ridge Road, east side of Madison, South Fair Oaks av and the newest
location in Janesville ten twenty one MineralPoint av don't forget the open house at

(18:33):
that Mineral Point Avenue location in Janesvillethis upcoming Thursday the fourth, from noon
until five. Doctor Nicole will beout there, Doctor Quality will be out
there. I'll be out there aswell. We'd love to see you.
And I'm really excited to see thatclinic, doc, because it just looks
absolutely amazing. Till then, youtake care. We'll talk real soon,
my friend, you too, Sean. Thank you, Doctor nicolehem Kiss of

(18:53):
Advocate, MD. The website AdvocatesDPC dot com. That's Advocates DPC dot
com. Tellphone number so eight twosix eight sixty two eleven. That's six
O eight two six eight sixty twoeleven. Certified Financial Planner Tracy Anton.
She comes your way next right hereat thirteen ten WIBA