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November 1, 2024 16 mins
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Speaker 1 (00:03):
It O five thirteen ten WIBA and full scope with
doctor Nicole Hemkiss, Wisconsin's directcare doctor. Of course, Doctor Hemkiss
comes to us each week from Advocate MD, a direct
primarycare practice with four clinics. One on the west side
in Middleton, right on Glacier Ridge Road, east side of
Madison on fair Oaks Drive, South location Janesville that's the

(00:26):
far south location, right on Mineral Point Avenue, and the
southern location right on the Madison Fitchburg line on Syene Road.
And doctor, great to talk with you this morning. Always
a lot of great stuff going on at Advocate MD,
and we'll talk about some of the really cool things
that you're able to do with direct primarycare and things
you're able to do at Advocate MD. Mentioned the website

(00:47):
ADVOCATESDPC dot com. That's ADVOCATESDPC dot com. Telphone number six
eight two six eight sixty two eleven. That's six h
eight two six eight sixty two to eleven to make
a member and become a patient at a name member
at a d kN MD. Again that number six so
eight two six eight sixty two eleven. Doctor, How you
doing this morning?

Speaker 2 (01:05):
I'm doing well, Sean.

Speaker 3 (01:06):
How are you.

Speaker 1 (01:06):
I'm doing really, really good and great to see you.
The other week, of course, you had the grand opening
of the Fitchburg Clinic, and the Fitchburg Clinic though it's
been it's been up and running for a little while now.
It's a beautiful, beautiful space, and it's a really convenient
location for folks, isn't it.

Speaker 3 (01:22):
Yes, you know, it's right on the Fitchburg Madison line,
so you know, people that live either in Fitchburg or
Stouton or Oregon, you know, it's it's pretty quick for
them to get there. And we do now have you know,
three different doctors working out of that clinic, and we're
soon to be adding. We have we'll definitely be adding
another physician. Doctor Jennifer Philben will be joining us at

(01:45):
the beginning of next year. And she worked for a
number of years which with Fort Health out of Lake Mills,
but she lives in Madison and is a I believe
she grew up in Madison, so she is a long
time a local resident and she's going to join us,
and then we hopefully will have a second new doctor

(02:05):
joining us very soon.

Speaker 1 (02:06):
Also very exciting, and obviously you're adding doctors and we're
seeing more and more folks come to Advocate MD. And
one of the great things is as more people become
members and join Advocate MD, you keep those patient panel
numbers down, so folks and get in to see their doctor.
More people become members, that means you hire more doctors,
build more clanks. Everybody's really excited. It's a win win

(02:29):
for everybody and doctor. I heard Robin during the news
there mentioned open enrollment and it's a big time a
year for everybody. A lot of questions, a lot of
decisions to be made. Let's talk about open enrollment and
what that means for your options and what that means
for direct primary care.

Speaker 3 (02:47):
Yes, you know, I think it is something as we've
spoken about. You know, insurance isn't the most clear cut
things sometimes and it can be very confusing, you know,
all the choices and what choice you should make. So
in terms of options that people have, you know, in
kind of broad strokes, so many people are offered some
sort of insurance benefit through their employer. So if you
work for maybe a small business like less than fifty employees,

(03:10):
you might not be offered an insurance, any health insurance.
If you're self employed or contracted employee, then you might
not be offered health insurance benefits again. Or you know,
you work for a business that has you know, ten
or twenty employees, but if you work for any sort
of larger company, then they are required to offer you
some health benefits. And you just have to be very

(03:33):
kind of careful and informed consumer and you know, read
all the fine print. You know, it used to be
that companies could afford to offer very good benefits to
their employees. You know, sometimes the employee paid almost nothing
or very small amount out of their paycheck every two weeks.

Speaker 2 (03:49):
You know.

Speaker 3 (03:49):
Unfortunately, what's happened in the last you know, decade or
a little bit longer, is that as health insurance has
become more expensive, right, that cost is now being passed
on to the employer and then you know, eventually to
the employee. So you know, I constantly hear I mean,
I hear this from friends, family members, and patients and
potential patients. You know, people out in the community that

(04:12):
you know, maybe they used to pay twenty dollars a
paycheck or one hundred dollars a paycheck, and now they're
paying you know, three hundred or four hundred or five
hundred dollars a paycheck for their health insurance. So I
think that that's one of the things to look at.
You know, your employer might offer you multiple options. You know,
in many cases they'll offer you two or three different options.
You know, Option number one might be a lower deductible

(04:35):
plan where you pay more premium. So that's the monthly
amount that you're paying just to have that health insurance.

Speaker 2 (04:40):
You know.

Speaker 3 (04:41):
One of the things to consider is if you're like
most you know, the average American, the average person, you know,
we tendn't tend to go to the doctor maybe one
or two times a year, you know, I mean maybe
maybe one sick visit or one follow up visit. I
think the average is like two and a half times
a year. So most people are not consuming a lot
of healthcare. You know, obviously we need some form of

(05:03):
health insurance or catastrophic coverage. If something bad happens, like you, you
obviously you know you need surgery, you need you know,
the emergency room. For something you have an unfortunate diagnosis
like cancer. You need to have some form of you know,
catastrophic coverage to cover for those things. But for most
of us, for the everyday medical needs. You know, we're

(05:25):
not going to meet our deductible. So I would say
that that's something to consider when you look at your employer.

Speaker 2 (05:31):
Based health insurance options.

Speaker 3 (05:33):
You know, if you have a choice, for example, of
a five hundred dollars deductible or one thousand dollars deductible
versus let's say four or five thousand dollars, yes, that
is a lot of money, but again, you likely will
never meet.

Speaker 2 (05:47):
That amount, you know.

Speaker 3 (05:48):
I think the statistic is the average person is hitting
their deductible every eight years, right, So what does that
mean When you pick the five hundred dollars deductible or
a thousand, that means, you know, every month they're taking
let's say, you know, five hundred dollars out of your paycheck,
or if it's a family, they're most likely taking you know,
a lot more than that. So that means, you know,

(06:08):
I'm paying six thousand dollars a year, you know, just
to have insurance that I likely am not really getting
much out of it because I haven't met my deductible
as opposed to if you choose let's say a higher
deductible policy, you know, maybe the cost of that is
you know, one hundred or two hundred dollars a month

(06:30):
versus you know, five hundred or six hundred dollars a month,
and you can add up the cost savings of that.

Speaker 2 (06:34):
You know.

Speaker 3 (06:35):
Again, so so you're not going to get much of
a benefit until you hit your deductible. But most people
are not going to hit their deductible. And again you
know that once every eight years where you have a
catastrophic need, you need surgery, you have you know, an
accident or something like that, then then you will hit
your deductible in those times. But when you add up
the cost savings over those years where you're not hitting

(06:57):
your deductible, for most people, to vast majority of people,
it makes more sense to choose the higher deductible. And
then the other part of this is that the direct
primary care what we do at Advocate MD, will kind
of fill that gap. So again the idea behind direct
primary care is that we are keeping you out of
the system so as much as we can do in
the clinic, so you know, the preventive care visits, the

(07:21):
chronic disease managements like your high blooders, your cholesterol, your thyroid,
your urgent care, and then your minor procedures that we
can do in the office, if we can do all
of that in a direct primary care clinic, and basically
that is no out of pocket costs for you other
than your monthly membership fee. So when we're kind of
using direct primary care to fill that gap, then most

(07:43):
people's out of pocket costs are extremely low. And again,
you have the insurance that's sitting there waiting in case
you have a big medical expense. It's there, so you're
not going to be put into financial ruin, have to
file for bankruptcy, all these horrible things that happen to
patients now, so you need that, But for most of
your medical care, you're going to come to the direct

(08:04):
primary care clinic. And let's say you're not in the
situation where you have a company sponsored health plan, you
work for you know, a small business, you're self employed,
you're unemployed, all of these different situations. Then you log
into the marketplace, you know that, which I think that
was what she was talking about. You log into the
marketplace and then you you know, look at you know,

(08:26):
it's going to ask you a bunch of information. It's
going to ask for your income and where you live
and how old you are, and it kind of plugs
it all into all into this algorithm and it's going
to spit out some choices.

Speaker 2 (08:36):
It's going to usually give you like the.

Speaker 3 (08:39):
Gold, Silver, Platinum plan options. And again, those those are
the ones where you have to kind of scrutinize, you know,
what the deductible is, what the copay is, and you're
going to have to figure out, you know, which one
fits best for you. But depending on what your income is,
you might be getting a discount. Again, this is a
discount kind of coming from the federal government. They're partially

(09:02):
subsidizing this plan, and also the insurance company has made,
you know, some sort of an agreement, you know, who
knows exactly what that entails with the government to give
you a discounted rate for people that are fit into
certain income levels. So that might be a good option
for you to purchase your plan through the marketplace if
you fit into one of those categories and your income

(09:24):
level is lower. That doesn't mean that if you have
a higher income level you can't purchase it through the marketplace,
but you likely will not be getting that subsidy. And
then I would say that the other option that we've
spoken about before is to do these marketplace, I'm sorry,
is to do these health shares. So health shares are
not insurance. They are you know, not governed by the

(09:46):
same rules that insurance is governed by. They typically are
much cheaper. If you go to our website and click
on the pair with, you'll kind of see what the
various health share options are and again the main limitations
of those if you have some sort of major prexisting condition,
then they will not cover that presisting condition for the
first three years.

Speaker 1 (10:06):
Typically pretty amazing stuff, and of course you can learn
more as the doctor mentioned Online ADVOCATESDPC dot com. That's
Advocates DPC dot com. There's a little section there, it's
right up in the top banner. It says pairs pair
with and it'll explain to you some of the really
really cool stuff when it comes to options for whether
it's going with a hell share or going with a
high deductible insurance policy, kind of understanding how all that

(10:29):
stuff works. Again, the Fantastic resource Advocates DPC dot com.
That's Advocates DPC dot com. You can learn also what
makes direct primary care and specifically advocate MD so special
what they offer Again, all online at ADVOCATEDPC dot com.
Become a member. All you gotta do is pick up phone,
give a call six eight two six eight sixty two eleven.
That's six eight two six eight sixty two eleven. And doctor,

(10:52):
I remember when you and I first started doing this
show together. You have the clinic on the west side
in Middleton, and obviously since grown at many more doctors
more clinics as well. But when you first started out,
you were you were really a trailblazer and continue to
be a trailblazer, uh in this area. Obviously, other dpcs
have seen your the you know the response and and

(11:13):
you know that people are really loving what you're doing,
and others have kind of come into the area and
people say, well, what is the difference what makes direct
primary care specifically from Advocate MD. What do you guys
do that that maybe is unique from other direct primary
care practices?

Speaker 3 (11:29):
Yes, you know, I think when we think of a
lot of direct primary care practices, which these practices are
all over the country now, most of them are owned
privately by a physician. I mean it might be one
physician or two or small group, but the vast majority
of them are very small. They're single clinics. You know,
they don't deal with a lot of employer groups. You

(11:50):
know that they there's a saying they say, if you've
seen one one DPC, you've seen one DPC, because there
they can be very different in terms of, you know,
the level of services they have and things like that.
But I would say what makes Advocate m D very
unique is that we only have physicians. We have multiple clinics,
we deal with a lot of employers. This makes kind

(12:11):
of differentiates us from a lot of direct primary cares
and of course the system in terms of having only physicians,
so it gives patients more of a choice as far
as like you know, if they live on a certain
side of town, it gives them a choice of doctors.
We provide a you know, a pretty wide range of
services in terms of you know, we've talked about cardiac monitoring.

(12:32):
We do holter monitors, event monitors, We do pulmonary function testing.
We do this thing called digital skin mapping. We do
vision and hearing screening. We can do pre employment physicals.
We do a lot of things I would say that
aren't necessarily in a typical family medicine and primary care office.
And again, what's happening in the system is that they're
doing less and less because most of that is now

(12:53):
being pushed to specialists or to the hospital because that's
where they can get higher reimbursement rates. So our model,
and especially in the Advocate MD world, is that we
try to do as much as we possibly can in
the office that's more convenient for the patient, it's it's
more cost effective for the patient, and that just helps
us to provide more comprehensive care.

Speaker 2 (13:15):
So that's kind of our goal.

Speaker 1 (13:17):
It's a pretty amazing and I see you know your
success and how people have responded. It's a pretty amazing
model specifically what you guys are doing at Advocate MD.
Not only for people individuals. You know, families. I know
you've got a lot of mom, dad and all the
kiddos come in to see you, and of course a
lot of businesses as well. It's an amazing model. It's
an amazing opportunity. Today would be the day to learn

(13:39):
more or even better, become a member at Advocate MD.
All you got to do to become a member pickup
phone game call six h eight two six eight sixty
two eleven. That's six h eight to six eight sixty
two eleven. You can learn more online the website Advocate
DPC dot com. That's Advocate DPC dot com. Doctor Hegis,
I know you've got a busy day this morning. Thank
you so much for joining us, and fantastic.

Speaker 2 (14:00):
Weekend you too, Sean, thank you, and.

Speaker 1 (14:03):
Again the website ADVOCATESDPC dot com. That's Advocates DPC dot com.
It was interesting. I got a chance to stop on
out at the open house at the newest clinic in
Fitchburg and doctor Hemkiss of course provides you know, a
little informational packets and pamphlets to folks if you're wondering,
and I'm just kind of looking at from it. The
membership you get, you know, direct communication with your physician.

(14:24):
There's a physician available twenty four hours a day, seven
days week, forty five minutes to our long appointments at
Advocate MD in office procedures. As the doctor was just
talking about a lot of things. If you're in that
insurance system where they'd send you to a specialist, you
have to wait forever to get in to see them.
They're doing right in the clinic at Advocate MD. It's
pretty cool what they're able to do in clinic after

(14:45):
hours visits available nights and weekends. I know doctors at
Advocate MD will do home visits. They'll also do work
visits available. There's a little small charge obviously for the
travel in time, but it's very affordable opportunity. There other
things like specialist consultations available using telemedicine, so you can
have your doctor there to work with that. They do

(15:06):
medications at wholesale price is dispensed right from the clinic,
which is also very cool, as well as discounted labs
and discounts on radiology. It's a really really cool uh
says system and a really really cool wait for primary
care to actually have a doctor that knows you, that
you know as well. Learn more online the website ADVOCATEDPC
dot com. That's Advocates DPC dot com. Even better, pick

(15:27):
a phone, gave a call this morning six oh eight
two six eight sixty two eleven. That's six 'oh eight
two six eight sixty two eleven. Mention all that stuff
and the doctor tells you about. Of course, with open
enrollment are things saying, yeah, but what does it cost?
Membership is insanely affordable, so definitely check that out. Whether
something for yourself, for your family, or you're a business.
Doctor also has discounts for businesses as well. You can

(15:50):
learn more more online ADVOCATESDPC dot com. That's ADVOCATESDPC dot com.
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