May 5, 2023 • 20 mins
Dr. Hemkes talks about what's going on with telehealth, why some doctors are leaving the big hospitals, and what the hospitals are trying to do about it.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:07):
And full scope with doctor Nicole hemKiss of Advocate MD online Advocates DPC dot
com. That's Advocates DPC dot comand the telephone number to make an appointment
and to become a member at Advocatem D six eight two six eight sixty
two eleven. That's six O eighttwo six eight sixty two eleven. Doctor
Nicole Hempkiss, how you doing thismorning? I'm doing well, Sean.
(00:29):
How are you? I'm doing great? What time did you finally close down
for the open house last night?We closed down pretty much on schedule really,
I think just a little bit afterfive. But we had a really
good turnout, so it was niceto meet people. It was I got
a chance to stop out say helloand yeah it was hopping and as I
was pulling out of your parking lot, there were more cars coming in and
(00:52):
it's like, I bet you she'sgonna be here for a bit still.
But luckily, this this clinic,we don't have to worry about barth it
is. It was great to see, great to see the new clinic,
and of course I got to seein chat with doctor Shulman. Also doctor
Quality was there as well, andit's a really, really neat clinic you
(01:12):
have and for folks that don't know, three locations to serve you at Advocate
MD, west side of Madison,right in Middleton on Glacier Ridge Road,
east side of Madison on South FairOaks Avenue. And as as the last
night's open house says Janesville it isopen ten twenty one Mineral Point AV as
well. And doctor um As weare talking this week and kind of new
(01:34):
times and there's always innovation, sometimesfor the better, sometimes for the worse.
And um we saw a lot offolks using towards like the telehealth telemed
kind of thing the past couple ofyears. And with the good comes the
bad. What have you seen onyou know, on the medical side of
the use of things like telemed andtelehealth and those type of services. Yeah,
(01:57):
you know, I think that obviouslytechnolo elogy, you know, has
brought us a lot of efficiencies andyou know that things are more convenient,
um, you know, so there'sdefinitely pluses to some of the technology that
we have now in terms of ourelectronic medical record and you know, creating
more accessibility to people. I mean, I think telemedicine visits, you know,
especially when we had COVID you know, HIT, and sometimes the clinics
(02:23):
were actually shut down maybe for aperiod of time, or it was it
was just not accessible for people togo into a doctor's office. So people
kind of turned to telemed as away to talk to a doctor or get
their medical care as opposed to actuallyphysically going in. And I think that
in some ways kind of transformed theway we deliver healthcare medical care, you
(02:43):
know, both for primary care,doctors, specialists, I would say,
across the board. But what youknow, I think that along with the
conveniences and the accessibility to it,I think unfortunately there's now in some cases
almost a push to have people dotelemed visits rather than come into the office.
UM. I don't you know,I don't know if a lot of
people are aware. But when COVIDhit, UM, you know, prior
(03:05):
to that, originally telemedicine visits werereimbursed at a very different rate than when
you walk into a doctor's office.You see the medical system or the nurse
and then you see the doctor andthey you know, do an exam and
the medical system is taking your vitalsand you know kind of all of this
hands on things. Um, whenwhen COVID hit and we were kind of
forced in some cases to do thesetelemed visits. Um they change. You
(03:28):
know, a lot of the hospitalsand the health systems lobbied to have these
visits reimbursed at a higher rate becausethey, you know, they were supposedly
losing so much money. Um.And now these telemedicine visits are reimbursed at
the same rate in some cases asan in person visit. If you can
imagine that. UM. So,now what health systems are doing or you
(03:50):
know, what I've seen them doand heard patients telling me that they are
doing, is they're kind of pushingpatients towards doing telemedicine. Um. You
know that that like okay, well, you know, you don't really need
to come into your doctor, youjust schedule a telemed visit. If you
think about it in terms of fromthe health systems perspective, this is great
for them. They have much lessoverhead. Right, a doctor can literally
(04:10):
be sitting in their living room andtalking to you. Um. You know,
so that the hospital system or thehealth system doesn't have to pay for
an m A or a nurse tocome in. They don't have to pay
for the receptionist, but sitting atthe front desk checking you in. UM.
So from their perspective, that wouldbe great for them if if all,
you know, all docs did waswas telemed um you know and kind
of just saw you through the computerscreen. But unfortunately, you know,
(04:32):
I think obviously there there are alot of restrictions in terms of what we
can take care of through a computerscreen and you know, with a no
exam um and just kind of talkingto a patient and getting their history and
the symptoms. And the other partthat kind of bothers me is that it's
very difficult, you know, througha computer to develop that kind of doctor
patient relationship. UM. You know, obviously you can have a rapport with
(04:56):
a patient that you've seen and they'reestablished and you're doing follow up visits through
tell medwich. Sometimes that works reallywell. But if this is a newer
patient or if you're discussing something that'svery sensitive, you know, it really
does help. I think to havesomebody there in person talking this morning with
doctor to Colehemkiss of Advocate MD onlineAdvocates DPC dot com. That's Advocates DPC
(05:17):
dot com. The telephone, I'mgoing to make an appointment and become a
member at Advocate MD six O eighttwo six eight sixty two eleven. That's
six O eight two six eight sixtytwo eleven. Again, you can learn
more online Advocates DPC dot com.That's Advocates DPC dot com and and doctor.
We were talking earlier this morning onthe show about AI, artificial intelligence.
(05:40):
Um, it's being integrated and broughtinto all different walks of life.
Are we seeing anything about AI andin that getting involved in some of the
some of these digital communications between patientsand healthcare providers or what's going on there.
Yes, um, so I thinkprobably most of the listeners are familiar
(06:00):
with you know, EPIC and mychart messages and and so you know,
if you if you need to aska question or relay communications to your doctor,
you are sending this this my chartum. And what's happening now is that
a recent news story they were talkingabout that EPIC is kind of piloting this
artificial intelligence which would have the capabilityto answer some of these my chart messages.
(06:25):
And and you know, the reasoning, of course, they say,
is like to increase efficiency and tohelp the doctors out because all the doctors
are so burnt out and so thisthis robot or this AI is going to
answer your your my chart messages.And again, you know my concern with
that, I mean, obviously there'slots of concerns, but the concern is
that as the system gets bigger andyou know, technology takes on a larger
(06:46):
and larger role, is that,you know, again, we kind of
lose the patient and all of this. We lose the doctor and we lose
the patient, and we lose thatrelationship. And then you know, also
it seems a little funny that aautomated thing is kind of answering messages could
be potentially very important. I mean, these could be medical concerns or you
know, things where people need,you know, somebody to really take the
(07:09):
time to look through their chart andfigure out what's going on. So again
I think that you know, thereis this kind of loss of the personalized
care and you know, just kindof the humanity in medicine. I think
a while back I posted something abouthow we've lost humanity and that looking at
that patient as a person. Andagain, as as the systems get larger
(07:30):
and larger, we lose the relationshipwith the doctor and the system doesn't really
look at the patient as an individual. They kind of look at them as
a number. And so I thinkthat unfortunately, this type of technology doesn't
necessarily serve the best the best intentionsfor that patient. It's more kind of
serving the purpose of increasing productivity andbillables and you know, being able to
(07:56):
let that doctor see more and morepatients because now they don't have to check
as many my messages. And unfortunately, I feel like that's not a good
kind of trend to get into.You know. One of the things that
that I've noticed, but last nightwas a was A was a prime example
of this. Is UM mentioned agreat turnout at the open house at the
new Janesville location for Advocate empty thenew Jamesville clinic and UM people coming in
(08:18):
with questions and actually kind of havingthat that human conversation that let's let's talk,
hell, let's can I see thecan I see the facility, Can
I see your clinic? Can Isee your your and like people talking with
people and it's it was it remindsI think it's it's a it's a really
good example of what you're able todo at Advocate MD and what you're able
(08:39):
to do it's not a you know, it's not AI, it's not a
my chart message. It's literally patientsdoctors, a prospective patients, doctors asking
questions. I heard some you know, great folks had some really interesting questions
about how direct primary care worked,and um just I think it's just kind
of a great illustration of the kindof work that you are able to do
(09:03):
at Advocate m D with your directprimary care practice is actually having human to
human conversation about about things, whetherit's it's it's specific to a medical concern
or just a lifestyle type question.You guys are able to do that at
Advocate MD exactly. You know,I think that again, part of this
direct primary care model is that wetake care of a much smaller panel of
(09:28):
patients. Um. You know,I was talking with a family medicine doc
in the big system just a coupledays ago, and he was telling me
that he has a panel of liketwenty seven hundred patients. So twenty seven
hundred patients identify him as their doctor. You know. That of course doesn't
mean that he's seeing all of thosepeople, you know regularly. He couldn't
possibly be. But that's part ofthe reason why it's so difficult now when
(09:52):
you call to make an appointment withyour doctor, you know, oh,
well, you can't see doctor Hempkissfor six months, nine months a year,
you know. And that's also partof the reason why docs are kind
of pushed to see more and morepatients during the day, and they're seeing,
you know, twenty five to thirtypatients a day, and in our
model, they're seeing you know,six to eight patients a day, and
they have a panel of five hundredpatients rather than twenty five hundred patients.
(10:15):
So again, it just kind ofgoes back to that more personalized, patient
centered care that I think, unfortunatelyis kind of being lost in the large
systems. Right now, talking thismorning with doctor Nicolehempkiss, Wisconsin's directcare doc.
Of course, doctor Niccolehempkiss comes tous from Advocate MD three locations West
Side and Middle ten righte at thirtytwo o five Glacier Ridge Road, aside
(10:35):
of Madison, one fifty seven SouthFair Oaks AB and the newest location in
Janesville at ten twenty one Mineral PointAvenue. And of course the website Advocates
DPC dot com that's Advocates DPC dotcom and the telephon number. Make an
appointment to become a member at AdvocateMD six O eight two six eight sixty
two eleven. That's six O eighttwo six eight sixty two eleven. If
(10:58):
you picked up a paper recently,listen to the radio station, in the
news, or say on television,SSM has had an interesting thing going on
involving their former orthopedic doctors. We'lltalk with doctor Nicole Heempkiss. What's the
latest there and what's been going onkind of not only what you see,
but also things going on behind thescenes. We'll get the details from doctor
Nicole. We will do that nextas Full Scope continues right here on thirteen
(11:22):
ten WIBA eight eighteen thirteen ten WIBAand Full Scope with doctor Nicole Heempkiss,
Wisconsin's directcare doc. Of course,doctor Coolehempkiss comes to us from Advocate MD,
a direct primary care practice. Tolearn more about direct Primary Care and
(11:43):
Advocate MD, check them out onlineAdvocates DPC dot com. That's Advocates DPC
dot com. It's telphen number sixto eight two six eight sixty two eleven
at six O eight two six eightsixty two eleven. And latest news involving
SSM building a new a surgery centerand they're actually up in sun Prey and
(12:03):
they're closing the er. What's kindof the story what's going on there?
Doct Yeah, that was a bigtopic of conversation lately amongst the doctors and
it came up at the open houseyesterday. So kind of back up a
little bit, and I think we'vetalked on the program before um that SSM
Health had basically the majority of theirorthopedic surgeons left, so they formed a
(12:28):
group called Orthopedic and Spine Centers ofWisconsin. So what happens in health systems
is as a doctor, when I, you know, join employment there,
I am you know, of coursesign a contract with them, and there's
different things that they can put intothese contracts. There are things like non
competes where that means I can't justleave and you know, open up a
practice or potentially even join another practicewithin a geographic area. There are things
(12:52):
called like non solicitations where I can'tyou leave and then you know, contact
all of my patients and bring themwith me. But unfortunately, what's happened
recently, and we we've talked onthe program, and this has been in
the news, you know, theCap Times or Wisconsin State Journal in the
last i would say six months ormore that this group of orthopedic surgeons that
(13:16):
you know, had worked many ofthem had worked with SSM Health for many
years. Um, you know,very well respected, trusted, experienced docks.
They had gone to SSM and expressedsome concerns, you know, wanted
to see some changes happen that theythought would improve patient care and accessibility and
all of these things. And ofcourse, in a large corporate health system,
(13:39):
you know, most of the timethey humor the docks like, oh,
yeah, that sounds like a greatidea. You know, we're gonna
form a committee to talk about that. And then you know, six months,
nine months, a year later,of course nothing happens. So you
have this situation in which you havedoctors who care about their patients. They
work hard, you know, theymake a good living doing that, but
you know, ultimately they're stuck ina situation where the health system that they
(14:03):
are employed by is not serving theinterest of their patients, nor serving their
interests of their doctors. Um,they're serving their interests. They're serving the
interest of the hospital to maximize profitsor whatever it might be. And so
these docs, um, you know, after expressing their dissatisfaction with things multiple
times, decided, you know,we're going to leave and form our own
(14:24):
group. You know, we thinkwe can do this better. We can
do it more affordably for patients,we can make it more accessible to patients.
And that's exactly what they did.And it takes a lot of gumption,
as you can imagine as a docand you're employed and you're making a
good salary to say, you knowwhat, I'm gonna leave this and do
something on our own. Um.You know, obviously I did that.
(14:45):
I'm not an orthopedic desertion, butI you know, I really handed to
them because they unified together, whichis another thing that doctors are not good
at doing. We are not goodat acting as a as a kind of
a body of people and you know, kind of coming to a common consensus
about something that we're very kind ofindependent minded people. So they kind of
(15:07):
got together and said, you know, we can do this, and we
can form our own group. Andthat's what they did. And so now
SSM is fighting them legally for that, even though they really don't have grounds
to stand on, you know,based on their contracts from what I have
heard, um, you know,they don't have a legal grounds to stand
on. And when you think aboutit, it's kind of fascinating that a
health system. So let's say I'vebeen seeing you know, hypothetically, I've
(15:31):
been seeing one of these orthopedic surgeonsfor ten years and they did my surgery,
and you know, I trust them. They're good guys. And so
they leave SSM Health and they goform their own group, and now SSM
Health can legally try to prevent themfrom seeing me as a patient, even
though I, as a patient,say, you know what, I don't
necessarily have allegiance to SSM Health.I like this doctor, I trust this
(15:54):
doctor, I have a relationship withthem. But now this hospital system can
tell me that I'm not allowed tosee this doctor because now they're not employed
by them any longer. And that'sexactly what they're trying to do. But
that is the that is really scarywhen you think about it, and that
is really not good patient care,right because patients should have the ability to
see the doctor that they want tosee. They should have the freedom to
(16:17):
do that. And obviously, youknow, uh, if a health system
can prohibit them from doing that.You know, that raises much larger issues.
Um, you know, but that'sthat's exactly what's currently happening. And
this the surgery center comes into playbecause part of the threat to SSM Health
and hospital systems is that independent doctorswill open up independent surgery centers and then
(16:41):
basically they will do these surgeries fora fraction of the cost of what they
charge in a hospital. Because whenyou go into a hospital and have a
surgery, you know, obviously youhave the doctor's charge, the hospital charger's
a facility fee, there's the radio, you know, the the antithesiology fee
if they're you know, any ancillaryservices. But if they do it in
an outpatient setting, you know,there's no facility fee. All of these
(17:03):
charges are a fraction of the cost. So that is very threatening to a
large hospital system because now you havethese independent docs that can do what they're
doing at much lower prices, higherquality in some cases, and more accessible
because the surgeries are happening faster,patients aren't having to wait six months or
nine months to get their surgery done. So as you can imagine SSM Health
(17:27):
or these other hospitals don't like this, so now to compete with these independent
docks at Ortho and Spine Centers ofWisconsin, they are now all of a
sudden opening up a surgery center andSun Prairie and closing the er there.
And that was the latest news story. That is that's interesting too. And
I think sometimes people also assume,I know that some of the some of
(17:48):
the big players are not quote anidea air quotes nonprofit. There is a
there is. It's not to saythat there's anything nefarious with that, but
people need to understand what happens whenyou are a quote unquote nonprofit exactly.
So you know, you most hospitalsystems now the majority of hospital systems are
(18:08):
nonprofits. But what that means isthat they kind of take their quote profit
and put it back into the system. So they build a new building,
they renovate a building that they thinkdoesn't look as nice. They put some
fancy you know, water features anda player piano and you know, sculptures.
And when you think about it again, this does this serve patient care?
I mean, the fancier the facilityis that is that does that mean
(18:30):
you're taking a higher quality of careof that patient. No, of course
it doesn't. But again that allowsthem to claim nonprofit status. They can
build more and more buildings and youknow, they can turn this er and
sund Prairie into a surgery center andum, you know, compete with the
guys who are just trying to takecare of patients and you know, charge
more affordable prices. So again it'sit's sad that it's you know, everything
(18:52):
is a business. Obviously, medicineis a business, and you know there's
a bottom dollar and that you know, they have to make some sort of
a profit to continue to function.But at the same time, healthcare in
general, there should be a componentof it that's collaborative and there should be
a mission that's kind of overreaching thatsays, you know, what we're here
to do is to take you know, good care of patients, the best
care of patients, and to makeit affordable to them, which means it's
(19:15):
more accessible to them. And soif you have that overarching theme, and
obviously all these health systems have amission, so that should be the theme
of this, you know, andyou can still make a profit doing that,
but you can be collaborative in theway that you're not trying to kind
of like out to or push outthe other guy because he might be,
you know, charging less money forthe surgery than you. Um So,
(19:37):
I wish that there was kind ofmore of a collaborative, patient centered approach
to these these health systems and theyweren't just so concerned about their bottom dollar.
I know I'm a day late withthis comparison, and I'm probably going
to get some emails, but it'skind of like the rebel alliance versus the
Empire here there are I don't knowenough to know that if that's exactly app
(20:00):
but I'm going with it this morning. Doc you yes, you and the
other you know, whether it's directprimary care, and these orthopedic doctors are
saying, you know what we wantto We want to provide better care,
we want to do great care forour patients, want to have more time
with our our patients, who thinkabout what you're able to do at Advocate
m D. With direct primary care, it's an amazing model. If you
(20:21):
haven't learned about direct primary care,of course, you can always check out
the website Advocates DPC dot com.That's Advocates DPC dot com as well as
of course pick up phone game,a call to make an appointment. Become
a member at Advocate m D sixeight two six eight sixty two eleven.
That's six O eight two six eightsixty two eleven. Doctor Nicole, you
enjoy this beautiful day, have agreat weekend, and we'll talk real soon.
Certified financial Planner Tracy Anton comes yourway next year on thirteen ten. WIBA
And full scope with doctor Nicole hemKiss of Advocate MD online Advocates DPC dot
com. That's Advocates DPC dot comand the telephone number to make an appointment
and to become a member at Advocatem D six eight two six eight sixty
two eleven. That's six O eighttwo six eight sixty two eleven. Doctor
Nicole Hempkiss, how you doing thismorning? I'm doing well, Sean.
(00:29):
How are you? I'm doing great? What time did you finally close down
for the open house last night?We closed down pretty much on schedule really,
I think just a little bit afterfive. But we had a really
good turnout, so it was niceto meet people. It was I got
a chance to stop out say helloand yeah it was hopping and as I
was pulling out of your parking lot, there were more cars coming in and
(00:52):
it's like, I bet you she'sgonna be here for a bit still.
But luckily, this this clinic,we don't have to worry about barth it
is. It was great to see, great to see the new clinic,
and of course I got to seein chat with doctor Shulman. Also doctor
Quality was there as well, andit's a really, really neat clinic you
(01:12):
have and for folks that don't know, three locations to serve you at Advocate
MD, west side of Madison,right in Middleton on Glacier Ridge Road,
east side of Madison on South FairOaks Avenue. And as as the last
night's open house says Janesville it isopen ten twenty one Mineral Point AV as
well. And doctor um As weare talking this week and kind of new
(01:34):
times and there's always innovation, sometimesfor the better, sometimes for the worse.
And um we saw a lot offolks using towards like the telehealth telemed
kind of thing the past couple ofyears. And with the good comes the
bad. What have you seen onyou know, on the medical side of
the use of things like telemed andtelehealth and those type of services. Yeah,
(01:57):
you know, I think that obviouslytechnolo elogy, you know, has
brought us a lot of efficiencies andyou know that things are more convenient,
um, you know, so there'sdefinitely pluses to some of the technology that
we have now in terms of ourelectronic medical record and you know, creating
more accessibility to people. I mean, I think telemedicine visits, you know,
especially when we had COVID you know, HIT, and sometimes the clinics
(02:23):
were actually shut down maybe for aperiod of time, or it was it
was just not accessible for people togo into a doctor's office. So people
kind of turned to telemed as away to talk to a doctor or get
their medical care as opposed to actuallyphysically going in. And I think that
in some ways kind of transformed theway we deliver healthcare medical care, you
(02:43):
know, both for primary care,doctors, specialists, I would say,
across the board. But what youknow, I think that along with the
conveniences and the accessibility to it,I think unfortunately there's now in some cases
almost a push to have people dotelemed visits rather than come into the office.
UM. I don't you know,I don't know if a lot of
people are aware. But when COVIDhit, UM, you know, prior
(03:05):
to that, originally telemedicine visits werereimbursed at a very different rate than when
you walk into a doctor's office.You see the medical system or the nurse
and then you see the doctor andthey you know, do an exam and
the medical system is taking your vitalsand you know kind of all of this
hands on things. Um, whenwhen COVID hit and we were kind of
forced in some cases to do thesetelemed visits. Um they change. You
(03:28):
know, a lot of the hospitalsand the health systems lobbied to have these
visits reimbursed at a higher rate becausethey, you know, they were supposedly
losing so much money. Um.And now these telemedicine visits are reimbursed at
the same rate in some cases asan in person visit. If you can
imagine that. UM. So,now what health systems are doing or you
(03:50):
know, what I've seen them doand heard patients telling me that they are
doing, is they're kind of pushingpatients towards doing telemedicine. Um. You
know that that like okay, well, you know, you don't really need
to come into your doctor, youjust schedule a telemed visit. If you
think about it in terms of fromthe health systems perspective, this is great
for them. They have much lessoverhead. Right, a doctor can literally
(04:10):
be sitting in their living room andtalking to you. Um. You know,
so that the hospital system or thehealth system doesn't have to pay for
an m A or a nurse tocome in. They don't have to pay
for the receptionist, but sitting atthe front desk checking you in. UM.
So from their perspective, that wouldbe great for them if if all,
you know, all docs did waswas telemed um you know and kind
of just saw you through the computerscreen. But unfortunately, you know,
(04:32):
I think obviously there there are alot of restrictions in terms of what we
can take care of through a computerscreen and you know, with a no
exam um and just kind of talkingto a patient and getting their history and
the symptoms. And the other partthat kind of bothers me is that it's
very difficult, you know, througha computer to develop that kind of doctor
patient relationship. UM. You know, obviously you can have a rapport with
(04:56):
a patient that you've seen and they'reestablished and you're doing follow up visits through
tell medwich. Sometimes that works reallywell. But if this is a newer
patient or if you're discussing something that'svery sensitive, you know, it really
does help. I think to havesomebody there in person talking this morning with
doctor to Colehemkiss of Advocate MD onlineAdvocates DPC dot com. That's Advocates DPC
(05:17):
dot com. The telephone, I'mgoing to make an appointment and become a
member at Advocate MD six O eighttwo six eight sixty two eleven. That's
six O eight two six eight sixtytwo eleven. Again, you can learn
more online Advocates DPC dot com.That's Advocates DPC dot com and and doctor.
We were talking earlier this morning onthe show about AI, artificial intelligence.
(05:40):
Um, it's being integrated and broughtinto all different walks of life.
Are we seeing anything about AI andin that getting involved in some of the
some of these digital communications between patientsand healthcare providers or what's going on there.
Yes, um, so I thinkprobably most of the listeners are familiar
(06:00):
with you know, EPIC and mychart messages and and so you know,
if you if you need to aska question or relay communications to your doctor,
you are sending this this my chartum. And what's happening now is that
a recent news story they were talkingabout that EPIC is kind of piloting this
artificial intelligence which would have the capabilityto answer some of these my chart messages.
(06:25):
And and you know, the reasoning, of course, they say,
is like to increase efficiency and tohelp the doctors out because all the doctors
are so burnt out and so thisthis robot or this AI is going to
answer your your my chart messages.And again, you know my concern with
that, I mean, obviously there'slots of concerns, but the concern is
that as the system gets bigger andyou know, technology takes on a larger
(06:46):
and larger role, is that,you know, again, we kind of
lose the patient and all of this. We lose the doctor and we lose
the patient, and we lose thatrelationship. And then you know, also
it seems a little funny that aautomated thing is kind of answering messages could
be potentially very important. I mean, these could be medical concerns or you
know, things where people need,you know, somebody to really take the
(07:09):
time to look through their chart andfigure out what's going on. So again
I think that you know, thereis this kind of loss of the personalized
care and you know, just kindof the humanity in medicine. I think
a while back I posted something abouthow we've lost humanity and that looking at
that patient as a person. Andagain, as as the systems get larger
(07:30):
and larger, we lose the relationshipwith the doctor and the system doesn't really
look at the patient as an individual. They kind of look at them as
a number. And so I thinkthat unfortunately, this type of technology doesn't
necessarily serve the best the best intentionsfor that patient. It's more kind of
serving the purpose of increasing productivity andbillables and you know, being able to
(07:56):
let that doctor see more and morepatients because now they don't have to check
as many my messages. And unfortunately, I feel like that's not a good
kind of trend to get into.You know. One of the things that
that I've noticed, but last nightwas a was A was a prime example
of this. Is UM mentioned agreat turnout at the open house at the
new Janesville location for Advocate empty thenew Jamesville clinic and UM people coming in
(08:18):
with questions and actually kind of havingthat that human conversation that let's let's talk,
hell, let's can I see thecan I see the facility, Can
I see your clinic? Can Isee your your and like people talking with
people and it's it was it remindsI think it's it's a it's a really
good example of what you're able todo at Advocate MD and what you're able
(08:39):
to do it's not a you know, it's not AI, it's not a
my chart message. It's literally patientsdoctors, a prospective patients, doctors asking
questions. I heard some you know, great folks had some really interesting questions
about how direct primary care worked,and um just I think it's just kind
of a great illustration of the kindof work that you are able to do
(09:03):
at Advocate m D with your directprimary care practice is actually having human to
human conversation about about things, whetherit's it's it's specific to a medical concern
or just a lifestyle type question.You guys are able to do that at
Advocate MD exactly. You know,I think that again, part of this
direct primary care model is that wetake care of a much smaller panel of
(09:28):
patients. Um. You know,I was talking with a family medicine doc
in the big system just a coupledays ago, and he was telling me
that he has a panel of liketwenty seven hundred patients. So twenty seven
hundred patients identify him as their doctor. You know. That of course doesn't
mean that he's seeing all of thosepeople, you know regularly. He couldn't
possibly be. But that's part ofthe reason why it's so difficult now when
(09:52):
you call to make an appointment withyour doctor, you know, oh,
well, you can't see doctor Hempkissfor six months, nine months a year,
you know. And that's also partof the reason why docs are kind
of pushed to see more and morepatients during the day, and they're seeing,
you know, twenty five to thirtypatients a day, and in our
model, they're seeing you know,six to eight patients a day, and
they have a panel of five hundredpatients rather than twenty five hundred patients.
(10:15):
So again, it just kind ofgoes back to that more personalized, patient
centered care that I think, unfortunatelyis kind of being lost in the large
systems. Right now, talking thismorning with doctor Nicolehempkiss, Wisconsin's directcare doc.
Of course, doctor Niccolehempkiss comes tous from Advocate MD three locations West
Side and Middle ten righte at thirtytwo o five Glacier Ridge Road, aside
(10:35):
of Madison, one fifty seven SouthFair Oaks AB and the newest location in
Janesville at ten twenty one Mineral PointAvenue. And of course the website Advocates
DPC dot com that's Advocates DPC dotcom and the telephon number. Make an
appointment to become a member at AdvocateMD six O eight two six eight sixty
two eleven. That's six O eighttwo six eight sixty two eleven. If
(10:58):
you picked up a paper recently,listen to the radio station, in the
news, or say on television,SSM has had an interesting thing going on
involving their former orthopedic doctors. We'lltalk with doctor Nicole Heempkiss. What's the
latest there and what's been going onkind of not only what you see,
but also things going on behind thescenes. We'll get the details from doctor
Nicole. We will do that nextas Full Scope continues right here on thirteen
(11:22):
ten WIBA eight eighteen thirteen ten WIBAand Full Scope with doctor Nicole Heempkiss,
Wisconsin's directcare doc. Of course,doctor Coolehempkiss comes to us from Advocate MD,
a direct primary care practice. Tolearn more about direct Primary Care and
(11:43):
Advocate MD, check them out onlineAdvocates DPC dot com. That's Advocates DPC
dot com. It's telphen number sixto eight two six eight sixty two eleven
at six O eight two six eightsixty two eleven. And latest news involving
SSM building a new a surgery centerand they're actually up in sun Prey and
(12:03):
they're closing the er. What's kindof the story what's going on there?
Doct Yeah, that was a bigtopic of conversation lately amongst the doctors and
it came up at the open houseyesterday. So kind of back up a
little bit, and I think we'vetalked on the program before um that SSM
Health had basically the majority of theirorthopedic surgeons left, so they formed a
(12:28):
group called Orthopedic and Spine Centers ofWisconsin. So what happens in health systems
is as a doctor, when I, you know, join employment there,
I am you know, of coursesign a contract with them, and there's
different things that they can put intothese contracts. There are things like non
competes where that means I can't justleave and you know, open up a
practice or potentially even join another practicewithin a geographic area. There are things
(12:52):
called like non solicitations where I can'tyou leave and then you know, contact
all of my patients and bring themwith me. But unfortunately, what's happened
recently, and we we've talked onthe program, and this has been in
the news, you know, theCap Times or Wisconsin State Journal in the
last i would say six months ormore that this group of orthopedic surgeons that
(13:16):
you know, had worked many ofthem had worked with SSM Health for many
years. Um, you know,very well respected, trusted, experienced docks.
They had gone to SSM and expressedsome concerns, you know, wanted
to see some changes happen that theythought would improve patient care and accessibility and
all of these things. And ofcourse, in a large corporate health system,
(13:39):
you know, most of the timethey humor the docks like, oh,
yeah, that sounds like a greatidea. You know, we're gonna
form a committee to talk about that. And then you know, six months,
nine months, a year later,of course nothing happens. So you
have this situation in which you havedoctors who care about their patients. They
work hard, you know, theymake a good living doing that, but
you know, ultimately they're stuck ina situation where the health system that they
(14:03):
are employed by is not serving theinterest of their patients, nor serving their
interests of their doctors. Um,they're serving their interests. They're serving the
interest of the hospital to maximize profitsor whatever it might be. And so
these docs, um, you know, after expressing their dissatisfaction with things multiple
times, decided, you know,we're going to leave and form our own
(14:24):
group. You know, we thinkwe can do this better. We can
do it more affordably for patients,we can make it more accessible to patients.
And that's exactly what they did.And it takes a lot of gumption,
as you can imagine as a docand you're employed and you're making a
good salary to say, you knowwhat, I'm gonna leave this and do
something on our own. Um.You know, obviously I did that.
(14:45):
I'm not an orthopedic desertion, butI you know, I really handed to
them because they unified together, whichis another thing that doctors are not good
at doing. We are not goodat acting as a as a kind of
a body of people and you know, kind of coming to a common consensus
about something that we're very kind ofindependent minded people. So they kind of
(15:07):
got together and said, you know, we can do this, and we
can form our own group. Andthat's what they did. And so now
SSM is fighting them legally for that, even though they really don't have grounds
to stand on, you know,based on their contracts from what I have
heard, um, you know,they don't have a legal grounds to stand
on. And when you think aboutit, it's kind of fascinating that a
health system. So let's say I'vebeen seeing you know, hypothetically, I've
(15:31):
been seeing one of these orthopedic surgeonsfor ten years and they did my surgery,
and you know, I trust them. They're good guys. And so
they leave SSM Health and they goform their own group, and now SSM
Health can legally try to prevent themfrom seeing me as a patient, even
though I, as a patient,say, you know what, I don't
necessarily have allegiance to SSM Health.I like this doctor, I trust this
(15:54):
doctor, I have a relationship withthem. But now this hospital system can
tell me that I'm not allowed tosee this doctor because now they're not employed
by them any longer. And that'sexactly what they're trying to do. But
that is the that is really scarywhen you think about it, and that
is really not good patient care,right because patients should have the ability to
see the doctor that they want tosee. They should have the freedom to
(16:17):
do that. And obviously, youknow, uh, if a health system
can prohibit them from doing that.You know, that raises much larger issues.
Um, you know, but that'sthat's exactly what's currently happening. And
this the surgery center comes into playbecause part of the threat to SSM Health
and hospital systems is that independent doctorswill open up independent surgery centers and then
(16:41):
basically they will do these surgeries fora fraction of the cost of what they
charge in a hospital. Because whenyou go into a hospital and have a
surgery, you know, obviously youhave the doctor's charge, the hospital charger's
a facility fee, there's the radio, you know, the the antithesiology fee
if they're you know, any ancillaryservices. But if they do it in
an outpatient setting, you know,there's no facility fee. All of these
(17:03):
charges are a fraction of the cost. So that is very threatening to a
large hospital system because now you havethese independent docs that can do what they're
doing at much lower prices, higherquality in some cases, and more accessible
because the surgeries are happening faster,patients aren't having to wait six months or
nine months to get their surgery done. So as you can imagine SSM Health
(17:27):
or these other hospitals don't like this, so now to compete with these independent
docks at Ortho and Spine Centers ofWisconsin, they are now all of a
sudden opening up a surgery center andSun Prairie and closing the er there.
And that was the latest news story. That is that's interesting too. And
I think sometimes people also assume,I know that some of the some of
(17:48):
the big players are not quote anidea air quotes nonprofit. There is a
there is. It's not to saythat there's anything nefarious with that, but
people need to understand what happens whenyou are a quote unquote nonprofit exactly.
So you know, you most hospitalsystems now the majority of hospital systems are
(18:08):
nonprofits. But what that means isthat they kind of take their quote profit
and put it back into the system. So they build a new building,
they renovate a building that they thinkdoesn't look as nice. They put some
fancy you know, water features anda player piano and you know, sculptures.
And when you think about it again, this does this serve patient care?
I mean, the fancier the facilityis that is that does that mean
(18:30):
you're taking a higher quality of careof that patient. No, of course
it doesn't. But again that allowsthem to claim nonprofit status. They can
build more and more buildings and youknow, they can turn this er and
sund Prairie into a surgery center andum, you know, compete with the
guys who are just trying to takecare of patients and you know, charge
more affordable prices. So again it'sit's sad that it's you know, everything
(18:52):
is a business. Obviously, medicineis a business, and you know there's
a bottom dollar and that you know, they have to make some sort of
a profit to continue to function.But at the same time, healthcare in
general, there should be a componentof it that's collaborative and there should be
a mission that's kind of overreaching thatsays, you know, what we're here
to do is to take you know, good care of patients, the best
care of patients, and to makeit affordable to them, which means it's
(19:15):
more accessible to them. And soif you have that overarching theme, and
obviously all these health systems have amission, so that should be the theme
of this, you know, andyou can still make a profit doing that,
but you can be collaborative in theway that you're not trying to kind
of like out to or push outthe other guy because he might be,
you know, charging less money forthe surgery than you. Um So,
(19:37):
I wish that there was kind ofmore of a collaborative, patient centered approach
to these these health systems and theyweren't just so concerned about their bottom dollar.
I know I'm a day late withthis comparison, and I'm probably going
to get some emails, but it'skind of like the rebel alliance versus the
Empire here there are I don't knowenough to know that if that's exactly app
(20:00):
but I'm going with it this morning. Doc you yes, you and the
other you know, whether it's directprimary care, and these orthopedic doctors are
saying, you know what we wantto We want to provide better care,
we want to do great care forour patients, want to have more time
with our our patients, who thinkabout what you're able to do at Advocate
m D. With direct primary care, it's an amazing model. If you
(20:21):
haven't learned about direct primary care,of course, you can always check out
the website Advocates DPC dot com.That's Advocates DPC dot com as well as
of course pick up phone game,a call to make an appointment. Become
a member at Advocate m D sixeight two six eight sixty two eleven.
That's six O eight two six eightsixty two eleven. Doctor Nicole, you
enjoy this beautiful day, have agreat weekend, and we'll talk real soon.
Certified financial Planner Tracy Anton comes yourway next year on thirteen ten. WIBA
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.