Episode Transcript
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Speaker 1 (00:00):
Thirteen ten WIBA and full scope with Wisconsin's direct care
doctor that is doctor Nicole Hemkis. Of course, doctor Hemkis
comes to us from Advocate MD, a direct primary care
practice with four area locations. Of course, the original right
in Middleton on the west side of town on Glacier
Ridge Road, east side of Madison on South Fair Oaks
(00:20):
down in Rock County, a great place for those of
you in Rock County or southern Dane County, right across
from the hospital on Mineral Point Avenue. And the newest
location thirty two to twenty SI, which is right in Fitchburg. Beautiful,
beautiful location. All four locations of Advocate MD are absolutely fantastic.
Eight doctors to serve you at Advocate MD, and of
course has mentioned joining us this morning is doctor Nicole Hemkis.
Speaker 2 (00:41):
Doctor.
Speaker 1 (00:42):
How you doing this week?
Speaker 2 (00:44):
I'm doing well, Sean, how are you?
Speaker 1 (00:45):
I'm doing really really good and we're actually going to
talk about I mentioned eight physicians at Advocate MD, and
not all primary care practices are created equally. One of
the things I know that was an important thing for
you when you started ad MD is to have the physicians,
have the doctors with the patients at Advocate MD. We're
going to talk a little bit about that, talk about
(01:06):
some other things as well, about your journey through through
becoming a doctor and then of course starting your own
practice and what Advocate MD has become. But first and
foremost I mentioned, of course four locations. You started out
in Middleton, and one of the cool things that has
happened is as more people have become aware of Advocate
MD and what you're able to do, you're seeing more
(01:26):
and more folks sign on and become patients. Thus you're
adding more clinics and more doctors, aren't you.
Speaker 3 (01:33):
Yeah, you know, part of this model is that we
want to keep each doctor's panels small and not kind
of replicate the mistakes that we see in the large system. So,
you know, in the big hospital owned primary care practice practices,
we see that, you know, these doctors have panels of
two thousand, three thousand patients, so it becomes really difficult
(01:54):
to see them for an appointment. You know, you hear
doctors being booked out for nine months a year, you know,
and then when you get an appointment to see them,
you know, maybe they spend you know, eight minutes, ten
minutes with you in the room.
Speaker 2 (02:06):
You know, we're hearing more and more of these stories where.
Speaker 3 (02:09):
A patient has an appointment with one of these insurance
based family medicine or internal medicine docs, and they schedule
those appointments nine months or a year in advance, and
then when they get closer to the appointment, you know,
a few days or a week before the appointment, that
the system calls and says, oh, I'm sorry, the doctor
is going to be out that day. We need to
reschedule you. And so this person's been waiting already for
(02:32):
nine months or a year.
Speaker 2 (02:34):
It's just crazy.
Speaker 3 (02:35):
I was talking to a group yesterday and I said,
isn't it a crazy thing that you can be paying
every month for your insurance and then the doctor can't
see you for nine months or a year, Like, how
is that fair that you're paying for something that you
actually can't use.
Speaker 2 (02:52):
You know, that would be like us.
Speaker 3 (02:53):
Saying, come join our practice, pay you know, the seventy
bucks a month for a membership, but we can't.
Speaker 2 (02:57):
See you for ten months. You know, nobody would agree
to that. They'd be like, welly, so why.
Speaker 3 (03:02):
Am I paying this seventy bucks a month if you
can't see me? For ten months, but for some reason
people do that with insurance.
Speaker 1 (03:08):
Is some of it just that that's what we like.
I think sometimes we as humans are a little hesitant
to try something different. And one of the things I've
loved in getting to know you and getting to know
Advocate MD and direct primary care is it's not scary
at all. I think sometimes when we think of like, well,
(03:29):
this is just you know, we get insurance, we see
our dial like people are like so programmed that that
suddenly somebody comes along and says there's a better way.
Initially it's I think for some folks a little scary.
But the more that folks learn and the more that
you hear from folks that have used direct primary care
and become patients at Advocate MPD, it's really a refreshing
change from what's sadly become the norm.
Speaker 3 (03:51):
I think it is. I think there's a lot of
fear of change. I think most people just there's something
about human nature that we have this kind of inertia
even though something isn't really working well for us. And
we can see this in many aspects of life. For people,
is like we just kind of stay in this situation
even though it's not a great situation, or we stay
with insurance even though we're getting ripped off and we
(04:11):
don't have a good experience, but we stick with it
because you know, who knows what else is out there.
And I think in some cases too, you know, we've
brought this up on the program. I think there's almost
it sounds too good to be true type of aspect
to this, where it's like, well, so I'm paying one
thousand dollars a month for insurance, which I don't like,
but I can pay you seventy dollars a month and
(04:31):
you're promising to do all of these different things.
Speaker 2 (04:33):
Spend an hour with me, My doc's.
Speaker 3 (04:36):
Going to text me after hours, they're going to spend
an you know, they're going to be able to see
me right away for an appointment.
Speaker 2 (04:43):
So I think that some people are just kind.
Speaker 3 (04:44):
Of like, it's hard to wrap your brain around that
and think, like, how can there be such a stark
contrast between what you're offering and what the hospital system
is offering?
Speaker 2 (04:54):
You know? So I think that's that's a big part
of it too.
Speaker 1 (04:57):
I remember early on one of the I think the
great illustration that stuck with me that you made. As
far as what Advocate MD is and what direct primary
Care is, you said, it's it's like, it's kind of
like when you used to go see your doctor when
you were a kid, or you know, for those folks
that are a little bit younger, maybe what your parents
experienced when they were younger. When you go to a doctor,
it was you your doctor. Your doctor knew you, Your doctor
(05:18):
knew your family, Your doctor knew your story. If you
needed anything, your doctor was there for you. And that
stuff still exists with Direct Primary Care and Advocate MD.
You can learn more online the website Advocates DPC dot com.
That's Advocates DPC dot com. Tell if a number, make
an appointment, become a member at Advocate MD six oh
eight two six eight sixty two eleven. That's six oh
(05:38):
eight two six eight sixty two eleven and doctor. A
lot of folks sometimes don't understand. And I admit, until
I started doing this show with you and getting to
know you better, I didn't know what a family medicine
physician was. As a matter of fact, I always just
just use the term family medical physician or that type
of thing. What is a family medicine physician? And you
are that's what you are, correct, Yes.
Speaker 2 (06:01):
So I am a family physician.
Speaker 3 (06:03):
All the doctors and our practice our family physicians, I
mean sometimes we use this interchangeably with primary care. There's
some slight difference. All family physicians are primary care doctors.
That there are different types of primary care doctors. So
even you know, internal medicines considered primary care pediatrics. Sometimes
obg i ns are considered primary care doctors. But in
(06:25):
terms of family medicine, it's a little bit unique that
we take care of a broad scope of people. So
everything from you know, newborn babies all the way to
elderly people are people that are you know, in the
process of passing on you know, hospice doctors or are
many times family medicine docts. So we also do a
lot of procedures in the office, which is again somewhat unique,
(06:49):
So skin procedures, orthopedic procedures, gynecologic procedures, and that is
again different than internal medicine doctors a little bit. So
we do more urgent care care, more procedures. We take
care of all ages of people, men and women. Again,
there are some specialties like obgu i N they only
see women. So it's a lot of variety of patients.
(07:12):
And the cool part about it for me as a doc,
and I think also for the patient, is that we
can take care of the whole family. So, you know,
I have many patients where I take care of the husband,
the wife, the children, sometimes their parents or the grandparents,
which is a really interesting thing because you not only
get to see obviously the medical issues, you get to
see the social dynamic.
Speaker 2 (07:34):
You know that the family dynamics, and.
Speaker 3 (07:36):
That sometimes the context of that can help you better
understand what's going on with the patient. So I really
enjoy that part of it, and that's part of the
reason that I chose family medicine. And also the other
part of family medicine that's really nice is that you
can practice in a variety of settings. So right now
I'm a family medicine doc practicing in an outpatient outpatient clinics.
(07:59):
But I have, in the asked you know, worked for hospitals.
I've worked as a hospitalist, so that means we take
care of patients from the time they're admitted to the
hospital until their discharge. I've worked in emergency departments and also,
you know, you can work in some very rural areas
versus like inner city, so you get to kind of
have a large breadth of experiences in this specialty, which
(08:23):
is really nice.
Speaker 1 (08:24):
And you mentioned some of the rural areas for folks
that don't know you work in a very rural area
when you were just getting started parts of Alaska.
Speaker 3 (08:33):
Yes, yes, no, I'm Alaska, and then some of the
they call it the Nordic Sound Native Alaskan.
Speaker 2 (08:40):
Villages that are up there. So yeah, that was a
really interesting experience.
Speaker 3 (08:45):
But yeah, so that before starting the practice advocate MD,
I worked as an employed physician, So so to give
you some background of you know, what does it take
to become a physician? And I like to talk about
this kind of remind people or to bring it to
the forethought of, you know, the amount of years that
(09:06):
it takes, the amount of training and education and experience
in clinical hours that it takes to become a doctor,
because I think it's important what we see happening. And
the reason this was kind of on my mind lately
is that, you know, we've had some legislation passed recently
and it's it's allowing for a greater amount of autonomy
and independence to non physicians in our community, and I've
(09:28):
worked alongside many non physicians that you know, do a
great job. They're very knowledgeable, they're part of the healthcare team.
So there's definitely a value there. But there is a
difference between a physician and a nurse practitioner a PA,
and I think it's always important to point out these
differences so people understand. And so when you walk into
(09:49):
a clinic or a hospital or an emergency department, you
know who's treating you and know what their educational background
and their training is to get to that point. And
for a physician, it's it's the most extensive of any
of these kind of layers of healthcare professionals.
Speaker 2 (10:06):
So you know, all doctors go through four years of.
Speaker 3 (10:09):
Undergraduate So in my case, I was a biology major
chemistry minor, but you don't have to necessarily major in sciences.
You have to do your pre medical classes and then
you go through four years in medical school. So four
years of medical school includes your first two years, which
is what I call the book learning, so you know anatomy, physiology, pharmacology, pathology,
(10:29):
you know all of these different core classes, and then
your second two years are basically your clinical years. So
the third year is a very intense where you rotate
through you know, surgery, internal medicine, family medicine, pediatrics, emergency medicine.
You get a taste of all of these different specialties
(10:50):
and that's supposed to help you figure out what you
want to ultimately do. Your fourth year is usually mainly elective,
so the things you want to focus on. In my case,
I did extra time in dermatology and procedures. I did
some extra time in radiology because I wanted to get
better with reading X rays and things like that. You know,
so you can decide if there's things you want to
(11:13):
spend more time on. I also spend some extra time
working in the hospital. So that's your fourth year, and
then you apply and you do a residency. So in
the case of family medicine and a lot of primary
career specialties.
Speaker 2 (11:26):
It's three years.
Speaker 3 (11:28):
Then you can decide after those three years to do
a fellowship. Some people do that and other specialties. And
again I don't want to get too far off the
you know, off the into a tangent here, but you know,
specialties like surgery, you know, these subspecialties like neurosurgery or
urology or you know, E and T, so that those
(11:49):
people do even longer residencies. So again this is just
a point out so that doctor that you're seeing, they
have completed, in almost all cases, eleven years of schooling
to get to that point, and that's supervised you know,
medical school and residency. They still have you know, they're
being graded, they're being evaluated, they have somebody in a
(12:10):
looking after what the work that they're doing to make
sure it's good.
Speaker 2 (12:12):
To make sure it's it's you know, meeting standards. You
have to go through US m l E.
Speaker 3 (12:17):
US Medical Licensing exams during that time again to make
sure you're proficient and knowledgeable in these areas. And then
you have you know, your board certification exam that you
have to go through. This is very again different than
the process for non physicians. So I like to always
point that out so that people can know, you know,
(12:38):
again all the background that their physician has, you know,
And let's say, is every single physician in the world great, No,
of course, like any specialty.
Speaker 2 (12:47):
Right is every lawyer, is every engineer?
Speaker 3 (12:51):
No, I'm sure there's a very small I think there's
a very small number of ones out there that aren't great.
But I think the vast majority of them are very good,
and you know, they've worked really hard to get where
they are, and they care about patients and and really
doing the right thing.
Speaker 2 (13:06):
You know what.
Speaker 1 (13:07):
As we talked this morning with doctor Nicole Hemkiss of
Advocate MD, the website Advocates DPC dot com. That's Advocates
DPC dot com. Talk about the experience at Advocate MD
and what makes it better from you know, the insured
system and why so many folks are coming to Advocate
MD and exploring direct primary care. There's also something that
pretty substantial that differentiates Advocate MD from a lot of
(13:30):
other direct primary care practices in that you only have
physicians that if somebody comes in to see a doctor,
they're going to see not just any doctor either, They're
only they're going to be able to see their doctor.
And even in the world of direct primary care, correct
me if I'm wrong, that's a unique position as well,
isn't it.
Speaker 3 (13:51):
It is very unique, you know, And it's it's interesting
because I spoke to this, I was I was on
a panel just yesterday and I spoke about this, and
I wear this as a badge of pride in a
way that you know, I'm very proud of the practice
that we have that we only have positions.
Speaker 2 (14:07):
There's many reasons for this, you know.
Speaker 3 (14:10):
I think one of the biggest reasons for me personally is,
you know, just as the way that the practice is
called advocate d I feel like we need to be
advocates for our patients, and I feel like I also
need to be an advocate for my profession, right. I mean,
I I feel like there's a lot of physicians out
there that are trapped in the system and you know,
burnt out, and I want to offer them a position
(14:32):
where they can have a very different way of practicing medicine.
Speaker 2 (14:34):
So I think that that's a big part of it.
Speaker 3 (14:36):
But there are a lot of external pressures, financial pressures
and otherwise to to hire non physicians, and you will
see what's happening in the large healthcare systems is that
physicians are going away, right, They're they're retiring, they're getting
burnt out, they're you know, switching to do you know,
work for the insurance company rather than see patients because
they think that's going to be easier. And then what
(14:58):
happens when those physicians lead well, in many cases, that
hospital system is not replacing them with another doctor.
Speaker 2 (15:05):
The reasons for that is not only is.
Speaker 3 (15:07):
It hard to find doctors, but also it's a lot
cheaper to replace them with a non physician, Right, So
the physicians believe they get replaced by a non physician.
So then that makes that cycle of seeing a physician
harder and harder. And then it kind of is a
vicious cycle because then the pressure is put more on
the doctors who remain, so they're kind of pushed to
see more and more patients and take over that panel
(15:29):
for the doctor that left. So it's kind of this
thing that's happening now in our healthcare system, and then
it's driving more positions out right, So we're seeing this
and now there's a lot more opportunities for non positions
to enter again. In our particular model of direct primary care,
I have been very kind of set on only having
(15:51):
physicians in our practice because I also feel that the
person that I once taking care of patients that's the
most knowledgeable, highly trained, highly experienced that can manage the
most things in the clinical setting, rather than referring them.
There's been a lot of studies that have been done.
You know, these are objective studies not subjective where they've
(16:11):
shown that you know, non physicians tend to order more testing,
you know, order more blood tests, order more X rays,
they tend to refer out things, right, because if I'm
not sure, if you know, Joe Smith walks into my
office and he's having you know, five different symptoms and
I'm not really sure and my diagnostic stills skills are
not so strong, I'm going to refer him to get
a bunch of blood tests and some imaging, and then
(16:33):
I'm going to probably refer to a specialist for that
because I don't maybe feel as confident in my my
diagnostic skills. And that's been proven you know again in
studies that that's what happens a lot of times when
we have non physicians that are taking care of patients.
So again, in this model of direct primary care, part
of one of the biggest aspects of it is that
(16:55):
we are trying to control costs, not only you know,
demonstrate that we can provide better acts says, higher quality,
but also control costs. Right, So if we are just
shifting those costs downstream to the specialists, to the radiology
facility back into the hospital system, that's not really controlling costs.
So again, my stance, and this is the way I
(17:15):
sell the model, is that we will do as much
as we.
Speaker 2 (17:19):
Can in our clinic with our docs.
Speaker 3 (17:22):
You know, we're going to take here as much as
we can without having to refer patients back into the
big system, or without having to refer them for unnecessary
testing and all of these things that are currently happening
in our healthcare system.
Speaker 1 (17:35):
Talking this morning with doctor Nicole Hempkiss of Advocate MD,
the website Advocates DPC dot com. That's Advocates DPC dot
com Direct Primary Care. An amazing model Advocate MD and
amazing practice, great data to learn more, even better. Best
day today to become a member at Advocate MD and
pick up the phone, give them a call six eight
two six eight sixty two eleven. That's six oh eight
(17:56):
two six eight sixty two eleven. Touched on some of
the ways that Advocate MD is able to keep things
affordable your doctor hempkis mentioned earlier earlier the average monthly
membership about seventy dollars. It is absolutely amazing. It's a
great value with amazing care. We'll talk a little bit
more about some of the ways that having a primary
care doctor, how costs are kept down at Direct primary
(18:16):
Care and Advocate MD with details from doctor Nicole Hempkiss.
We will do that next as full scope continues right
here on thirteen ten Double u ib A thirteen ten
Double UIBA and full Scope with doctor Nicole Hempkiss, Wisconsin's
directcare doctor mentioned the website Advocate DPC dot com. That's
Advocate d PC dot com all one word, great place
(18:37):
to learn more about Advocate MD. Also learn about options
when it comes to whether it's a high deductible insurance
plan or cast trophic or health shares. Things that pair
very well with direct primary Care can save you money
and of course get that amazing quality when it comes
to your primary care with Direct Primary Care and Advocate MD.
Today's a great data Become a member, make an appointment
(18:59):
at Advocate MD Elpha number six so eight two six
eight sixty two eleven. That's six h eight two six
eight sixty two eleven. Not only are they great for
you and your family, if you're an employer looking for
a great option for your employees, definitely check out Advocate
MD and Direct Primary Care. Again the website ADVOCATESDPC dot com.
That's Advocates DPC dot com doctor just before the break,
You're it's illustrating some of the ways that having a
(19:22):
physician only practice keeps costs lower. And a lot of
times that is the one thing too, that I think
a lot of a lot of folks wonder about it
is like, how are you able to have a practice
like this that operates this way and keep costs down?
And there's a big there's a big thing that's removed
from and not a not a beneficial thing, very expensive
(19:45):
factor that's removed from the equation when you when you
open a direct primary care practice. Let's talk about that
insurance and kind of the cost that's added by having
that that in the insurance system.
Speaker 3 (19:58):
Yeah, you know, when and practices are billing through insurance,
there is a lot of additional staff, you know, red
tape bureaucracy that has to be part of that because
you are having to deal with you know, prior authorizations
and pre certifications and when that claim gets denied and
then you know, having to negotiate the rate at which
(20:20):
that visit or that procedure is going to be reimbursed.
You know, you bill out claims they get denied or
they get paid. A portion of that gets paid. In
our model, we have simplified a lot of that, and
that simplification, you know, translates to not requiring as much staff.
We don't have basically in our practice, and this is
almost unheard of. We don't have any non clinical staff.
(20:43):
Every single person that is employed in our practice touches patients,
sees patients, you know, so we do not have billers,
encoders and secretaries and and you know, nursing administrators and
hospital administrators and all of these layers of bureaucracy that
add you know, millions of dollars onto healthcare cost, but
(21:03):
they don't actually ever take care of patients directly. They
just kind of sit in an office all day. So
in this direct premiary care model, similar to a lot
of other direct primary care practices, everybody that works in
our practice is taking care of patients and we don't
have to deal with insurance, so we don't have all
those additional costs. And so you pay the monthly membership fee,
(21:23):
the patient or the employer pays the monthly membership fee,
and then when you come in to see us, you.
Speaker 2 (21:28):
Know, we don't have to collect a copay. We don't
have to.
Speaker 3 (21:30):
Ask you to show your insurance card you come in
to visit is covered as part of your membership. And
then we have ancillary services we can provide like doing
lab work, dispensing medications, doing x rays, and those are
done at an additional cost, but much much cheaper than
utilizing your insurance because everything is done basically at wholesale cost.
Speaker 1 (21:51):
It's an amazing model, and we talk so much about
all the great benefits. And I know for a lot
of folks that are listening to the program this morning
nodding their head in agreement as doctor hamp Is talks
about these these problems and the solutions to them. Today's
a great day for you to be part of that solution.
Make things better for yourself, your family. If you're an
employer looking for amazing primary care for your employees, definitely
(22:12):
check out Advocate MD. Today is the day make that appointment.
Six oh eight two six eight sixty two eleven. That's
six oh eight two six eight sixty two eleven. Again
the website Advocates DPC dot com. That's Advocates DPC dot com.
Doctor Hemkiss, you have a great weekend and we'll talk
soon you too. Sean thank you, news comes your way
next right here. On thirteen ten Wiba
Thirteen ten WIBA and full scope with Wisconsin's direct care
doctor that is doctor Nicole Hemkis. Of course, doctor Hemkis
comes to us from Advocate MD, a direct primary care
practice with four area locations. Of course, the original right
in Middleton on the west side of town on Glacier
Ridge Road, east side of Madison on South Fair Oaks
(00:20):
down in Rock County, a great place for those of
you in Rock County or southern Dane County, right across
from the hospital on Mineral Point Avenue. And the newest
location thirty two to twenty SI, which is right in Fitchburg. Beautiful,
beautiful location. All four locations of Advocate MD are absolutely fantastic.
Eight doctors to serve you at Advocate MD, and of
course has mentioned joining us this morning is doctor Nicole Hemkis.
Speaker 2 (00:41):
Doctor.
Speaker 1 (00:42):
How you doing this week?
Speaker 2 (00:44):
I'm doing well, Sean, how are you?
Speaker 1 (00:45):
I'm doing really really good and we're actually going to
talk about I mentioned eight physicians at Advocate MD, and
not all primary care practices are created equally. One of
the things I know that was an important thing for
you when you started ad MD is to have the physicians,
have the doctors with the patients at Advocate MD. We're
going to talk a little bit about that, talk about
(01:06):
some other things as well, about your journey through through
becoming a doctor and then of course starting your own
practice and what Advocate MD has become. But first and
foremost I mentioned, of course four locations. You started out
in Middleton, and one of the cool things that has
happened is as more people have become aware of Advocate
MD and what you're able to do, you're seeing more
(01:26):
and more folks sign on and become patients. Thus you're
adding more clinics and more doctors, aren't you.
Speaker 3 (01:33):
Yeah, you know, part of this model is that we
want to keep each doctor's panels small and not kind
of replicate the mistakes that we see in the large system. So,
you know, in the big hospital owned primary care practice practices,
we see that, you know, these doctors have panels of
two thousand, three thousand patients, so it becomes really difficult
(01:54):
to see them for an appointment. You know, you hear
doctors being booked out for nine months a year, you know,
and then when you get an appointment to see them,
you know, maybe they spend you know, eight minutes, ten
minutes with you in the room.
Speaker 2 (02:06):
You know, we're hearing more and more of these stories where.
Speaker 3 (02:09):
A patient has an appointment with one of these insurance
based family medicine or internal medicine docs, and they schedule
those appointments nine months or a year in advance, and
then when they get closer to the appointment, you know,
a few days or a week before the appointment, that
the system calls and says, oh, I'm sorry, the doctor
is going to be out that day. We need to
reschedule you. And so this person's been waiting already for
(02:32):
nine months or a year.
Speaker 2 (02:34):
It's just crazy.
Speaker 3 (02:35):
I was talking to a group yesterday and I said,
isn't it a crazy thing that you can be paying
every month for your insurance and then the doctor can't
see you for nine months or a year, Like, how
is that fair that you're paying for something that you
actually can't use.
Speaker 2 (02:52):
You know, that would be like us.
Speaker 3 (02:53):
Saying, come join our practice, pay you know, the seventy
bucks a month for a membership, but we can't.
Speaker 2 (02:57):
See you for ten months. You know, nobody would agree
to that. They'd be like, welly, so why.
Speaker 3 (03:02):
Am I paying this seventy bucks a month if you
can't see me? For ten months, but for some reason
people do that with insurance.
Speaker 1 (03:08):
Is some of it just that that's what we like.
I think sometimes we as humans are a little hesitant
to try something different. And one of the things I've
loved in getting to know you and getting to know
Advocate MD and direct primary care is it's not scary
at all. I think sometimes when we think of like, well,
(03:29):
this is just you know, we get insurance, we see
our dial like people are like so programmed that that
suddenly somebody comes along and says there's a better way.
Initially it's I think for some folks a little scary.
But the more that folks learn and the more that
you hear from folks that have used direct primary care
and become patients at Advocate MPD, it's really a refreshing
change from what's sadly become the norm.
Speaker 3 (03:51):
I think it is. I think there's a lot of
fear of change. I think most people just there's something
about human nature that we have this kind of inertia
even though something isn't really working well for us. And
we can see this in many aspects of life. For people,
is like we just kind of stay in this situation
even though it's not a great situation, or we stay
with insurance even though we're getting ripped off and we
(04:11):
don't have a good experience, but we stick with it
because you know, who knows what else is out there.
And I think in some cases too, you know, we've
brought this up on the program. I think there's almost
it sounds too good to be true type of aspect
to this, where it's like, well, so I'm paying one
thousand dollars a month for insurance, which I don't like,
but I can pay you seventy dollars a month and
(04:31):
you're promising to do all of these different things.
Speaker 2 (04:33):
Spend an hour with me, My doc's.
Speaker 3 (04:36):
Going to text me after hours, they're going to spend
an you know, they're going to be able to see
me right away for an appointment.
Speaker 2 (04:43):
So I think that some people are just kind.
Speaker 3 (04:44):
Of like, it's hard to wrap your brain around that
and think, like, how can there be such a stark
contrast between what you're offering and what the hospital system
is offering?
Speaker 2 (04:54):
You know? So I think that's that's a big part
of it too.
Speaker 1 (04:57):
I remember early on one of the I think the
great illustration that stuck with me that you made. As
far as what Advocate MD is and what direct primary
Care is, you said, it's it's like, it's kind of
like when you used to go see your doctor when
you were a kid, or you know, for those folks
that are a little bit younger, maybe what your parents
experienced when they were younger. When you go to a doctor,
it was you your doctor. Your doctor knew you, Your doctor
(05:18):
knew your family, Your doctor knew your story. If you
needed anything, your doctor was there for you. And that
stuff still exists with Direct Primary Care and Advocate MD.
You can learn more online the website Advocates DPC dot com.
That's Advocates DPC dot com. Tell if a number, make
an appointment, become a member at Advocate MD six oh
eight two six eight sixty two eleven. That's six oh
(05:38):
eight two six eight sixty two eleven and doctor. A
lot of folks sometimes don't understand. And I admit, until
I started doing this show with you and getting to
know you better, I didn't know what a family medicine
physician was. As a matter of fact, I always just
just use the term family medical physician or that type
of thing. What is a family medicine physician? And you
are that's what you are, correct, Yes.
Speaker 2 (06:01):
So I am a family physician.
Speaker 3 (06:03):
All the doctors and our practice our family physicians, I
mean sometimes we use this interchangeably with primary care. There's
some slight difference. All family physicians are primary care doctors.
That there are different types of primary care doctors. So
even you know, internal medicines considered primary care pediatrics. Sometimes
obg i ns are considered primary care doctors. But in
(06:25):
terms of family medicine, it's a little bit unique that
we take care of a broad scope of people. So
everything from you know, newborn babies all the way to
elderly people are people that are you know, in the
process of passing on you know, hospice doctors or are
many times family medicine docts. So we also do a
lot of procedures in the office, which is again somewhat unique,
(06:49):
So skin procedures, orthopedic procedures, gynecologic procedures, and that is
again different than internal medicine doctors a little bit. So
we do more urgent care care, more procedures. We take
care of all ages of people, men and women. Again,
there are some specialties like obgu i N they only
see women. So it's a lot of variety of patients.
(07:12):
And the cool part about it for me as a doc,
and I think also for the patient, is that we
can take care of the whole family. So, you know,
I have many patients where I take care of the husband,
the wife, the children, sometimes their parents or the grandparents,
which is a really interesting thing because you not only
get to see obviously the medical issues, you get to
see the social dynamic.
Speaker 2 (07:34):
You know that the family dynamics, and.
Speaker 3 (07:36):
That sometimes the context of that can help you better
understand what's going on with the patient. So I really
enjoy that part of it, and that's part of the
reason that I chose family medicine. And also the other
part of family medicine that's really nice is that you
can practice in a variety of settings. So right now
I'm a family medicine doc practicing in an outpatient outpatient clinics.
(07:59):
But I have, in the asked you know, worked for hospitals.
I've worked as a hospitalist, so that means we take
care of patients from the time they're admitted to the
hospital until their discharge. I've worked in emergency departments and also,
you know, you can work in some very rural areas
versus like inner city, so you get to kind of
have a large breadth of experiences in this specialty, which
(08:23):
is really nice.
Speaker 1 (08:24):
And you mentioned some of the rural areas for folks
that don't know you work in a very rural area
when you were just getting started parts of Alaska.
Speaker 3 (08:33):
Yes, yes, no, I'm Alaska, and then some of the
they call it the Nordic Sound Native Alaskan.
Speaker 2 (08:40):
Villages that are up there. So yeah, that was a
really interesting experience.
Speaker 3 (08:45):
But yeah, so that before starting the practice advocate MD,
I worked as an employed physician, So so to give
you some background of you know, what does it take
to become a physician? And I like to talk about
this kind of remind people or to bring it to
the forethought of, you know, the amount of years that
(09:06):
it takes, the amount of training and education and experience
in clinical hours that it takes to become a doctor,
because I think it's important what we see happening. And
the reason this was kind of on my mind lately
is that, you know, we've had some legislation passed recently
and it's it's allowing for a greater amount of autonomy
and independence to non physicians in our community, and I've
(09:28):
worked alongside many non physicians that you know, do a
great job. They're very knowledgeable, they're part of the healthcare team.
So there's definitely a value there. But there is a
difference between a physician and a nurse practitioner a PA,
and I think it's always important to point out these
differences so people understand. And so when you walk into
(09:49):
a clinic or a hospital or an emergency department, you
know who's treating you and know what their educational background
and their training is to get to that point. And
for a physician, it's it's the most extensive of any
of these kind of layers of healthcare professionals.
Speaker 2 (10:06):
So you know, all doctors go through four years of.
Speaker 3 (10:09):
Undergraduate So in my case, I was a biology major
chemistry minor, but you don't have to necessarily major in sciences.
You have to do your pre medical classes and then
you go through four years in medical school. So four
years of medical school includes your first two years, which
is what I call the book learning, so you know anatomy, physiology, pharmacology, pathology,
(10:29):
you know all of these different core classes, and then
your second two years are basically your clinical years. So
the third year is a very intense where you rotate
through you know, surgery, internal medicine, family medicine, pediatrics, emergency medicine.
You get a taste of all of these different specialties
(10:50):
and that's supposed to help you figure out what you
want to ultimately do. Your fourth year is usually mainly elective,
so the things you want to focus on. In my case,
I did extra time in dermatology and procedures. I did
some extra time in radiology because I wanted to get
better with reading X rays and things like that. You know,
so you can decide if there's things you want to
(11:13):
spend more time on. I also spend some extra time
working in the hospital. So that's your fourth year, and
then you apply and you do a residency. So in
the case of family medicine and a lot of primary
career specialties.
Speaker 2 (11:26):
It's three years.
Speaker 3 (11:28):
Then you can decide after those three years to do
a fellowship. Some people do that and other specialties. And
again I don't want to get too far off the
you know, off the into a tangent here, but you know,
specialties like surgery, you know, these subspecialties like neurosurgery or
urology or you know, E and T, so that those
(11:49):
people do even longer residencies. So again this is just
a point out so that doctor that you're seeing, they
have completed, in almost all cases, eleven years of schooling
to get to that point, and that's supervised you know,
medical school and residency. They still have you know, they're
being graded, they're being evaluated, they have somebody in a
(12:10):
looking after what the work that they're doing to make
sure it's good.
Speaker 2 (12:12):
To make sure it's it's you know, meeting standards. You
have to go through US m l E.
Speaker 3 (12:17):
US Medical Licensing exams during that time again to make
sure you're proficient and knowledgeable in these areas. And then
you have you know, your board certification exam that you
have to go through. This is very again different than
the process for non physicians. So I like to always
point that out so that people can know, you know,
(12:38):
again all the background that their physician has, you know,
And let's say, is every single physician in the world great, No,
of course, like any specialty.
Speaker 2 (12:47):
Right is every lawyer, is every engineer?
Speaker 3 (12:51):
No, I'm sure there's a very small I think there's
a very small number of ones out there that aren't great.
But I think the vast majority of them are very good,
and you know, they've worked really hard to get where
they are, and they care about patients and and really
doing the right thing.
Speaker 2 (13:06):
You know what.
Speaker 1 (13:07):
As we talked this morning with doctor Nicole Hemkiss of
Advocate MD, the website Advocates DPC dot com. That's Advocates
DPC dot com. Talk about the experience at Advocate MD
and what makes it better from you know, the insured
system and why so many folks are coming to Advocate
MD and exploring direct primary care. There's also something that
pretty substantial that differentiates Advocate MD from a lot of
(13:30):
other direct primary care practices in that you only have
physicians that if somebody comes in to see a doctor,
they're going to see not just any doctor either, They're
only they're going to be able to see their doctor.
And even in the world of direct primary care, correct
me if I'm wrong, that's a unique position as well,
isn't it.
Speaker 3 (13:51):
It is very unique, you know, And it's it's interesting
because I spoke to this, I was I was on
a panel just yesterday and I spoke about this, and
I wear this as a badge of pride in a
way that you know, I'm very proud of the practice
that we have that we only have positions.
Speaker 2 (14:07):
There's many reasons for this, you know.
Speaker 3 (14:10):
I think one of the biggest reasons for me personally is,
you know, just as the way that the practice is
called advocate d I feel like we need to be
advocates for our patients, and I feel like I also
need to be an advocate for my profession, right. I mean,
I I feel like there's a lot of physicians out
there that are trapped in the system and you know,
burnt out, and I want to offer them a position
(14:32):
where they can have a very different way of practicing medicine.
Speaker 2 (14:34):
So I think that that's a big part of it.
Speaker 3 (14:36):
But there are a lot of external pressures, financial pressures
and otherwise to to hire non physicians, and you will
see what's happening in the large healthcare systems is that
physicians are going away, right, They're they're retiring, they're getting
burnt out, they're you know, switching to do you know,
work for the insurance company rather than see patients because
they think that's going to be easier. And then what
(14:58):
happens when those physicians lead well, in many cases, that
hospital system is not replacing them with another doctor.
Speaker 2 (15:05):
The reasons for that is not only is.
Speaker 3 (15:07):
It hard to find doctors, but also it's a lot
cheaper to replace them with a non physician, Right, So
the physicians believe they get replaced by a non physician.
So then that makes that cycle of seeing a physician
harder and harder. And then it kind of is a
vicious cycle because then the pressure is put more on
the doctors who remain, so they're kind of pushed to
see more and more patients and take over that panel
(15:29):
for the doctor that left. So it's kind of this
thing that's happening now in our healthcare system, and then
it's driving more positions out right, So we're seeing this
and now there's a lot more opportunities for non positions
to enter again. In our particular model of direct primary care,
I have been very kind of set on only having
(15:51):
physicians in our practice because I also feel that the
person that I once taking care of patients that's the
most knowledgeable, highly trained, highly experienced that can manage the
most things in the clinical setting, rather than referring them.
There's been a lot of studies that have been done.
You know, these are objective studies not subjective where they've
(16:11):
shown that you know, non physicians tend to order more testing,
you know, order more blood tests, order more X rays,
they tend to refer out things, right, because if I'm
not sure, if you know, Joe Smith walks into my
office and he's having you know, five different symptoms and
I'm not really sure and my diagnostic stills skills are
not so strong, I'm going to refer him to get
a bunch of blood tests and some imaging, and then
(16:33):
I'm going to probably refer to a specialist for that
because I don't maybe feel as confident in my my
diagnostic skills. And that's been proven you know again in
studies that that's what happens a lot of times when
we have non physicians that are taking care of patients.
So again, in this model of direct primary care, part
of one of the biggest aspects of it is that
(16:55):
we are trying to control costs, not only you know,
demonstrate that we can provide better acts says, higher quality,
but also control costs. Right, So if we are just
shifting those costs downstream to the specialists, to the radiology
facility back into the hospital system, that's not really controlling costs.
So again, my stance, and this is the way I
(17:15):
sell the model, is that we will do as much
as we.
Speaker 2 (17:19):
Can in our clinic with our docs.
Speaker 3 (17:22):
You know, we're going to take here as much as
we can without having to refer patients back into the
big system, or without having to refer them for unnecessary
testing and all of these things that are currently happening
in our healthcare system.
Speaker 1 (17:35):
Talking this morning with doctor Nicole Hempkiss of Advocate MD,
the website Advocates DPC dot com. That's Advocates DPC dot
com Direct Primary Care. An amazing model Advocate MD and
amazing practice, great data to learn more, even better. Best
day today to become a member at Advocate MD and
pick up the phone, give them a call six eight
two six eight sixty two eleven. That's six oh eight
(17:56):
two six eight sixty two eleven. Touched on some of
the ways that Advocate MD is able to keep things
affordable your doctor hempkis mentioned earlier earlier the average monthly
membership about seventy dollars. It is absolutely amazing. It's a
great value with amazing care. We'll talk a little bit
more about some of the ways that having a primary
care doctor, how costs are kept down at Direct primary
(18:16):
Care and Advocate MD with details from doctor Nicole Hempkiss.
We will do that next as full scope continues right
here on thirteen ten Double u ib A thirteen ten
Double UIBA and full Scope with doctor Nicole Hempkiss, Wisconsin's
directcare doctor mentioned the website Advocate DPC dot com. That's
Advocate d PC dot com all one word, great place
(18:37):
to learn more about Advocate MD. Also learn about options
when it comes to whether it's a high deductible insurance
plan or cast trophic or health shares. Things that pair
very well with direct primary Care can save you money
and of course get that amazing quality when it comes
to your primary care with Direct Primary Care and Advocate MD.
Today's a great data Become a member, make an appointment
(18:59):
at Advocate MD Elpha number six so eight two six
eight sixty two eleven. That's six h eight two six
eight sixty two eleven. Not only are they great for
you and your family, if you're an employer looking for
a great option for your employees, definitely check out Advocate
MD and Direct Primary Care. Again the website ADVOCATESDPC dot com.
That's Advocates DPC dot com doctor just before the break,
You're it's illustrating some of the ways that having a
(19:22):
physician only practice keeps costs lower. And a lot of
times that is the one thing too, that I think
a lot of a lot of folks wonder about it
is like, how are you able to have a practice
like this that operates this way and keep costs down?
And there's a big there's a big thing that's removed
from and not a not a beneficial thing, very expensive
(19:45):
factor that's removed from the equation when you when you
open a direct primary care practice. Let's talk about that
insurance and kind of the cost that's added by having
that that in the insurance system.
Speaker 3 (19:58):
Yeah, you know, when and practices are billing through insurance,
there is a lot of additional staff, you know, red
tape bureaucracy that has to be part of that because
you are having to deal with you know, prior authorizations
and pre certifications and when that claim gets denied and
then you know, having to negotiate the rate at which
(20:20):
that visit or that procedure is going to be reimbursed.
You know, you bill out claims they get denied or
they get paid. A portion of that gets paid. In
our model, we have simplified a lot of that, and
that simplification, you know, translates to not requiring as much staff.
We don't have basically in our practice, and this is
almost unheard of. We don't have any non clinical staff.
(20:43):
Every single person that is employed in our practice touches patients,
sees patients, you know, so we do not have billers,
encoders and secretaries and and you know, nursing administrators and
hospital administrators and all of these layers of bureaucracy that
add you know, millions of dollars onto healthcare cost, but
(21:03):
they don't actually ever take care of patients directly. They
just kind of sit in an office all day. So
in this direct premiary care model, similar to a lot
of other direct primary care practices, everybody that works in
our practice is taking care of patients and we don't
have to deal with insurance, so we don't have all
those additional costs. And so you pay the monthly membership fee,
(21:23):
the patient or the employer pays the monthly membership fee,
and then when you come in to see us, you.
Speaker 2 (21:28):
Know, we don't have to collect a copay. We don't
have to.
Speaker 3 (21:30):
Ask you to show your insurance card you come in
to visit is covered as part of your membership. And
then we have ancillary services we can provide like doing
lab work, dispensing medications, doing x rays, and those are
done at an additional cost, but much much cheaper than
utilizing your insurance because everything is done basically at wholesale cost.
Speaker 1 (21:51):
It's an amazing model, and we talk so much about
all the great benefits. And I know for a lot
of folks that are listening to the program this morning
nodding their head in agreement as doctor hamp Is talks
about these these problems and the solutions to them. Today's
a great day for you to be part of that solution.
Make things better for yourself, your family. If you're an
employer looking for amazing primary care for your employees, definitely
(22:12):
check out Advocate MD. Today is the day make that appointment.
Six oh eight two six eight sixty two eleven. That's
six oh eight two six eight sixty two eleven. Again
the website Advocates DPC dot com. That's Advocates DPC dot com.
Doctor Hemkiss, you have a great weekend and we'll talk
soon you too. Sean thank you, news comes your way
next right here. On thirteen ten Wiba
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