Why It Takes So Long to See Your Doctor

Episode Transcript

Speaker 1 (00:00):
More information available online ADVOCATESDPC dot com. That's Advocates DPC
dot com, Great data, pickup phone, make a point, become
a member at Advocate MD teleph number six oh eight
two six eight sixty two eleven. That's six'h eight two
six eight sixty two eleven. And joining us this morning
is doctor Nicole hempkiuse of Advocate MD. Doctor. How you
doing this week?

Speaker 2 (00:20):
I'm doing well, Sean, how are you?

Speaker 1 (00:22):
I'm doing fantastic. And we're going to tackle a topic
this week, and we've kind of skirted a little of
it here, a little bit of it there, which is
how long it takes to get in to see your doctor.
And it is crazy the stories I'm hearing from people.
I remember, like a year ago it started to be
specialist and now it's getting into like primary care doctors

(00:42):
as well. We're going to talk about how long we're
seeing time scheduling out for getting in just to just
to see a doctor. Before we get to this week's
conversation and how things have changed in healthcare, let's talk
a little bit just about direct primary care and specifically
Advocate MD. Doctor and as we're going to be talking
this week about how long it takes to get in
to see a doctor in that insurance system. Very different

(01:05):
when it comes to direct primary care and Advocate MD.

Speaker 2 (01:08):
Isn't it. Yes, So in our model in advocate and
d our practice, so all of our patients, all of
our physicians have a much smaller panel of patients. So
they might have four hundred, five hundred patients in their panel.
So that means that when you call to get an appointment,
it's going to be a lot easier to get in.

(01:29):
It could be a few days, it could be you know,
one week, two weeks is probably towards the very furthest
out that we book out typically, and if you need
something urgently, we get you in the same day, you know,
same day, next day for urgent care appointments. So it
is a very different you know, access to care than
what we're seeing. As you said, Sean, you know, we're

(01:50):
hearing stories from patients that it's taking nine months a
year to get an appointment in the big health systems
right now. I know, I always remember a story that
this was a little while back, but a patient that
emailed through the website and they said, well, I called
in to make an appointment with my you know XYZ

(02:10):
doctor through the insurance, and they said it was going
to be a year. So I made an appointment for
a year from today, and then I looked at you know,
I emailed you guys, and I made an appointment for
next week. Yeah, so we'll see how the appointment goes
next week. But I still have that appointment in a
year in case this doesn't work out. But it's it's
just crazy, you know again that people are willing to

(02:33):
accept that too.

Speaker 1 (02:34):
It is. And the thing I think for some people
is say, well, what choice do I have? I think
one of the great things is, especially if you can
hear our voice this morning, you have a great choice.
You have a great opportunity to become a member at
Advocate MD and make that first appointment. All I got
to just pick up phone, give the doctor call six
eight two six eight sixty two eleven. That's sixty eight
two six eight sixty two eleven, make an appointment, become

(02:55):
a member at Advocate MD. You can learn more online
Advocates DPC dot com. That's Advocates DPC dot com and
doctor What changed? Like what is kind of that like
like big picture stuff? Why has it gotten to this point,
What are what are those factors there that have gotten
us where we are.

Speaker 2 (03:12):
Yeah, I think in terms of the access issue, I
think there's there's multiple factors. You know. Obviously a big
one is that we don't have enough physicians for the
number of you know, people that we have in most
communities across the country. I think it's a little bit
worse here in the local area of Madison, Wisconsin or
southern Wisconsin. I think it's a little bit worse, you know,

(03:34):
harder to make an appointment with the doctor here versus
maybe other parts of our state or other parts of
the country. So we don't have enough doctors. And then
we also, you know, again have created a system where,
you know, doctors are kind of incentivized financially to see
more and more patients. So so it becomes harder too

(03:55):
when you see the doctor that they don't really spend
a lot of time with you, maybe ten minutes, fifteen minutes.
And it's funny too, I just am remembering, you know,
we've had a couple of stories in the last few
weeks where the patient had an appointment I think in
one case it was a primary care doctor, and in
one case it was a specialist where so they book
out this appointment for nine months or whatever it is,

(04:17):
and then like a week before the appointment or a
couple of days before the appointment, they're contacted and said, well,
I'm sorry, the doctor needs to reschedule or I'm sorry,
you know, something came up that now the doctor's not
going to be able to come to that appointment, so
we're gonna need to reschedule you. And in some cases,
I think in one of the cases they rescheduled them
for like a couple months later, and then the other
case it was like six months later, so it's like
they've already waited for nine months and now it's another

(04:39):
six months. But yeah, it's it's I think the physician shortage.
You know, doctors are obviously leaving practicing medicine. You know,
I think in many cases when you see a non physician,
sometimes they don't see as many patients, but so maybe
their schedule is a little bit more spaced out. But

(05:00):
I think doctors typically have like a greater number of
patients on their panels than non physician providers. But again,
you know, we just have we don't have enough doctors
right now for the number of patients.

Speaker 1 (05:12):
You know, I as we talk some morning with doctor
Nicole hab because of Advocate MD online advocates DPC dot com.
That's Advocate DPC dot com. Learn more about Advocate MD,
learn about direct Primary Care. It's a great resource. Advocate
DPC dot com Delpha number six oh eight two six
eight sixty two eleven. That's six oh eight two six
eight sixty two eleven. And as we talk about some

(05:32):
of these some of these problems right now, as far
as access, I think a lot of us feel that, well,
I've got insurance, therefore I have access, and we see
the cases that is not Again, we start seeing six'
nine a. Year you, know to get out to see your.
Doctor the two are one doesn't necessarily guarantee immediate. Access

(05:55):
let's talk about that and how those, two those two
things are are actually related to one, another health insurance
and health, care and how some of these problems are
exacerbated by.

Speaker 2 (06:07):
Insurance, YES i think for a lot of us we
have interchangeably used the words health insurance and health. Care
so if you have health, insurance that means you have health.
Care AND i kind of always want to break, that
breaks that habit of using those terms synonymously because they're
completely different. Things, Right, so health insurance is a means

(06:28):
to pay for health, care and as we've talked, about
in many, cases that actually creates barriers and makes health
care more, expensive which is also a barrier and makes
it less. Accessible but we have been ingrained to think
that if we have health, insurance that means we have health.
Care AND i think a big shift, happened you, know
during THE, aca which now it's BEEN i guess that's

(06:48):
been almost twenty years ago, Now but during The Affordable Care,
act Or obamacare as we like to call, it the
push was to put more people on health. Insurance so
we have all these people that are. Insured and, yes
in some cases when people are, uninsured that does mean
that they do not have access to healthcare for financial.
Reasons but the idea was that if we pushed everybody

(07:10):
into health, insurance that was going to create this environment
where everybody has access to. Healthcare, oh this is so.
Great but the problem that it created for many, people
AND i might say the majority of, folks is that
some people that had you, know quote unquote good. Insurance
then after THE aca, shift insurance policies started to become you,

(07:32):
know almost worthless in some. Cases so you have a six,
thousand nine, thousand twelve, THOUSAND i, MEAN i Think i've
the Highest i've heard is like fifteen thousand dollars. Deductible
so most, people if you have a nine or ten
thousand dollars, deductible you might not even have that much
money in the bank to cover. That but what that
means is that until you've hit that, deductible the insurance

(07:52):
actually isn't kicking. In so you're paying you, know a
five hundred dollars premium every, month or maybe it's you,
know a thousand dollars a month if you have a,
family it could be more than. That so let's just you,
know play out the numbers and, say you, know if
you're paying one thousand dollars a, month and that's twelve
thousand dollars a, year and then you have an additional you,
know nine or ten thousand dollars to hit your, deductible

(08:14):
that means you're paying basically twenty thousand dollars plus before
you have any health insurance coverage that kicks, in and
in most, cases again it's not going to cover. Everything
there could be co insurances deductibles. Copays so so that's
kind of the part THAT i think a lot of
people don't realize is that for most people now that

(08:35):
are on higher deductible, plans because that's another shift that's.
Happened most people, now you, know aren't on a two
hundred dollars five hundred dollars. Deductible they have five thousand dollars.
Deductibles so they are paying out a pocket for a
lot more things until they're deductible. Hits so in reality
we call this. Underinsured but basically you are footing the

(08:56):
bill before the insurance kicks, in and unless you hit your,
deductible which most people, don't it's almost like not having
insurance until you hit that. Deductible SO i think that's
the that's the kind of challenge that a lot of people.
Have so, again how does the direct primary care model
solve for? That, well the idea in direct primary care
is there are no, deductibles there are no co. Pays you,

(09:18):
know you're you, know everything starts from day one you
come into the. Clinic there's no charge for. That you,
know you don't have a copay to, pay you don't
have a charge for the office visit and we're filling the.
Gap you, know if you are someone who has a
higher deductible insurance policy or even a normal insurance, policy
you know you're coming to us for most of your.

(09:40):
Things hopefully we can take care of ninety ninety five
percent of your healthcare needs and so you don't, have you,
know all those out of pocket costs that you do
if you're using you, know your high deductible insurance. Plan
the lab work is. Cheaper there's no charge for the office.
Visits if you need some, imaging you, know a lot
of it we can do in our. Office it's going
to be at a mud produced. Costs so that's the

(10:02):
big kind of financial driver of. This and obviously you
know the access issue.

Speaker 1 (10:06):
Too one of the things you notice when you stop
in the clinics there is no no scanner for insurance
cards sitting at the front, desk WHICH i think a
lot of folks have gotten familiar. With in the insurance.
System the first thing they ask you when you're checking
in is, like do you got your insurance? Card and
they drop it in that little scanner and then they
give it back to. You and first thing they want to.
REMEMBER a couple of years, Ago christina had the wife

(10:30):
had to go in to the urgent. Care AND i
don't remember what had. Happened something she had hurt. HERSELF
i don't know if she's gardening or. What long story,
short we go in and you, know we get into
a room, finally and then when we're sitting, there somebody
comes in with a cart and a white, coat AND i, assume,
well we're going to see you, know we're going to
see somebody that's going to take care of the. Problem oh,
no this is somebody because they put us in a.

(10:52):
Room they didn't get a chance to get our. Insurance
the first person we're seeing in the in the in
the clinic room is isn't. It even though they look
like a, doctor they're. Not they're just somebody there making
sure that making sure they've got the billing all settled
out and making sure that you got money to cover.
Everything one of the great things about direct primary, care as,
mentioned you get right in when you need to see your.

(11:13):
Doctor they don't work through, insurance they don't bill your.
Insurance your membership which is very affordable between sixty and eighty,
dollars kind of an average seventy dollars for membership per.
Month At ADVOCATE, md you'd get right in to see
your doctor unlimited. Visits you're never. Rushed you actually are
seeing your, doctor which is another amazing feature Of ADVOCATE
md and direct primary. Care the Website ADVOCATES dpc dot.

(11:36):
Com That's ADVOCATES dpc dot. Com telp number six so
eight two six eight sixty two. Eleven that's six oh
eight two six eight sixty two. Eleven we'll continue our
conversation with Doctor Coole amkisz try get to the bottom
of why people don't get more angry and upset about. This,
overall you'll hear, talk but not everybody's taking. Action we'll
talk about that with the doctor next here on thirteen
TEN wiba thirteen TEN wiba and full scope With wishnson's

(12:00):
direct care, doctor Doctor Nicole. Hempkiss of, Course Doctor hempkiss
comes to us From ADVOCATE, md a direct primary care
practice for clinics in the area east side Of. Madison
right right on Far OAKS a westside The, middleton right
on thirty two oh Five Glacier, Ridge fitchburg got thirty
two to twenty Sigin. Road, beautiful beautiful clinics all of.

(12:21):
Them that sign road location is just great with The
Nature preserve right, there and of course the clinic right
In Rock county On Mineral Point avenue right across from
the hospital ten twenty One Mineral Point. Avenue very convenient
locations For ADVOCATE. Md also very convenient to get in
to see your doctor when you need to see your.
Doctor today is a great day to make that appointment
to become a member At advocate mdtel forh number six

(12:42):
oh eight two six eight sixty two. Eleven that's six
oh eight two six eight sixty two. Eleven of, course
the Website ADVOCATE dpc dot. Com That's ADVOCATE dpc dot.
Com talking this week with Doctor hemkiss about insurance versus
healthcare and some of the some of the issues that
are we're facing right now in. Healthcare and you, know,

(13:05):
doctor when we talk about not being able to get
in to see a doctor for, many many months in
the insurance, system people, generally it's it's bizarre to me
of like how they'll, complain but how unwilling to take
action people. Are do we know why more folks aren't
aren't getting, upset why more folks aren't taking? Action to

(13:28):
try and fix this.

Speaker 2 (13:29):
Issue, YEAH i constantly am asking myself this. Question and
it's a, FRUSTRATION i think for myself Because i'm always,
thinking why are people accepting that this is just the
state of affairs that you, know you call a doctor
and it takes nine months a year to get an,
Appointment like this isn't, right you, know and this isn't

(13:50):
the way it should, be and this isn't the way
it is, everywhere, RIGHT i. THINK i think in our
local area, here people HAVE i, think become kind of
complacent that, like this is just the way it. Is
there's no other. Option maybe they don't know about direct primary.
Care and that's why we, do you, know what we
do here and you, know try to advertise and everything

(14:11):
in other places so that people can you, know find
out about this model and that there are. Alternatives AND
i do think that there, is you, know in, general
human nature is there's a little bit of fear of.
Change you, know we all have this kind of aertia
thing where either we're stuck in a job we don't
like or or whatever it, is we're stuck in a
place in our personal life that we don't, like and you,

(14:31):
know kind of just it's hard to like make that
change even though you're unhappy where you're. At so you're, Like,
OKAY i don't like, this BUT i just don't know
what else, is you, know what the next step would.
Be SO i think there's that part of. It AND
i think there's another aspect of it for people that
do hear about, it or maybe there's people that listen
to us on the, radio you, know week after, week

(14:52):
and they, think you, know this just seems too good
to be, True LIKE i JUST i can't AND i
know you've brought this, Up. Sewan it's LIKE i can't
imagine That i'm paying sixty six dollars a, month so
that's like less than my cell phone. Bill that's probably
less THAN i spend On starbucks in a. Month you,
know how CAN i spend sixty six dollars a month
and get unlimited primary care And i'm going to get

(15:13):
a card WHERE i can text or call a doctor
like on the weekends When i'm, Sick LIKE i that's
that does not seem, real, Right like it's and it is,
HARD i think unless you've experienced. It so that's why
we always, encourage you, know when we sign on companies
and we go out and talk to their. Employees you,
know the first thing THAT i push is like come
on out and have a, visit like do your you,

(15:34):
know established, care your wellness visit and you, know see the,
clinic meet the. Doctor they're going to spend forty five
minutes to an hour with. You in most, cases you,
know people don't think that it's real until they can
actually you, know participate do it. Themselves so SO i
think that that's also kind of the hesitation and.

Speaker 1 (15:54):
With that as we talk, about you, know informing people
about what is what what is direct primary, care what
you guys are doing in, clinics what's the? Cost the
transparency and the importance of being being very transparent with
everybody as an information gets. OUT i think obviously as
we've seen with folks With ADVOCATE, md we've seen obviously the,

(16:14):
expansion more doctors. Added keeping it that, way it's important
for folks that listen to the, show and of course
that have had an opportunity to become members At ADVOCATE
md to share their. Experience AND i sometimes think people
forget that that there's others out there that that may need,
that you, know you could really help simply by by
having a conversation with them about your experience with direct

(16:37):
primary care And ADVOCATE. MD i know that goes a long.
WAY i, know You ADVOCATE, MD a lot of folks
come to you because they've got a friend or a
family member that, said, Hey i've been checking this. Out
i've been going to see Doctor hempkis or Doctor, balen Doctor.
Shulman i've been seeing them At ADVOCATE. Md you should
do the. Same that's a big thing for.

Speaker 2 (16:54):
You isn't. That, YES i think word of mouth definitely
helps a, lot and for or we've had growth through.
That you know, again it's it's STILL i, mean even
with word of, mouth it's it's. Interesting we'll have like
married couples where like the wife comes and sees us
and the husband is still in the, system and it
takes them like a couple of years to be, like,
well you, Know i'm not you know my. Doctors i've

(17:15):
had three different doctors leave in the last two, years
and you, KNOW i can't get an appointment for six,
Months so Maybe i'll just give this a. Try it's, like, okay,
yeah that sounds like a good, idea but SO I i,
yeah you would you would think that we'd even have
more of, that and you would think THAT i, MEAN
i you, know SOMETIMES i remember telling someone about the.
PRACTICE i think even BEFORE i started the. Practice it

(17:36):
was another, doctor AND i was kind of talking to
a doctor about direct primary. Care and at that, POINT i,
think you, know seven eight years, ago there was even
less people that knew what this. Was AND i remember
that doctor saying, Like, wow this just sounds so unbelievably,
great and like why doesn't everybody do this and why
don't we hear about? This and you, know then when
you go and talk to people about the cost of

(17:58):
all these things that you're getting ripped, off you, know
from the hospital, system THE MRIs and the blood, test
and how all of these things in reality are a
fraction of the, cost and you, know we can help
you with. That you, know sometimes the reaction is, like
why isn't this on the evening, News like why isn't
there a you, know a prime time special about the healthcare?
Ripoff and obviously there have been some Like, Expos's but,

(18:19):
AGAIN i THINK i think just you, know many times
we're complacent in the healthcare environment that we're, in and
we just think, like, OH i guess this is what it,
is and we have to spend all this money on
our health insurance and still not really enjoy the experience of.
Healthcare and you, know SO i think that you, know
for whatever, reason it's it's just hard to break that

(18:39):
kind of.

Speaker 1 (18:40):
Habit it's it's an important thing to to to take
that first. Step AND i think one of the things
that's that's also cool is the membership model At ADVOCATE.
Md getting in gets to your doctor and just take
that first step and actually make that. Appointment it goes
a really long. Way AND i think, too we're also
very much like and you had referenced this, earlier is
like like when it comes to taking, action like we

(19:03):
may have like good intentions or like, Yeah i'm gonna do,
That i'm gonna do, that and then and then we
just don't get around to. It that's WHY i encourage
folks like today is the day to actually do. That
take that step. Again you talk about the affordability of
direct primary, care what you do At ADVOCATE, md it
is a fantastic day to become a member and make that.
APPOINTMENT i got to just pick up phone game a
call six o eight to six eight sixty two. Eleven

(19:25):
that's six oh eight to six eight sixty two. Eleven
all the, information including the telephone. Number Online ADVOCATES dpc dot.
Com That's ADVOCATES dpc dot. Com where you're looking for
something for, yourself your. Family if you are an, Employer
oh my, goodness definitely check Out Direct primarycare And ADVOCATE.
Md again the Website ADVOCATES dpc dot. Com That's ADVOCATES

(19:46):
dpc dot. Com Doctor, hebkiss it's always great chatting with.
YOU i enjoy the, day have a great, weekend and
we will talk real. Soon to thank, you and again
that website ADVOCATES dpc dot. Com ADVOCATES dpc dot com
six oh eight two six eight sixty two. Eleven that's
six oh eight two six eight sixty two. Eleven more
Of madison in The morning comes your way next right

(20:07):
HERE a thirteen TEN wiba