Say hello to our beautiful and amazing #ladyboss guest today on the show, Dr. Nicole Hemkes owner and founder of "Advocate Md" Today we will learn how her passion and compassion for healthcare is changing how families experience their health journey's. We will learn what are the current challenges she's seeing right here in our community, how can we make healthcare more affordable, and what is unique about the Madison, WI healthcare!
Let's learn about Dr. Hemkes!
Born and raised in Orlando, FL. Dr. Hemkes left Florida to attend the University of North Carolina at Chapel Hill and graduated with Distinction with a BS Biology minor in Chemistry in 2002. She went on to attend medical school at the University of South Florida in Tampa graduating in 2006. Then Dr. Hemkes returned to North Carolina to attend one of the top Family Medicine residency programs at Wake Forest University in Winston Salem, NC, completing residency in 2009.
For the first ten years of her practice, Dr Hemkes gained experience in a diversity of roles and settings. She has worked in Emergency departments, in the inpatient setting as a hospitalist , and outpatient clinics as a traditional Family medicine doctor. Dr. Hemkes has worked in urban settings such as inner city Chicago and also in settings as remote as rural Alaska. She believes that this diversity of experiences has improved her skills and knowledge but also allowed her to become a more empathetic healer. After being an employed doctor for 10 years, she was excited to find a different model of care called “Direct Primary care”. Dr. Hemkes believes that DPC empowers the physician and the patient . She will advocate for your health as if you were a member of her family. Everyone deserves a healthcare advocate.
Dr. Hemkes lives in Madison, WI with her two young daughters Margo and Mona. In her free time she enjoys running, pilates, gardening and exploring this wonderful state we live in with her family. She is proud to call Madison her home and to build a practice here to serve the community.
Let's learn about Dr. Hemkes!
Born and raised in Orlando, FL. Dr. Hemkes left Florida to attend the University of North Carolina at Chapel Hill and graduated with Distinction with a BS Biology minor in Chemistry in 2002. She went on to attend medical school at the University of South Florida in Tampa graduating in 2006. Then Dr. Hemkes returned to North Carolina to attend one of the top Family Medicine residency programs at Wake Forest University in Winston Salem, NC, completing residency in 2009.
For the first ten years of her practice, Dr Hemkes gained experience in a diversity of roles and settings. She has worked in Emergency departments, in the inpatient setting as a hospitalist , and outpatient clinics as a traditional Family medicine doctor. Dr. Hemkes has worked in urban settings such as inner city Chicago and also in settings as remote as rural Alaska. She believes that this diversity of experiences has improved her skills and knowledge but also allowed her to become a more empathetic healer. After being an employed doctor for 10 years, she was excited to find a different model of care called “Direct Primary care”. Dr. Hemkes believes that DPC empowers the physician and the patient . She will advocate for your health as if you were a member of her family. Everyone deserves a healthcare advocate.
Dr. Hemkes lives in Madison, WI with her two young daughters Margo and Mona. In her free time she enjoys running, pilates, gardening and exploring this wonderful state we live in with her family. She is proud to call Madison her home and to build a practice here to serve the community.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
This is the Mad's Own Mom Squad podcast, a production
of iHeartRadio. Hard working real mama's having real conversations. Now,
sit back, relax, and get ready to talk mom life
with Christa and her Squad.
Speaker 2 (00:14):
Well Mama's.
Speaker 3 (00:15):
I am so excited to have this very special lady
boss with us today. First off, I have to give
a shout out to my dear friend nas Sean Preball,
who works on our sister station, for introducing this lovely
lady to me. Now, before I introduce her, I need
to let you know what she is all about. She
was born and raised in Orlando, Florida, then left Florida
(00:36):
to attend the University of North Carolina at Chapel Hill
and then graduated with distinction with a BS Biology minor
in chemistry in two thousand and two. She went on
to attend medical school at the University of South Florida
in Tampa, graduating in two thousand and six. Then she
returned to North Carolina to attend one of the top
family medicine residency programs at Wake Forest University in Winston Salem,
(00:59):
North Carolina, completing residency in two thousand and nine. For
the first ten years of her practice, she gained experience
in diversity of roles and settings. She also worked in
emergency departments, in in patient setting as a hospitalist, and
outpatient clinics as a traditional family medicine doctor. She has
worked in urban settings such as inner city Chicago, and
(01:20):
also in settings as remote as Rule, Alaska.
Speaker 2 (01:23):
I know sweet right.
Speaker 3 (01:25):
She believes that this diversity of experience has improved her
skills and knowledge, but also allowed her to become a
more empathetic healer. After being an employee doctor for ten years,
she was excited then to find a different model of
care called direct primary care. She believes that DPC empowers
the physician and the patient. She will advocate for your
(01:47):
health as if you were a member of her family.
I am so ecstatic to welcome doctor Nicole Hemkiss, owner
and medical director of Advocate MD.
Speaker 2 (01:58):
Hi. Doctor Hemkiss, how are you.
Speaker 4 (02:00):
I'm great? Thank you so much for having me on
your program.
Speaker 2 (02:02):
Yes, we're excited to have you here.
Speaker 3 (02:05):
I love what your business stands for and I want
to get into this and how you stand out from
typical health care that you see here in our community
and surrounding area. So what what are the current challenges
that you are seeing in healthcare here locally in Madison, Yes.
Speaker 4 (02:20):
There are many of you know, one of the challenges
is that we have an access issue, so it's difficult
when you call to make an appointment with your doctor.
You know, they might be booked out for nine months
a year even you know, obviously there is a financial barrier.
You know, a lot of people are seeing their health
insurance costs go up, you know, year after year, so
healthcare costs keep going up, access is going down, you know,
(02:43):
and then the quality of the care and the time
that you get with your doctor when you go in
to see them. Sometimes they're you know, you're going in
for the appointment and you get a ten or fifteen
minute actual time spent in the room with the doctor.
So it becomes very hard to be able to talk
to them about all of your medical concerns, and then
you might feel like you're rushed out of the room,
you know, without having all your questions answered. So I
(03:04):
think that those are the biggest challenges that we're seeing.
Speaker 3 (03:09):
I think that is so true, and it can be
very It can cause Atlanta anxiety and disappointment when you
are going through something personal right and you're like I
know I don't feel good, I need to get in,
especially you know with mental health that's a whole.
Speaker 2 (03:23):
Other crisis right there.
Speaker 3 (03:25):
It's just so difficult to know I've got to wait
like a month, two months. It makes your mindster you
don't feel good. Then you go in, like you said,
you meet your doctor, and sometimes you can't get that
feeling of For me, I love to like form a
relationship with my doctor, especially if this is going to
be my doctor that's going to be treating me and
having that compatibility. Having that trust is so important, which
(03:48):
you don't always find true.
Speaker 4 (03:51):
And I think a lot of people you know have
a doctor that they really like and they trust. But
again it's it's hard to form that relationship, as you said,
if you're only them for you know, fifteen minutes every
few years. Because you know, there's many people out there
that don't go to the doctor a lot. But then
when you do go into the doctor, you want to
have access to be able to see them. I mean,
if you do have a kind of a cute medical
(04:12):
issue going on, you don't want to have to wait
nine months to see the doctor. So you want to have,
you know, the ability to come in and see them
in a reasonable amount of time. So I think that
a lot of people are struggling with that.
Speaker 3 (04:23):
Now, Yeah, I don't know what happens to my body.
I turn forty eight, girl, and I'm like, what is
going on with my body? Now?
Speaker 2 (04:28):
Why is it hurt on my left side? Why am
I having the cold sweats?
Speaker 3 (04:31):
I'm like, oh, my gosh, am I going through metoposita?
But I was like, ah, and I love my physician
and she is a female, and like, I'm so loyal
to her. And I know, like I have a girlfriend
who's like Christa, She's like, my doctor's leaving.
Speaker 2 (04:44):
She's devastated.
Speaker 3 (04:45):
I mean, it's like losing your best friend when your
doctor leaves.
Speaker 4 (04:49):
You know, Yes, And I think we're seeing that a lot.
And there's you know, there's fewer doctors now people. You know,
doctors are retiring early, they're leaving, they're getting you know,
burnt out. They call it. You know, you a lot
about physician burnout and healthcare staff burnout. But I think
as as the system, you kind of pushes doctors to
see more and more patients and they have shorter appointments.
(05:10):
So I think a lot of them are kind of
leaving the system earlier, which just kind of creates this
vicious cycle where it's getting harder to see doctors when
they do, you know, stick around.
Speaker 3 (05:19):
Absolutely, And is that part of your passion is having
that relationship?
Speaker 4 (05:25):
Yeah, you know, as a family medicine physician, I think
most of us chose this field because we like talking
to people. We like taking care of the whole family,
you know, the mother, the father, the kids, the grandparents,
you know, And you don't really form that relationship, as
we talked about, unless you have some time with them
to talk talk about just not only their medical concerns,
but you know, how's work, how you know, where'd you
(05:46):
go on vacation?
Speaker 1 (05:47):
I love that.
Speaker 2 (05:48):
Thank you for saying that.
Speaker 4 (05:49):
Yeah, So you kind of have to to build that
relationship so that the person does have the trust because
you are going to be you know, not only is
the patient sharing with you very personal, intimate details of
their life, but also you're going to be giving them
medical advice. And so I think unless you have that
trusting relationship built up, it's hard to be able to
take that person's advice, you know. And there's a lot
(06:10):
of different sources of information nowadays, you know, through the internet,
your doctor Google, and so a lot of times people
have already looked up things on their own and they
come in and they really want their doctor to be
able to kind of boil it all down for them
and say like, Okay, this is what I would do,
or this is you know, you know, the best option,
or so I think that you really have to have
the time to develop that, you know, over the course
(06:31):
of a longer visit. So in our clinic, all of
the appointments are forty five minutes to an hour long.
You know, you don't feel like you're you know, rushed
out of the office and wonderful.
Speaker 3 (06:40):
Yeah. Yeah, I'll just say and I won't I won't
say why my daughter met with this doctor, but it
was through you know, zoom and for her to diagnose
my daughter within thirty minutes, I'm like, are you kidding?
Speaker 2 (06:53):
You don't know my daughter?
Speaker 3 (06:54):
Yeah, And so I was just unhappy with that program
that that we experienced because I was just like, how
can you say that when you don't even know anything
about her yet. Yes, So I'm really happy that for
you personally, as a doctor, you choose to take that pathway.
So how can we make health care more affordable because
(07:16):
that is just so devastating to realize there are families
out here who cannot seek help.
Speaker 2 (07:21):
I mean, everyone deserves treatment.
Speaker 4 (07:24):
Yes, part of this model is that we kind of
look at healthcare differently, and we look at health insurance differently,
and a lot of people equate health insurance to healthcare,
which I think those are two separate things.
Speaker 2 (07:34):
Right.
Speaker 4 (07:34):
Health insurance is a way to pay for health care,
but it doesn't it doesn't substitute for health care. And
a lot of times we use the analogy of car insurance,
So we have car insurance, but we don't use the
car insurance every time we go in to get the
oil changed or to get the tires rotated.
Speaker 2 (07:49):
We can't cash for those things.
Speaker 4 (07:51):
So similar to this model, you know, we have health insurance,
and we would use that for the catastrophic things, you know,
big things like you have to go in the emergency
department and you need surgery, you have an unfortunate diagnosis
like cancer, You need health insurance for those things.
Speaker 2 (08:05):
But for the.
Speaker 4 (08:05):
Everyday stuff for you know, ninety percent of medical issues
for most people, you know, we can take care of
that in a primary care setting. And when we separate
that out from the rest of healthcare, we're able to
keep it much more affordable. So if we can take
care of more in the office spased primary care setting
rather than sending you into these large healthcare systems that
are typically owned by hospitals, which tend to charge more
(08:28):
for everything because you're going into the hospital for the MRI,
or you're going into the hospital to get the blood
work done, or whatever it might be. If we can
take all of that out and put it in the
clinic setting, it becomes much more affordable.
Speaker 2 (08:41):
Wow, I love that. I love that, doctor Hemkes.
Speaker 3 (08:45):
What is unique about, of course Madison area in healthcare?
Speaker 4 (08:49):
Would you say, yes, our location here is very dominated
by HMOs, and that's not true necessarily everywhere across the country.
Other thing that's unique about this is that our large
hospital systems actually own the insurance companies here, which again
brings up a lot of issues and questions, but it
(09:10):
also kind of makes it so that there's not an
incentive to control cost because basically the hospital can build
the insurance whatever they want, and the insurance is owned
by that hospital, so they will pay out on those claims,
but then they will also pass that cost onto the
patient or the consumer because it will continue to increase
their insurance premiums. So I would say that those two
things are very unique. But also I think the access
(09:32):
issue here is somewhat unique. You know, even though we
have very wonderful, you know, healthcare systems and doctors. You know,
I always say to people, you know, it doesn't matter
how wonderful the doctor is, if you can't ever get
in to see them, or if every time somebody told
me a story the other day of they have a
doctor that they're assigned to and they really like, but
every time they go to make an appointment, that doctor
(09:53):
is booked up. So they offer them to see somebody
else or you know, yeah, a PA or nurse practitioner.
Then they make an appoint with that person, and then
you know, a week or two before the appointment, they're
called and said, okay, well we need to cancel and
reschedule your appointment because the person's out that day. And
so it's it's now taken them a year and a
half and they still haven't been able to get in
to see the doctor, which is crazy when you think
about it, because you're paying again for this health insurance,
(10:16):
which should give you access to healthcare, but in some
cases we're finding that it doesn't.
Speaker 2 (10:20):
Wow.
Speaker 3 (10:21):
That is so true, girl, And I feel like we've
all been in that situation and it's like oh no,
or I'll get the phone call like, oh we sorry,
we accidentally, you know, double booked her.
Speaker 2 (10:31):
I'm like, no, I know she's fabulous, but don't tell
me that.
Speaker 3 (10:38):
I know for for a lot of people, and I
went through it. Budget cuts, so many people are losing
their jobs. And when you lose your health insurance, I mean,
that's that's a whole other thing in its own. I mean,
I unfortunately, you know, lost my job and through you know,
two other radio hosts at a different radio company. And
(10:58):
for me to even think about, oh my gosh, I
got to go and find my own health insurance.
Speaker 2 (11:02):
That was just anxiety in itself.
Speaker 3 (11:05):
And to find the right one and then to figure out, like,
you know, what I was covered originally is not covered anymore.
Those doctors aren't covering. I got to go to a
different hospital. So I had gotten a brand new kitten,
and the very first week I got that little guy,
I fell and I crushed my foot and broke it
in five places, five places of like, are you kidding me?
But I originally was going to UW Health and I
(11:28):
found out that I was no longer able to go
there anymore.
Speaker 4 (11:33):
So then I was, you know, to navigate. Okay, how
do I purchase my health insurance? You know, obviously there's
the marketplace and options there. There are also these options
called health shares, which are considered non insurance, but many
of our patients look at those as a possible option too.
But as you said, it's it's interesting when you talk
to a lot of patients. You know, many times people
(11:55):
you know, if you ask them what they're deductible is
or what their copays are, it's hard to keep track
of all of that. So most people don't really even
fully understand what their insurance benefits are. But that's a
very good thing to look at and make sure that
you know the facts of what your insurance covers, just
to kind of be an informed healthcare consumer. And if
you don't understand it, you know, knowing who to go
(12:16):
to through your HR department or through the insurance company
to explain those things to you, so you do know
when you go into the doctor what's covered, what's not covered?
Speaker 2 (12:24):
Right, right?
Speaker 3 (12:26):
Man? I wish doctor Jazz was here because she's a
pediatrician doctors, so I know you too would have a
great time, you know talking, What would you want most
people to understand about advocate MD. You know, when they
come to see you, they're going to get this. What
would you say, Yeah.
Speaker 4 (12:44):
I think you know, it's going to be a very
different experience. You know, when you walk in the door,
you're greeted by a person that's sitting at the front desk.
I think we've lost a lot of that human component
of healthcare, like in many I guess, I guess in
other industries also. But you know, I think there's some
health care systems now where you walk in, you type
into a computer screen to check in. You know, a
(13:04):
lot of places now you're even rooming yourself in the room.
There's nobody that's getting you out of the waiting room
and walking you there and bringing you into the room.
So it's it's you know, smaller clinics, patients are you know,
again greeted, they're put almost immediately back into the room
so they don't have to sit in the waiting room
for for a long time. And then again you have
a physician that's going to spend a lot longer time
(13:27):
with you, and it's much more patient focused. Again, you
know what's right for the patient, how can we make
this easier, more convenient for the patient, rather than kind
of just when things get really large in these big
health systems, a lot of times you feel kind of
like you're just being pushed through a numberber Yeah, exactly, so,
(13:47):
so I think that that's that's a big difference between
like going to a small medical practice versus a large
healthcare system. You know, it's just that you you feel
like you're being heard, like people are actually you know,
the care about out you, not just the doctor the
rest of the staff. When you go in, you're going
to see the same doctor every time. You're not going
to kind of be pushed on to whoever is seeing
(14:08):
patients at that time. And and as we talked about,
it's it's now getting harder to have that continuity with
the same doctor because doctors are leaving the system, and
so you know, it's it's you know, getting harder and harder.
Our practice is only physicians. We don't have any non
physician providers, so that also is something unique and we've
done that intentionally just because of the training and the
(14:30):
education it takes to become a physician. You know, there's
a greater scope of practice of what we can do
in the office, again without having to refer you on
to a specialist. So if a patient comes in, like
can you take a look at the spot on my arm, Like, well, yeah,
we can actually remove that here, or freeze that or
really you know, biopsy that rather than send you to
the dermatologists. Well, isn't that fabulous because that's a whole
(14:51):
lot of Ye, yes, exactly, that's the worst.
Speaker 2 (14:54):
Yeah, one of the dermatologists.
Speaker 4 (14:56):
Good luck that it could be six months and then
you know, yeah, so it's in a additional costs, additional inconvenience.
So we try to do as much as we can
in our in our clinic without having to.
Speaker 2 (15:05):
Refer to you. Wow, that's so good to hear that.
Speaker 3 (15:08):
Yeah, especially too with having to get like checked for
maybe certain things you know that might you know, go
past just a you know, a urine test you see something, Okay, Well,
now we want to give you an ultrasound.
Speaker 2 (15:21):
You do those there as well, like we do.
Speaker 4 (15:23):
We have X rays and ultrasounds that come into the
office that we can do. We also offer this telemedicine
specialty service. So, as you mentioned, Crystal, the example like
if you if we did some lab work and something
came back abnormal, we can actually send that on to
let's say an intercrinologist or a rheumatologist, and they'll review
your labs, they'll review our notes, you know, if you
had imaging done, and they'll come back and say, okay,
(15:46):
well we think you should order this test, or we
think you should let's try this medication, or let's you know,
if they need to be seen by a specialist, then
we can do that. But I would say, you know,
in ninety percent of cases, it's things where we can order,
you know, additional work up the patient or try a
treatment with them rather than sending them to a pestalist.
Speaker 2 (16:04):
And isn't this easier?
Speaker 3 (16:05):
Honest moms too who have jobs, because it is not
easy to be like, okay, now I got to email
my boss again that oh I have another a doctor's
appointment because I have to go here.
Speaker 2 (16:15):
Now I have to go here.
Speaker 3 (16:17):
You know that's not always easy because you're like, uh no,
I hope they're not getting upset with me, because you know,
I can't get it all done one please.
Speaker 4 (16:24):
Yes, that's very true. Yeah, And I think just like
having to wait a long time for an appointment and
not knowing, you know, if if the issue that you're
having is going to get worse during that time, and
that creates anxiety for people to have to wait. Yes,
you know, we've had situations where a patient had something
significant going on to the point where they needed to
go to an emergency department and then you know, they
(16:45):
can't get in for a follow up visit with a
cardiologist or you know, so again, we can utilize that
telemedicine specialty service to kind of get you know, sometimes
a second opinion and then to kind of start their
their treatment or their work up before they can get
the appointment to see that the specialist.
Speaker 2 (17:01):
How wonderful. So where's your location?
Speaker 4 (17:04):
So we have four clinics right now. We have one
in Middleton, one in East Madison off Fair Oaks, We
have a clinic on the Fitchburg South Madison border off
Sign Road, and then a clinic down in Janesville.
Speaker 2 (17:16):
Oh, how fabulous would you say? For you specifically, what
are like your top like?
Speaker 3 (17:21):
These are my top things that I just love to
you know, see people about or advancements.
Speaker 4 (17:27):
Yeah, I I personally like doing procedures, so I like
doing a lot of skin procedures. I enjoy women's health,
you know, I do. I do some procedures associated with
women's health that some of the other docks in the practice.
I would say, each each doctor in our practice has
like a little area of expertise that we like. You know,
I think it's it's I really like to take care
(17:47):
of families and seeing kids and seeing kids for their
you know, well checkups and all of that. So I
think that's part of you know why I really enjoy
being a family medicine doc. But yeah, it is going
to be interesting to see, you know, what happened in
the in the future with all the technological advancements and
AI and oh start on, Ani.
Speaker 2 (18:06):
Are you real or not? Like you know, we need
real people. Yes, it's crazy.
Speaker 3 (18:11):
I just had that conversation where you know, you know,
in so many years, like we're getting rid of teachers.
Absolutely not, you know doctor, No, I mean my job. No,
I mean it's I mean it's heartbreaking. Do you even
have those conversations?
Speaker 2 (18:25):
Yes?
Speaker 4 (18:25):
And and the scary thing is that there are some
systems one locally here where Now they are having AI
like writing back messages to patients if they email the
doctor about something or in my chart them that they
could be an AI that's generating the message that's going
back to. I think it has to put a disclaimer
at the bottom saying that that's who's the message. But
(18:46):
that's still when you think about it, it's kind of
crazy because again you lose that human component of like, oh,
I know, you know Susan Smith and like I you know,
I remember when she had the similar issue before. You know,
It's like you can't really I mean at this point,
I don't think we can replicate that with a computer.
I mean, the computer is obviously smarter than us, but
it still doesn't really understand all the intricacies of human
(19:07):
behavior and all of that.
Speaker 3 (19:08):
Well, I was just talking on the radio and Z
one O four how there are many college students now
whose homework is being done by AI.
Speaker 2 (19:16):
So teachers don't even know.
Speaker 4 (19:18):
Yes, I know, it's like I don't know how you
solve that.
Speaker 3 (19:21):
I was like, I remember using cliff notes, like that's
how I got through in college.
Speaker 2 (19:27):
Definitely, Well, I I love what you offer.
Speaker 3 (19:30):
Again, you're it's it's like you one place, you do
it all. You don't have to wait, You're caring, you're compassionate,
you get to know who we are, and you know
the purpose of what you do, and you know, obviously
the passion of becoming a doctor.
Speaker 2 (19:45):
Like how fabulous is that?
Speaker 3 (19:47):
Like do you still I don't know, as a woman,
like and you know, do you pinch yourself to I
mean I would do that I'm a doctor, like or
does that is that not like crush your mind?
Speaker 4 (19:57):
I mean, I do feel lucky to be where I'm at,
and I I mean, I think the practice has kind
of allowed me to find my joy in practicing medicine again,
because I didn't necessarily feel that way when I was
an employed physician. You're seeing twenty twenty five patients a day,
But now that I can spend longer with patients and
truly develop that relationship, it's been a lot more satisfying
(20:18):
for me.
Speaker 2 (20:19):
I love that.
Speaker 3 (20:20):
Well, it's very very much needed again, doctor Hemkiss. She's
the owner medical director of Advocate MD at Direct Primary
Care Healthcare with four locations, correct, So that's wonderful.
Speaker 4 (20:33):
You just keep growing then, Yeah, we're trying to have
enough locations where it's convenient to people, and hopefully we'll
continue to grow.
Speaker 3 (20:41):
Do you all like your girlfriends go and see you.
They're like, I don't go to anywhere else, go to
my best day?
Speaker 4 (20:45):
Some of them do?
Speaker 3 (20:46):
I do?
Speaker 2 (20:47):
I would?
Speaker 3 (20:48):
I would. Well, now you will become a best friend
of many women out here. So we so appreciate your
expertise and coming on the show and doing what you do.
Speaker 2 (20:57):
And we'd love to have you back on. Learn more
about what you do.
Speaker 3 (21:01):
I'm very curious too about more of the procedure work
that you do, because I think that's super important.
Speaker 2 (21:06):
I know for myself as a mom.
Speaker 3 (21:09):
You know, I've got to get my skin checked every
year because both my father and my grandfather pass away
from melanoma. So that's like, right, something that's always in
my mind to make sure I'm taking care of myself.
Speaker 4 (21:19):
So it's great to know that you offer that. Definitely,
I would. I'd be happy to come back on. Thank
you for having me again.
Speaker 3 (21:25):
Yes, thank you, and yeah, have a fabulous summer. I
don't know, do you do you find time to yourself
as a doctor during the summer.
Speaker 4 (21:32):
Yes, I'm trying to take up some new hobbies. I
just started golfing, which is a yeah, yeah, I do
some running golfing. I have two girls that are seven
and nine.
Speaker 2 (21:44):
Have fabulous yeah. So you got it all. You got
it all. Are you ready for back to school yet?
Speaker 3 (21:50):
No?
Speaker 4 (21:50):
I haven't been thinking about that yet.
Speaker 2 (21:52):
You're like Chris turning that off. Sorry, guys, sorry I
didn't bring that up yet. We need to enjoy our
summer yet. So thank you so much. We really appreciate
your time.
Speaker 4 (22:01):
Thank you too. You're welcome.
Speaker 1 (22:03):
This is the Matton Mom Squad podcast, a production of iHeartRadio.
Speaker 4 (22:07):
Here.
Speaker 1 (22:07):
Every episode of Matton Mom Squad Podcast available on the
iHeartRadio app, Apple Music, or wherever you listen to your
favorite podcasts
This is the Mad's Own Mom Squad podcast, a production
of iHeartRadio. Hard working real mama's having real conversations. Now,
sit back, relax, and get ready to talk mom life
with Christa and her Squad.
Speaker 2 (00:14):
Well Mama's.
Speaker 3 (00:15):
I am so excited to have this very special lady
boss with us today. First off, I have to give
a shout out to my dear friend nas Sean Preball,
who works on our sister station, for introducing this lovely
lady to me. Now, before I introduce her, I need
to let you know what she is all about. She
was born and raised in Orlando, Florida, then left Florida
(00:36):
to attend the University of North Carolina at Chapel Hill
and then graduated with distinction with a BS Biology minor
in chemistry in two thousand and two. She went on
to attend medical school at the University of South Florida
in Tampa, graduating in two thousand and six. Then she
returned to North Carolina to attend one of the top
family medicine residency programs at Wake Forest University in Winston Salem,
(00:59):
North Carolina, completing residency in two thousand and nine. For
the first ten years of her practice, she gained experience
in diversity of roles and settings. She also worked in
emergency departments, in in patient setting as a hospitalist, and
outpatient clinics as a traditional family medicine doctor. She has
worked in urban settings such as inner city Chicago, and
(01:20):
also in settings as remote as Rule, Alaska.
Speaker 2 (01:23):
I know sweet right.
Speaker 3 (01:25):
She believes that this diversity of experience has improved her
skills and knowledge, but also allowed her to become a
more empathetic healer. After being an employee doctor for ten years,
she was excited then to find a different model of
care called direct primary care. She believes that DPC empowers
the physician and the patient. She will advocate for your
(01:47):
health as if you were a member of her family.
I am so ecstatic to welcome doctor Nicole Hemkiss, owner
and medical director of Advocate MD.
Speaker 2 (01:58):
Hi. Doctor Hemkiss, how are you.
Speaker 4 (02:00):
I'm great? Thank you so much for having me on
your program.
Speaker 2 (02:02):
Yes, we're excited to have you here.
Speaker 3 (02:05):
I love what your business stands for and I want
to get into this and how you stand out from
typical health care that you see here in our community
and surrounding area. So what what are the current challenges
that you are seeing in healthcare here locally in Madison, Yes.
Speaker 4 (02:20):
There are many of you know, one of the challenges
is that we have an access issue, so it's difficult
when you call to make an appointment with your doctor.
You know, they might be booked out for nine months
a year even you know, obviously there is a financial barrier.
You know, a lot of people are seeing their health
insurance costs go up, you know, year after year, so
healthcare costs keep going up, access is going down, you know,
(02:43):
and then the quality of the care and the time
that you get with your doctor when you go in
to see them. Sometimes they're you know, you're going in
for the appointment and you get a ten or fifteen
minute actual time spent in the room with the doctor.
So it becomes very hard to be able to talk
to them about all of your medical concerns, and then
you might feel like you're rushed out of the room,
you know, without having all your questions answered. So I
(03:04):
think that those are the biggest challenges that we're seeing.
Speaker 3 (03:09):
I think that is so true, and it can be
very It can cause Atlanta anxiety and disappointment when you
are going through something personal right and you're like I
know I don't feel good, I need to get in,
especially you know with mental health that's a whole.
Speaker 2 (03:23):
Other crisis right there.
Speaker 3 (03:25):
It's just so difficult to know I've got to wait
like a month, two months. It makes your mindster you
don't feel good. Then you go in, like you said,
you meet your doctor, and sometimes you can't get that
feeling of For me, I love to like form a
relationship with my doctor, especially if this is going to
be my doctor that's going to be treating me and
having that compatibility. Having that trust is so important, which
(03:48):
you don't always find true.
Speaker 4 (03:51):
And I think a lot of people you know have
a doctor that they really like and they trust. But
again it's it's hard to form that relationship, as you said,
if you're only them for you know, fifteen minutes every
few years. Because you know, there's many people out there
that don't go to the doctor a lot. But then
when you do go into the doctor, you want to
have access to be able to see them. I mean,
if you do have a kind of a cute medical
(04:12):
issue going on, you don't want to have to wait
nine months to see the doctor. So you want to have,
you know, the ability to come in and see them
in a reasonable amount of time. So I think that
a lot of people are struggling with that.
Speaker 3 (04:23):
Now, Yeah, I don't know what happens to my body.
I turn forty eight, girl, and I'm like, what is
going on with my body? Now?
Speaker 2 (04:28):
Why is it hurt on my left side? Why am
I having the cold sweats?
Speaker 3 (04:31):
I'm like, oh, my gosh, am I going through metoposita?
But I was like, ah, and I love my physician
and she is a female, and like, I'm so loyal
to her. And I know, like I have a girlfriend
who's like Christa, She's like, my doctor's leaving.
Speaker 2 (04:44):
She's devastated.
Speaker 3 (04:45):
I mean, it's like losing your best friend when your
doctor leaves.
Speaker 4 (04:49):
You know, Yes, And I think we're seeing that a lot.
And there's you know, there's fewer doctors now people. You know,
doctors are retiring early, they're leaving, they're getting you know,
burnt out. They call it. You know, you a lot
about physician burnout and healthcare staff burnout. But I think
as as the system, you kind of pushes doctors to
see more and more patients and they have shorter appointments.
(05:10):
So I think a lot of them are kind of
leaving the system earlier, which just kind of creates this
vicious cycle where it's getting harder to see doctors when
they do, you know, stick around.
Speaker 3 (05:19):
Absolutely, And is that part of your passion is having
that relationship?
Speaker 4 (05:25):
Yeah, you know, as a family medicine physician, I think
most of us chose this field because we like talking
to people. We like taking care of the whole family,
you know, the mother, the father, the kids, the grandparents,
you know, And you don't really form that relationship, as
we talked about, unless you have some time with them
to talk talk about just not only their medical concerns,
but you know, how's work, how you know, where'd you
(05:46):
go on vacation?
Speaker 1 (05:47):
I love that.
Speaker 2 (05:48):
Thank you for saying that.
Speaker 4 (05:49):
Yeah, So you kind of have to to build that
relationship so that the person does have the trust because
you are going to be you know, not only is
the patient sharing with you very personal, intimate details of
their life, but also you're going to be giving them
medical advice. And so I think unless you have that
trusting relationship built up, it's hard to be able to
take that person's advice, you know. And there's a lot
(06:10):
of different sources of information nowadays, you know, through the internet,
your doctor Google, and so a lot of times people
have already looked up things on their own and they
come in and they really want their doctor to be
able to kind of boil it all down for them
and say like, Okay, this is what I would do,
or this is you know, you know, the best option,
or so I think that you really have to have
the time to develop that, you know, over the course
(06:31):
of a longer visit. So in our clinic, all of
the appointments are forty five minutes to an hour long.
You know, you don't feel like you're you know, rushed
out of the office and wonderful.
Speaker 3 (06:40):
Yeah. Yeah, I'll just say and I won't I won't
say why my daughter met with this doctor, but it
was through you know, zoom and for her to diagnose
my daughter within thirty minutes, I'm like, are you kidding?
Speaker 2 (06:53):
You don't know my daughter?
Speaker 3 (06:54):
Yeah, And so I was just unhappy with that program
that that we experienced because I was just like, how
can you say that when you don't even know anything
about her yet. Yes, So I'm really happy that for
you personally, as a doctor, you choose to take that pathway.
So how can we make health care more affordable because
(07:16):
that is just so devastating to realize there are families
out here who cannot seek help.
Speaker 2 (07:21):
I mean, everyone deserves treatment.
Speaker 4 (07:24):
Yes, part of this model is that we kind of
look at healthcare differently, and we look at health insurance differently,
and a lot of people equate health insurance to healthcare,
which I think those are two separate things.
Speaker 2 (07:34):
Right.
Speaker 4 (07:34):
Health insurance is a way to pay for health care,
but it doesn't it doesn't substitute for health care. And
a lot of times we use the analogy of car insurance,
So we have car insurance, but we don't use the
car insurance every time we go in to get the
oil changed or to get the tires rotated.
Speaker 2 (07:49):
We can't cash for those things.
Speaker 4 (07:51):
So similar to this model, you know, we have health insurance,
and we would use that for the catastrophic things, you know,
big things like you have to go in the emergency
department and you need surgery, you have an unfortunate diagnosis
like cancer, You need health insurance for those things.
Speaker 2 (08:05):
But for the.
Speaker 4 (08:05):
Everyday stuff for you know, ninety percent of medical issues
for most people, you know, we can take care of
that in a primary care setting. And when we separate
that out from the rest of healthcare, we're able to
keep it much more affordable. So if we can take
care of more in the office spased primary care setting
rather than sending you into these large healthcare systems that
are typically owned by hospitals, which tend to charge more
(08:28):
for everything because you're going into the hospital for the MRI,
or you're going into the hospital to get the blood
work done, or whatever it might be. If we can
take all of that out and put it in the
clinic setting, it becomes much more affordable.
Speaker 2 (08:41):
Wow, I love that. I love that, doctor Hemkes.
Speaker 3 (08:45):
What is unique about, of course Madison area in healthcare?
Speaker 4 (08:49):
Would you say, yes, our location here is very dominated
by HMOs, and that's not true necessarily everywhere across the country.
Other thing that's unique about this is that our large
hospital systems actually own the insurance companies here, which again
brings up a lot of issues and questions, but it
(09:10):
also kind of makes it so that there's not an
incentive to control cost because basically the hospital can build
the insurance whatever they want, and the insurance is owned
by that hospital, so they will pay out on those claims,
but then they will also pass that cost onto the
patient or the consumer because it will continue to increase
their insurance premiums. So I would say that those two
things are very unique. But also I think the access
(09:32):
issue here is somewhat unique. You know, even though we
have very wonderful, you know, healthcare systems and doctors. You know,
I always say to people, you know, it doesn't matter
how wonderful the doctor is, if you can't ever get
in to see them, or if every time somebody told
me a story the other day of they have a
doctor that they're assigned to and they really like, but
every time they go to make an appointment, that doctor
(09:53):
is booked up. So they offer them to see somebody
else or you know, yeah, a PA or nurse practitioner.
Then they make an appoint with that person, and then
you know, a week or two before the appointment, they're
called and said, okay, well we need to cancel and
reschedule your appointment because the person's out that day. And
so it's it's now taken them a year and a
half and they still haven't been able to get in
to see the doctor, which is crazy when you think
about it, because you're paying again for this health insurance,
(10:16):
which should give you access to healthcare, but in some
cases we're finding that it doesn't.
Speaker 2 (10:20):
Wow.
Speaker 3 (10:21):
That is so true, girl, And I feel like we've
all been in that situation and it's like oh no,
or I'll get the phone call like, oh we sorry,
we accidentally, you know, double booked her.
Speaker 2 (10:31):
I'm like, no, I know she's fabulous, but don't tell
me that.
Speaker 3 (10:38):
I know for for a lot of people, and I
went through it. Budget cuts, so many people are losing
their jobs. And when you lose your health insurance, I mean,
that's that's a whole other thing in its own. I mean,
I unfortunately, you know, lost my job and through you know,
two other radio hosts at a different radio company. And
(10:58):
for me to even think about, oh my gosh, I
got to go and find my own health insurance.
Speaker 2 (11:02):
That was just anxiety in itself.
Speaker 3 (11:05):
And to find the right one and then to figure out, like,
you know, what I was covered originally is not covered anymore.
Those doctors aren't covering. I got to go to a
different hospital. So I had gotten a brand new kitten,
and the very first week I got that little guy,
I fell and I crushed my foot and broke it
in five places, five places of like, are you kidding me?
But I originally was going to UW Health and I
(11:28):
found out that I was no longer able to go
there anymore.
Speaker 4 (11:33):
So then I was, you know, to navigate. Okay, how
do I purchase my health insurance? You know, obviously there's
the marketplace and options there. There are also these options
called health shares, which are considered non insurance, but many
of our patients look at those as a possible option too.
But as you said, it's it's interesting when you talk
to a lot of patients. You know, many times people
(11:55):
you know, if you ask them what they're deductible is
or what their copays are, it's hard to keep track
of all of that. So most people don't really even
fully understand what their insurance benefits are. But that's a
very good thing to look at and make sure that
you know the facts of what your insurance covers, just
to kind of be an informed healthcare consumer. And if
you don't understand it, you know, knowing who to go
(12:16):
to through your HR department or through the insurance company
to explain those things to you, so you do know
when you go into the doctor what's covered, what's not covered?
Speaker 2 (12:24):
Right, right?
Speaker 3 (12:26):
Man? I wish doctor Jazz was here because she's a
pediatrician doctors, so I know you too would have a
great time, you know talking, What would you want most
people to understand about advocate MD. You know, when they
come to see you, they're going to get this. What
would you say, Yeah.
Speaker 4 (12:44):
I think you know, it's going to be a very
different experience. You know, when you walk in the door,
you're greeted by a person that's sitting at the front desk.
I think we've lost a lot of that human component
of healthcare, like in many I guess, I guess in
other industries also. But you know, I think there's some
health care systems now where you walk in, you type
into a computer screen to check in. You know, a
(13:04):
lot of places now you're even rooming yourself in the room.
There's nobody that's getting you out of the waiting room
and walking you there and bringing you into the room.
So it's it's you know, smaller clinics, patients are you know,
again greeted, they're put almost immediately back into the room
so they don't have to sit in the waiting room
for for a long time. And then again you have
a physician that's going to spend a lot longer time
(13:27):
with you, and it's much more patient focused. Again, you
know what's right for the patient, how can we make
this easier, more convenient for the patient, rather than kind
of just when things get really large in these big
health systems, a lot of times you feel kind of
like you're just being pushed through a numberber Yeah, exactly, so,
(13:47):
so I think that that's that's a big difference between
like going to a small medical practice versus a large
healthcare system. You know, it's just that you you feel
like you're being heard, like people are actually you know,
the care about out you, not just the doctor the
rest of the staff. When you go in, you're going
to see the same doctor every time. You're not going
to kind of be pushed on to whoever is seeing
(14:08):
patients at that time. And and as we talked about,
it's it's now getting harder to have that continuity with
the same doctor because doctors are leaving the system, and
so you know, it's it's you know, getting harder and harder.
Our practice is only physicians. We don't have any non
physician providers, so that also is something unique and we've
done that intentionally just because of the training and the
(14:30):
education it takes to become a physician. You know, there's
a greater scope of practice of what we can do
in the office, again without having to refer you on
to a specialist. So if a patient comes in, like
can you take a look at the spot on my arm, Like, well, yeah,
we can actually remove that here, or freeze that or
really you know, biopsy that rather than send you to
the dermatologists. Well, isn't that fabulous because that's a whole
(14:51):
lot of Ye, yes, exactly, that's the worst.
Speaker 2 (14:54):
Yeah, one of the dermatologists.
Speaker 4 (14:56):
Good luck that it could be six months and then
you know, yeah, so it's in a additional costs, additional inconvenience.
So we try to do as much as we can
in our in our clinic without having to.
Speaker 2 (15:05):
Refer to you. Wow, that's so good to hear that.
Speaker 3 (15:08):
Yeah, especially too with having to get like checked for
maybe certain things you know that might you know, go
past just a you know, a urine test you see something, Okay, Well,
now we want to give you an ultrasound.
Speaker 2 (15:21):
You do those there as well, like we do.
Speaker 4 (15:23):
We have X rays and ultrasounds that come into the
office that we can do. We also offer this telemedicine
specialty service. So, as you mentioned, Crystal, the example like
if you if we did some lab work and something
came back abnormal, we can actually send that on to
let's say an intercrinologist or a rheumatologist, and they'll review
your labs, they'll review our notes, you know, if you
had imaging done, and they'll come back and say, okay,
(15:46):
well we think you should order this test, or we
think you should let's try this medication, or let's you know,
if they need to be seen by a specialist, then
we can do that. But I would say, you know,
in ninety percent of cases, it's things where we can order,
you know, additional work up the patient or try a
treatment with them rather than sending them to a pestalist.
Speaker 2 (16:04):
And isn't this easier?
Speaker 3 (16:05):
Honest moms too who have jobs, because it is not
easy to be like, okay, now I got to email
my boss again that oh I have another a doctor's
appointment because I have to go here.
Speaker 2 (16:15):
Now I have to go here.
Speaker 3 (16:17):
You know that's not always easy because you're like, uh no,
I hope they're not getting upset with me, because you know,
I can't get it all done one please.
Speaker 4 (16:24):
Yes, that's very true. Yeah, And I think just like
having to wait a long time for an appointment and
not knowing, you know, if if the issue that you're
having is going to get worse during that time, and
that creates anxiety for people to have to wait. Yes,
you know, we've had situations where a patient had something
significant going on to the point where they needed to
go to an emergency department and then you know, they
(16:45):
can't get in for a follow up visit with a
cardiologist or you know, so again, we can utilize that
telemedicine specialty service to kind of get you know, sometimes
a second opinion and then to kind of start their
their treatment or their work up before they can get
the appointment to see that the specialist.
Speaker 2 (17:01):
How wonderful. So where's your location?
Speaker 4 (17:04):
So we have four clinics right now. We have one
in Middleton, one in East Madison off Fair Oaks, We
have a clinic on the Fitchburg South Madison border off
Sign Road, and then a clinic down in Janesville.
Speaker 2 (17:16):
Oh, how fabulous would you say? For you specifically, what
are like your top like?
Speaker 3 (17:21):
These are my top things that I just love to
you know, see people about or advancements.
Speaker 4 (17:27):
Yeah, I I personally like doing procedures, so I like
doing a lot of skin procedures. I enjoy women's health,
you know, I do. I do some procedures associated with
women's health that some of the other docks in the practice.
I would say, each each doctor in our practice has
like a little area of expertise that we like. You know,
I think it's it's I really like to take care
(17:47):
of families and seeing kids and seeing kids for their
you know, well checkups and all of that. So I
think that's part of you know why I really enjoy
being a family medicine doc. But yeah, it is going
to be interesting to see, you know, what happened in
the in the future with all the technological advancements and
AI and oh start on, Ani.
Speaker 2 (18:06):
Are you real or not? Like you know, we need
real people. Yes, it's crazy.
Speaker 3 (18:11):
I just had that conversation where you know, you know,
in so many years, like we're getting rid of teachers.
Absolutely not, you know doctor, No, I mean my job. No,
I mean it's I mean it's heartbreaking. Do you even
have those conversations?
Speaker 2 (18:25):
Yes?
Speaker 4 (18:25):
And and the scary thing is that there are some
systems one locally here where Now they are having AI
like writing back messages to patients if they email the
doctor about something or in my chart them that they
could be an AI that's generating the message that's going
back to. I think it has to put a disclaimer
at the bottom saying that that's who's the message. But
(18:46):
that's still when you think about it, it's kind of
crazy because again you lose that human component of like, oh,
I know, you know Susan Smith and like I you know,
I remember when she had the similar issue before. You know,
It's like you can't really I mean at this point,
I don't think we can replicate that with a computer.
I mean, the computer is obviously smarter than us, but
it still doesn't really understand all the intricacies of human
(19:07):
behavior and all of that.
Speaker 3 (19:08):
Well, I was just talking on the radio and Z
one O four how there are many college students now
whose homework is being done by AI.
Speaker 2 (19:16):
So teachers don't even know.
Speaker 4 (19:18):
Yes, I know, it's like I don't know how you
solve that.
Speaker 3 (19:21):
I was like, I remember using cliff notes, like that's
how I got through in college.
Speaker 2 (19:27):
Definitely, Well, I I love what you offer.
Speaker 3 (19:30):
Again, you're it's it's like you one place, you do
it all. You don't have to wait, You're caring, you're compassionate,
you get to know who we are, and you know
the purpose of what you do, and you know, obviously
the passion of becoming a doctor.
Speaker 2 (19:45):
Like how fabulous is that?
Speaker 3 (19:47):
Like do you still I don't know, as a woman,
like and you know, do you pinch yourself to I
mean I would do that I'm a doctor, like or
does that is that not like crush your mind?
Speaker 4 (19:57):
I mean, I do feel lucky to be where I'm at,
and I I mean, I think the practice has kind
of allowed me to find my joy in practicing medicine again,
because I didn't necessarily feel that way when I was
an employed physician. You're seeing twenty twenty five patients a day,
But now that I can spend longer with patients and
truly develop that relationship, it's been a lot more satisfying
(20:18):
for me.
Speaker 2 (20:19):
I love that.
Speaker 3 (20:20):
Well, it's very very much needed again, doctor Hemkiss. She's
the owner medical director of Advocate MD at Direct Primary
Care Healthcare with four locations, correct, So that's wonderful.
Speaker 4 (20:33):
You just keep growing then, Yeah, we're trying to have
enough locations where it's convenient to people, and hopefully we'll
continue to grow.
Speaker 3 (20:41):
Do you all like your girlfriends go and see you.
They're like, I don't go to anywhere else, go to
my best day?
Speaker 4 (20:45):
Some of them do?
Speaker 3 (20:46):
I do?
Speaker 2 (20:47):
I would?
Speaker 3 (20:48):
I would. Well, now you will become a best friend
of many women out here. So we so appreciate your
expertise and coming on the show and doing what you do.
Speaker 2 (20:57):
And we'd love to have you back on. Learn more
about what you do.
Speaker 3 (21:01):
I'm very curious too about more of the procedure work
that you do, because I think that's super important.
Speaker 2 (21:06):
I know for myself as a mom.
Speaker 3 (21:09):
You know, I've got to get my skin checked every
year because both my father and my grandfather pass away
from melanoma. So that's like, right, something that's always in
my mind to make sure I'm taking care of myself.
Speaker 4 (21:19):
So it's great to know that you offer that. Definitely,
I would. I'd be happy to come back on. Thank
you for having me again.
Speaker 3 (21:25):
Yes, thank you, and yeah, have a fabulous summer. I
don't know, do you do you find time to yourself
as a doctor during the summer.
Speaker 4 (21:32):
Yes, I'm trying to take up some new hobbies. I
just started golfing, which is a yeah, yeah, I do
some running golfing. I have two girls that are seven
and nine.
Speaker 2 (21:44):
Have fabulous yeah. So you got it all. You got
it all. Are you ready for back to school yet?
Speaker 3 (21:50):
No?
Speaker 4 (21:50):
I haven't been thinking about that yet.
Speaker 2 (21:52):
You're like Chris turning that off. Sorry, guys, sorry I
didn't bring that up yet. We need to enjoy our
summer yet. So thank you so much. We really appreciate
your time.
Speaker 4 (22:01):
Thank you too. You're welcome.
Speaker 1 (22:03):
This is the Matton Mom Squad podcast, a production of iHeartRadio.
Speaker 4 (22:07):
Here.
Speaker 1 (22:07):
Every episode of Matton Mom Squad Podcast available on the
iHeartRadio app, Apple Music, or wherever you listen to your
favorite podcasts
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