MacIver News Service | June 3, 2019
By M.D. Kittle
MADISON, Wis. — Nicole Hemkes was growing tired of being another employee doctor.
The Madison-area physician spent much of the past decade employed at hospital or group health care facilities, much like the vast majority of her peers in medicine. In fact, less than a third of physicians identified as private practice owners, according to a 2018 survey by the Physicians Foundation and Merritt Hawkins.
Hemkes had had her share of insurance-based medicine, seeing her standard 30 patients a day, spending more time on paperwork than with the people she is supposed to serve.
“A 10- or 15-minute appointment is just not enough,” she recently told MacIver News Service. “You’re kind of hooked to the computers because you have to have so much documentation done that you need to submit to a code that is going to bill for that visit, and that’s the way the health system gets paid.”
“So much of what we do seems to be more focused on the billing and the payment rather than the patient,” the physician said.
The same Physicians Foundation survey found doctors spending nearly a quarter of their time completing paperwork, and 78 percent surveyed reporting widespread burnout.
There had to be a better way, Hemkes said. That’s when she began exploring direct primary care. She liked what she discovered. In December, she opened Advocate M.D. in Middleton, the Madison area’s first DPC clinic, according to Hemkes.
The transparent and cost-effective health care model has grown in popularity over the decade, amid the escalating health insurance rates under what was supposed to be the Affordable Care Act.
As MacIver News has reported, direct primary care isn’t health insurance. It’s a transparent method of delivering health care in which patients pay their primary care doctors directly via a monthly fee. It does bypass health insurance and the morass of red tape, inflated costs, and financial uncertainty that plague the traditional system of financing primary health care.
And while direct primary care may not be warmly received by insurance interests, it is doing its part in bending the health care cost curve. More so, Hemkes says, it’s getting back to the basics of medicine.
“The physician is making more of the decisions based on what the patient needs rather than what the outcome is as far as payment or what the insurance is going to reimburse us. We don’t have to deal with any of that,” she said.
A bill that would define direct primary care in state law was reintroduced earlier this year. A similar measure died on the vine in the last session. The legislation could induce more physicians to do as Hemkes did, transition from employee doctor to medical director of her own direct physician-to-patient clinic.
Hemkes is our guest on this edition of MacIver Newsmakers.