In this episode of Wealthyist, host Deanne Phillips, CFP® and Managing Director of Client and Community Engagement at Annex Wealth Management, interviews Dr. Suzanne Gehl (a board-certified family physician, former WAFP president, and owner of a solo Direct Primary Care practice in Hartford, Wisconsin.

Dr. Gehl explains Direct Primary Care (DPC) as a membership-based model that provides unlimited access to a personal physician without insurance billing for primary care. Key features include:

• Ultra-accessible care: Same/next-day appointments (30–120+ minutes long), 24/7 direct phone/text/email response (often within hours), telemedicine, home visits, and no waiting rooms or phone trees.
• Cost savings: Covers unlimited visits, point-of-care testing (e.g., rapid strep, urine tests), drastically discounted labs (90–95% off), and low-cost generic meds (e.g., 3-month supplies under $3). No copays, deductibles, or markups.
• Patient experience: Direct doctor interaction from the start, comprehensive histories/exams, in-office procedures (e.g., joint injections, EKGs), and proactive management—catching issues like undiagnosed hypertension, thyroid problems, or even cancer early.
• Business/employer angle: Companies can cover memberships to slash group health costs (examples: 16–42% savings in first year, preventing job offshoring by reducing expenses). Employees gain easy access, leading to better preventive care and fewer ER/urgent care visits.
• Differences from alternatives: More affordable than concierge medicine ($2,700–$40,000+/year, often bills insurance); no middlemen, fancy lobbies, or large staffs—keeps overhead low.
• Medicare integration: Practices opt out of Medicare (no billing/reimbursement), but patients can use it for hospitalizations/specialists. DPC complements (doesn't replace) high-deductible or catastrophic insurance for major needs.
• Advanced tools: Dr. Gehl highlights innovations like multi-cancer early detection blood tests (e.g., Galleri), genetic longevity profiling (e.g., via GB Insights or New Amsterdam Genomics for personalized prevention, supplement/medication guidance), and virtual specialist consults—enabled by small patient panels (500–700 max) for deeper research and faster implementation.

The discussion emphasizes DPC's growth since ~2010 (now ~9% of U.S. primary care docs), its efficiency for busy/high-net-worth individuals , and its wellness focus—promoting healthier lives, reduced overall healthcare spend, and better quality/quantity of life.

Deanne ties it to strategic choices for the wealthy: using DPC as a smart, proactive complement to insurance for time savings, cost control, and superior outcomes. Listeners can find DPC providers via dpcare.org.

This episode positions DPC as an empowering lifestyle upgrade—restoring the doctor-patient relationship while aligning health with financial savvy.

In this episode of Wealthyist, host Anthony Mlachnik, a senior wealth advisor at Annex Wealth Management, sits down with Amanda Payne, President and CEO of the Waukesha County Business Alliance (the local Chamber of Commerce). The conversation explores why Waukesha County ranks among Wisconsin's wealthiest and the top 200 in the U.S., highlighting its appeal as a hub for business success, family life, and community vibrancy.

Key highlights include:

• Attractions for the Wealthy: Amanda attributes the county's draw to a thriving business ecosystem, excellent schools, high quality of life, and family-friendly environment. As a fifth-generation Waukesha resident, she shares personal anecdotes, like her family's deep roots (e.g., her grandfather leading Waukesha Engine) and historical ties to local institutions like Carroll University.
• Economic Growth and Investments: The county saw a 35% surge in single-family housing permits in 2025, outpacing most areas except Dane County. Major corporate expansions were spotlighted, including GE Healthcare's $100M Waukesha campus upgrade, ABB's $100M New Berlin facility, Milwaukee Tool's $40M+ investments in Menomonee Falls and Brookfield, and Generac's new sites adding jobs. These reflect a booming economy, with biohealth emerging as a key cluster (boosted by Wisconsin's federal Biohealth Tech Hub designation and outpacing national job growth).
• Challenges and Trends: Discussions cover housing supply constraints (rising prices outstripping incomes), talent shortages for growing firms, and the appeal of short commutes compared to big cities like Chicago. Amanda notes the influx of high-net-worth individuals to areas like Lake Country, driven by proximity to Milwaukee's amenities (e.g., sports, arts). Future priorities include expanding I-94 to ease bottlenecks, reduce crashes, and support regional development, while maintaining small-town charm in places like Delafield.
• Small Businesses and Community Ecosystem: Over 90% of Waukesha businesses are small, forming the "heart and soul" of the county. Growth in larger firms fuels suppliers, restaurants, and shops, creating an interconnected ecosystem. Amanda emphasizes preserving this amid expansions from giants like Costco and Amazon.
• Workforce and Youth Engagement: Post-COVID shifts have aided talent attraction via remote work, low cost of living, and lifestyle perks (e.g., easy access to "up north" getaways). The Alliance runs programs exposing over 3,000 middle and high school students annually to local careers through tours, expos, and CEO interactions to foster retention and entrepreneurship.
• Community Leadership and Giving: Wealthy leaders excel by blending business success with philanthropy, board service, and employee support (e.g., helping with loans or cars). Programs like Leadership Waukesha County (30+ years running) build the next generation of civic-minded executives. Younger workers prioritize companies invested in community causes, as seen in initiatives like United Way campaigns.
• Wealth Transfer and Business Transitions: With a massive $70–120T U.S. wealth shift underway, Amanda stresses early planning for family-owned businesses (e.g., generational handoffs, ESOPs, private equity sales). Key is maintaining local involvement and community ties, especially as private equity from coasts enters for roll-ups. She sees rising interest among younger generations in buying/owning businesses, fueled by gig economy flexibility and entrepreneurial spirit.
• Differentiation and Collaboration: Waukesha stands out by prioritizing business growth, professional development, and regional partnerships (e.g., with Milwaukee 7). Anthony ties in Annex's fiduciary approach, emphasizing comprehensive client service aligned with community values.