January 11, 2016

I have always wanted my practice to be different, more personal, and put the patients’ interests first.

One thing I do to accomplish this, is every year I write a letter to my patients. I try to talk about things that are going on with the practice, my patients, and medicine.

If you go to our website at WWW.TCDERMATOLOGY.COM you’ll see past copies of letters that I have written throughout the years. I hope you take the time to read some of them, there is good information about choosing doctors, changes in medicine, and my philosophy as a physician.

Many of the patients reading this letter are new to the practice, and though I‘ve told the story in a previous letter about how the patient party started; I’d like to tell it again.

I had just opened my office, and as was customary I held an open house for the local physicians and their staff. Only one physician came. Needless to say I was pretty disappointed. I spoke about this to a patient who came in the next day, and he said “Doc, why are you having a party for the doctors when it’s the patients who are the ones supporting your practice?”

About three weeks later we threw a patient party in the parking lot of my office in Fort Pierce and about 200 people came. Some of those people who came to that party are still my patients 17 years later.

This year, our party for our patients will be held on Saturday, February 6th, between 11:00 a.m. and 2:00 p.m. at Tradition Field (527 NW Peacock Blvd., Port St. Lucie, FL 34986). There will be food, drinks, music, and a demonstration given by the St. Lucie County Sheriff’s K-9 unit.

Unfortunately, last year we got rained out. PA BBQ in St. Lucie West and their amazing staff were kind enough to open their restaurant early, to serve many of our guests. They did a phenomenal job, and I am still grateful for their hard work.

Many of you might remember last year’s letter where I spoke about Roger and Suzie and her health issues. This dynamic couple had entertained us with their music at every party that I have had from the very beginning. With a heavy heart I write that Suzie is no longer with us, but Roger has asked to come back and will provide the same great music with his daughter. We are sad for the loss of Suzie, but we appreciate that Roger is still a part of our family.

My wife Cammy and I have been married going on 10 years. Marrying her is the best thing I ever did. We have two children, Cammy (nicknamed CC), and George. Please feel free to compliment me on how cute my kids are, I never get tired of hearing it. They will all be at the party so please come up and say hello.

Dr. Golomb is doing well. Her practice is growing and thriving. We are lucky to have such a kind, compassionate, and thoughtful physician working with us. Dr. Golomb is Double Board Certified and is an incredible resource and asset to our practice and community. If you have not met Dr. Golomb, please take the opportunity to try and meet her at the picnic. If you are a patient of Dr. Golomb’s, I’d love to meet you. Please come over and introduce yourself, I will be the guy chasing the two kids at the party.

Medicine is changing, and in many ways not for the better.

One of these changes is that the cost of generic medicines is soaring. Remember generics? They were supposed to be cheaper than the brand name drugs.

Recently a former hedge fund manager purchased the rights to a drug and increased the price from $13.50 per pill to $750.00 per pill overnight. The explanation he gave for the increase (and this is a quote) was this: “I believe drugs should be priced relative to the value they confer”.
This is one of the most insane rationalizations for ripping people off that I have ever heard.

Let’s take an example of seat belts. They save thousands of lives and prevent millions of injuries every year. The “value that they confer” is in the billions of dollars. Based on this rationalization, car companies should charge us some additional thousands of dollars per car, just because they have seat belts! Let’s face it, if car companies did that, the only people who could afford to buy cars would be the drug company executives who are ripping us off.

Senior citizens, the sick, and especially those on fixed incomes are the ones who are paying the cost of these changes not only financially, but emotionally and personally.

Earlier this year I wrote a letter that was sent out by email about this particular issue. It is on our website if you are interested in reading it.

In this letter I said; “I am no socialist, and I understand that capitalism has brought many great things to this country. But the ruthless efficiency of pure capitalism must be tempered with compassion for the members of its marketplace.” To me, in pursuit of profits, some pharmaceutical companies have lost that compassion.

Congress is only now looking into these problems. I hope our politicians do a better job of addressing these issues in the future, but this may be a false hope. Unfortunately, we have to try and tackle these problems by ourselves, for ourselves.

There are some ways to help lower the cost of drugs. I hope you will look at our website and previous letters which give some hints on how to save money on your medications. There are resources on the web that have helped my patients save thousands of dollars. GoodRx.com is one of these resources. I don’t make one penny or get anything by you using them. I’m just hoping this info will help you save some money.

If you don’t have web access please don’t hesitate to call or come by the office and we will be glad to give you instructions on how to find the best prices on the medications that you’re taking. Again, I make nothing by doing this, I’m just sick and tired of the people I care for and take care of getting ripped off.

Unfortunately, medicine is changing in other ways also.

Some people blame ObamaCare, but the truth is that big business, not government, is taking over medicine.

Many of you remember decades ago hospitals were run as not-for-profit centers. They were run by doctors and members of the community for the general good of that same community and their patients. These people are now being replaced by businessmen whose major concern is the income that can be generated from these institutions.
They are not only taking over hospitals but they’ve taken over surgery centers and clinical laboratories, too.

Doctors’ practices are next.

Many doctors have sold their practices to hospitals or insurance companies. In many ways they’ve been forced to do this. The bureaucracy and paperwork that’s necessary to keep a doctor’s office open is increasing and overwhelming. Coupled with additional restrictions and regulations that do nothing to help the patient, these changes only make it more difficult to keep a private practice open.

Medicare is cutting doctors’ payments if they don’t use newly required Electronic Medical Records (EMR). I’m one of the doctors who have resisted such changes. And yes, I get paid less because I won’t use EMR.

It’s questionable whether EMR makes doctors’ offices more efficient. But I will tell you this: It definitely makes medicine less personal.

How can a doctor relate to a patient if he/she isn’t looking at the patient, but rather is staring into a computer screen typing? I’ll be honest, I have a great marriage, but if I tried to have a conversation with my wife while looking at a computer screen, I’d be getting cold soup for dinner.

This computerization depersonalizes the relationship between the patient and the doctor. It’s hard to relate to a person, let alone diagnose them, if you’re not looking at them. A patient is not a bunch of lab values on a computer screen.

But like many things, I believe that there might be another agenda going on here. Think how much easier it is for a big corporation to take over a doctor’s office if all of his patients information can be transferred out of his office on a computer drive. I believe these rules and regulations are being made to compel doctors to join larger groups.

To the businessmen running many of these corporations, a doctor’s office is not a place of healing, but rather an income stream. And it’s an income stream that they want to control.

I’m doing my best to deal with the changes that take away from good patient care and keep the ones that make it better for the patient. As an example, I don’t use telephone trees. You know what I’m talking about. You call a doctor’s office and a robot voice comes on and says “If this is an emergency, call 911. Press 1 for a nurse, press 2 for directions, press 3 for any other questions, etc.” Then you press the number and what do you get? “Please leave a message, and we’ll get back to you when we can.”

In my office, during business hours this is what you get. “Hello, this is Ingrid (or whoever’s name it is picking up the phone) at Treasure Coast Dermatology, how can I help you.” A person answers, who gives you their name. Who is now personally responsible for the message, who can make your appointment right there, or pass on a message directly to a nurse in case it’s urgent. During office hours you will always be able to speak with a member of my staff who can help you. You will not be routed to a voicemail or automated system.

These things reflect the care that I want to give my patients, and the care I want from my own doctors.

Lastly, I want to reemphasize that we at Treasure Coast Dermatology are a medical practice. Part of our philosophy is this: At Treasure Coast Dermatology you will see a physician the first time, every time.

We’re different in another way too. These days dermatologists are all trying to get the cosmetic dollar. At Treasure Coast Dermatology we’re not trying to sell you Botox, collagen, or wrinkle creams.

We’re here for your medical issues. You don’t need a salesman; you need a physician who cares about your health, and the health of your skin.

You’ll get that at Treasure Coast Dermatology.

There’s much more I want to say, but this letter has gone on long enough.

Thanks for taking the time to read it, and I’ll see you at the party.


Tim Ioannides, MD