January 3, 2017


Every year I write a letter to my patients to let them know how things are going in the practice, with my family, and with some pertinent things going on in medicine.

I started doing this as part of the invitation to our annual patient appreciation party. Every year for the past 18 years, I have had a party for my patients. There’s food, music, and drinks.

For the past 12 years or so, the St. Lucie County Sheriff’s K-9 Unit has given a demonstration of their incredible animals and how they help protect our community, as well as our dedicated law enforcement officers.

This year, our party will be held on Saturday, February 4th, between 11:00 a.m. and 2:00 p.m. at Tradition Field (527 NW Peacock Blvd., Port St. Lucie, FL 34986).

There’s something that I hate to bring up, but this year I think it is necessary. Over the past years, as the party has grown in size, there have been more and more uninvited guests.

Some people who attended last year’s party were people who were driving by, saw the tent, and got curious. One man even asked what the event was and proceeded to get in the food line.

Because it was at the end of the party and I didn’t want to cause a scene; I just let him get some food. In a way it was humorous, but in a way it wasn’t so funny either. It’s difficult and time consuming to throw the party. Last year, we had food for more than 2500 people.

People who are uninvited make it difficult, if not impossible to plan appropriately. I would hope that everyone who is invited would understand that, and help me keep this party between us as much as we can this year.

So, unlike last year, where things were sort of open, I ask you to please bring this letter with you as your invitation.

I am so sorry to have to do this. I appreciate your help and understanding.

Now, on to more pleasant subjects. My family is doing well, my wife Cammy is still the pillar and rock of my life. I cannot imagine how I was so lucky to have found her and how blessed I am to have her love me as she does.

The kids are getting bigger. My daughter is bossing me around, and like any father, I probably spoil her a little too much. We (just me and her, without Mommy) went to the movies for the first time, and she promised to hold my hand through the scary parts. We went to see the animated movie “Trolls”, and there were some scary parts, but she made sure to keep a tight grip on her Dad’s hand. My son is three and a half. He’s a happy, healthy and strong kid, but he seems to be speech delayed, and is talking very little. I had a similar thing when I was a child, and my parents sent me to speech therapy. This was in the late 60’s, when therapy was rarely done. Cammy and I are concerned, but hopeful, and we’ve started him with some therapy too. Life has many bumps, and though we are sorry our son is having one so early,we realize that we all proceed at a different pace.

Dr. Golomb is also doing well. She still lives full time in Miami, but comes up here for two or three days per week. She and her husband have ties to Miami, but I am still trying to get her to come up full time…maybe one day.

I appreciate everyone making her feel so welcome. She’s an incredible person, and a great doctor. We are lucky to have her in our community.

I hope you take the time to go online and read my letters from years before. In my last letter, I spoke about how medicine was becoming increasingly impersonal, and how it seemed that when I went to the doctor, he spent more time punching things into a computer than looking at me.

I got some flack from some of my patients who are physicians about this, and I should have presented a more balanced perspective.

Many doctors these days feel “stuck”, just like patients do. Doctors are under enormous pressure from a variety of sources to follow increasingly stringent guidelines. Big business has taken over hospitals, drug companies, laboratories, radiology and surgery centers, and the last “income stream” on the chain is doctors’ practices.

By making it so difficult to practice on your own, doctors are being forced to join large groups that don’t care about you as a patient, or even about the doctor. The doctor is a cog in a wheel, and you the patient are an “income stream”.

The quality of medicine that is provided, and more importantly, your health are secondary to the smooth running and profit making of the corporation.

We as patients are partially at fault with this, and I’d like to give you an example. The biggest complaint in my office is the wait time.

People feel that I am somehow indirectly disrespecting them if they have to wait. I am puzzled by this. People want personal attentive medical care. I try to give my patients this. If you have an emergency, anything from an infected spider bite, to a severe allergic reaction, I will see you the same day.

These days, a policy like this is an exception. The majority of physicians’ practices will send you to an emergency room, where the wait, might be 6-8 hours, and the costs to you as a patient will be in the thousands of dollars.

I have this policy, because the overwhelming philosophy of this practice is that I want it run from the patients’ perspective.

I try to provide to my patients what I would want from a practice.

That’s why I or Dr. Golomb see each and every patient, each and every time. We don’t use “physician extenders”. We are the ones taking care of you.

And that’s why I am puzzled when I am accused of disrespecting a patient’s time when I run over. Please know that this is not my intention.

I spend the time with my patients that need it. It may be dermatologically related, or it may be that the patient needs an ear to talk about a sick spouse or the death of a loved one.

I am going to give the sick the time they need. I would do the same for you.

One can’t want personal attention from a doctor, and then demand that he cut someone else off to get you to your appointment on time.

I liken it to the difference between McDonalds and a great restaurant. If we’re in a rush, we go to McDonalds. But when we want something better, we often have to wait for it. (By the way, I am not knocking McDonalds; I eat there probably more than I should.)

I think we at Treasure Coast Dermatology are offering something better, but, and I say this with only the utmost respect; If an office running on time is that important to you, maybe we’re not a good fit.

This isn’t meant to be impolite, but rather, I am not trying to cater to everybody. I just don’t think the McDonalds philosophy should apply to medical care.

Most people understand this.

Another complaint that people are having is with drug prices.

PLEASE READ LAST YEAR’S LETTER ON HOW TO DEAL WITH THIS ISSUE. (it’s on our website at www.TCdermatology.com)

There is a website called goodrx.com that lists the prices for drugs at various pharmacies. You can print a coupon off the website. Often these prices are cheaper than your copay.

If this is the case, when you drop off your prescription ask the pharmacist not to run it through your insurance. Ask that they use the coupon or discount card that you are providing to process the transaction instead. If they have any trouble using the discount, ask that they call the number on the coupon.

If you come across a pharmacy that refuses to accept this discount, my suggestion is that you find another pharmacy that will. These resources are made available to you because of the outrageous cost of medications, and it saddens me that places would refuse you savings knowing that many people are on strict fixed incomes.

It’s a poor reflection of our society that our senior citizens have to play games like this.

In many ways, you and I are in the same boat. There has been many times where I have printed these coupons for prescriptions, rather than paying my more expensive copay.

We thank you, and appreciate the time you have taken to read this letter.

We are honored that you have chosen us to help take care of your health. Have a great new year, and hope to see you at the party.