December 26, 2018

DEAR FRIENDS:

It’s been a tradition that every year I write a letter to all of my patients to announce the Patient Appreciation Party and to talk a little bit about the practice and my family. (You can read previous years letters on our website at TCDermatology.com)

And so, though I’ve written about it before, many people ask about the party and how it started. Here’s the story:

I had opened my new office in Fort Pierce and as is traditional, I had an “open-house” for the local physicians.

One doctor showed up. One doctor, no one else.

I was worried – really worried – about whether my practice
would be successful or not. I talked about it with a patient, and he said,” The other doctors don’t support your practice, your patients do. You should have a party for us instead!”

So I did, and about 200 people showed up. I felt really relieved, and that was 17 years ago. I guess we have done ok. So we’ve continued the patient party for all of these years, through good and bad weather, and…everything else. The party has food, drinks, and the local K9 officers come and do a demonstration, it’s a lot of fun.

My family is doing well. As many of you know, my wife Cammy and I just celebrated our twelfth anniversary. I got married when I was 40, and people asked me what I might’ve been waiting for.

If you meet my wife, you’ll know. I married the best woman I ever met. And the fact that I didn’t find her until I was in my late thirties makes me appreciate her even more.

Cammy and I have two children. Our daughter Cammy is seven, and in first grade. She is smart and strong and beautiful like her mother. She likes school and enjoys swimming and playing tennis.

She is growing up so fast and she has me wrapped around her little finger. That’s ok. I am enjoying every minute of it.

Our son, George, is five and a half now. As many of you know, he is on the autism spectrum. That is, he’s been diagnosed with autism. He has had trouble speaking, but for the first time, literally tonight just before I started this letter, he had a short conversation with Cammy.

He’s literally never had a back and forth conversation in his life until tonight, but it happened. We are overjoyed by this milestone.

Our son is strong, and like other little boys he likes to play and yell. He loves listening to the Beatles and watching cartoons much like I did when I was his age.

We are grateful for him in our lives and despite any label he is given, George is a happy boy. His teachers and tutors all tell us how he has lit up their lives. He has a joy of life that I don’t see often in many people, let alone kids. He has helped Cammy and me find that in ourselves, too.

Because sometimes even adults need that reminder, and we find it every day in both of our children.

I hope you get the chance to meet my family at the picnic.

Now for some more personal news. I got a pacemaker in September. I’ve mentioned to many people that I have a genetic heart condition. It’s so rare that there are only about 10,000 people diagnosed with it in the world. And I am unlucky enough to be one of them. Like with many conditions, this genetic issue can manifest itself differently in different people. But the experts say, I might have a long and normal life despite this “disease”, but as a backup, get the pacemaker.

So I did.

Many of my patients have called asking how I am doing. I feel great; with some minor adjustments I still exercise and enjoy my work. I appreciate all your prayers and good wishes. And I look forward to writing the follow up to this letter every year for the next 20 years.

In last year’s letter I mentioned about the possibility of
University of Miami (UM) coming up here to open a dermatology clinic on the Treasure Coast. After spending a lot of time and effort, we thought an agreement was just around the corner. Unfortunately, due to some bureaucratic leadership changes at UM, the project was put on hold. Despite every physician and professor involved in it wanting this clinic to go forward, and politics being politics, their hands were tied.

For now, I decided to pull the plug because of my heart, but also because I am not the kind of person who has a lot of patience when dealing with this type of bureaucracy. I am still hopeful that it still might happen, but I don’t think
anytime soon.

This missed opportunity is a loss to the patients of the Treasure Coast as well as to the University of Miami School of Medicine.

I also mentioned in my letter last time about the research that I was involved in. I was the Senior Author on two papers in the Journal of the American Medical Association Dermatology (JAMA DERM) regarding the use of a vaccine to treat skin cancer. JAMA DERM is one of the most prestigious journals in academic dermatology.

I can’t tell you how proud I am of the honor and distinction
of being Senior Author. Members of our team (me included) have been invited around the world to discuss this development.

We have published two papers, with more coming. A vaccine that prevents many skin cancers is an exciting development and it will probably put many dermatologists out of business. We have found a dramatic reduction in skin cancer in many patients, and there have been no appreciable side effects. We have used it to treat end stage cancers with almost total remissions.

(If you want to watch the news video about the vaccine that went international, please visit our website at: TCDermatology.com. Click on “Videos” under the “Media” tab.)

It’s interesting though. Many of my colleagues say that they are not sure they want to use this vaccine. If there’s
less skin cancer, there’s less business. I have had medical
professionals tell me this directly. It makes me a target and some (a few) have actually discouraged me from moving
forward with this research.

The plan had been to start a clinical study of the vaccine here in conjunction with UM opening their clinic. But since they are not coming to the Treasure Coast I am uncertain about my involvement in a long-term large study locally.

Clinical studies and the research that goes along with them take a huge commitment and a lot of time. With my heart issues and my wanting to be at home more with my son and daughter, I realized I can’t do everything.

But with our publications, the seed is planted, and University of Miami has already received initial funding to start the studies needed. And approval might not be that far away, as the vaccine is already available for use for other conditions besides skin cancer. It’s been given to tens of millions of people already who are at risk for other diseases.

I told several patients that I would help them get access to that study if it was done in our office, and I am sorry that the circumstances changed so much. As things progress, I will put the study related information on our website so people can apply to receive the vaccine when it is up and running.

One question people ask about the vaccine is, “is it safe?” Every member of my family and many of my staff has gotten it. The nurses and staff have seen what it can do. So those of us on the front line can attest to its safety by the fact we, in fact, have used it. I didn’t push it on my employees, but made it available if they wanted it. After seeing how well it worked, they did.

That goes to my next subject, and that is the “corporatization” of medicine. Many dermatology practices are being bought by venture capitalists groups. In the past two years, I, myself have had more than six groups contact me in order to discuss selling my practice to different groups of investors.

Many of you might not know this, but my practice is consistently ranked by Medicare as one of the top ten skin cancer dermatologic practices in Florida (this was reported in the Wall Street Journal, among other publications).

Not kidding.

Like with the vaccine, this makes our practice a trophy, as well as a target. Some people want to bring you down; some people want to associate with you to figure out what you are doing right.

I was shocked when I saw the listings, too. I never thought I would be at the top of that list, I just tried to do things right by my patients. But I guess when you do things that way, people see it, and support you.

But this type of success, I believe, is because we at Treasure Coast Dermatology put the patients’ health first. For example, we don’t sell cosmetics. We don’t push Botox or collagen or laser or liposuction.

So the patient who is truly interested in their health first comes to us.

If you’re reading this letter, you are probably one of those people.

Many of you know, in my first full time job, I worked with
a plastic surgeon, and the money in cosmetics is…well, at times, the cost of cosmetic procedures borders on the
obscene. And it’s cash that a doctor gets, without having to go through insurance companies.

But when I worked there, for the plastic surgeon, I didn’t feel like a doctor, I felt like….well someone who was pushing people to use Botox and collagen, and get liposuction and lasers.

And to tell you the truth, though the money was great while I was working as a cosmetic surgeon, I was as unhappy as I’ve ever been.

That’s why I opened my first office in St. Lucie County. Though I didn’t know it at the time, St. Lucie County has the second highest rate of skin cancer of any county in the country. I didn’t know that statistic, but I did see the need. Successful cosmetic practices are generally located in big cities. The Treasure Coast needed a medical dermatologist much more than a cosmetic one. And based on my previous experience, and my unhappiness, that’s what I needed too. People told me “there’s not a big market for cosmetics there, in St. Lucie County.”

And I said “you’re right.”

I have never regretted that decision. I am glad I am a Medical Doctor taking care of people’s health, not a Cosmetic Surgeon doing liposuction/Botox/Collagen etc.

Sorry about that digression from my talking about the corporatization of medicine, but I’ll try to pull it together as to why that’s important.

You see when these “venture capitalists” call me to talk about selling my practice, they always emphasize how much more money can be brought into the practice if I use “physician extenders” and sell and push cosmetics and cosmetic procedures.

They look at each individual patient as profit centers, not as people.

If you really believe that physicians who work for one of these practices that has been “bought out” can truly insulate themselves from these pressures to generate more profit from each patient, you are more idealistic than I am. Next time you go to a dermatologist’s office, ask them who owns the practice. Often, it’s not the doctor anymore.

It’s owned in whole or in part by a big corporation.

Me, I’m not going to sell. I’m just not. I’ll pass on the Botox, liposuction and collagen.

And that’s not a judgment on people who do get those procedures, it’s just a choice that I have made for my practice.

And, if you’re reading this letter, you’re not a profit center to me, you’re my patient.

My heart might not be in the best shape, but my soul is intact, and it’s not for sale.

And you honor me by trusting me to take care of you.

I won’t betray that trust.

See you at the party.

Sincerely,
TIM IOANNIDES, MD