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Family doc practicing as an "acne specialist" - grossing over 900k ??


medigeek

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I know this doctor, and having talked to him he says he was a family doctor (+ said so on ratemymd.com from before) and his title is "acne specialist."

 

At first of course I thought he was a dermatologist of course, but he shares his clinic office with a dermatologist. Anyways, after I talked to him, he said he works 55 hours a week. He has an extremely large patient base... his place is always seated to the max number of chairs and it doesn't take long at all if you're there with tons of people ahead of you.

 

He sees me + prescribes in 5-6 mins and leaves. The first time he saw me it took 10 mins at most to explain everything. However, his stuff has worked (just thought I'd add).

 

So I was thinking he charges 30$ or so per patient? (minimum amount I'm assuming) Only cause he's a family doc perhaps? He also charges 10$ (in cash) for dry ice per every person, per visit.

 

I'm guessing realistically he sees 8-9 patients per hour.

 

So 40$ x 8 hours = 320$/hour.

 

320$/hour x 55 hours = 17600$ per week

 

17600$/week x 52 weeks = 915200$ per year

 

This is assuming he only charges 30$ per visit (as I don't know about billing that much).

 

So adding in extra patients he sees, time he doesn't work etc etc he grosses ~900k.

 

He has a single secretary though + zero nurses... so overhead must be low...

 

What are thoughts on such a practice? Could a family doc add in things like these to their traditional practice to make more $$$ without much problem?

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Seems like a lot. He's probably not actually seeing pts for the 55 hours, unless he specifically told you that - a good chunk of his time would be spent dealing with paperwork. And of course he wouldn't be working 52 weeks a year, either. But I wouldn't be surprised if he makes more than the average family doc. Like Alastriss said, you can definitely train to do cosmetics, and even if you don't, many family docs will charge for filling out medical fitness forms for work/school, for writing sick notes for work, etc. But I can't imagine dealing with JUST acne, ALL day, EVERY day.

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Maybe. Family docs can also do hair transplants, blepharoplasties, etc. You can make a lot of money doing cosmetics, I don't know if that much is a reasonable amount.

 

Are you sure about the blepharoplasty bit? Seems a little too invasive - not to mention, I wouldn't want anyone other than a plastic surgeon or ophthalmologist doing that, as there are pretty serious risks involved with it.

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He takes appointments from early morning till evening so it seems like the bulk of his time is spent doing acne...and the place is practically always filled up and he wants to be out the door in <5 mins usually. lol...

 

After overhead but before taxes probably still making ~700 ?? In any case, that is if he charges as much as a family doc does for a quick check up which is ~30$.

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Dr. Cole graduated 3rd in his class from the The Universtity of Western Ontario Medical School in London, Ontario, in 1985. He has served as a flight surgeon with the Canadian Armed Forces in Winnipeg Manitoba, the Medical Director for Chrysler Canada in Windsor, as well as a community physician in Belle River, Ontario. He obtained a Master's Degree in Public Health from the University of Michigan in 1993.

 

Sounds like he trained as a general surgeon, otherwise I doubt he'd be allowed to be a flight surgeon. If that's the case, then I have no problem with him doing blepharoplasties...

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Wow, so out of curiosity, I punched this guy's name in the CPSO, and I couldn't find a specialty. If he was a family doc - it would say CCFP. Now I'm starting to think this guy didn't even do residency at all. Hence why the website is so elusive about telling us what his real specialty is.

 

I'm actually intrigued, as well, there doesn't seem to be ANYTHING about him online except for his own website and ONE ratemd review (5 stars, so probably by his own staff, lol). With most docs, you gets dozens of hits.

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i heard that you can do a lot of cosmetic procedures by doing weekend courses, so maybe this guy did that without a residency. Maybe all you need is an MD. However they said he was a physician at some point, and in practice, so he must have some sort of board certification.

 

Alastriss, thorough research fail.....should've checked on the ON College of Family Physicians - license # 55804. Someone needs to review his EBM notes.:P

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Oh what? so he is a Family doc? damn I didn't think to check there, thought the cpso search would reveal it.

 

I'm actually glad you brought this up, as this search eventually led me to randomly look up docs I know and I proceeded to find out that my boyfriend's Dr is currently under review for unprofessional conduct AND is required to have a female chaperone with him whenever seeing female pts......creepy! Switching docs ASAP.:eek:

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Waste of your medical training, IMO.

 

I agree that these doctors are motivated by money... but if they are happy with their job and treat their patients well, then they aren't bad doctors in that sense. It's not the conventional way of practicing medicine but it's also not necessarily wasted training. These procedures don't come without risks, so they require a certain level of competency to perform. If you think about what the majority of people go into their GP's office for, many times it's because of a cosmetic issue. Hair falling out, acne, things on their skin, being fat, something on their face looks a certain way that they don't like, etc. So while these guys are making a lot of money, they are serving a population of people who would otherwise be wasting the system's money on seeing dermatologists, getting MRI scans, antibiotics, and so on.

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I agree that these doctors are motivated by money... but if they are happy with their job and treat their patients well, then they aren't bad doctors in that sense. It's not the conventional way of practicing medicine but it's also not necessarily wasted training. These procedures don't come without risks, so they require a certain level of competency to perform. If you think about what the majority of people go into their GP's office for, many times it's because of a cosmetic issue. Hair falling out, acne, things on their skin, being fat, something on their face looks a certain way that they don't like, etc. So while these guys are making a lot of money, they are serving a population of people who would otherwise be wasting the system's money on seeing dermatologists, getting MRI scans, antibiotics, and so on.

I didn't say they weren't helping people, I just said it was a waste of training. I'm not referring to plastic surgeons either, as they undoubtedly receive a lot of very important training that is unrelated to elective cosmetic procedures. I mean a doctor who spends 6 intense years of dedicated training to practice family medicine and then throws that all away to do only hair transplants for the rest of his life.

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I didn't say they weren't helping people, I just said it was a waste of training. I'm not referring to plastic surgeons either, as they undoubtedly receive a lot of very important training that is unrelated to elective cosmetic procedures. I mean a doctor who spends 6 intense years of dedicated training to practice family medicine and then throws that all away to do only hair transplants for the rest of his life.

 

I can see your point :)

 

I guess though to the overall system - the total number of hair transplants etc is more or less fixed and some one or some ones have to do them. Does it really make a difference if that is spread around among 10 doctors or concentrated to just one etc? and by different I suppose I mean cost to the system or quality of care to the patient. If anything I guess hyper specializing like that would let you be faster/do a better job, and let the other doctors focus on other areas (which might also improve). Using that logic it might be possible to argue it is not an overall waste at all, even if it seem that the single doctor range of abilities is not being fully used.

 

Personally I would still be bored silly doing the same thing over and over but that is just me :)

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what about the principles of autonomy and self determination... i love ethics, you can never be wrong :P, what if his intention was never to practice family medicine but make lots of money and travel the world, suppose he wasn't the type that looked to find deep personal satisfaction in work but rather in other endeavours in life, which are made possible by his acne practice... i hear the education is subsidized and you owe something to society argument coming , but if i'm making 900 k, i'll gladly pay back the 500 k i was subsidized with to make such an exorbitant salary

 

if i could get away with running an acne clinic and making 900 k i'd do it for a few years, sorry to all you guys suffering in internal medicine residences :P

 

I didn't say they weren't helping people, I just said it was a waste of training. I'm not referring to plastic surgeons either, as they undoubtedly receive a lot of very important training that is unrelated to elective cosmetic procedures. I mean a doctor who spends 6 intense years of dedicated training to practice family medicine and then throws that all away to do only hair transplants for the rest of his life.
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These are surgeons not family doctors.

And yes, they make a killing because they become so efficient.

 

part of that efficiency - if I am remembering the place correctly - is because the patient population is also very controlled. The don't do repairs on overweight people for instance (but do have a diet program etc - I wonder how much that costs outside of OHIP I am sure.) and restrict on some chronic conditions as well. They also recommend staying there 3 days post procedure in the semi private rooms with some more billings I am sure :)

 

They don't even do all types of hernia repair either.

 

The main problem with the concept of places like this is all the more complex, ie less lucrative procedures, are tossed to other doctors. So you have doctors who don't do as many over all cases getting stuck with cases that would require the most experience to handle best.

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These are surgeons not family doctors.

And yes, they make a killing because they become so efficient.

 

It should be mentioned that they also have EXTREMELY good results because of the repetition. They are frequently cited as the gold standard for hernia repair, and an example of how practice makes perfect in surgery.

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what about the principles of autonomy and self determination... i love ethics, you can never be wrong :P, what if his intention was never to practice family medicine but make lots of money and travel the world, suppose he wasn't the type that looked to find deep personal satisfaction in work but rather in other endeavours in life, which are made possible by his acne practice... i hear the education is subsidized and you owe something to society argument coming , but if i'm making 900 k, i'll gladly pay back the 500 k i was subsidized with to make such an exorbitant salary

My argument wasn't about the morality of what he was doing, which I think is an entirely different debate. It's just that I'd personally never want to invest so much of my life learning medicine only to throw it away. Of course maybe he had the same feelings but became jaded by family practice and was lured away by the 900k salary?

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It should be mentioned that they also have EXTREMELY good results because of the repetition. They are frequently cited as the gold standard for hernia repair, and an example of how practice makes perfect in surgery.

 

Well, the gold standard for elective hernia repair, though I'd be interested in seeing some robust outcomes evidence that it's superior to mesh repairs and the like.

 

In any case, doing nothing but elective abdominal wall defect repair is the absolute most boring thing to do with an FRCSC in general surgery.

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In any case, doing nothing but elective abdominal wall defect repair is the absolute most boring thing to do with an FRCSC in general surgery.

 

You're right. The issue is that many of the doctors at the Shouldice clinic are not surgeons. I think there are a few FPs and maybe an Obgyn or two. I'm not sure if there are any surgeons at all.

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