Dr. Anna Chacon, a renowned telemedicine dermatologist, joins host Dr. Leo Damasco on Telemedicine Talks to share her journey from traditional medicine to building a thriving telehealth practice across all U.S. states, Virgin Islands, Guam, and Puerto Rico. Recorded live from Canada during her rare vacation, she discusses overcoming compliance challenges, the stigma of virtual care, and balancing work-life demands, offering valuable lessons for physicians seeking flexibility and autonomy in their careers.
Can telemedicine offer physicians the work-life balance traditional medicine often denies? Host Dr. Leo Damasco welcomes Dr. Anna Chacon, as she recounts her shift from hospital-based roles to owning a medical office building, spurred by her father’s sudden job loss during COVID when his pediatric ICU closed. She delves into the complexities of compliance, the stigma of lacking a brick-and-mortar presence which led to rejections from pathology groups, and the relentless connectivity of virtual care, even during hikes or flights. With insights on navigating regulatory hurdles, diversifying practice models, and setting boundaries, this episode equips doctors with strategies to thrive in telemedicine while addressing the emotional and financial burdens of maintaining multiple licenses and insurances costing tens of thousands annually.
Three Actionable Takeaways:
About the Show:
Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.
About the Guest:
Dr. Anna Chacon is a board-certified dermatologist and telemedicine pioneer, offering services across all U.S. states, the District of Columbia, Virgin Islands, Guam, and Puerto Rico. A double Ivy League graduate from Brown University, where she earned her medical degree through the Program in Liberal Medical Education, she completed her dermatology residency at Los Angeles County + University of Southern California Medical Center, serving as chief resident. Her passion for teledermatology emerged during the pandemic, driven by a desire to serve underserved and rural populations, a mission inspired by her father, a critical care pioneer in South Florida. With over a decade of experience, she balances an in-person surgical practice in Florida, California, and Alaska with a virtual platform, addressing conditions like acne and psoriasis. Fluent in five languages—English, Spanish, French, Arabic, and Hebrew—she leverages her multicultural background to care for diverse patients. An influencer and author of numerous peer-reviewed articles, she also works with indigenous communities in Alaska and advocates for physician autonomy through her social media presence.
About the Hosts:
Speaker 1: [00:00:00] All right. Hello everybody. Welcome back to Telemedicine Talks this week. Um, today, super special guest. I've been super excited to talk to her about, um, telemedicine, what she's been doing. We have Dr. Anna Chacon. Um, she's a telemedicine dermatologist based out in Miami, and, uh, she has been offering telemedicine services all across the United States, the Virgin Islands in Guam.
She's been super successful at it, doing what she does, and yeah, would love to pick her brain today. So everybody welcome Dr. Anna Ko.
Hi, how's it going today?
Speaker 2: Thank you. Thank you everybody. Good. Um, how are you? Uh, thank you for having me as a guest. Um, I know this was lost.
Speaker 1: Yeah. Mm-hmm. No, this is great. Um. Yeah, so we are actually, [00:01:00] both of us are recording, um, from not our main home bases. Um, you know, I'm in, not, not in Hawaii right now, and.
Doctor in it. Um, you are in, where are you at right now? You said Canada, right?
Speaker 2: I'm actually in Canada, yeah. Trying to enjoy my first vacation in four years. Uh, oh my God. I've already seen like eight patients. I have eight more patience tonight. I had, uh, this podcast and yeah. Mm-hmm.
Speaker 1: Yeah.
Speaker 2: Yeah.
Speaker 1: You know, yeah.
You're out and about, but you're still working. Right? So let's tell, tell me about your story, you know. You are in dermatology and now you're doing telemedicine in all, is it all states now or?
Speaker 2: Yeah. I also have an in-person practice, so I, you know, I really like to do surgery. Okay. Um, okay. Uh, I really like to do surgery.
Okay. Um, and so I also, you know, with telehealth, um. I love [00:02:00] telehealth, but I almost felt like not having an in-person practice led to a certain level of just disrespect, I hate to say. Um, and an example of this was when I tried to, um, join a, um, a big, um, pathology practice. Um. Hold on. Um, in, uh, Miami and, um, they did not, um, accept me because I didn't have an in-person practice.
Okay. 'cause at the time I was working, working, working, um, um, and, uh, working to save, to buy, actually I have an medical office building. And the reason I didn't have an in-person practice is because I didn't have a place to practice. It was really expensive. Um, and so I. Did a lot of telehealth to save and purchase this.
Uh, um, um, so, um, okay. Um, so I'm [00:03:00] sorry. I'm trying to, to type something in my medical assistant. I'm sorry. I'm just trying to multitask, um, uh, and, and do this. But basically, um, I have an in-person practice where we do mostly procedures, mostly surgery on patients who need surgery. Um, and, uh, and uh, I also have my telehealth.
I like telehealth because you can do it from anywhere.
Speaker 1: Yeah, absolutely right. You you're doing it now. Yeah. Right. From Right
Speaker 2: clear
Speaker 1: across the country.
Speaker 2: Right. Another story I wanted to bring up, 'cause I know you do er, is that my dad did ICU and he was, although very creative, successful, a great businessman.
Um, he was a hundred percent. Dependent on an in-person practice, a hospital based practice kind of. Like a lot of ER doctors. And it's sad because you go to school for so long and a lot of the people you work with, like my accountants, my attorneys, they work from home. Yeah. They [00:04:00] take vacations. Uh, they, um, even, you know, bill from home, a lot of them don't even have offices.
Right. They just work from home and they have a great work life balance. Yeah. And that's really missing from medicine. And they went to school maybe half. The years that you did that, you and I did. Oh,
absolutely.
Speaker 2: Half of the years. And, um, you know, I, I was like, well, why can't doctors have that? It's ridiculous that it's so hard for us to attain that.
Um, and my dad, although he had his own practice, it was very much hospital based and, um, uh, and when COVID happened, uh, the hospital, um. Let go of over 200 employees because they closed pediatrics and he's pediatrics ICUs. So they closed the entire department, financial decision, poor reimbursement, and all of, all of a sudden overnight, he lost his job, basically because he had no place to practice.
You know, you can't do [00:05:00] ICU outside of a condo, medical office building. Yeah. Um, depended on, basically the hospital was almost like his tenant, his location. Right. And so he had not, he's never done a virtual visit. He has never done kind of the stuff that you and I do. Um, so he really didn't know where to, uh, pick up from mm-hmm.
When that happened. And luckily he had saved, so that really scarred me. And I was like, you know what? I wanna create, and I know it's gonna be hard, but an environment where I can just work from anywhere. I can have my office, I can have my practice, I can work for somebody else's office even if I want to, or I actually have privileges at other hospitals where I see patients.
Yeah. But I do it 'cause I want to and I don't. I have to, and at the end of the day, if they close or decide to kick me out because I'm not making enough money for them, just like happened with my father. I'll be fine, you know, and I can, you know, get [00:06:00] up and walk away and I know I'll be fine. And so that kind of is an, it's been hard, you know, as you know, I don't take a lot of time off.
I wouldn't even say that today I am fully off, I'm in another country. Um, 'cause I do, I have already worked three hours today. Yeah. Uh, before this podcast, um, from Canada. I've been up since like. 6:00 AM Oh, oh man. But I do it because I kind of want to do it, you know, and I can do it and um, and I could always go back to being a clinic based dermatologist or hospital based dermatologist if I wanted to.
I just. Choose to have more of a variety. Yeah.
Speaker 1: Yeah. Mm-hmm. And you know, you brought up a, a few things that a lot of telemedicine doctors bring up all the time. And a couple things point, uh, stick out. One is the, the thought that you're not a real doctor, right. If you're just a telemedicine doctor, right.
You're, there's this [00:07:00] kind of. Thinking that one, you have to work real hard, right? The only way you're a good person, a good doctor, is if you're working your butt off for somebody, right? Like, more work. More work. You're a good doctor. But if you're, you're trying to do well, uh, uh, work life balance. If you're trying to enjoy yourself and trying to do things for yourself, you may not be a really good doctor.
Right? And also, you know, the, the pathology. The pathology group. Right. Not letting you in because you don't have a brick and mortar location. It's
Speaker 2: a dermatology practice or dermatology. But I found, yeah, and I found that when people do that, it's actually for the best. Um, when you're not accepted and yeah, I have, have people
Yeah, absolutely.
Speaker 2: Um, not take me seriously because of the telehealth thing. And, um, I, that's why I opened in person and I actually do a lot more surgery, uh, even than that, that person that rejected me actually. Um, I, I do a lot more, uh, [00:08:00] procedures than, um. Than that, that actual physician, uh, himself. 'cause I actually think he doesn't see patients.
He's a pathologist. Yeah. Um, but uh, you know, yeah, I have been rejected, you know, so for all the doctors listening out there, I have been rejected from opportunities because they think that I don't see patients in person. Um, unfortunately. Yeah.
Speaker 1: Right.
Speaker 2: And,
Speaker 1: and you do, right? You do. You talk to 'em, you see 'em an audiovisual, do you do mostly synchronous or asynchronous hair, you know, or, or mixture?
Mixture. Both.
Speaker 2: Everything. It's a combination of everything. I'm really big on compliance.
Speaker 1: Um, yeah. Yeah, absolutely. You have to right?
Speaker 2: When you do this? Uh, yeah. I mean, it's, I, I'm on top, you know, I have the best attorneys, um, the best. Uh, I know all the regulations and all that, and I work really hard at it. Um, and it's, uh, yeah.
So, um, but yeah, uh, you know, I just try my [00:09:00] best with everything.
Speaker 1: Mm-hmm. Yeah. No, and, and that's, that's another great point. It's co compliance and knowing is key because a lot, a lot of doctors come in and say, Hey, I'm just gonna practice, right. I'm gonna practice however I want to in whatever state I want to, and game 'em on.
And just do it. But, you know, I think you make a good point. Uh, the best telemedicine doctors and the best telemedicine businesses, they focus on safety, they focus on compliance, right? Because I think in telemedicine, and you know, this may be, um, some people may not agree, but I think compliance is more important to pay attention to than actual malpractice.
And sometimes, right, because compliance is in telemedicine is what's gonna get you in trouble. It's what gonna, it's what? The board is gonna key into, and it's gonna take away your license and yeah, and once one license goes down, right, then all the other states will follow, and then there goes your practice.
Right. You can't practice. Yeah. Once that happens, and yes, malpractice, yes. Standard care obviously, you [00:10:00] know, that is ingrained in us as med students, so forth and so on. But compliance, nobody really teaches that, right? No.
Speaker 2: And it sucks because, yeah, my, I went to the best schools, um, yeah, I think, and they do not.
Dive into this whatsoever, and it could exactly like what you said, it could prevent you from ever seeing a patient again, from ever getting a job again. Absolutely. As a doctor, I don't understand why they don't, they also don't dive into even, you know, now that I have a private practice setting up a private practice, which I think is a huge mistake.
Speaker 1: Yeah, yeah, yeah. No, exactly right. And, and that's good because now you're not only a doctor, right now, you're a business woman, right? You're a business owner, an entrepreneur, and you're right. Nobody's ever taught us to do that. How many business classes did you have in med school? None. How many classes?
Yeah, right. How many classes do you have in investment? How many classes do you have in like really medical law, anything that's important to actually set up and lead [00:11:00] a business? Right, and lead your own practice? Not really. Maybe a few, uh, medical schools out there will have it, but really we're not trained.
To be business people, right. We're trained to what I call clinic monkeys. We're trained to work hard, too hard for somebody else. And then, you know, at 65, if we have enough savings, then just walk away. Right?
Speaker 2: Yeah.
Speaker 1: So telemedicine yeah. Is, is, is probably giving you greater opportunities now. You're work life balance, you know, you get to do stuff.
Now looking back, what do you think your biggest challenge has been? Um, creating this? Practice for yourself. You know, you're well established. You're, you're a 53 er right? You know, you have all the states plus 54. Which, which one's got
Puerto Rico?
Speaker 1: Yeah, I just got Puerto Rico. Oh, you got Puerto Rico. Yeah.
You are, you are. Yeah. I think, I think I only know one more person that has 54. Um, but that's, that's hard. Right. So what's, [00:12:00] what's the hardest step? What's the hardest? You know, what, have you been your challenges to actually build that up and move forward? You know, has there been any time where you're like, no, I'm just, I'm just gonna stick in brick and mortar.
I'm done.
Speaker 2: Well, yeah, the compliance has been honestly a challenge. Um, or even knowing, you know, um, there are moments where you hear about colleagues, I'm sure you've heard of them, um,
oh yeah.
Speaker 2: That have been through a lot of hardships and it's, it's just very scary. Um, yeah. I think also, um, the regulatory bodies haven't caught up to a lot of trends in telemedicine and all of that, and so this is all very new to them and they're very old school.
Yeah.
Speaker 2: And so it's kind of, um, keeping up with that. Um, a lot of fees. So one thing that, um, every doctor should know is that there's a lot of fees that come with practicing. Like even my malpractice insurance for
Yeah.
Speaker 2: It [00:13:00] covers me for in-person and online. 'cause I do have an in-person practice in various states.
Mm-hmm.
Mm-hmm.
Speaker 2: Um, not just in Florida, um, it is about $30,000. So if I were to say, Hey, you know what, IM retiring. I'm retiring, I'm not gonna see a patient, but I wanna keep all my licenses and I wanna keep
mm-hmm.
Speaker 2: This option, an opportunity open, well guess what? That is still gonna cost tens of thousands of dollars per year.
So you still have to, um, work basically. Yeah, you still have to work. Um, there's people that do kind of live off, live off of, um, these regulatory burdens. Uh, all the medical boards and all their staff live off of them. Uh, the malpractice insurances live off of 'em. Um. So you kind of feel like you have to work just to, for the privilege of being able to practice.
Yeah. So that, that's just what I would say. So there's almost no way to not work hard
do this. [00:14:00] Yeah, yeah.
Speaker 2: Like, so you still will be working hard. So the remote thing, um, and, and I don't know. I mean, I, I have met those doctors that they have a great life and they're going to concerts and vacations and trips.
I would say, um. I do not have a similar life as that. Uh, I'm still early in practice. Yeah. But, um, yeah, I would say work life balance is still the most challenging and obviously, um, the being able to work remotely comes with. Uh, as I mentioned, you know, compliance, things like CMEs, uh, reminders. Like I have an assistant that's designated for reminders.
Yeah. On operation dates and all of that. We have spreadsheets. Like it is certainly not, um, something that you can just take lightly.
Um,
Speaker 2: yeah. You can't take it lightly, but you can't take all medicine lightly. No. So that, that's really the whole field altogether, you know? Yeah. That's. That's the entire [00:15:00] field altogether.
Yeah,
Speaker 1: yeah. No, and and that's a great point, right? It takes, you know, just to maintain the licenses itself, plus the fees, plus the CMEs. You know what, it's there, there's a maintenance fee. And, and yeah, it's, it's not, it is work. You're right. And it's funny 'cause I tell everybody, Hey, you know, I, I found a good work life balance, but.
My hours are not different. You know, I don't work more, less hours than I did in the year, maybe even more. 'cause it's too easy. Right. I, my office is wherever my laptop is and my laptop goes with me wherever I go. Right. So you're never really off. Right. You're on vacation. You know, I pop open my computer for a couple hours, knock it out, you know, pay for the day and then go, but you're never really off.
Off. Right, right off,
off.
Speaker 1: Right. And sometimes you have this, this thinking that, hey, you know, and it, this isn't gonna happen when brick and mortar, but this thinking, when you're not doing anything, you're actually losing money. Right? Because the potential for you to gain money is there 24 7 when you open your computer.
But if you're going to dinner or if you're enjoying yourself going on a hike, whatever, [00:16:00] that's hours lost, that's money lost. Right? So it's, it's, it's hard to put it down. Right? It's hard to put it down once you stop. So, yeah.
Speaker 2: Yeah, yeah. No, I know. It's, uh, I look at people like, um, I even work on planes and stuff.
Oh, absolutely. Yeah. I'll connect to wifi and start, you know, popping out notes or reviewing. I will, I will start doing that. Tell you, I have three different internet systems. I have a starlink in case that it goes down. I mean, I have two to three different services. I have different locations with different internet.
I have actually driven to public libraries or places. Right. Um, there's a hurricane. I will do that. Um, it, it's just the, the stuff. Um, I will flip. There's no internet, I will just kind of start freaking out and the people that work with me, but I'll start doing
Speaker 1: that. You know, it's, it's funny you say that 'cause I have the same thing.
I have [00:17:00] two phones, you know, each are hotspots. And I bought the starlink Rome because you know, I live in Hawaii and the same thing weather comes around, it knocks out internet. And I'm like, what am I doing? And I've found myself fally driving around the island trying to find a hotspot that works because, yeah, I'm.
And I'm on call, or I,
Speaker 2: yeah, so I have about four. Yep. I have like four internet sources.
Speaker 1: Yeah,
Speaker 2: yeah,
Speaker 1: yeah,
Speaker 2: yeah.
Speaker 1: It's, it's, it's funny you say that and you're like, you're going no internet, right? Just internet. You take it for granted, but you're like, oh my gosh. And it's, it's, it's a fire, right? It, it's, it's, you know.
Speaker 2: I, you, I really wanted to go to Antarctica. This is a story 'cause I travel a lot. Um, yeah. And I still work and I decided not to go 'cause there was no way they could guarantee the company taking me a stable internet. That's how that, that's
Speaker 1: crazy. Right. There was, I couldn't,
Speaker 2: yeah. I mean, how can you go as a tele or even a doctor period, not just telehealth?
How can you go and take like a, what is it, a two to three? You? You almost can't.
Speaker 1: [00:18:00] Yes. Two, three weeks. Right. And
Speaker 2: extra a whole month. That's
Speaker 1: your whole month. Right. And you were like, what? I can't work. You know? And you're right. 'cause even in vacations, yeah. I take my computer and I'm like, okay, I'm gonna knock out two, three hours so I can pay for the day.
Yeah. And, and you depend on that, right? You'll rely on that and brick and mortar when you didn't have that option, you're just like, I'm just, you know, I'm just not gonna take the vacation or I'm just gonna take a limited one. You're so tied. But it's funny how there's different kinda leashes. Personally, I like the telemedicine leash.
Um, yeah, just 'cause life's way better, you know? And I could do this from anywhere, but, um, there's still leashes. You're right. It's not all right, you know, uh, you know, beds and roses and whatnot.
Speaker 2: Right. I was gonna say, just an example. Yesterday I went to a waterfall.
Speaker 1: Yeah. Um,
Speaker 2: um, which was actually I think like 45 minutes away or whatever.
I did a hike.
Yeah.
Speaker 2: I lost reception for four hours. Oh. Um, when I got back to the hotel, it was actually, I had about [00:19:00] five panic. Emails from, oh my God, this was actually not even patient care. 'cause I'm also an influencer as well online. Yeah. But we were gonna do a, um, like, um, A-Q-Q-V-C sort of thing, and they needed a set up engineering.
And it just so happens that, you know, you were also expected to be on by these people. You, you're expected to be on by almost everyone as a doctor, whatever it is that you do. Right. You can't imagine that you could be hiking a waterfall and, and. You know, without any reception for four hours. Um, you know, if, if, if there is a power outage, there's literally panic in my practice, uh, which is sad to say.
Yeah. But yeah, I, I do like the telemedicine leash, so yes, you.
Speaker 1: Yeah, it's funny, it's funny that, you know, people expect it and now you're, you're on just like anything instant, instant, right? And you're not allowed to come off, right? You're not allowed to be a person to take four hours off. [00:20:00] Now. This, no, I
Speaker 2: mean, it was nuts.
It, it was just, the reaction was, was actually completely nuts
Speaker 1: really. That's crazy for,
Speaker 2: for not even being patient care related. Yeah. But you know, you kind of learn to work with different people and, and roll with punches and, um, yeah. Mm-hmm. Yep.
Speaker 1: Well, hey. Yeah. You know, it's, it's setting up those expectations.
Right. You know, I know there was one book, I think it was a 40 hour work week, right. That said, Hey. If you set up the expectations, especially with emails and context, you know, they only took calls on certain days or answered their emails on certain days, and everybody, at first it was like, Hey, what are you doing?
Why are you not answering? But when they set it up, then everybody expected, I know I'm only gonna get, you know, a response email on Tuesdays and Thursdays, so I'm not gonna bother them. You know what I mean? But it's, it's crazy that we're not taught that mindset. The business people are right. The business people know that, right?
Like the business people have figured it out, you know, they've figured out that, hey. I don't need to work more to, to be worth more and people are gonna need me. So I'm just, you know, do [00:21:00] what I want and, and when I'm ready for it, I'll answer you. Right. You know, that's, that's a pinnacle of like, you know, business, entrepreneurship, business success.
And we don't see that as a pinnacle.
Right.
Speaker 1: I, 'cause we've been worked as clinic monkeys, so. No, this is awesome. This is awesome. Um, you know, and, and wrapping up, I always like to ask this question, you know, if you could go back in time and talk to your future. Self right before intern year. Right. So June 30th, right before intern year, what would you tell your, your soon to be intern self knowing what you notice?
Um,
Speaker 2: yeah. I would just seek more learning and I almost, um, I hate to say it, but it's almost like an expectation that you have to seek it on your own, that you're not necessarily gonna be taught, don't expect. The best schools or the best residency programs to teach you what you need to know.
Yeah. Okay.
Speaker 2: Um, they're gonna teach you [00:22:00] what you have to know, and that's it.
Not what, uh, you want to know necessarily. Okay. Even if you seek it out, because I did kind of seek, uh, more information out. Um, and I would've probably started earlier. Um, I didn't really get. Um, into entrepreneurship or thinking outside the box until my dad lost his job. Um, so it really had to take a catastrophe and, um, for, you know, a pandemic as you know Yeah.
For me to realize, Hey, I should have done this a long time ago. I cannot depend on just a hospital, you know, I shouldn't after studying this long. Um, and, uh, yeah, so that, um. Is what I'd like to mention to other people. But, um, and then just taking things into your own hands, like I said, just, um, uh, try to, you know, learn on your own.[00:23:00]
Don't expect people to teach you necessarily, um, especially if they're not obligated to, they, they probably won't, um, like a, a residency program or a school, um, even if you think it's the best one. Mm-hmm.
Speaker 1: Yeah, no, it'd be nice to see a telemedicine curriculum, I think, and an entrepreneurship curriculum coming into med schools as a regular thing.
Right. I think, you know, we're in this, we're in this time now where that's gonna be where it is important. Right. And, you know, telemedicine is gonna be the majority of the bulk of medicine. I, I swear in like two to three decades. Right. So why not teach the generation now? Right. And so, yeah. And how many years were you practicing before you decided to go telemedicine?
Speaker 2: Um, it was, so I did three years, uh Okay. Full time at Cleveland Clinic, which, which was great, don't get me wrong. It's a, but it's very structured. Yeah. Yeah. Um, little things kind of, um, I would say that they bothered me. Like you can't, you couldn't pick your start and [00:24:00] stop time.
Speaker 1: Yeah.
Yeah. You also can't
Speaker 2: even work, believe it or not, four days a week.
Um, you could not work. A week, you had to be five days a week, Monday through Friday. Um, if you didn't request your vacation time, uh, a month or more in advance, you were not permitted to go. Um, you know, I mean the, but these things are present at a lot of jobs. Like I think you heard from Kaiser, it was. I think a doctor told me something crazy, like six months or a year that you have to plan vacation advance, and I thought that was crazy.
So Cleveland Clinic is relaxed compared to other places. Then I went to the VA and I worked part-time. Oh. The VA I thought was gonna be more relaxed. It was even worse.
Speaker 1: No, no, not at all. I was, I was a military doctor, so, you know, working around that system so we, I know, I know.
Speaker 2: Yeah. I looked, I looked that up.
That's awesome. The VA was actually even worse. Yeah. So I thought [00:25:00] I went from, you know, restrictive to, less restrictive. I went from a little bit restrictive to even More restrictive. Yeah.
Yeah. And
Speaker 2: they didn't see it as wrong, they thought. It was normal to ask somebody, uh, for their time off. Uh, three months in, there was actually three months in advance and that actually was very hard to do.
I even lived in another county and drove two hours a day just to work.
Oh, yeah. Whereas,
Speaker 2: yeah. Whereas in, um, my own practice, you know, I have employees as well, and I will tell you that that would be impossible for me to ask from them. Oh, absolutely. And they're doctors. They will let me know. I'm lucky. If I get to know their days off a month in advance after, uh, bugging them.
Emailing them. Yeah. Um, asking them a million times. So they would never be able to work. Uh, they would never be able to give me days a year in advance or three months in advance. Yeah. And they have not gone to school to [00:26:00] sacrifice as much as we have, uh, in terms to get to where we are. Um, so I think it's just a mistake that medicine is like that, you know?
Um, I really don't know any other profession where they demand. These days. So, so, so that alone just bothered me. That actually made it very difficult to work there. And I had to, uh, quit after six months. I couldn't take it.
Speaker 1: Yeah, no, it's, it's the clinic where, clinic, you know, martyrs, right? They know, they know that, hey, if we wanna work, we're gonna have to play by their rules.
And we've, we've given up the objective, right? We've given up our power over ourselves. Because you know, we just, it's just we. That's what we do, right? We trust everybody else to do everything else, admin, so forth and so on, right? That. Now we're working for somebody else. Now they're dictating. And the va, you know, I mean, just like the military, it's almost like an act of Congress to go off.
Right. Or even work, you know, another job, right? Because then you have to submit a, a letter of exemption saying, Hey, I'm working a [00:27:00] another, you know, second job outside of va if you're a W2 or if you're a contract employee for the, or a, a salaried employee for the va, right. If you're like a GS employee. So,
Speaker 2: yeah.
Yeah, they were, um, actually, they, um. I was doing some work for Google at the time.
Yeah, yeah. And,
Speaker 2: um, my, this actually really happened. Um, I think it was an RN or an MA or something like that, that overheard that.
Yeah. And
Speaker 2: she actually submitted a complaint saying that she, uh, heard that I was doing some work for Google.
And I, I didn't understand it because to me, um, that's another problem with medicine is you spend all these years, all this money. Getting to where you are and people think you shouldn't be allowed to work elsewhere. How, how, how are you gonna make a living?
Speaker 1: No, exactly.
Speaker 2: Hundreds of thousands of dollars. You know, I don't care what my staff does outside of their own time.
They could babysit, they could be a dog walker. Um, I long as it doesn't interfere with what [00:28:00] they're doing.
Yeah. And
Speaker 2: to kind of, I, I do miss, I, I actually do work for other places. Yeah. As a contractor and as employee, but I give my times, um, a year in advance and I do it every three months. And they also, it's with the understanding that if I can't go, uh, we're gonna pick other dates, you know?
Yeah. Um, because it's also to my benefit to give days out far in advance, but there were some places that they just kind of demanded too much. Yeah. Um, and the VA doesn't pay well, that's the other thing. I mean, they would not. Uh, pay what, what is even fair market value, uh, for dermatologists, hourly, and I don't know how they get away with that.
Yeah. Because
Speaker 2: it's not fair market value. It's about a fourth of fair market value. I think it was even $50 an hour. Um, I think it was actually That's crazy. That low, that's, I think it was actually that low. Yep.
Speaker 1: That's lower than, you know, the nurses [00:29:00] making the ER and ICUs, right? Correct.
Speaker 2: Correct. Yeah. And they still.
Felt like they had the audacity to add, to ask for all these things. Yeah. So, and actually it was my dad's friend that, uh, my dad's colleague, he heard me one day complaining about it and he said, you know what, um, and I talked to him. I said, well, I'm gonna try to save five years for the pension. He goes, you're not gonna last five years.
You need to quit right now with everything that you're
saying.
Speaker 2: Courage.
Just get the heck out, letter
Speaker 2: in and quit. Because even with all these things that just seem like impossible, uh, demands, uh, they do have an attitude, uh, they did have a sense of entitlement. Like, yes, I'm gonna ask you this thing, and it's gonna sound crazy, but to me it's normal.
They had no insight into just the demands that they were making. Mm-hmm.
Speaker 1: Right, right. No, and again, we've given up the objective. We've given up our place in there where we could dictate our own means. [00:30:00] And you know when, when you switch to telemedicine now, now you go in and say, if you don't want me, you don't want me, I'm okay.
I'm gonna make my own hours. Right. Isn't it, it's, I found it refreshing when I went in and talked to a telemedicine doctor and came in with, you know, what I could offer them. And then, you know, they offered me something and I'm like, no, I'm just gonna walk away. And then they came back. They're like, no, no, no.
Come, come on back. Or people seeking out, you know, your, your expertise in saying, Hey, please, please work for us. It's, it's nice to come to the table and knowing that you have the advantage at the table. You know? Right. And then that's not brick and brick and mortar. Right. You're right. It's, it's like, you know, in the VA you're gonna do this and you're gonna like it and you're gonna get paid less than, you know what, what intensive care nurses get paid, but you're gonna take it.
Right,
Speaker 2: right. So yeah, I think it's just because it's not, because it's a government's money. Yeah, they kind of don't care. It's not like a business owner. Yeah. You know, they're okay. You need somebody like, I can compromise on flexibilities [00:31:00] because I need, I need literally a body to help me with patients.
Yeah. Yeah.
Speaker 2: And I will compromise on certain things. The VA can keep going because they live off your tax dollars. So you people are still gonna pay taxes. They're still gonna be able to operate 'cause they know that you're gonna pay your taxes. 'cause if not, you go to prison. You know? And so they are willing to be as.
You know, uptight as possible on these things. Uh, because they can still operate. Yeah, they can still operate though. It'll take, I think after I left that position might have been posted for years. I think it's still being posted. Four years. Um, yeah. But you know, again, they'd rather be as uptight as possible than compromise on wellbeing, you know?
Yeah. Um, so anyway,
Speaker 1: yeah, no, that, that position must be a great deal if it's still posted for four years, you know what I mean?
Speaker 2: Nobody, they find somebody as dumb as I was to and be able to, um. [00:32:00] Still, uh, submit hours in Yeah. Like three months in advance and not have another job without running it by everyone.
Speaker 1: Yeah. So, yeah. Right. No, and, and that's just what they do. They prey on our ignorance. Right. They prey on our ignorance and our lack of training to know what good business sense is. Right. And, and how to finagle that and haggle that. Right. Nobody's given us classes on how to go into an interview and ask for a good salary.
Right, right, right. You know, they throw you in, in, in residency and really just work, work, work. Right. And that's how they got us in the first place. We were working for peanuts during residency, most of us. Right. Um, if you, if you were in a military residency. Right. And, and that was accepted. We, we were begging to go in these residencies where they'd like, you know, pay his peanuts so well and abuse.
Oh, go ahead.
Speaker 2: Even when it's legal and Yeah, yeah, yeah. Right. Yeah. And certain things are legal. That shouldn't be like, you know, in my residency program Yeah, it was, it was peanuts. Um, I couldn't actually [00:33:00] afford an apartment in Los Angeles. And you were actually not allowed to have another job. Um, really?
Yeah. You weren't, so you, you're kind of locked.
Yeah.
Speaker 2: Yeah. Mm-hmm. So, um. Any other questions?
Speaker 1: No, no, no. Again, I don't wanna take too much of your time. Thank you so much for taking, you know, taking a slice of your busy day. Um, one last question is, you know, how do, if people want to check your side out, you know, check your hand without, you know, you said you're an influencer, guys, check it out.
It's awesome. I love the content. Um, how can they find you on the interwebs?
Speaker 2: Uh, yeah, so I'm really big on social media, so, um, they could find me on my website, dr.com. Um, also on, uh, Instagram as well. Um, Miami Derm, it's my, even though it's Miami Derm, I, I work all over the United States. Um, [00:34:00] yeah, it's, my handle is at Miami term and that's it.
Awesome.
Speaker 1: Well, hey, thank you again so much, Mahalo, and enjoy your, your quote vacation.
Speaker 2: Thank you. Awesome. Thank you so much. Really nice to meet you.
Speaker 1: Nice to meet you.