There is no question that profits are important for any business to thrive. However, for dermatologist Dr. Tim Ioannides profits are not now and never have been the driving force behind Treasure Coast Dermatology, his five-location practice in southeastern Florida.
For him, it is the impact he wants to have on his community and the world that has led to profits and sustainable success over the course of two decades. Operating in the Treasure Coast of Florida for over 20 years, he sees the profits his practice makes as a welcome byproduct of his purpose in life: making a difference in the lives of others. Whether it be his commitment to ensuring the patients at his practice have a pleasant experience, ensuring they have access to the best options in skin cancer removal, or his work with the University of Miami on a groundbreaking treatment for inoperable tumors, Ioannides exemplifies the idea of “purpose over profits” in both his career and his life.
In the beginning of Ioannides career, he accepted a position under a plastic surgeon at a dermatology practice in order to gain experience within the industry. However, while the practice provided medical dermatological services, it also sold cosmetic products and procedures such as botox and collagen injections. Because they are considered elective, more often than not the practice was not required to go through an insurance company and therefore was able to collect a higher profit, but Ioannides quickly began to feel that he was acting more as a salesman than a doctor.
For Ioannides, these products and procedures were unnecessary distractions from a dermatologist’s true focus: the health and vitality of a patient’s skin. He envisioned starting his own practice in which medical dermatology was the sole focus, and began saving his money in order to do so.
While some tried to deter him, saying that if he ever wanted to succeed and make a profit he would need the income cosmetic procedures generated, Ioannides remained steadfast in his convictions. Choosing to move from the bustling city of Miami to the more relaxed atmosphere of Port St. Lucie, Dr. Ioannides started his practice, named Treasure Coast Dermatology for the coastal region into which he had relocated. Although unbeknownst to him at the time, the county of St. Lucie was not only one that had a low demand for cosmetics and plastic surgery but also had the second highest skin cancer rate in the country. Getting to work, Ioannides was soon able to prove his naysayers wrong as his personable nature and tenacious drive toward his purpose saw his practice expand to four additional locations within the Martin, St. Lucie, and Indian River counties of the Treasure Coast.
Ignoring convention proved to be a pattern in Ioannides’ career at his practice, as he continually placed a focus on patient experience in his decision-making rather than profitability. Knowing that a visit to the doctor’s office is not something a person chooses to do unless it is a necessity, he made sure to listen to any and every suggestion his patients had for making their experience as pleasant as possible. While other offices may utilize fluorescent lighting because of its cost-effectiveness, Ioannides made sure to install ambient lighting to help keep his patients’ stress levels at a minimum.
After reading about a hospital that saw a reduction in reported pain and depression after installing art throughout their building, he purchased art for all of the rooms of his practice in order to aid in offsetting what can often be an anxiety-inducing experience. He even purchased cable for his waiting rooms after one patient made a comment requesting it. While these may seem like unnecessary expenses that reduce the bottom line for some, for Ioannides these changes were invaluable tools that allowed him to foster a long-term relationship with each of his patients.
Perhaps one of the largest deviations Ioannides made from the norm is in his system of record-keeping. When his practice first opened, he invested in the computerized record-keeping and note-taking software that were typical of practically every office at the time, dutifully installing one in each examination room knowing that they had the ability to improve efficiency greatly when compared to the time-intensive color-coding file system of paper that his father (who was also a doctor) had used.
However, Ioannides had always been a strong proponent of the importance of active listening in medicine, and he became perturbed by the way the computer screen discouraged engagement in both himself and his patients. He had learned that you can discern as much about what a patient is experiencing through what they don’t say as what they do, and by having his back to his patients ticking box after box, he was missing much of these key subtleties. The straw that broke the camel’s back occurred during an appointment just like any other, when he found himself having to ask his patient to repeat themselves not once, but twice because he had been so focused on the computer screen in front of him.
While he apologized and the patient was understanding, Ioannides knew that the system he currently had in place wasn’t serving the purpose of his practice. Even though he would be taking a loss for getting rid of the current computer system and forgoing a streamlined process for one that was arguably more archaic, he knew that the extra bit of time spent transcribing hand-written notes at the end of an appointment was well worth the improvement in patient interaction.
There are many other ways in which Ioannides has chosen the purpose-driven path over a profit-driven one. He is staunchly not in favor of using physician extenders – a popular term for a trained health professional who provides quasi-autonomous health care under a particular physician’s license such as physician’s assistant or nurse practitioners. Although they would greatly increase the number of patients he could see on any given day and therefore improve profitability, as with his decision on record-keeping his commitment to patient experience means that he wishes to give each of his patients his personal and undivided attention. He also refuses to accept any sort of gift from drug representatives whether it be a party, invitation to lunch, or even something as small as a fruit basket. While working with drug representatives can be lucrative for both parties involved, his purpose-driven approach means that he will not promote one drug over another simply because it benefits him.
The first year Ioannides was in business he threw a party for all of the local physicians as was customary, but barely anybody showed up. Deciding that it was a silly tradition as the people he really wanted to form a connection with were his patients, he decided to hold a picnic for all of his patients and staff instead. The picnic became an annual tradition that still occurs to this day, and Ioannides also sends out a yearly newsletter in which he provides general updates on the practice and its staff along with useful insights and helpful information about often confusing topics such as Medicare, HMOs, and other dermatology-related issues. Ioannides also works hard to not only make his patients feel comfortable at his practice, but also his employees. Almost his entire nursing staff has worked with him for over a decade, and he regularly organizes team volunteer outings to encourage teamwork and build co-worker relationships. On one occasion after Hurricane Dorian hit the Florida coast, he organized for his team to get involved with supporting the community by assisting in the rebuilding of houses destroyed by the storm. Although the excursion was voluntary, nearly every single member of his team ended up attending, a testament to the loyalty his staff feels toward his purpose-driven practice.
Ioannides’ parents also worked in the medical field, and growing up in Miami much of his sense of purpose came from observing them at work. They both worked at the University of Miami, his mother as a technician at the school’s Bascom Palmer Eye Institute and his father in the School of Medicine’s Pathology Department. His father was from Greece, and had earned his medical degree from the University of Thessaloniki School of Medicine before immigrating to the United States in 1957. Taking a job at the University of Miami, he soon became a noted figure in the field of dermatopathology – the study of cutaneous diseases at a microscopic and molecular level. He was the founder of the school’s first Dermatopathology Laboratory and served as a guiding light and inspiration for Ioannides throughout his life.
While Ioannides admired father’s professional work, it was his attitude toward every person around him that inspired him to see people as the main source of his purpose. Like his son, George Ioannides was driven by his deep desire to help people, and carried this with him both professionally and personally. When Ioannides was young, a sewer line backed up in his home and his father called a plumber – promptly greeting him at the door with his sleeves rolled ready to help. After fixing the messy plumbing issue, the plumber turned to Tim and told him that in all his time working he had never had a doctor offer to help him, a statement that stuck with him well into his adulthood. If you have the ability to help somebody, why wouldn’t you?
When he was in his second year of medical school, this ethos was put to the test in a way he never could have imagined. While driving along a bridge, he witnessed a car crash through a roadside construction barrier and plummet into the water below. Pulling over, he quickly realized that none of the other onlookers who had stepped out of their cars intended to do anything besides watch as the car began to slowly sink with a terrified elderly couple still trapped inside. Pulling off his t-shirt and sandals, he took a running start and dove the fifteen foot drop into the water below. Managing to find a rock and smash the rear window of the car, he and two others who had followed in after him were able to pull the two occupants to safety just as the vehicle sunk below the surface of the water.
While Ioannides may have learned his purpose in life from his parents, he has said that it was the University of Miami School of Medicine that taught him to think like a doctor. While other large cities such as Chicago or New York have multiple prestigious medical schools to choose from, the University of Miami holds the premiere medical school in the city, meaning that only the best and the brightest students as well as educators are hosted. The school was practically a second home for him growing up, and after earning his undergraduate degree in chemistry he went on to attend medical school at the university. Even with his busy practice, Dr. Ioannides has maintained a connection with the university, where he assists in the instruction on dermatologic and reconstructive surgery as a voluntary associate professor and was also a senior author on two papers recounting a study he was involved in regarding the human papillomavirus and skin cancer.
The study involved the treatment of a 97-year-old patient with multiple cancerous tumors on her right leg. The sheer number of them negated the option of surgery, and other attempted therapies such as topical ointments and injections had failed. The only other option seemed to be chemotherapy, but weighing the decrease in quality of life that the woman would experience with the odds of a successful treatment, it did not appear to be a viable solution. Ioannides colleague Dr. Anna Nichols had previously researched the correlation between the human papillomavirus (HPV) and skin cancer by administering the HPV vaccine Gardasil 9 to two of her patients, finding that the number of new cancer growths decreased after they had received the vaccine. Treating her new patient the same way, the vaccine produced a local inflammatory response in the majority of the tumors, indicating that a reaction was happening as a result of the vaccine. Upon observing this, Ioannides suggested to Nichols that she inject the vaccine directly into the tumors themselves.
This approach was considered “off-label” as Gardasil 9 had only previously been approved for the prevention of cervical cancer. However, Ioannides’ purpose-driven approach to medicine meant that his top priority was always what was best for the patient. The treatment proved to be vastly successful, with every single one of the patient’s tumors disappearing within a year. The study was published as two papers in the Journal of American Medical Association of Dermatology, earning one of the “Most Talked About” honors in 2018, and Ioannides was awarded a patent for the novel use of the vaccine. However, Ioannides would tell you his greatest success was not the honors or the patent, but the fact that the woman went on to celebrate her 100th birthday. For Dr. Tim Ioannides, profits are a reward, not a purpose. His question when he wakes up every morning is not “how much money will I be making today?” Instead, it is “what kind of value am I adding to the world?”