Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision, and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome to Meet the Doctor. My guest today is Dr. Anna Chacon. She's a board certified dermatologist in the Miami area, but she practices in all 50 states and probably some countries too. Is that right? 

Dr. Chacon (00:44):
No, not quite

Eva Sheie (00:46):
Oh, I got it wrong. Okay, fix it. 

Dr. Chacon (00:47):
Yeah. They're actually trying to get me a license to practice in Greenland because there's a lot of indigenous patients there. It's mostly an Inuit country, and I've done work with those populations before. 

Eva Sheie (01:00):
So forgive my ignorance and the audience too, but will you tell us what an indigenous patient is and why is this important? 

Dr. Chacon (01:08):
Yeah, it's important to me because part of my background is indigenous from my mom's side. My grandfather spoke five different languages, native tongues, and a lot of them are becoming extinct now. There's also a lot of traditions within those cultures that manifest themselves in medicine and other aspects of life, which I'm just trying to revive, apart from keeping the culture alive as a physician and also as a descendant. And indigenous populations really vary when we think about who they are or what they are. We think of places like Australia with the Aboriginals, New Zealand, with the Maori. There's the Sami in Finland. There's also the natives here in the United States, native Americans, American Indians, Alaska Natives, and native in South America, central America as well. So different tribes that were affected by colonization and immigration. 

Eva Sheie (02:10):
So within dermatology, are there conditions or specific things that happen within these populations that require additional expertise? Am I making that up or is that something that's happening? 

Dr. Chacon (02:22):
No, that's true.

Eva Sheie (02:22):
It is true. 

Dr. Chacon (02:22):
Yeah, it's very true and it's relevant in our fields as well as other aspects in medicine because most of the tribes, not all of them are in rural areas, so it's hard to get to these areas sometimes. And as a result, there's different dermatologic conditions and medical conditions that manifest themselves more in these areas and in others through the founder effect and things like that. 

Eva Sheie (02:49):
So how are these people finding you? 

Dr. Chacon (02:52):
Oh, well, I usually find these opportunities myself, or I try to make a name for myself in this area. It's not a very explored area. In fact, there was only one indigenous dermatologist in the United States as of last year. There's two as of this year, that are officially registered as Native American dermatologist in the United States. There's only one in Canada, one in Australia, and one in New Zealand. So it's very rare to find a physician who has this background. 

Eva Sheie (03:25):
Have you all formed a society yet? 

Dr. Chacon (03:27):
We did. It's called Indigenous Dermatology. It started out as a nonprofit, but the paperwork just got too overbearing and I think it's better off as a society eventually as it grows, it might need full-time staffing and things like that. But for right now, it's sort of an interest group. 

Eva Sheie (03:45):
So does this work require you to travel to these places? 

Dr. Chacon (03:49):
It does in the United States, and it's a lot of travel. I used to, I spent about 16 hours traveling to California, rural California to work at tribes there? 

Eva Sheie (04:01):
By car?

Dr. Chacon (04:01):
No, well, combination of planes and a car. And then Alaska. I would take five planes to sometimes in one shot to get to where I needed to work. 

Eva Sheie (04:14):
I'm trying to picture what this is like. Is it similar to mission travel where you go and you see a whole bunch of patients in a very short amount of time? 

Dr. Chacon (04:22):
Not so much for California. It is kind of like that. It's very underserved area. It's rural, and there's definitely the only dermatologist that comes there. And there's six different tribes all located in the same region, very rural, middle of nowhere ish, low income in Alaska, it was very rural, so that line was actually not that big. But most villages, they call them villages. There are under a hundred people. It's very small. They're very rural. They're not accessible by water or by land, and you have to fly in to those areas. It's very expensive to get there. There's no hotels. You would sleep on the floor of a clinic and the patients, it's likely the first time they've ever seen a specialist. 

Eva Sheie (05:19):
Are you funding this yourself? 

Dr. Chacon (05:20):
No, I did it through the government. Although I do pay for my own travel to go to California. Yeah, I get a small stipend, but it doesn't cover the cost of travel, which is a lot. Coming from an urban location, I live very close to the airport here in Miami, 20 minutes away. I'm also concierge key. I travel a lot, so I have a special service when I go to the airport, that waits for me and escorts me. It helps. But that will not help you to get to these rural areas. It does not exist. 

Eva Sheie (05:55):
They don't have that in Alaska. 

Dr. Chacon (05:56):
Yeah, it will not exist. 

Eva Sheie (05:59):
Bush airport. 

Dr. Chacon (06:00):
Yeah, exactly. 

Eva Sheie (06:01):
Okay. This is really fascinating. 

Dr. Chacon (06:03):
Thanks. 

Eva Sheie (06:04):
And so were you inspired by something else to go into this field, or did you just decide on your own that this was something you were going to figure out and go hunting? 

Dr. Chacon (06:12):
This was just how my career evolves over time. I mean, it definitely was not a straight line. My family didn't really like it. I had heard many, not horror stories, but maybe frightening misadventures of people that travels in Alaska. It's really hard to land there. And also in California it's very rural. There's lots of cliffs, there's very few paved roads on your way there, and there's actually a lot of drug use actually in both places. So it's very common. 

Eva Sheie (06:46):
So, there's a danger element.  

Dr. Chacon (06:48):
Yeah. It's very common. And there's a lot of substance use and misuse problems within both areas and just many medical problems, not necessarily the crime that you see in cities, but a different type of crime and poverty that you see there. 

Eva Sheie (07:07):
So you have a practice here in Miami too, 

Dr. Chacon (07:10):
Yeah. 

Eva Sheie (07:10):
where you see regular? 

Dr. Chacon (07:11):
Yep, Coral Gables, and we're open seven days a week. 

Eva Sheie (07:14):
Seven days a week. 

Dr. Chacon (07:15):
Yeah.

Eva Sheie (07:15):
And who covers you when you're not there? 

Dr. Chacon (07:17):
No one. 

Eva Sheie (07:18):
No one. 

Dr. Chacon (07:19):
I wish I had somebody. I'm bringing on a nurse practitioner, but she just had a baby and her hours are limited, but pretty much I'm open to who wants to work with me. But I am pretty accessible, at least virtually when I'm here, I am open, but when I'm not here, it's still accessible from remotely from a computer. 

Eva Sheie (07:41):
So what percentage are you away from Miami? 

Dr. Chacon (07:45):
I would say 25% of the month. 

Eva Sheie (07:48):
Okay. So about one week out of the month, you head off somewhere? 

Dr. Chacon (07:52):
Yeah. 

Eva Sheie (07:54):
Where's your next trip? 

Dr. Chacon (07:56):
It's Los Angeles next week. 

Eva Sheie (07:58):
Next week? 

Dr. Chacon (07:58):
Yeah. I film something next week in LA. I went to school there and I used to live in LA for three years, and I almost moved there permanently. But I do love Florida, so I live here mostly. 

Eva Sheie (08:13):
And are you planning to stay here then? 

Dr. Chacon (08:15):
Yeah, these are where my roots are. This is where my family is. I find it easier or has been as of late to live here. It's gotten more expensive. Definitely Florida has attracted more immigration. I do like LA, I consider it my second home, and I would say Alaska is my third home. 

Eva Sheie (08:35):
So what part of Alaska are you going to? 

Dr. Chacon (08:38):
So I worked in Barrow, which was the Arctic slope, and that was all the way at the top. So that's actually the northernmost point of the United States. It's about over a hundred miles above the Arctic Circle. So very interesting to come from Miami all the way there. There's actually a couple differences I want to point out that I was not aware of. So there are no trees and there's no plants. So summer is really short. You do see the ground most of the time it's covered by snow, as you would expect, like five feet of snow. It's permafrost, so the ground is frozen and it's tundra. It's arctic tundra. So there's not many things that are capable of growing there. Most of the animals are white. They just blend into the background. So you'll see snowy owls, that's really common. Foxes will be white, and actually that's where they have polar bears and they're white. They're also really, really big. They're 2000 pounds, and since there's no vegetables, farming is pretty much non existent, most of the animals are carnivorous, so it is kind of dangerous. If you are outside, you could get eaten. 

Eva Sheie (09:57):
So it's cold. There's nothing growing. The animals are all white and they just eat each other. Okay, got it. 

Dr. Chacon (10:04):
Yeah, there's lots of hunting as you would expect. The foods really expensive there. There's no Whole Foods at all actually. There's no chains of anything. There's not even a McDonald's or any of that.

Eva Sheie (10:16):
How many people total are even there? 

Dr. Chacon (10:18):
So Barrow's the hub of the Arctic, and it's like 4,000, which is actually not bad. That's huge for that area. They do have small little villages where it's like one to 200 people. They do have places in Alaska where three people live or they have a population of three or 50 or very little. And it's mostly in Pac, which is a type of Inuit tribe that has commonalities with Greenland. So the Inuit spans Eastern Russia. There's a province called, I'm blanking out on what it's called, Chuka, which is similar to Barrow. It's like right across the Bering Strait. And it also has similar climates. They do similar types of hunting for walrus seal and whales. They do bowhead whales, which are really large. They're 2000, 2000 tons. I have to double check the weight of a bowhead whale, but it's huge. And actually four can feed an entire village, and they spread them out to other villages. And once they hunt a bowhead whale, it takes many people to do that. It's a life-threatening activity. There can be deaths resulting from that. These are icy waters that are usually frozen most of the year, and so they take a small boat with 20 hunters on it, and they just kind of take a spear that has a balm attached to it, and it explodes in the whale, pretty much. In the past, it used to be just a harpoon or spear, but now they've made it a little more common and then they drag it on the ice. That whole process is pretty life-threatening for the hunter as well. This is a tradition. I've actually tasted whale, seal, all those animals. I've had walrus as well. It's actually really good. 

Eva Sheie (12:19):
So is there a doctor in Barrow year round? 

Dr. Chacon (12:23):
There's primary care physicians, like one or two, very few family. Family medicine mostly. I was the first dermatologist there. 

Eva Sheie (12:33):
So how often are you there? Is that something you do once a quarter?

Dr. Chacon (12:35):
I was going quarterly. Yeah. There aren't that many patients to go more often, but there's definitely a lot of skin problems because of the cold and there's a lot of eczema. I prescribe a lot of Dupixent there because of the eczema. And also it's federally funded, so it's somewhat easier to get the medications for them than an average patient. 

Eva Sheie (13:00):
There is a silver lining then. 

Dr. Chacon (13:02):
Yeah. 

Eva Sheie (13:03):
So can you see Russia from Barrow? 

Dr. Chacon (13:06):
I was never able to see it. So actually standing from the tip of the beach, it's different depending on what season you're in. There's always ice on the Arctic Ocean. There's always slabs of ice. It's never warm. You can never jump in thinking that going to be a warm summer day. It, it's always freezing. The closer you are to the ocean and the slabs of ice, the more you will see things like polar bears. So you got to be careful. No one really just hangs out at the beach by themselves because they could get eaten. The polar bears hang out on slabs of ice, and they have three months of sunlight, so it's just straight up sunlight. You could walk out of your house at three o'clock in the morning and it looks like it's 3:00 PM or one o'clock, it doesn't matter. It's just sunlight. 24 hours a day in the summertime for three months. And then in the wintertime, it's like that for three months, the opposite, where it's just pitch black. And actually at 1:00 PM you see a hint of orange, but that's actually not the sun. That's the distal most rays of the sun, the distal most ray. So you won't actually see a sun, you'll just see a tinge of orange in the horizon. 

Eva Sheie (14:23):
This life you've built for yourself, sounds to me like a lot of extremes. Opposites. Opposites. Is there anywhere else in your life where you're doing this similar kind of opposite thing? 

Dr. Chacon (14:36):
No, but I really like to do this and I'd like to make it more international. As I mentioned in Greenland, they're trying to get me a medical license so I could see patients which are similar to the ones in Alaska, and in fact, Greenland, they've preserved the language, so they've preserved the Inuit language. Whereas in Canada and the United States, because of the boarding schools and a lot of the oppression we had of the cultures, when Alaska became a state or even before that when it was a territory, a lot of them were forced to boarding schools. It's hard to revive that language. They teach it at universities in Alaska, but it's really hard to revive that in Greenland. It's the official language, I believe. And most people speak the Inuit language, which is

Eva Sheie (15:27):
Do you speak it? 

Dr. Chacon (15:27):
No, it's really hard. 

Eva Sheie (15:29):
They didn't translate i c d 10 codes into Inuit yet?

Dr. Chacon (15:34):
No, and they also have a different alphabet, at least when I've seen signs and things. They'll have triangles, they'll have different crosses, and it's a different language entirely and alphabet.

Eva Sheie (15:48):
It's really. I feel like any word I choose is going to sound really just corny and silly. It's very inspiring what you're doing. 

Dr. Chacon (15:56):
Thank you. 

Eva Sheie (15:58):
Is there something in your past that triggered you? See, now it's the end of the day, so I'm not pulling the best of words. I've been visualizing ice road truckers and the deadliest catch to try to pull up what does this look like and how do I ask smart questions about what we're doing. But I'm really kind of dumbfounded. I've never heard anything like this. 

Dr. Chacon (16:20):
Yeah, it was definitely different and out there, no, really, I just always look for new opportunities that are enriching, even if I'm extremely busy, which I am. It just actually was an email that was sent to me, and then I just expressed interest and 

Eva Sheie (16:36):
And you were the only one, and so they said you're in. 

Dr. Chacon (16:39):
Yeah. Well, I think I was the most reasonably priced dermatologists. Most dermatologists charge a lot more. It does take a lot of time to do this, whether it's traveling, being stuck at the airport, it takes a lot of time. 

Eva Sheie (16:53):
Well, I applaud you for being this bold. 

Dr. Chacon (16:55):
Thanks. 

Eva Sheie (16:57):
It takes a rare kind of person to do work like this. 

Dr. Chacon (17:01):
Thank you. 

Eva Sheie (17:02):
What do you want patients to know about you before they come see you? 

Dr. Chacon (17:06):
So I kind of want them to know I really enjoy practicing medicine. It's really what I've wanted my whole life, and I enjoy being a doctor, and I like seeing patients. I'm never bored. I'm always accessible. So whether I'm physically there or whether you're able to physically see me or not, you'll be able to communicate with me and my staff either the same day or the day after. And that I'm always learning and working on different opportunities, and I'm pretty open-minded and keep up to date with literature and really that I'm mostly willing to work with everyone as long as it doesn't harm the patient. 

Eva Sheie (17:48):
Does the visual nature of dermatology make it a little bit easier to treat people or help people from across the other side of the world? You can look at a picture and say, I know what to do with that. 

Dr. Chacon (17:59):
Yeah, of course. I mean, I never was really dumbfounded by anything I saw except the obvious signs of extreme temperatures, which we also have in Florida because it's really hot. 

Eva Sheie (18:15):
If someone's listening today and they want to learn more about your practice and come see you either in Miami or in Barrow. 

Dr. Chacon (18:21):
Yeah. 

Eva Sheie (18:22):
How do they get ahold of you? 

Dr. Chacon (18:24):
Of course. So the easiest thing to do is follow me at Miami Derm and I actually have a channel on Instagram. I have 10 staff members, medical assistants that manage my communication portals. You could join my practice for free. There's a signup on my Instagram as well as Facebook, and we're pretty accommodating. We usually don't take many insurance plans. We had tried, but they do not want to partner with small physicians. They actually keep telling us they're saturated, which is common in big cities. It's very hard. We've been trying since December, 2022, but we're actually doing really quite well, not taking them, and we don't even think that's necessary in the future. But if a patient really wants that, we will apply. Of course, it depends on the insurance if they want to take us or not, but we're pretty open-minded and kind. I would say the easiest way to start is just by following me on Instagram at Miami Derm, and I'm on Twitter, Facebook, TikTok, YouTube as well, and that's it. And we also have a channel, and actually on Instagram, I'm one of the creators, so I was invited by Instagram actually Wednesday I went to an event. I was the only doctor there here in Miami, and it was sponsored by Instagram. It was for creators that had met a certain threshold and busy me. I was not going to go, and I'm really glad I did because it really opened a lot of doors. And so I'm very active on that platform. 

Eva Sheie (19:57):
That is an accolade you can actually use. 

Dr. Chacon (19:59):
Yeah, so I'm really excited about that. And of course, to work with RealSelf, yeah.

Eva Sheie (20:08):
The mission of RealSelf is to help people connect with good doctors. So hopefully that's working. 

Dr. Chacon (20:13):
Awesome. 

Eva Sheie (20:15):
Excellent. 

Dr. Chacon (20:15):
Well, you thank you so much and thanks for having me. I really wish I could film the video, but I'm not sure if I have time. 

Eva Sheie (20:21):
It's okay. I am glad I got you on the podcast and that

Dr. Chacon (20:25):
Of course. 

Eva Sheie (20:26):
yeah. It was really a privilege getting to hear your story, and I thank you. 

Dr. Chacon (20:30):
Awesome. Thank you so much. Appreciate it. 

Eva Sheie (20:35):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links, including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at Meet the Doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, t h e a x i s.io.