Welcome. I'm Dr Mark Donohoe, a registered Australian General Practitioner and Integrative Medicine doctor. I am a Sydney University graduate, and have worked in private practice for 30 years.

I utilise a blend of Western Medicine, Environmental Medicine, Nutritional Medicine and Complementary Medicine approaches to meet the needs of patients with complex illnesses & sensitivities.


Practice Details

Practice Hours
Monday Tuesday 9 AM - 5 PM
Wednesday - CLOSED
Thursday Friday 9 AM - 5 PM

Practice Address
4 Best Ave, Mosman NSW 2088
MAP

Postal Address
P.O. Box 328, Mosman NSW 2088

Phone & Fax
Tel:  +61 2 9960 5755
Fax: +61 2 8569 0185

Email & Web -
Mylene about all practice matters
pm@mimpractice.com

Or use this contact form

Web (you are here already!)
www.docmarky.com

 

Consulting Fees (from 15 August 2017)

New Patients
Standard New Patient $600
 Up to two hours duration including paperwork. 

For more complex cases, additional time will be billed at $300 per additional hour. Please advise at the time of booking if you need additional time, otherwise the consultation will be strictly limited to 2 hours.

Returning Patients
Face-to-face consultations
$100 per quarter hour

Vaccination advice
$100 per 15 minutes

Telephone / Skype consults / email queries
$90 per 15 minutes

Scripts and forms
Standard prescriptions from $15
Authority prescriptions from $20
Medical certificates, letters and forms charged at $60 per 10 min

Medicolegal & Commercial Consultancy  
Spot rate $550 per hour + GST
Half day (9am - 1pm, 1pm - 5pm) $1,800
Full day (8 hrs) $3,000
(plus all on-costs, travel, technology etc)


Other Practice Information

Medicare rebates 
Medicare rebates are generally applicable for Australians for all medical consultations related to illness and disease diagnosis and treatment. Medicare does not cover prevention generally, and that is one of Medicare's greatest failings! It is an excellent disease treatment system, but a poor disease prevention system.

Dr Donohoe is not (and never intends to become) RACGP vocationally registered, and all consultations are billed according to time, not complexity. There are many good reasons for this. It's too long a story to go into here.

We do not bulk-bill under any circumstances. We know this causes hardship for some clients, and we wish Medicare would rebate appropriately for consultations over 45 minutes. But they don't.

 

Long consultations and my fees
Complex and chronic illnesses are extremely difficult to manage within the constraints of normal General Practice in Australia, with its high reward for consultations under 15 minutes addressing one medical item per consultation.

Shoehorning my patients into brief consultations always resulted in compromises that I was unwilling to accept. To practice "Integrative Medicine", with my focus solely on the best care of my patients, I have had to decouple my consultations and fees from the Medicare model.

A referral from your usual doctor or health care practitioner with a brief note and copies of recent pathology and other test results is desirable but not essential for this first consultation. Any records you have accumulated through the period of your illness is also useful in the initial consultation.

The first consultation with a new patient suffering a chronic or complex illness typically requires 2 to 3 hours for me to understand the causes of, and contributions to these illnesses, to organise appropriate testing, and to commence a management program for each individual patient.

Follow-up consultation is usually 4 to 6 weeks after the initial consultation, and typically requires an hour or more to assess initial responses to treatment, to identify and explain pathology results, and develop an ongoing plan of management.

I am always happy to record the medical consultation, and my written notes are extensive and clearly describe the plan of management. If you have been referred by other health practitioner, I will usually write back to that practitioner with the details of pathology identified and a proposed management plan after this second consultation.

There is a considerable gap between my fees and the Medicare rebate for my consultations, as Medicare does not rebate beyond the 45 minute mark. I appreciate the difficulties experienced by many of my patients in meeting that shortfall, but Medicare has proven a very difficult institution to bring into this field of complex illness and chronic disease management. Believe me, I have tried!

So, we discount our usual hourly rate by over 25% for the first consultation, at $600 for two hours and $900 for three hours. Subsequent consultations are rarely as long and involved as the first one.

 



Disclaimer, conflicts of interest, and other ways I earn money

Phone, FaceTime and Skype consultations
A high proportion of my patients are very sick and come from outside the Sydney area, often from interstate or even overseas. While most of the work and planning is done at the first consultation, a follow-up consultation is usually needed, typically when the pathology and other tests results are back about six weeks after the first consultation.

Telephone or video consultations are available for such follow-up of initial response to treatment and to identify abnormalities on the pathology testing which require additional or alternative treatment, further testing or referral.

The duration of these consultations can vary from a few minutes to more than an hour and are billed in increments of 10 minutes.

 

Pathology and other tests requested
Dr Donohoe will typically request specific testing following the first consultation, and often after subsequent consultations. Many of the tests attract a Medicare rebate, but different pathologists have wildly differing policies on billing, and out-of-pocket costs can vary from $0 to many hundreds of dollars. Please check with the practice about pathologists recommended to keep the cost of testing low.

 

Non-rebatable pathology
Medicare does not cover costs of so-called "screening" (sets of tests to screen for future disease risk), nor most tests designed for prevention of serious disease. However much we may disagree with this, these are Medicare regulations. Medicare covers a specified set of tests reasonably required for the diagnosis and management of disease.

Some tests (e.g. urinary iodine, some thyroid tests, specific genetic tests and "functional pathology" tests) do not attract Medicare rebates under any circumstances. If it is not clear, please ask Mark.

 

Treatments
I am a GP, so many prescribed treatments are PBS subsidised, reducing costs to my patients. However, Integrative Medicine often utilises supplements, compounded prescribed products and other non-drug therapies (mindfulness, meditation etc), and these are not usually subsidised except by some private health funds.

 

Selling treatments
I derive my  medical practice income from consultations, and not from the sale of any medications, supplements or products to my patients. This maintains what I regard as a necessary separation between prescriber and prescription, and removes any conflict of interest in deciding what prescriptions are necessary.

That being said, there are a number of therapeutics that I prescribe that are not easily available in Australia, or are available only at considerable cost or with considerable difficulty. When this results in patients failing to take their prescribed treatment, we try to source these products for my patients at the lowest possible cost and for their convenience.

I do a considerable amount of work outside my medical practice utilising my knowledge and skills derived from 30 years of practice in Medicine, Environmental Medicine, Nutritional Medicine and medical research. Some of this work is done for free, while other work is paid. I advise on and organise research, I help create and run educational events for doctors and other healthcare practitioners, I present at community and other conferences, and I promote the concept of Complementary Medicine and Integrative Medicine in the areas of prevention, sustainable health promotion and disease management. 

Specifically, I work with a number of companies and organisations in the field of complementary medicine in areas of practitioner education, podcasting, symposium content and management, and advice in areas of my clinical expertise. I do not promote products to the public, but I do promote the use generic nutrients such as omega-3 fats, vitamin D and iodine.

I am also one of the directors of the Centre for Evidence-Based Complementary Medicine (CEBCoM), and have been involved in assessment of therapeutic and diagnostic products since 2009. We independently assess the quality of evidence for a broad range of therapeutic interventions, and we are paid for this work. We also develop apps to facilitate education and communication in the areas of complementary medicine. If you're an iPad user, you can download the Friends of Complementary Medicine (FoCM) App from iTunes.

The companies and groups I work for vary over time, and include (or have included) Bioceuticals, Blackmores, Blackmores Institute, Flordis, YourHealth, MedlabComplementary Medicines Australia (formerly CHC), ASMI, BioConcepts, Newcastle University, National Institute of Complementary Medicine (NICM) –  all of them businesses and organisations run by people I know and respect as ethical and committed to the highest quality of patient care and practitioner support.