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 34 years. I am a Fellow of the Australasian Society of Lifestyle Medicine (FASLM), a Fellow of the Australian College of Nutritional and Environmental Medicine (FACNEM) and have worked in the area of Environmental and Nutritional Medicine for over 33 years.
I utilise a blend of Western Medicine, Environmental Medicine, Nutritional Medicine and Lifestyle Medicine approaches to meet the needs of patients with complex illnesses & sensitivities. Digby is my cavalier-maltese-poodle pooch, and he has walked me ten thousand kilometres in his 10 years! (#getadog)
I see patients from around Australia and overseas with complex illnesses, including chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), fibromyalgia (FM), chemical toxicity and sensitivities (MCS) and chronic inflammation. Treatment usually starts with non-drug therapies, including diet, exercise and lifestyle change, moving on to specific, individualised therapeutic needs of each patient.
I have developed a stepwise approach (GEMINI) for assessment and treatment of complex syndromes and diseases, and while I am comfortable with prescribing drug therapies when necessary, my preference is for very specific non drug therapies to restore capacity and balance, and to achieve long-term, sustainable recovery.
An outline of these approaches can be found on this site.
Other Practice Information
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.
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)
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.
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.
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.
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 34 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 Lifestyle 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.
The companies and groups I work for vary over time, and include (or have included) Bioceuticals, Blackmores, Blackmores Institute, Flordis, YourHealth, Medlab, Complementary 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.
The following is written in the third person, because it just sounds wrong if I say that I have done these things myself. If you would like my current CV please email me.
About Dr Donohoe
Dr Mark Donohoe is one of Australia’s most experienced and best known medical practitioners in the fields of Nutritional and Environmental Medicine. He has a long history working in the emerging field of “integrative medicine”, and continues to bring orthodox & complementary medicine together in his Cremorne medical practice..
The underlying philosophy of Dr Donohoe’s practice is that knowledge and understanding provide people with the ability to manage their own health, and even to heal themselves.
Understanding the contribution of stress, nutrition, the work and home environment and genetics to health and illness provides the best opportunities to make specific and profound changes often required to return to health.
Dr Donohoe’s experience and knowledge of complex medical conditions, and his use of orthodox & complementary modalities and management options approach to identifying and managing chronic illness.
Dr Mark's Brief Biography in Complementary Medicine
Mark Donohoe graduated from the Faculty of Medicine at Sydney University in 1980, and has worked in private practice since 1983. He works in General Practice in Cremorne, Sydney, where he sees patients suffering complex medical illness, including CFS/ME, fibromyalgia and chemical sensitivities
He has specialised in environmental and nutritional medicine for twenty eight years, is a Fellow of ACNEM, and in 1994 was elected founding president of the the Australian Comprehensive Medicine Association (ACMA), which has since become the Australian Integrative Medicine Association (AIMA). From 2004 to 2010, he was founding president of the Natural Health Care Alliance (NHCA), a national body representing the Natural Healthcare / Complementary Medicine profession.
Dr Donohoe and other medical colleagues experienced in Integrative Medicine have established the Centre for Evidence-Based Complementary Medicine (CEBCoM), a private venture committed to building the evidence-base for natural, complementary and integrative medicine approaches to prevention and treatment of disease.
Dr Donohoe is committed to the goal of identifying the best and most clinically relevant Complementary Medicine research to support IM practitioners and improve health outcomes for all Australians.
Dr Donohoe continues in private practice at Mosman in Sydney, where he averages 90 minutes per consultation with patients mainly referred by other integrative and complementary healthcare practitioners.