Self-reliance, determination, build passion for dermatology, state-of- the-art practice

Self-reliance, determination, build passion for dermatology, state-of- the-art practice

Feb 1, 2006
By: Maureen Hrehocik
Dermatology Times

It is a perfect fall Sunday afternoon in Northeast Ohio. The sun glints off jewel-toned leaves and sends a spectrum of color flooding into the well-appointed office of Helen M. Torok, M.D.

She has just finished a training session with one of her M.D. associates, her husband, Leonard Torok, M.D., an orthopedic surgeon, and a representative from a laser company. The representative says her goodbyes after Dr. Torok loads her up with a bottle of wine for the holidays, a basket of products from her spa and two muffins "for the road."

"I just called her a few days ago, and she dropped everything to come here and train us on a Sunday," Dr. Torok relates. "It's the least I could do."

'Dirt poor'
Rising from "dirt poor" beginnings as a 10-year-old German immigrant, when enough food, clothes and other necessities were sometimes nonexistent, Dr. Torok has built Trillium Creek, a 24,000-square-foot, $10 million state-of-the-art campus on 35 acres in Medina, Ohio, a community with a population of less than 30,000.

There are plans within the next year and a half to install a "cosmetic enhancement center" focusing on Botox (Allergan), fillers and lasers in the current spa area, and to build a new, 6,000-square-foot dermaspa. There are also plans for an enlarged surgery center and for adding a plastic surgeon. The campus already has a conference center, clinical research center, spa and holistic medicine facility.

Many times in Dr. Torok's life she has swum against the current. Her plans to become a cloistered nun were quashed by her very strict stepfather, who burned her application. The next day, he yanked her out of Catholic school, placed her in public school and told her she would become a doctor.

With no money to finance her college education, she worked hard and won a full academic scholarship to Case Western Reserve University in Cleveland; as medical school loomed and with no financial assistance in sight, she worked three jobs to put herself through the first accelerated three-year program at The Ohio State University, where she had two weeks off, total; when she decided to build a state-of-the-art practice in Medina, many of her colleagues asked why she wanted to practice in "cow country."

She has had her share of personal family tragedies, as well.

Galvanized determination
For some, adversity can erode self-confidence and ambition. For Dr. Torok, adversity galvanized her to push harder, no matter what. Once she found her "passion," dermatology, she never looked back.

While she gives equal credit for her success to her husband, Leonard, who also has a holistic practice and helps with laser procedures at Trillium Creek, and to her younger daughter, Heather, an M.B.A., who is CEO of Trillium Creek, Dr. Torok is the 5-foot-4-inch spark plug who created the vision and the mission of Trillium Creek. Her goal is simple: Do what's best for her patients by offering the latest technology, medical expertise and education, all in one state-of-the-art facility.

"My vision was to be able to offer the people in Medina the highest level of care and technology without them leaving the community," she says. "I'm not saying I don't refer patients. I'll be the first one to tell you if I don't know what to do, I'm going to find someone who does."

Patient and doctor education is the cornerstone of care at Trillium Creek. Dr. Torok's stepfather's dictum that "Education is your ticket to success" is ingrained in her. A practitioner for 30 years, she logged 117 hours of continuing education last year alone, when the Ohio mandate is 150 hours over three years. Thirteen-hour days are her norm. She works Saturdays when she's not traveling.

Dr. Torok credits "guts, a family support system and a generous bank" for the success of the 3-year-old practice.

"I couldn't do this without proper staffing," she tells Dermatology Times. "We have accounting people, business people, marketing people. Heather, Leonard and I meet at least three times a week and always on Sunday nights to discuss the direction of the business and the things we want to accomplish, add or modify. There are no surprises."

Currently, the practice draws from a 60-mile radius and sees 200 to 250 patients a day, five days a week. There are seven providers — Drs. Helen and Leonard Torok; Mohs surgeon Patrick Killian, M.D.; dermatologist Julie Mark, M.D.; and three physician assistants. Dr. Torok hopes to add another dermatologist and a plastic surgeon. Her elder daughter, Amy, will be joining the practice as a plastic surgeon after she completes her residency at Akron General Medical Center.

"Our overhead is high," Dr. Torok explains. "Where the average practice overhead is 40 to 55 percent, ours is 70 percent; but it will come down. We've purchased many new lasers and new technology."

A good mix
Currently, about 15 percent of the practice is cosmetic; 85 percent is medical.

"It's a good mix," she says. "When you have lean years and your patients are concerned with how they're spending their disposable income, we can rely on the medical portion, which may go up to as high as 95 percent of our practice. I would advise other practitioners to not limit your practice, unless you're a Mohs surgeon. It is good to have this marriage of a cosmetic and medical practice."

Dr. Torok says general dermatology is still very rewarding to her. She enjoys cosmetic dermatology as well, but she says the patients are more demanding, making the work more taxing and requiring more energy, time and worry.

The lifesaving and quality-of-life aspects of general dermatology are what appeal to Dr. Torok.

"If I can diagnose skin cancer or a melanoma early, get that patient treated and save someone's life — that's gratifying," she says. "Making someone more comfortable by diagnosing an allergy — that's gratifying. I do have to admit I like my older patients best. They tug at my heart. They always have a kind word and a smile, or come with a joke — or cookies."

A bend in the road
In medical school, Dr. Torok had planned to become an obstetrician. But a case of tinea versicolor changed her career path.

"When I was in medical school I got a rash and went to see the head of the dermatology department, Dr. Ed Lowney," she says. "He knew right away what I had, and his snap diagnosis puzzled me. I said to him, 'Aren't you going to do something, instead of just telling me to slap on this solution?'

"He asked me how much time I'd spent in dermatology, and I told him two weeks. I also told him it was horrible! It was the most confusing, frustrating specialty I'd ever encountered. There were 10 names for each disease, and they're all in Latin and incomprehensible! Everything looks the same.

"He said to me, 'OK, smart aleck, you're spending the next two months with me.' He wouldn't take 'no' for an answer.

"We think we control our fate," she says. "We don't."

Those next two months, Dr. Torok says, were "the most intriguing, fascinating time" in her education. "Dermatology is not an isolated specialty," she says. "There's such an interplay of different specialties — rheumatology, hematology, oncology — you can 'see' so much. It's all right there (on the skin)."

After medical school, Dr. Beno Michel at Case Western Reserve University in Cleveland told her he'd have a residency position for her, but not for another two years. She spent those two years in internal medicine at Akron General Medical Center, and then returned to Case.

"I thank Beno Michel every day of my life," she says. "I got that position two years after my internal residency at Akron."

"The day I wake up and find dermatology tedious is the day I quit, " she says. "I wake up every day excited about who I'm going to see and what I'm going to learn."