What happens when a physician knows a patient still has a chance — but the hospital, the insurance company, and the nursing staff have all decided it's time to let go?

Dr. Anna Chacon, board-certified dermatologist and host of Skin Deep, welcomes a truly singular guest — her father, Dr. Arsenio Chacon. A retired critical care pediatrician with more than thirty years of practice in Miami, Dr. Arsenio trained at Cook County Hospital in Chicago and spent the bulk of his career leading the pediatric critical care unit at Baptist Hospital. What drove three decades in one of medicine's most demanding specialties? A conviction that took root in rural Cuba and never left: that a physician's most important quality, beyond clinical skill, is the courage to act on instinct when every force in the room is telling you to stand down.

From a childhood of coffee trees and cane fields in rural Cuba to the political persecution that forced his family's escape, Dr. Arsenio traces the origins of a resilience that would define his entire career. What does it mean to fight for a patient's life when the insurance company, the hospital administration, and even the nursing staff have already moved on? He's direct about it. He also offers candid views on why physicians must educate themselves in business — or risk being exploited by those who did. "The patient is the one with the disease," he says. That one principle, he explains, protected his family life as much as it shaped his clinical practice. A rare and personal conversation.

Dr. Arsenio Chacon is a retired physician who practiced critical care pediatrics in Miami, Florida for over thirty years. Born in rural Cuba and raised amid political upheaval, he immigrated to the United States as a teenager with his family, overcoming language barriers and cultural displacement to pursue medicine. He completed a pediatrics residency at Cook County Hospital in Chicago and a fellowship in critical care, ultimately leading the intensive care unit at Baptist Hospital in Miami. Known for his clinical perseverance, ethical integrity, and outspoken advocacy for physician business literacy, Dr. Chacon retired from practice and is the proud father of host Dr. Anna Chacon.

In This Episode:

• (00:00) Dr. Anna Chacon welcomes her most personal guest yet to Skin Deep
• (03:30) A father jailed for his politics, a mother who sold coffee on the black market, and the family's escape from Cuba
• (09:36) The one rule Dr. Arsenio never broke — and the advice he gives every doctor who wants a sane life
• (16:47) From Cook County's busiest wards to Miami's ICUs — how a critical care career was built
• (24:31) Why a physician must hold the line when the hospital, the insurance company, and the nurses have all moved on
• (33:40) What living with Opus Dei priests taught a future doctor about discipline, methodology, and never improvising
• (45:55) When administrators outearn the physicians — and why every doctor needs to understand business
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-cer...

• (00:00:00) - Skin Deep
• (00:07:02) - How to transition from dermatology to pediatrics
• (00:16:25) - Inspiring doctors: Dr. J. Janakiraman
• (00:24:27) - Don't Give Up
• (00:29:36) - Cuban doctors on the issues of nationality
• (00:39:00) - How to survive a melanoma in the United States
• (00:46:53) - Cuban doctors learn the business of medicine

Why did a successful solo aesthetics business owner close three locations in two years to join a med spa?

Dr. Chacon welcomes award-winning Miami aesthetician Ornella Lopresti to Skin Deep. Ornella shares her unique journey from graduating Miami Senior High's cosmetology program with her full specialty license at 18 to becoming a competitive esthetician who approaches every treatment with championship-level precision. With over a decade in aesthetics—including three years in med spa settings and work with luxury brands like Clarins and La Prairie—Ornella discusses her evolution from solo entrepreneur to successful med spa professional. Her expertise centers on anti-aging treatments, sensitive skin care, and microneedling, with a refreshing emphasis on setting professional boundaries and maintaining quality standards.

The conversation explores critical topics for both professionals and patients in the aesthetics world. Are there red flags clients should watch for when choosing an esthetician? What's the reality behind trending treatments like salmon DNA and Morpheus? Ornella candidly discusses the financial challenges of solo practice, why she transitioned to a med spa model, and the importance of medical oversight for procedures like microneedling. From social media strategies to firing difficult clients, this episode delivers honest insights into the business of beauty. Plus, discover why a tinted SPF 50 is her desert island product and learn the one facial treatment she believes transforms skin better than any other.

Ornella Lopresti is an award-winning aesthetician based in Miami with over 10 years of experience in the beauty and skincare industry. A graduate of Miami Senior High's cosmetology program, she earned her full specialty license in facials, waxing, and nails before turning 18 and competed at regional and state levels. Her career spans luxury skincare companies including Clarins, La Prairie, and Sisley, culminating in founding Fountain of Youth Beauty before transitioning to med spa settings. Specializing in anti-aging treatments, sensitive skin care, and microneedling, Ornella combines championship-level precision with genuine client care. She also offers pop-up facial services in Orlando and provides complimentary skin consultations to help clients navigate their skincare journeys.

In This Episode:

• (00:00) Award-winning aesthetician Ornella Lopresti and her Miami journey
• (02:35) Competitive cosmetology training and the importance of industry standards
• (05:59) Birth of Fountain of Youth Beauty and transitioning from corporate to solo practice
• (10:39) Wearing all the hats: the realities of entrepreneurship versus med spa employment
• (14:25) Trending treatments explained: salmon DNA, exosomes, and what's worth the investment
• (17:45) Red flags in aesthetics: why medical oversight and licensing matter
• (22:05) Professional boundaries and when to fire a client
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, spec...

• (00:00:00) - Esthetician on Entrepreneurship
• (00:01:32) - Miami Senior High Cosmetology Student
• (00:03:10) - How Fontaine of Youth Beauty started
• (00:06:27) - Florence Fountain of Youth Beauty
• (00:07:39) - How to manage a med spa business effectively
• (00:11:12) - What kind of certifications or training is required? How long is
• (00:16:06) - Red Flags in the Esthetics Industry
• (00:18:00) - Morphenes for the Face
• (00:20:29) - What would you say is your favorite facial treatment?

Is locum tenens just a gap year option, or could it be the foundation for long-term financial freedom and lifestyle design?

Dr. Anna Chacon welcomes Dr. Genevieve Jacobs, a board-certified physician who launched her locum tenens career immediately after residency in 2020. Why did Dr. Jacobs choose temporary assignments over traditional employment? She shares how this path allowed her to work across the United States and internationally while maintaining complete autonomy over her schedule. Beyond clinical work, Dr. Jacobs has built a thriving consulting business, presenting to prestigious residency programs including Johns Hopkins, Yale, and Cleveland Clinic while creating digital courses filmed across five countries.

The conversation explores the financial realities of locum work, from negotiating competitive rates to maximizing tax advantages through LLC structures. Dr. Jacobs reveals her strategies for avoiding red flags in assignments, streamlining the credentialing process, and maintaining secure document management systems. They discuss international opportunities, the challenges of licensing in different provinces and countries, and how locum tenens can serve as both a lifestyle choice and a legitimate small business model for physicians seeking flexibility without sacrificing income.

Dr. Genevieve Jacobs is a board-certified physician who began her locum tenens career directly after residency in 2020. Passionate about travel and flexibility, she has worked in diverse U.S. locations including Alaska, Montana, and California, as well as pursuing international assignments. Dr. Jacobs has built a consulting business to guide physicians into locum tenens, offering digital resources, courses filmed across five countries, and presentations to residency programs at Johns Hopkins, Yale, and Cleveland Clinic. She shares expertise on workplace insights, licensing, credentialing, compensation negotiation, and the business side of locum tenens, empowering physicians to balance professional growth with personal fulfillment while maintaining financial independence.

In This Episode:

• (00:00) Dr. Jacobs explains how she discovered locum tenens and why she chose this path immediately after residency
• (03:46) Building a consulting business and creating digital courses for physicians across multiple countries
• (07:03) Understanding locum agencies, finding reliable recruiters, and identifying red flags in assignments
• (15:50) Navigating licensing, credentialing, and the IMLC process for multi-state practice
• (21:16) Negotiating competitive rates and the financial realities of locum tenens compensation
• (26:04) Leveraging locum work as a small business with LLC benefits and tax advantages
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients in remote and rural communities. As the first dermatologist serving Alaska's Bush region, she travels by bush plane to reach isolated communities. Dr. Chacon holds medical licenses in all 50 states, DC, Guam, and the U.S. Virgin Islands, pr...

• (00:00:00) - Skin Deep
• (00:00:35) - How to start a locum tenens work in your residency
• (00:06:16) - Reveal: The Search for a Physician
• (00:08:36) - The challenges of traveling on a solo mission
• (00:12:22) - Comp Health and the Locummart monopoly
• (00:13:42) - What Happens to the VMS?
• (00:18:06) - Canada vs International Jobs
• (00:25:31) - Do locum doctors need to start a business?

Can you truly innovate in medicine without standing at the bedside?

Dr. Anna Chacon welcomes Dr. Geoff Bocobo, a physician innovator reshaping the intersection of clinical medicine and healthcare entrepreneurship. With research credentials from Brigham and Women's Hospital—where his work contributed to FDA-approved pulmonary arterial hypertension therapy—Geoff co-founded Med6, a surgical monitoring startup, and later joined Boston Consulting Group's healthcare AI practice. What drives someone to return to residency after such accomplishments? Geoff believes meaningful healthcare innovation requires ongoing clinical insight. His conviction: you cannot transform systems-level care without understanding patient care firsthand.

The conversation explores pressing public health challenges facing modern medicine. How can we shift from reactive to preventative care? Geoff identifies access and affordability as the two most critical barriers undermining quality healthcare delivery. As host of The MD Plus Podcast—a 4,000-member community for aspiring physician innovators—he shares guidance for clinicians entering biotech and health tech spaces. From generative AI applications in biopharma manufacturing to electronic health record transformations, this episode examines where clinical expertise meets technological advancement in today's evolving healthcare landscape.

Dr. Geoff Bocobo is a physician innovator, healthcare consultant, and founder of The MD Plus Podcast, a community of 4,000 aspiring clinician-entrepreneurs. His research at Brigham and Women's Hospital contributed to Sotatercept (WinRevir), an FDA-approved pulmonary arterial hypertension treatment. As co-founder of Med6, he developed automated surgical drain monitoring technology. His consulting work at Boston Consulting Group focused on generative AI applications in biopharma and government healthcare systems. Currently applying for internal medicine residency, Geoff envisions a career split between clinical practice and innovation work—believing that meaningful healthcare transformation requires sustained bedside experience to inform systems-level solutions.

In This Episode:

• (00:00) From neuroscience research to contributing to FDA-approved pulmonary hypertension therapy
• (05:00) Why successful healthcare consultants return to residency training for innovation impact
• (10:00) Inside BCG's healthcare practice: generative AI transforming biopharma manufacturing
• (15:00) Designing a career that balances clinical medicine with systems-level innovation
• (18:00) Practical advice for physician founders entering biotech and health technology spaces
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients in remote and rural communities. As the first dermatologist serving Alaska's Bush region, she travels by bush plane to reach isolated communities. Dr. Chacon holds medical licenses in all 50 states, DC, Guam, and the U.S. Virgin Islands, providing both in-person and teledermatology services.

Resources:

The MD Plus Po...

• (00:00:00) - Immunity in Healthcare: Jeff Smith's story
• (00:03:47) - Post-Post-Bacc MS in Internal Medicine
• (00:04:23) - Why Would You Go Back to Residency?
• (00:06:55) - How old are you? Just curious.
• (00:07:21) - In the Elevator With MD+
• (00:09:45) - Immigration to the Consulting World
• (00:14:36) - What legacy do you hope to leave in your work in medicine after
• (00:16:02) - The MD Podcast: From Scientific rigor to accessibility
• (00:18:14) - How to Get Out of the Medical Innovation Field

Can going back to school in your 30s or 40s actually make you a better clinician than starting straight out of college?

Dr. Anna Chacon sits down with Christina Algeciras, LMHC, a psychotherapist who transformed her career from international logistics to holistic mental health care. Christina shares her journey through corporate burnout, yoga instruction, and ultimately establishing a thriving private practice in South Florida. With a master's degree in psychotherapy completed in 2019, she brings unique insight into career reinvention, having navigated the challenges of returning to school as a non-traditional student. Her approach centers on helping clients understand the root causes of their struggles rather than surface-level symptom management.

The conversation explores the realities of mid-life career transitions, the importance of support systems during professional reinvention, and the courage required to step outside comfort zones. Christina discusses her decision to build a bespoke therapy practice that doesn't accept insurance, allowing her to focus on depth-oriented work with clients facing anxiety, depression, chronic health issues, and intergenerational trauma. How does one overcome the fear of starting over? What role does emotional intelligence play in patient care? The discussion offers valuable perspective for healthcare professionals considering alternative practice models and anyone navigating significant life transitions.

Christina Algeciras, LMHC is a psychotherapist in private practice based in South Florida who specializes in holistic, relationship-focused care. After experiencing burnout in her corporate career in international logistics, she transitioned through yoga instruction before earning her master's degree in psychotherapy, which she completed in December 2019. Christina works with diverse populations addressing anxiety, depression, trauma, chronic health conditions, and intergenerational challenges, particularly within immigrant families. Her practice philosophy emphasizes getting to the root of issues through depth-oriented work rather than insurance-dictated protocols. She is known for her commitment to individualized care and her integration of somatic practices with traditional psychotherapy.

In This Episode:

• (00:00) From corporate burnout to discovering a calling in mental health
• (05:49) Teaching yoga as a bridge between physical wellness and emotional intelligence
• (10:19) The advantages of becoming a therapist later in life and staying focused on your goal
• (15:37) The transformative power of therapy and the courage to pursue personal growth
• (20:21) Building a practice that prioritizes depth over insurance company protocols
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients in remote and rural communities. As the first dermatologist serving Alaska's Bush region, she travels by bush plane to reach isolated communities. Dr. Chacon holds medical licenses in all 50 states, DC, Guam, and the U.S. Virgin Islands, providing both in-pe...

• (00:00:00) - Skin Deep Therapy
• (00:08:37) - Coming to work at 60
• (00:12:25) - How to Get Out Of Your Career Trap
• (00:17:32) - How to start a business in the psychotherapy field
• (00:21:26) - The Immigrant Story

What are the three biggest tax mistakes Jose Cruz sees entrepreneurs make—and how do you avoid them?

In this episode of Skin Deep, Dr. Chacon welcomes Jose Cruz, CPA and founder of Cruz Tax and Advisory Group. Jose, a Cuban-American accountant who arrived in the U.S. at age three, shares his journey from a high school accounting internship to building a practice dedicated to serving immigrants and bilingual clients. What drove him to accounting? The desire to bridge the knowledge gap for those—like his parents—navigating an unfamiliar financial system. Jose believes big-firm quality should be accessible to small businesses and startups, and he's making that vision a reality in South Florida.

What are the biggest tax mistakes holding your practice back? Jose reveals common pitfalls like Schedule C misuse, inadequate expense tracking, and the misconceptions surrounding business valuation. Should you elect S-Corp status? How do CPAs differ from EAs and traditional tax preparers? What tools actually help streamline your accounting? From real estate investor strategies to the optimal timing for S-Corp conversion (hint: it's around $20-25K net profit), this conversation delivers actionable insights on maximizing deductions, avoiding IRS red flags, and building sustainable financial habits. "Accounting is the language of business," Jose reminds us—and understanding it could save your practice thousands.

Jose Cruz is a Certified Public Accountant and founder of Cruz Tax and Advisory Group, based in South Florida. Born in Cuba and arriving in the United States at age three after his parents won the Cuban lottery, Jose discovered his passion for accounting during a high school internship. His mission is simple yet powerful: deliver big-firm expertise at accessible rates to small businesses, entrepreneurs, and immigrant communities who face language and resource barriers. With experience at global and national accounting firms, Jose brings sophisticated financial strategies to mom-and-pop businesses, real estate investors, and bilingual clients. His approach emphasizes transparency, education, and relatability—helping the next generation of entrepreneurs understand complex tax strategies through plain English communication.

In This Episode:

• (0:00) Jose Cruz shares his Cuban immigrant journey and discovering accounting through a high school internship
• (3:35) The most common tax mistakes: Schedule C misuse and the importance of proper expense documentation
• (12:44) Understanding business valuation: why accurate numbers matter for lenders, investors, and sale negotiations
• (19:28) CPA versus EA versus tax preparer: knowing the credentials behind your financial advisor
• (26:01) Mileage tracking strategies: maximizing deductions through proper vehicle expense documentation
• (32:41) Essential accounting technologies: QuickBooks, mileage apps, and receipt tracking tools for busy professionals
• (38:53) S-Corp election explained: when does converting save you thousands in self-employment taxes?
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

A...

• (00:00:00) - In the Elevator With Ana Chacon
• (00:02:02) - BNI Young: Growing Your Network
• (00:03:48) - How to Avoid Tax Mistakes on Your 1040
• (00:08:43) - How to Get Audited on Your Income Tax Return
• (00:12:57) - What is a Business Valuation?
• (00:16:33) - Real Estate Tax SAVES
• (00:19:37) - What Is Working With a CPA?
• (00:21:22) - Do You Need a CPA or an EA to Prepare Your Taxes
• (00:22:54) - How to Track Everything on Your Business Income and Tax Return
• (00:26:16) - How to deduct business mileage under the Internal Revenue Code
• (00:29:04) - How the Tax Law Impacted Clients
• (00:32:52) - Other Accounting Technologies for Small Business Owners
• (00:38:42) - "Tick tock: A Tax Talk Podcast"
• (00:39:03) - Can an S Corp Save You Money?

Could telehealth services make you eligible for Puerto Rico's 4% tax rate and 0% capital gains?

Dr. Chacon speaks with Víctor Delerme, CPA, founder of Delerme CPA with offices in San Juan, Miami, and Atlanta. With over 16 years of experience and licenses in both Puerto Rico and Georgia, Víctor specializes in helping high-income physicians, entrepreneurs, and investors dramatically reduce their tax burden through Puerto Rico's Act 60 incentives. What if you could reduce your tax rate from 50% to as low as 4%—or even 2%—on export services, and pay 0% on capital gains? Víctor explains how relocating to Puerto Rico offers physicians practicing telehealth unprecedented opportunities to build wealth rather than surrender it to excessive taxation.

The conversation explores Puerto Rico's distinct tax incentives for both business owners and investors, compliance requirements including the six-month residency rule, and the critical importance of working with strategists who understand both U.S. and Puerto Rico tax law. Víctor shares compelling success stories, including one client who recovered $800,000 in overpaid taxes. They discuss the holistic planning approach necessary for a smooth transition, emerging trends in global tax mobility, practical considerations for establishing a medical practice in Puerto Rico, and why proper guidance makes all the difference in maximizing these life-changing opportunities.

Víctor Delerme, CPA, is the founder of Delerme CPA, a boutique tax advisory firm specializing in Puerto Rico's Act 60 incentives with offices in San Juan, Miami, and Atlanta. Licensed in both Puerto Rico and Georgia, Víctor leverages over 16 years of experience helping physicians, entrepreneurs, and high-income earners keep more of what they earn through strategic, compliant tax planning. After beginning his career at KPMG and working with regional firms in Atlanta, he identified a critical gap in personalized tax strategy and built a team of 30+ professionals dedicated to export service optimization, capital gains planning, cryptocurrency strategies, and international tax structuring. What sets Víctor apart? His holistic approach combines deep expertise in both U.S. and Puerto Rico tax law with genuine understanding of each client's financial goals and lifestyle, ensuring seamless transitions that transform tax burdens into wealth-building opportunities.

In This Episode:

• (00:00) How high-income physicians can reduce tax rates from 50% to as low as 4% or even 2%
• (05:00) Puerto Rico's dual tax incentives: 4% on export services and 0% on capital gains
• (10:41) Compliance requirements, the six-month residency rule, and addressing audit concerns
• (16:07) Success story: How one client recovered $800,000 in overpaid taxes
• (22:07) First steps for business owners considering relocation to Puerto Rico
• (27:19) Establishing a medical practice in Puerto Rico and understanding the market
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients...

• (00:00:00) - CPA Victor Delerme on Puerto Rico Taxes
• (00:02:32) - Don't Overpay Taxes
• (00:05:04) - Puerto Rico tax incentives for doctors and business owners
• (00:12:49) - Are Tax Aspirations Common in Puerto Rico?
• (00:14:24) - How do you approach the Puerto Rico tax incentive?
• (00:16:03) - Tax Success Story
• (00:18:26) - Starting a firm after earning your CPA
• (00:20:22) - How to Prepare and Prepare Tax Returns in Puerto Rico
• (00:23:32) - What trends do you see in global mobility taxation?
• (00:24:57) - MDs on the Cost of Relocating to Puerto Rico
• (00:29:08) - What is the youngest person you have helped?