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Telemedicine: Complement To Health Care

Today, we have one physician per 325 patients in the US, medical schools provide about 18,938 new graduates who enter the workforce every year, according to the latest AMA statistics.

The US grows at a rate of 3.0 per 1,000 people per year (975k new patients every year).

As you can see, it will be impossible to keep up the pace of our growth as a country and still deliver good quality care that can reach everyone.


What is Telemedicine?

Telemedicine is the use of telecommunication and information technology to provide clinical healthcare remotely.



  • Monitor patients remotely and receive alerts when something is wrong, decreasing the possibility of a patient to go to the ER or being hospitalized.
  • Doctors can examine patients while away, giving doctors more control of their time and quality of life while still delivering non-emergent care to their patients.telemedicine device
  • A patient can connect with a physician from home via a HIPAA-compliant video conference for non-urgent medical matters.
  • Patients are able to go anywhere in the world and be examined, advised and eventually treated by her/his own primary care.
  • Patients can overcome distance bars and increase access to medical care services that would often not be consistently available in distant rural communities areas.
  • To save lives in critical care and emergency situations.
  • You are able to save time and money and travel expenses. Doctors are happier because they can work from their offices, home or any part of the world.

Telemedicine Applies To All Sectors:

Treating direct to consumer, helping practices increase their reach to patients, monitoring chronic disease thereby preventing future hospitalizations and even treating patients in the hospital in an acute care setting.


It could be as simple as a phone call or HIPAA-compliant video communication to your doctor to as sophisticated as being able to examine and listen to heart, abdominal and lung sounds remote, allowing to start lifesaving treatment right away.

You are able to save time and money, and travel expenses. Doctors are happier because they can work from their offices, home or any part of the world.

Telemedicine treatment


Definitely not, telemedicine is a very powerful tool to empower patients and increase the doctor’s reach. More than a replacement, I see it as a complement to medicine. We probably will be able to do more each year as technology advances. For example, the use of augmented and virtual reality might allow doctors to palpate patients remotely in the decades to come.

Meet Dr. Samuel Maghidman of SM Concierge Medicine

Dr. Samuel MaghidmanToday we’d like to introduce you to Dr. Samuel Maghidman.

Dr. Maghidman specializes in Internal Medicine. A Diplomate of the American Board of Internal Medicine (ABIM), he is a graduate of the prestigious University of Texas at the Texas Medical Center in Houston-Texas.

He was born and raised in Lima, Peru. He was a scholar in Medicine at Universidad Peruana Cayetano Heredia school of medicine, the most prestigious school of medicine in the country. He was awarded the first place for scientific achievement at the VIII National Scientific Congress of Medical Students, among others like the Pedro Weiss award and Roemmers award.

He then moved to Houston, Texas where he worked in Genetic Research at the University of Texas Health Science Center. This work was then widely recognized and published in different prominent medical journals. It was in Houston where he did his Internal Medicine training at Hermann Memorial Hospital and University of Texas Medical School working also at different hospitals on the world-renowned Texas Medical Center.

Dr. Maghidman did his HIV Disease Fellowship at the University of Texas Medical School and upon completion moved to Miami Beach to start his Internal Medicine and HIV private practice. He has over six years of experience practicing medicine in their community.

Overall, has it been relatively smooth? If not, what were some of the struggles along the way?
Smooth road initially, but lately many struggles and challenges and finally rewarding once I open my Concierge Practice.

SM Concierge Medicine – what should we know? What do you guys do best? What sets you apart from the competition?
SM Concierge Medicine is a revolutionary approach to medical care. We build a personal relationship with every patient that allows us to proactively care for their well being. At SM Concierge Medicine, we focus primarily on preventive medicine. We use highly-advanced diagnostic techniques to tailor our care to your individual medical needs.

At SM Concierge Medicine, we believe a few minutes is simply not enough time to build a meaningful relationship with a patient or provide care that is in a patient’s best interest. That’s why we do things differently. We limit our practice. As a result, each patient is assured the highest level of service and convenience in an unhurried manner.

Having a small practice allows Dr. Maghidman to pay special attention to the details, giving the quality of care that you deserve. You will never feel rushed during your visit. We schedule generous appointment times, so you have plenty of time to discuss all healthcare concerns. At the conclusion of your visit, Dr. Maghidman will give you and your family all the necessary tools to stay on top of your health.



HIV Diagnostic

An estimated 10 to 60 percent of individuals with early HIV infection will not experience symptoms. The exact proportion is difficult to estimate since patients generally seek medical attention because of symptoms, and thus asymptomatic infections often remain undetected.

An estimated 1.1 million persons in the United States have been infected with HIV; at the end of 2003, approximately 405,926 persons were living with AIDS. The number of reported cases in 2003 was essentially the same as the number in 1999. This trend follows a period of sharp decline in reported cases after the introduction of HAART (Highly Active Antiretroviral Therapy).
The tests to detect HIV are based on detecting either an antibody (our body own immune response) or an antigen( the virus or parts of the virus itself).

The standard third generation enzyme linked immunosorbent assays (ELISAs or immunoassays) used in clinical practice and in blood banks in the United States do not detect antibodies to Human immunodeficiency virus until three to seven weeks after symptoms.

Thus, depending on the time since infection and the sensitivity of the ELISA used, patients with acute Human immunodeficiency virus infection may have both a negative ELISA test and a negative Western Blot test or a positive ELISA with a negative or indeterminate Western Blot.

HIV RNA detection (Viral Load) — Early infection is characterized by markedly elevated Human immunodeficiency virus RNA levels or viral load, easily detectable with the HIV RNA (viral load) assays commonly used for monitoring of HIV disease.

Following infection, the time at which antibodies against Human immunodeficiency virus antigens can be detected in the serum depends upon the sensitivity of the serologic test as well as the person’s own immune system.


HIV Preexposure and Post exposure prophylaxisAlthough research is ongoing, there is no available HIV vaccine to date. In the meantime, clinical trials are evaluating whether regular or preexposure use of antiretroviral therapy provides additional protection for HIV-negative persons at high risk of infection who are offered standard preventive care with advanced laboratory testing, including HIV testing, counseling, condoms, and management of sexually transmitted infections.

Currently, preexposure or post exposure prophylaxis involves the administration of ARV (HIV meications) to prevent the transmission of the virus either before or after the exposure.

The role of antiretroviral therapy (ART) in preventing HIV infection was first evaluated in pregnant women to decrease the risk of mother to child transmission (MTCT) and among healthcare personnel who had accidental needlestick exposures.

HIV Preexposure and Post exposure prophylaxisThese limited data form the basis for the current recommendations for postexposure prophylaxis after sexual or injection drug use exposures.

  • The overall risk of contracting HIV from any single exposure to body fluids from an HIV-infected patient from nonoccupational exposures is low.
  • It is important to determine the exact nature of the HIV exposure (eg, unprotected sexual intercourse or injection drug use), which may confer varying levels of risk. For example, receptive anal intercourse carries a higher risk of HIV acquisition than other exposures, such as vaginal intercourse.
  • Level of viremia (viral load) in the source patient and presence of genital lesions in the source or the exposed patient may augment HIV exposure risk significantly,
  • Patient need to have a detailed discussion with his doctor about the potential risks and benefits of postexposure prophylaxis. The risk/benefit ratio of postexposure prophylaxis rises in patients with lower risk exposures (eg, fellatio versus anal intercourse)
  • Patients must be aware of potential medication side effects and toxicity concerns.
  • An example of high-risk exposure would include receptive anal intercourse with an untreated HIV-infected individual.
  • Postexposure prophylaxis (PEP) should be started as early as possible after an exposure and should be continued for 28 days.
  • PEP is not indicated if the patient presents for care more than 72 hours after an exposure.
  • You should ask your specialist what is the more appropriate medication combination.