An ambitious technology project conceived in Chile could offer Spanish-speaking doctors who emigrated to the United States and have not validated their diplomas with U.S. authorities a chance to work in their profession.
The digital platform Intermeds seeks to offer patients in Latin America the opportunity to have their medical records reviewed by specialists in the United States, said Carlos Araya, 43, a Chilean entrepreneur who started the project.
Financed with funds from the Committee for Productive Development, which is part of the Economy, Development and Tourism Ministry, in Chile's Antofagasta region, the initiative could help the nearly 9 million people in the region on waiting lists to consult with specialists, he said.
Araya, who has a doctorate in computer science, said the initiative also could create an opportunity for Spanish-speaking specialists in the United States who have not been able to re-validate their diplomas or are in the process of doing so. Many of them now work in jobs unrelated to their degrees.
The shortage of specialists and waiting list
In both the public and private health systems of many Latin American countries, patients see general practitioners, undergo tests and, if required, are then referred to specialists, Araya said.
But the shortage of specialists in isolated areas like Antofagasta in northern Chile, where Araya lives, makes for long waiting lists and patients often have to travel to the capital, Santiago de Chile, for the consultation they need.
You have to take an airplane, which costs about $250, find a place to stay, and all that is very expensive,” Araya said during a visit to Miami. “It would be much more convenient if I could give my medical records to a specialist at a much lower cost.”
Patients who cannot afford the trip to Santiago have no option but to put their names on waiting lists. “What happens is that the waiting list takes nearly two years,” said Araya. “A lot of people die on the waiting list.”
The problem is not exclusive to Chile, where about 2 million people are on waiting lists, Araya said. He found the same problems in Argentina, Peru, Bolivia and other Latin American countries.
“What we want to do is to resolve the problem,” he said. “What's needed is the expert who can classify and diagnose. Everything else flows from there.”
Underused doctors in the U.S.
Searching for a solution, Araya said he found other countries “that have the opposite situation, which is underused doctors in places with high concentrations of immigrants, like the Latin Americans who immigrated to the United States.”
Many of those medical professionals “have experience in their countries, like the Cuban doctors, for example, and are in the process of validating their degrees so they can work as doctors in the United States, but that process can take several years.”
Miami alone has more than 8,000 immigrant physicians, many of them specialists who want to work in their areas, according to Solidarity Without Borders, a non-profit based in Hialeah that helps immigrant health professionals.
Blocked from practicing medicine until they validate their credentials, the immigrant doctors wind up working in other areas in order to survive, said SWB founder Dr. Julio Cesar Alfonso. Intermeds is a good opportunity for them, he said.
“This is an excellent opportunity to remain close to medical services, helping patients who need the assistance,” said Alfonso. “This is beneficial for the doctors, apart from the money, a chance to remain current, gain experience and measure yourself, which is essential.”
Araya explained that the Intermeds digital platform will be “an information service for patients” who will be able to submit their medical records, receive a second opinion and make their own decisions. “The report is considered technical information that allows the patient to make a decision, but the patient must still go to local doctors for treatment,” he said.
The doctors who register with Intermeds will be able to review the medical records on the Web, hold video conferences with the patients and issue opinions without having to re-validate their diploma in the patient's home country, Araya said. The laws of several Latin American countries were reviewed and allow the arrangement, he said.
But the deputy press secretary for the Florida Department of Health, Brad Dalton, told el Nuevo Herald that if the foreign doctors “perform any task that would be considered the practice of medicine they would have to be licensed with the Florida Department of Health.”
Florida Statutes define “Practice of medicine” to be the diagnosis, treatment, operation, or prescription for any human disease, pain, injury, deformity, or other physical or mental condition,” Dalton said in an email.
Araya said Intermeds “is a platform that seeks to provide a service of second opinions, and therefore is not considered medical practice since there will be no prescriptions or treatments for patients. It is a service to provide advice or generate information. Ultimately, it's a report.”
The Intermeds platform does not seek to provide telemedicine services, which involves a series of homologations and partnerships with hospitals, Araya said. In a second stage, “it is being evaluated to make an agreement with a hospital or clinic in each country, so that the project can advance into telemedicine,” he said.
Araya acknowledged his project will likely be met with “resistance,” specially among the medical establishment.
“This is similar to Uber, but on a different scale. Innovation is always resisted by groups in power that see that their privileges will be affected,” he said. “In this case the privilege is knowledge, the right of patients to be informed, to fully understand their condition and make the best decisions possible.”
The people and institutions who oppose the implementation of “telemedicine” see it as a disruptive technology, said Juan Antonio Blanco, a former director of the Center for Initiatives for Latin America and the Caribbean at Miami-Dade College who has researched the issue.
“When an innovative technology arrives, there's always opposition, like what happened with Uber,” Blanco said. “There are people who resist change and look for excuses to discredit it. When the Industrial Revolution arrived there was also a rejection of the technology, of the machines. But progress cannot be stopped.”
The first phase
Ophthalmology is at the top of the waiting list in Chile, and that's why Araya and his team are looking for ophthalmologists in South Florida for the pilot phase of their project. They also are in the process of opening an office on Brickell Bayview, 80 SW Eighth St., Suite 2000, to receive phone calls and meet with doctors.
“The good part of ophthalmology is that with four or five tests more than 99 percent of the cases can be diagnosed,” said Araya. “There can be very accurate tests, And it's the specialty with the longest waiting list.”
Miami's advantage is that it has the same time zone as Chile and that it has a high concentration of immigrant doctors.
The consultations will cost patients $100, the average cost of a private visit in Chile but without the transportation costs. The doctors will receive $16 for each report, and part of the rest of the money will subsidize patients who are on the waiting list but have no money for a specialist — starting with the oldest on the waiting lines. Another part will be used to maintain the platform, said Araya.
“We are looking for doctors who want to help with a social cause,” he said. “The focus is on helping these two groups, patients and doctors. At the same time, we seek a platform that is sustainable and does not depend on government subsidies.”