Overall wonderful experience. Staff was pleasant, NP was also fun and likeable &knowledgeable. Dr Carames was superb, methodical, sharp to issues, and won me over quickly. I will def stay for a long time. 5 stars read more

His staff is not patient friendly and they never return calls. The doctor wrote me a script for the wrong exam. I couldn't get a call back from the nurse. Went to the office in person to get a new script and he puts down the wrong diagnosis. Back to the office I go. The nurse gets nasty, blames everything on me, tells the doctor. The doctor comes out starts getting increasingly louder with me, then walks away from me. When I call him out on that, he comes back at me yelling to find a new doctor. Very upsetting. read more

This review concerns Internal Medicine Associates in general and Dr. Carames in particular. I am or was a relatively new patients for this practice beginning in early July of this year. First, the kiss: I had the good fortune to be assigned to Dr. Persaud. Dr. Persaud is is pleasant, humane, and competent medical professional. I have enjoyed our brief association due to his engaging personal manner, willingness to listen and comprehensive medical knowledge, particularly concerning prevention, and treatment for current infectious diseases. Now, the slap. As of about 10:10 am I was "fired" as a patient after an acrimonious encounter with Dr. Carames. Here's the story. I had a scheduled follow up appointment with Dr. Persaud at 10 am this morning and happily anticipated discussing certain matters with him. Arriving early, I donned my N95 mask and entered the lobby. As on my previous visits to the clinic, I noted that not a single one of the staff members, technicians or physicians wore such protection. Most wore paper masks, some even wore cloth masks. I was received by an individual who acknowledged my appointment and asked that I fill out a signed affidavit which sought to confirm vaccination status, COVID exposure and existence of symptoms. On previous visits to the clinic, I had indicated to the staff that I was happy to truthfully answer the requisite questions but did not feel comfortable signing a legal document concerning the questions. The staff stated they understood, checked the relevant boxes on the form, noting that I had declined to sign the form. The appointments proceeded without incident. The problem with the affidavit is that it asked whether the patient has been exposed to COVID. A definitive question that is quite possible to answer factually. One can only aver that they haven't been exposed to COVID TO THE BEST OF THEIR KNOWLEDGE. Rather, the affidavit requires that one positively affirm that they haven't been exposed. The required affidavit is of questionable actual value and legally suspect. How can one possibly know whether they may have been exposed to an asymptomatic or early stage infected individual and why would one issue a signed affidavit to stating that they HAVE NOT been exposed? After waiting a few minutes in the lobby, I heard my name shouted from the reception area. As I approached the window, an individual who did not identify himself began belligerently barking questions: Had I been vaccinated? Had I been exposed? Did I have symptoms? Despite his failure to identify, I answer his questions to the best of my ability. Concerning vaccination, on two previous visits I had confirmed my full vaccination status and had provided both the date and batch numbers for each of the inoculations. It was clear that this individual had not bothered to look at my medical record prior to addressing me. This individual, as it turns out was Dr. Carames, then bellowed that I had not signed the affidavit. Before I could respond or discuss it with him, he proceeded to loudly and aggressively roar "There's a pandemic! This form is for our safety and the patient's safety. This is my practice and I'll run it any way I want!" Since I had already answered the "safety" questions on two occasions in the last 10 minutes, for his staff and for him, what role did the affidavit have in patient safety? The answer is absolutely none. The real purpose of the affidavit has nothing to do with patient safety; rather, it is nothing more than a bum cover born of sloppy and over broad legal advice. As Dr. Carames continued his bellicose rant he informed me that he didn't need me as a patient, and based this first and only interaction with him, I concurred that he didn't need me as a patient, nor did I have a desire to continue as a patient of "his" practice. (You're fired! No, I quit!) There is one more troubling aspect to today's encounter: by identifying me by name and asking for the disclosure of personal medical information in the public space of the clinic, Dr. Carames has committed a demonstrable and actionable HIPPA violation. On two of my previous visits, as I was checking out following my appointment, the staff at the desk openly discussed sensitive medical information within my hearing with other patients who approached the desk after I did. ("Mrs. Jones, Dr. X gave this diagnosis and recommends this test.") Also, a HIPPA violation. Had Dr. Carames chosen to approach me as sat in the lobby to calmly discuss the situation, I have no doubt that we could have resolved the matter amicably and to one another's satisfaction. His choice of public confrontation, improper disclosure of personal health information, and belligerent and bureaucratic demeanor created an adverse result for all parties. Having said all this, I truly regret not being able to confer this morning with Dr. Persaud. I wish him well in an unpleasant environment. read more

Dr. Carames is probably the best doctor I've ever had. He is so thorough and so perceptive. He is very efficient, and has an office that is very efficient also. I'm just asking Dr. Carames to take care of my 90 year old mother - I know he'll do the best job for her. read more

I have been a patient of Dr Carames for five years now. He is excellent! He is very thorough, and is very accessible. The staff can always get you in when you need to see your doctor. It might sometimes be an assistant but Dr C always supervises. When I am in the hospital he always comes in to check on me, even when I am there under another doctor. I can't say enough good things about him! read more

Dr. Carames office cancelled my annual physical appt. for Sept 20th. The office scheduled me an Oct 4th appt which they said was a Wellness review recommended by Medicare, after that I could get my physical appt next. When I checked out for my next appt., the rude appointment lady said, I need to come back for the results from the wellness test, then I can get another appt for the physical. The wellness test for a person in good health is a waste of time. They take your weight, blood pressure, and pulse.....and the nurse asked 5 min of health question like do you smoke, drink, eat veggies, etc. I did not mind wasting my time. My health insurance pays in full all medical expenses, so this is not about money with me. What I did not like was I needed a follow up visit with the doctor for the wellness review.... and then I could get the physical appt, which was my original Sept. 20th appt. This Doctor is all about MONEY,,,,MONEY,,,,MONEY,,,,FIRST I would not even give Doctor Carames a one star.......also, he needs to talk with the appoint ment lady about respect , courtesy, and manners.... good luck, if you go to this Doctor. Dave read more

On 6-3-11 I went to my appointment with Dr. Carames at the Internal Medicine Assoc. offices in St. Augustine. It was my first appoint so I made sure they accepted my Medicare part A&B insurance. I was examined by Dr. Carames and then went to get my blood test. I made a second appointment for 7-6-11. On 6-10-11 I received a letter from Internal Medicine Assoc. saying "We regret that we find it necessary to inform you that we are withdrawing from providing you with future professional services." On 6-10-11 I called and left message asking why I was rejected as a patient. I never got a answer to my question. Just wanted you to be aware this may happen to you. Dan Weston read more