Pagiel Shechter, M.D. Pagiel Shechter, M.D., Inc. Internal Medicine & Nephrology Pagiel Shechter, M.D., Assistant Clinical Professor, UCLA Nic Hristea, M.D. Milton Kogan, M.D. Nic Hristea, M.D. Dr. Kogan has joined our office. He is an expereienced Family Prcatitioner. Dr. Kogan will manage our nursing home patients. This practice integrates General Internal Medicine, Nephrology (kidney diseases), Hypertension (high blood pressure) and Diabetes . It concentrates on the early detection, and hence risk attenuation and modification of traditional cardiovascular risks factors. It concentrates on efforts at early dtection of disease states, when most of the deterioration prevention is effective.   Modifying and attenuating these risk factors by edidence-based medical interventions, such as pharmacological agents, diets, education, and modification of lifestyle factors, slows down the progression of many known diseases, such as diabetes, kidney failure, hypertension and heart diseases and their complications. Our practice uses only evidence based methods. We discourage use of unproven modalities, and agents or methods of questionable utility. We practice the principle of "primum non nocere" (Latin for: "first do not harm", derived from the famous Hipocratic Oath). Our location and the ease of access,  make it ideal for the elderly and the disabled patients. We practice Medicine with Compassion. We believe in humanistic approach to our patients. We include our patients in the decision making process towards their healing.  As a result, our patients are loyal and happy. We always welcome new patients. We specialize in dialysis patients. We care about them. If you a dialysis patient, and you are not happy try us. We encourage our dialysis patients to get ready for kidney transplant. We help our patients cope with their social problems. We provide support for dependent dialysis patients in finding nursing homes and other support systems in our area. We follow our patients in the hospitals and whereever they go.  Our office is located across Olympia Hospital Medical Center (previously Midway Hospital), and close to  Cedars Sinai Medical Center, which serves as our main admitting hospital.  There is ample parking in the parking structure next door. The proximity to hospitals facilitate admissions and access to  both important and sophisticated diagnostic tools, such as MRI and spiral CT Scanning. We perform most of our diagnostic studies on our premises. Our waiting room has been recently upgraded to the comfort of our patients. Waiting time is reasonable. We schedule appointments within several days. Urgent patients can be seen earlier.  Our office schedules appointments usually within several days to a week. If you need an urgent appointment, our friendly staff will accommodate you as soon as possible. In some cases it may be even done on the same day, depending on avaiability. Above all, you get the great personal care of Dr. Shechter and Dr. Hristea and our staff . Special Services We offer innovative diagnostic tools, not available in other offices, such as the State-of-The-Art non-invasive measurements of heart function by Cardiodynamics   http://www.cardiodynamics.com/ , which accurately and non-invasively calculate the heart performance and all the hemodynamic measurements. This tool is especially important for patients with heart problems, such as Congestive Heart Failure and High Blood Pressure.   It can accurately predict subtle changes in the heart function, even before other methods can detect it. It can save more invasive tests, that are done in a hospital setting. We perform Holter heart monitoring, for detection of significant heart irregularities. We added a state-of-the-art nerve conduction machine, to diagnose and quantify nerve damages, secondary to trauma or a variety of diseases or conditions, such as diabetes, anemia, vitamin deficiencies,kidney failure and more. Peripheral arterial disease (PAD) is a common condition leading to disability. This condition involves hardening of the arteries leading to the legs. When it happens it can result in severe leg pain. Risk factors include among others: smoking and diabetes. When it happens, it also means that the affected person has a similar process in the arteries leading to other organs, such as the brain and the heart. When it exist, it increases the risk of heart attack, stroke and death. We launched an initiative, in accordance with recommendations from experts like the American Heart Association, to diagnose PAD early  http://www.americanheart.org/presenter.jhtml?identifier=3020242.  In our office we perform the ABI test, that can discover PAD early. When discovered early there are many treatment options that can save the legs and life. We have a team of technicians and specialists to assist in diagnosing and treating PAD.  About one in five patients with PAD will have a major cardiovascular event within a year (stroke, heart attack or death). Even patients with asymptomatic PAD are at a major risk. Patients who are smokers or have conditions such as diabetes or high blood pressure are at risk for asymptomatic PAD. Find out more about PAD at http://www.padcoalition.org Have your limbs checked for PAD today. Call us to schedule an appointment. The test is covered by most insurance carriers. On Site Lab Results We perform on-site blood analysis for the convenience of our patients. We use cutting edge tools for laboratory tests that are unique to our office. We get immediate lab results from a fingerstick. We get immediate results for chemistry tests including  Lipid Panel, Lipid Panel Plus, Liver Panel Plus, General Chemistry 13, & General Chemistry 6. We perform on-site PT/INR measurement for patients on Coumadin. These lab results are available within minutes. In the future, we intend to add CBC analysis. Disclaimer The material provided in this website is for informative purposes only. If you need specific medical advice, please contact the office for an appointment. This website is not designed for emergencies. If you have an emergency you need to call 911 or go to the nearest Emergency Room. No doctor-patient relationship exists until you visit the office, registered and seen in the office by one of our doctors. Sending us records via mail, email, facsimile or leaving a voice mail, do not constitue a physician-patient relationship.