Sunday, June 22, 2014

Going to the Doctor (part 1)

If you know me, you'll know that I both love being sick (time off from work!) and hate going to the doctor. I'm never really sick enough to warrant a trip to the MD, but I blame that on taking care of myself in the early stages of illness. Luckily, though, I'm a pretty fairly healthy person with fairly healthy kids.

There are a million and one blog posts I could write about the medical care and its administrators in the DR - but it's depressing and sad, especially medical care in the public sector. A few years ago, health care was universalized and, I think, it has only gotten worse for the very large working class of the population. To be fair, though, it hasn't gotten better for the rich either.

As a family, we've benefited from the universalization of healthcare because we no longer have to use the state-run insurance for public school teachers. We have been free to choose a private ARS company (private insurance), and, in turn have a larger pool of doctors to choose from. I had positive experiences in the state-run clinic until Amely came along, and then I wanted out - the pediatricians were TERRIBLE and the care was generally just withering away to no care at all.

Two years ago, at the end of our rope with the system, Amely got sick. Except, we never really know when Amely is sick because she has the pain-threshold of my brother (who once fell out of a moving truck and had the wound cured with a metal scrub brush - and WATCHED while they did it). She had been complaining of everything except an ear ache, and then one morning she woke up covered in blood. Does it hurt? Nope. We headed to the emergency room because, well, what do you do when your daughter is bleeding profusely from her ear? We were sent to pediatrics, only to be told in pediatrics that the doctors were on strike and so we'd have to wait until the "on-turn" doc came it at 3pm. Um. Yeah, the kid is bleeding from her ear. Back to the ER.

In the ER, I found a sympathetic doctor who told me we'd have to go to another state-run clinic (for those familiar, the Seguro Social) where we'd see an ENT. I was willing to jump through those hoops, but only if the problem wasn't terribly serious. Could this kind lady just look into Amely's ear and let me know if she had, I don't know, stuck a bead or a bean or something in her ear? I wasn't going to wait for craziness of an already overcrowded clinic (who was now dealing with the overflow of our clinic) if Amely needed some real medical care. The poor ER doctor agreed - eventhough "you know we're on strike right?" - and tried to look in Amely's ear. She tried because the otoscope was so scratched that she couldn't see into the canal at all - not even to see if there was a bean or not.

I kind of spun my wheels a bit, but decided to go to the SS clinic. Wrong decision. We got there and were sent to emergency, in emergency we were sent to reception in reception they tried to send us back to emergency and finally an ex-student took us to the area where one ENT worked. A clinic serving thousands with one ENT. We get to the consult area, where the secretary in charge looks at us, asks what we need, and tells me, "the first appointment is in 8 weeks."

excuse me?
are you not seeing the blood still pouring out of my 3 and a half year old's ear? 8 weeks? lady, this is an emergency. oh, well, in that case, you'll need to come back tomorrow. the doctor is not in today.

I ended up at a private clinic, in the consultory of the son of a co-worker who is, I guess, an okay doctor. He pulled chunks of wax out of Amely's ear as big as my pinky-finger nail and prescribed some antibiotics, and for the future routine ear cleanings. Turns out her poor little ears don't spew forth wax like her brother's do (seriously? that kid's ears are nasty). We paid $2,000 pesos out of pocket (about $50USD) for the consult and wax-removal and another $500 ($12USD) for her medicine.

That was the final straw for me. It took Amalio a little longer to figure out that we needed to get into a private insurance - because even though we would have to pay a co-pay, at least we'd be getting medical care, which we were not receiving from the no-co-pay state-run insurance. We did finally switch and I have been searching for a pediatrician ever since.

I'll be writing more on what it is like to find a doctor here - some of the cultural issues we have been dealing with as a family (like do you really take your child to the ER if she has vomited once? and is it okay to question the use of antibiotics for viral processes?) and some of the snafus we've had with doctors (like the doctor I visited yesterday who wanted to test my daughter for sickle cell because she has strep throat). stay tuned!

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