Another Healthcare Experience

For the past week I have been assisting a lady whose husband is in the Regional Hospital. He came to the Regional Hospital after spending time in the Mae Lewis hospital. I was told that the bill in Mae Lewis was $28,000 for two weeks.

The decision was made to enter the Regional Hospital to get costs under control. The plan is when the patient is stabilized to return to the U.S. for final treatment.

The lady, I am working with, is paying a private nurse $150 a week and the nurse is also acting as her Spanish/English translator.

The current problem is that the patient is in a special unit in the Regional Hospital and to get information from the doctor, the wife has been told that the doctor will only communicate with her between 6AM-6:30AM. It is currently unknown if the doctor speaks English.

To complicate things more, the wife had a stroke a year ago and is still suffering effects from it. This means that she needs to get a large amount of rest and sleeps from 8PM until 8AM and that prevents an early AM meeting with the doctor.

The U.S. Embassy contacted the hospital and was told that the process would require communicating with the Social Worker in the Regional Hospital and having that he Social Worker be the interface. From previous visits with the social workers in the Regional Hospital. I know that they speak Spanish and have little to no English capability.

I said I would come today and be her interface with the social worker. The social worker’s offices are on the fourth floor of the hospital.

I am going to step out on a limb a little and give you my current thinking based on my ongoing experiences. In this case, the private nurse that is being employed, has told me that the care that this individual has received in the Regional Hospital has been better than what was given in Mae Lewis. That was her opinion.

As I have said before, the doctors in the Regional Hospital also practice in the private hospitals. However the daily costs for everything is much lower in the Regional Hospital.

In my mind the key factors to good care boil down to a couple key factors.

The first and most important is having a good doctor that has the reputation for quality care and more I interested in patient care and less in diagnosing the more expensive treatments. It is very important to research your doctor well.

The second is to have family and/or friends that will put in the time to monitor the care being given. Sometimes the difference between living and dying is someone that cares being vigilant.

The third, and still very important, is the ability to communicate in Spanish. I can’t emphasize how important this is. In your vocabulary, you must add the parts of e body, pain, temperature, etc. if you don’t have that ability, you need to have easy access to someone that can act as your interface.

As I write this, I have been waiting for a social worker to return to their office. There are two offices and it has been almost an hour and no one to be found. My patience is up and I am going to search for the worker.

I learned something. I was not waiting in front of the main social workers offices. The mail office is also on the fourth floor, but down the hall from the two offices I was waiting at.

OK. I am completing this after talking with the Social Worker, who immediately got me an appointment with the doctor. All information has been confirmed and transferred to the wife so she can now do a little more planning. I will say that I was impressed with the doctor that I talked with.

I have been think about a couple items, I will run by my readers to get an opinion.

The first is creating a list of volunteers that would be willing to check on patients in the David hospitals that don’t have family members who can do that. Anyone that is willing to do that can drop me an email. It would be good if you can speak Spanish, because you may have to talk to doctors and/nurses and you should not expect all or any of them to speak English.

I sometimes have received requests from the U.S. Embassy to see people in the hospital that I have not been able do, and that list would help me.

The second item, is that I am considering setting up a website that could be used to communicate to others in Chiriquí, experiences and recommendations for doctors with various specialities. This is obviously a tricky item, because it would be easy for some doctors to have themselves recommended to get access to English speaking clients.

It would also be easy to have negative experiences posted that could damage reputations and invite legal suits. Setting up the website is the easy part. I am interested on thoughts related to its practicability and associated risks.

19 thoughts on “Another Healthcare Experience

  1. Don,
    Your heart is is the right place and you should be commended for your concern but you can’t take on all these peoples problems. I strongly disagree with the website. This one appears to be sufficient. I beleive that inviting volunteers into the equation would be like opening up Pandoras box. There are many people in the area that would love to translate for us. Some do it for free and others charge. The hospitals should have such a list. You could start one. If I was in trouble at a hospital I would love to be able to contact a translator. I hand out small pocket spanish/english dictionarys to those I communicate with often. The Panamanians love it because they can learn English. I carry one around with me all the time. They are pretty cheap considering whar can be accomplished. You do more than your share Don. And we all appreciate all your efforts.

  2. Don I agree with you that a recommended doctors list has the potential to do more harm that good.. A retired US doctor and I were planning to create such a list but backed off for fear of posting recommendations canvased from ex pats by money hungry doctors lacking in competence. To publish a negative about a doctor could lead to a mega lawsuit. Regarding translators the ideal would be to have a list of those who are capable of both translating and taking medical notes. To record with accuracy the doctor’s instructions requires being confident to ask for verification on any point not understood. This is a step above just being fluent in both languages. The bilingual nurse sounds ideal.

  3. Hi Don,
    Would this work to avoid liability?
    Have a page titled ¨Doctors I would not use again¨. Listing would contain only the doctor´s name and the poster´s name and contact info. Anyone wanting to know details could contact the poster directly.
    Dave

  4. Maybe just a list of English speaking doctors , their specialty and contact info, without comments. Then people could do their own research.

  5. Hi Susan, thanks for taking the time to leave a comment. I think that English would be an attribute. The best doctors are not always the ones with the best English. In fact those that promote their English capabilities are sometimes the ones that are looking for more money.

  6. I like to use a word translator (SpanishDict.com) to write down my medical problems and history in Spanish. I usually provide this to the doctor’s receptionist before seeing the doctor. English speaking doctors and private hospitals charge more. At Punta Pacifica Hospital the doctors like to refer you to another doctor within their hospital. Is that the same in other hospitals? A person ends up paying double. The same in the U.S. The Boquete group has a list of English speaking doctors in Chiriqui. The U.S. Embassy web has a list of doctors in Panama.

  7. Don,
    Who is the Boquete group and is that list available to the rest of us in Chiriqui?

  8. I am not sure if it will work for you all but my first advice is look for a very good MEDICO DE CABECERA, that means your personal doctor. The one you use to visit frequently for checking. He will keep a complete record of your health conditions and medical history. You could ask this doctor to work with you in looking for the best specialist he knows and recommend as serious, professionals, reliable and not hungry of money.

    If anything happens to you, he must be contacted to coordinate with the specialist what treatment or special attention you should have at any hospital: private or government. He could provide information to the specialist of you health history.

  9. In my opinion, I believe that the hospitals are not taking payments from insurance from the US because they want to charge more than what is allowed for treatment in the US. I just don’t see any resolution to this problem. If you have insurance, I don’t believe you should have to pay out of pocket up front. Maybe I am just too old and confused?

  10. Since I use a Panama insurance company for my healthcare insurance, I can’t speak to that. I don’t know the restrictions placed on usage of U.S. insurance outside the U.S. and imagine that is different for every insurance provider. One thing a person should do before moving to Panama is to plan for their insurance needs. You should know ahead of time if your insurance will be accepted befor moving here. If it won’t work here, then you should consider the cost of an insurance that will work here.

    Living anywhere in the world without some level if insurance coverage, is insane.

    Now if insurance that is stated to cover a person in Panama is not being accepted, that sounds like something that is a legal matter with either the caregiver or the insurance provide.

    I agree with some of the previous commenters in that once here you need a personal physician to act as your consultant when general medicine is not enough and a specialist is involved. No list of names will replace each individual taking responsibility for his own healthcare planning.

  11. Don for those who, like me, are getting on in age and have multiple body parts in need of repair and maintenance, I recommend considering putting yourselves under the care of Dra. Hilda Gomez at Chiriaui Hospital. Dra. Gomez, who specializes in geriatric medicine, is a new addition to the hospital staff. I make this recommendation based on only one visit but she so impressed me that I feel justified in doing so. She asked for copies of the reports from my cardiologist, my neurologist, my urologist and my lung specialist, along with the medicines they prescribed for me. She spotted a conflict between two of the medicines and made adjustments with the approval of the respective specialists. . She now heads my team of specialists and keeps note of when I should have my next check up procedures in each field. I have no problem accepting that in all but mind, I’m geriatric and better off under the watchful eye of a geriatric specialist. During my visit, I had a Panamanian with me to translate and take notes. I agree with you Don , the ability to speak English and charm potential patents should definitely not be a factor in arriving at your choice of doctor. . . .

  12. Don, there already is a volunteer organization that will make hospital visits and monitor care. It is Boquete Hospice. They don’t just work with the dying. They also work with people who are sick and need care, either at home or in the hospital. They have a website, and they do go to David.
    http://boquetehospice.com/

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