Tag Archives: Doctors

Lilliam Had Her 6 Month Cancer Checkup

Lilliam has her 6 month checkup with Dr. Bullen today. Doctor Bullen comes from Panama City once a month. For an appointment, you can see the first post I did announcing that he was coming to David.

I had a second post when the office opened.

Dr. Bullen invited me to be in the room for Lilliam’s examination. Since her cancer was a skin cancer, he inspected all of her skin. Literally from head to toe.

When he inspected the scalp, he moved all strands of hair looking for suspicious areas. He checked the bottom of the feet. He said different areas were susceptible to different types of cancer. Some cancers much more serious than others.

While he didn’t look at 100% of her body, he probably looked at 95%.. I was impressed at how thorough he was.

Lilliam got a clean bill of health and will return for next 6 month visit. It is really nice that she can see him in David and not have to go to Panama City.

Checkup Time 2015

A couple months ago, I went to see Dra. Marta Sánchez for the annual prostrate exam.

All went well, however, this year I also needed to see an internist to get a letter stating I am in good health and qualify to get a driver’s license. In Panama, this is required every two years following your 70th birthday. Prior to 70 it costs $40 for a 4 year license, i.e $10/year. After 70 it cost $40 for a 2 year license, i.e. $20/year.

Dra. Marta had recommended Dr, Héctor R. Caballero, who is an internist as well as a specialist in diabetes. My dad had diabetes, and I had asked her if she had an internist with experience in diabetes.

When Lilliam called, to set up an appointment, the admin asked if I spoke Spanish. My name had raised the red flag of a potentially Spanish challenged client.

Lilliam said my Spanish should suffice and she would be there as well. Apparently, Dr. Caballero wasn’t taking any more patients that only spoke English because of past communication problems.

This is why all people planning on living in Panama need to learn Spanish. While you can find doctors that speak English, you will be limiting your options.

I was extremely impressed with Dr. Caballero. It may have been the most thorough exam I have had, He asked me to get a special blood test, since my sugar level is borderline. I did that yesterday and will have the results for the next visit in a couple weeks.

He did provide the required letter for the transit authority. I will get that taken care of before the end of the month.

The office visit was $50. $40 with the jubilado discount. I got the blood test at Hospital Mae Lewis, since we are there every day and no need for a special trip to Hospital Chiriqui to get the results.The blood test was around $16.

My appointment yesterday was for 1:30 PM. We were told to be a little early. We arrived at 1:00PM. We entered the doctor office at about 2:45 PM..

We were entertained in the waiting room by a confused woodpecker. At least I think it was a woodpecker.

I kept hearing this noise. For a while I thought someone was working outside. It continued and I finally noticed this bird pecking at the corner of the windows. He would leave and return. I am not sure what he thought he was going to accomplish by tapping on the window, but he did keep me amused. As you can see, it doesn’t take much to amused.

Doctor Reference

Always good to get a good doctor referral.

Hi Don,

FYI, MSPH Care now covers med/Dr services at Hospital Mae Lewis.

Planning my hernia surgery, I got exams from 4 Drs; 3 at Hospital Chiriqui, 1 at Mae Lewis. I choose Dr Samuel Cattan Jr, who only practices at Mae Lewis, and does not float between both private hospitals. Meaning also, I choose Mae Lewis over H. Chiriqui, even tho H. Chiriqui is a much better facility; better to pick the Dr, not the building. Dr Cattan was the only 1 of 4 who thoroughly examined me, detailed my condition, and explained the surgery.

I had exams one day, had lab tests the second day, had surgery the third day, was released from hospital the forth day. Couldn’t have had faster than that! Much of that service due to the hand-holding of Dr Cattan. He personally walked me thru the 4 lab tests; he was there to greet me when I was admitted into hospital; after his surgery he visited me in my room; the next morning he post-op examined me and issue a hospital release. After 2 days convalescing, I bussed home to Bocas. A week later, I was back to my regular self. That only happened due to the care and skill of Dr Cattan. I cannot more highly recommend a surgeon.

Post on CC if you wish.

Larry

Another HealthCare Observation

I have another healthcare case, which is providing more experience, that I feel I should share.

This individual came to Panama with no insurance, only social security income, and has developed significant healthcare issues. He was taken to one of the public healthcare facilities and was seen by the resident doctor.

The doctor was very vocal in stating that he did not understand why elder American citizens, with medical problems, are allowed in Panama and why the U.S. Embassy does not provide assistance to them. He ended the conversation saying that he would limit his service, for this patient, to just writing a report on his condition and no more.

He explained that there are no beds in the public hospitals and that a Panamanian needs to wait almost seven days for a bed.

I know this doctor, as he is the doctor that Hogar Santa Catalina took Robert (the stroke victim) for a checkup. In that meeting, he accused all U.S. Citizens of being insolvent and if he needed treatment that he would have to be taken to his private practice in Hospital Chiriqui where he would bet paid his specialist fee.

Needless to say, this doctor was removed from my list of doctors receiving a recommendation by me. His attitude is a discredit to the medical profession and he is a poor representation of Panamanian physicians. He was extremely rude to me when I was was with Robert in his office.

That being said, it should be noted that his sentiments are shared by others. Luckily, they are the minority. I will admit, that while this doctor’s deportment is deplorable, he has some valid points behind his statements.

If this individual goes to the Regional Hospital and has the proscribed CAT scans, x-rays and other tests, he may not have the ability to pay. If that happens, it will put more more burden on the already overburdened Panama system.

Most private hospitals will not admit patients without proof of payment. The public hospitals are crowed and understaffed. Walk-ins to the public hospital will most likely be placed on the same 7 day waiting list mentioned by the doctor.

I had another case where the Regional Hospital asked a U.S. citizen to leave because they said he was in good enough condition and they hospital needed the bed. I received a call from his landlady about 6 hours after his release telling me that he was not doing well. He died about 2 hours after the 911 services arrived. It was obvious that it was an error by the hospital to release the patient.

Bottom line is that if you are moving to Panama, with a problematic medical history or the probability that medical care will be needed, be prepared to pay. I took a physical prior to moving to Panama and found that I needed surgery and didn’t know it. The rumors of cheap health care in Panama is always relative.

I can visit a clinic for a cold or infection or minor office visit. The cost will be $6 for the visit and I have always been treated with respect. However, if I need to see a specialist, the office visit will be from $35 to $80 or so after the jubilado discount. In all of my specialist doctor visits, I have always been treated with resect.

I always advise any person making an exploratory trip, for viewing Panama as a retirement location, to visit the hospitals. You should also visit the Regional Hospital (public) even though you think you would only use a private hospital, because the public hospital is most likely where you will be taken, if you are in a serious accident.

If you do move here, you should immediately determine what doctors you want to use as your primary care physicians. Finding one in an emergency may put you with one doesn’t like foreigners.

Dr. Bullen’s Next Office Date – June 13

I received an email from Dr. Bullen asking me to let those in Chiriquí know that he will be in his David Office on June 13.

When Lilliam’s search for a skin cancer specialist resulted in finding Dr. Bullen in Panama City, she would tell him of the real need in David for a doctor with his capability. She was going to him every six months and on each follow up, she ask when he would open a David office.

You can than Lilliam for him being here.

The original post and the previous post have more information of his dermatology practice. I saw what the treatment by a doctor without Dr. Bullen’s experience can do and I have seen how he has taken care of Lilliam.

That is why I don’t mind helping him become known in Chiriquí.

S.O.L. In Paradise – Beating A Dead Horse

As I mentioned in the previous S.O.L. post, it will be worth following the thread in Boquete Ning.

Today, Bonnie Williams wrote a comment that I don’t want to get lost in the midst all the other comments on the ongoing thread. While she limited it to ExPats in Boquete, I would expand it to all of Chiriquí.

Here is her comment.

I think we’ve beaten this subject to death. To summarize, I see expats in Boquete having essentially four options for healthcare:

1) Have no insurance in Panama. Go to Hospital Regional for medical emergencies, but be aware that it may be difficult to receive timely attention. And you will be billed upon departure. Non-emergency surgery will be delayed, perhaps forever. Plan to return to the U.S. for any needed medical non-emergency services.

2) Enroll in the Hospital Chiriqui co-pay plan. This will pay for many routine, preventive procedures, but it will pay only part of the cost of hospitalization and/or surgery, and there is a relatively low cap on how much it will pay annually. It pays for no bodily appliances such as stents and pacemakers. This can result in the patient owing a significant amount of money.

3) Buy comprehensive national or international insurance. It is expensive. But it has a high payout limit and, after the chosen deductible, pays most or all medical expenses. There generally is no required deductible for emergency or pre-approved hospitalization or procedures.

4) Self insure and hope that you have enough put aside to cover a catastrophic medical event such as heart surgery, serious automobile accident, etc.
As routine medical care in Panama is relatively inexpensive, most expats can meet those expenses without incurring significant financial difficulty. When considering health insurance needs, it is my opinion that particular attention should be given to catastrophic medical events which, without good insurance, could subject one to no care, poor care, and/or financial ruin.

Dr. Bullen’s Office is Open

Like the butcher that backed into his blade, I have been getting a little behind in my work.

As I said I would in my previous post, I went by Dr. Bullen’s office on May 16 and took photos. Unfortunately I took them with my real camera and not my iPhone and forgot about the project and didn’t post them.

His office is easy to locate in Hospital Chiriquí. Take the hallway directly across from the Pharmacy and the first office on the right is his Office. The sign on the office follows:

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I talked to Dr. Bullen and asked if he could do everything as if he were in Panama City. He said he will be able to after he gets the pathology lab trained. He said some of the lab work is done differently than they are trained to do it, but that will change.

He said his charges are the same in Panama City as in David. $75 for the consultation. That is $60 for jubilados.

Dr. Bullen has two areas to serve patients. I am including two photos.

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I picked up a card in his office that takes about services he provides.

bullen x

bullen4

I wish he had been in David when Lilliam first had her problem diagnosed. However, He was a god send when she was advised to see him in Panama City. See Previous post for office hours.

Dr. Ricardo Bullen – New Dermatology Clinic in David – May 16

UPDATED May 6: Office information at end of post.
It is a pleasure for me to announce a new dermatology clinic that will be opening in David.

I recently received an email from Dr. Ricardo Bullen, who notified me that he will be opening a Dermatology Clinic In Hospital Chiriquí in Office #1 on the main floor.

He said they are currently in the process of getting furniture and setting up the office. His intent is to be open in March.

His main clinics are in Panama City in Paitilla and San Fernando from Monday through Friday.

The new David Office will have office hours on Saturdays from 9:00 AM until 5:00 PM.

Following are Dr. Bullen’s current websites:

www.ricardobullen.com
www.dermatologypanama.com
www.dermatologiapanama.com 

Following are Dr. Bullen’s Credentials:

Board Certified Dermatologist

Sub specialty skin cancer surgery  Mohs surgery

Dermatology training – USA and Canada – McGill University and Boston University,  clinical dermatology – University of Wisconsin and University of Texas,  skin oncology, skin cancer surgery Mohs surgery and reconstruction.

George Washington University – Director of the department of dermatologic , surgery ,Mohs surgery and reconstruction 2008-2011

Medical Lic. Panama, California, Massachusetts, and District of Columbia.

Now on a personal note, I have been wanting to write up Dr. Bullen’s practice for some time. Continue reading Dr. Ricardo Bullen – New Dermatology Clinic in David – May 16

First & Last Visit to Policlinica David

Back on November 17, we escorted the stroke victim for his scheduled examination at the Policlinica. This had been scheduled by the doctor when he had seen him in the Regional Hospital several months ago.

IMG_0628One of the benefits of the new residence for the stroke victim is that he was able to be transported to and from the Policlinica or other medical facilities by ambulance. While not an easy trip, it was easier than loading him in and getting him out of my car,

He was taken by wheelchair to the ambulance and then moved to the ambulance gurney. At the Policlinica, he was put back in the wheelchair. There is when the ordeal began.

It took over 2 hours to see the doctor, even though the visit was scheduled, the lead caretaker from Hogar Santa Catalina had to stand in many lines because it was his first visit and had no chart. We were finally told that appropriate paperwork wasn’t there and we could not see the doctor. The letter I carry as introduction from the Embassy finally convinced them to make an exception. The charge was only $2.00+. The doctor we saw (who will remain unnamed) was a horrible example of doctor.

He did a very cursory examination and then proceeded to berate U.S. citizens as being indigent and unable to pay their bills at Chiriquí Hospital (where he also offices). Of course I have dealt with several cases, where U.S. citizens have been charged tens of thousands of dollars (one was $40k+) for operations in Chiriquí Hospital and then when their funds ran out, they were moved to the Regional Hospital. Doctors like him can cause many people to become indigent.

Lilliam set him straight on his accusations. Luckily I got experience with this doctor without being a patient.

Needless to say, that is one doctor who will not see the stroke victim again. The lead caretaker didn’t like the doctor either, however, she comes from a belief in really caring for people. On returning to Hogar Santa Catalina, she had another doctor perform a physical and he was scheduled a complete lab workup.

I continue to be impressed with Hogar Santa Catalina. I am convinced that better care is not available for the elderly in Panama.