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A Balance of Patience and Persistence

October 31, 2012

Posted by Kanga.

Part of me wants to sing the praises of health care here and say it is much better than back in the States, but that isn’t true. It is just different. It has different challenges and different advantages.

The big advantage is being able to be seen right away or at least same day. You may have to wait awhile, but they will get you in. This is in contrast to the States and having to call for an appointment, that, if you are lucky, is a week away or waiting until after 6 pm so you can go to “urgent care.” (Nothing quite like having a urinary tract infection and they want you to wait a week to see the doctor or having a lump in your breast and having to wait two weeks before you can get a mammogram to determine whether it is benign or killing you.)

The most prominent challenge is that you have to be both patient and aggressive to get what you need. In the States, clinics and hospitals are very structured and have built in barriers to keep the patients contained and controlled. There are several layers of employees between you and the doctor and their job is to make sure you stay in line. It is very clear where the “public areas” of a clinic are versus the inner sanctum of the exam rooms, labs, etc. There is a certain organizational benefit to this structure. Patients wait their turn, get treated equally, and know their place. There’s a certain comfort in that. It involves a great deal of patience and NO aggressiveness. Aggression is frowned upon.

There is a semblance of this structure here, but not the reality. There are receptionist desks, waiting rooms, nurses, etc., but none of them pose a barrier to waltzing into the exam room unannounced. In fact, the receptionist might tell you to go straight to the radiology department and ask them to perform your test without a doctor’s involvement. Of course, the radiology department will send you back to the receptionist, because you don’t have a health card and they can’t do anything until you have a health card or a number in their system. The doctor may examine you, then send you off to radiology and the lab for tests and tell you to just come back after you finish there and she means “just come back to the exam room and come on in.” I knocked and waited, because some habits cannot be shed so easily.

There will also be a dearth of signage, directions, and clear communication. When sent back to radiology for the third time to insist on getting the test done today, not next week, and dropping the name given by the doctor of the person who said the test could be done today, you may be waved on in a general manner down the hallway with no real indication of where to find this person who will do the test. So, after knocking on doors and asking random people, you join the collection of patients waiting in the makeshift waiting area and hope for the best. When someone new comes along and starts shaking hands and maneuvering for his wife to be next, you have to step up your game and make sure you get in next. After the test is done, don’t expect the technician to politely tell you that the test is done and that you can get dressed now, but she will act surprised when she finds that you are still laying on the table because she hasn’t told you. When you ask if there is paperwork that you should wait for, she will give you a vague answer which leaves you waiting outside the door hoping that it is not for naught. When you go to get your blood drawn for tests, there won’t be good signage or a reception desk. You are supposed to just poke your head in the rooms until you find someone willing to take your blood.

Then it is back to the doctor for the wrap up. Finally, you are given medication prescriptions and can call it a day. It only took from 9:00 a.m. to 12:33 p.m.

We had to go to the government run clinic because the private hospital didn’t have the staff on duty (holidays) who could do the ultrasound, so our insurance didn’t count. Out of pocket expenses: 200 AED to get a number in the system, 80 AED for the blood tests, 100 AED for the ultrasound. ($103.50) Prescriptions purchased at a RX across town – 187 AED ($51.00). I am fairly certain you could not get all that for $154.50 in the States.

black and white blurry images

The upshot is that there is no deep vein thrombosis, only a minor infection. Back to business as usual.

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