I went to the doctor yesterday, and I thought you might be curious what differences I’ve observed in Bahamian medical care and the care we’ve received in the U.S. Yesterday’s visit was unexpected, though I was due for a check-up, so it was good for me to get established at an OB/Gyn here. We’ve been ill in the C household this week. KLC was first, and then I caught what she had: fever, aches, sore throat, blah. KLC recovered quickly, but as I recovered I began to develop some strange symptoms.
A couple of the symptoms I won’t describe, but they led me to think that going to the OB/Gyn was a good idea. I won’t be graphic in this post, but feel free to stop reading if you haven’t already been turned off by the words “lady doctor” in the title. I also noticed painful, blistering bumps on my hands and feet. What in the world? Enter Dr. D and the Pros and Cons of a Bahamian OB/Gyn office.
- Last-Minute Scheduling: After hemming and hawing and posting a query about my symptoms on a closed Facebook group with mothers and medical professionals, I called for an appointment at 10 AM. The only OB/Gyns I’ve heard much of in Nassau are a married couple, the husband practicing near me downtown in their main office and the wife practicing “out west,” 35 minutes away. I called the husband’s office since she doesn’t have office hours on Friday, and I got an appointment for 10:40 AM.
- Minimal Forms: Is it just me, or do you have to fill out your entire life history on 10-12 sheets of paper or 100 computerized screens to go to ANY doctor in the states now, ESPECIALLY the first time? Well, at Dr. D’s office, I filled out the front side of a sheet of paper, handed over my insurance card, and done!
- Coffee Machine: I’m a sucker for a waiting room coffee machine, even if the coffee is crap. At this office, they have an old-school coffee/hot chocolate/latte press-the-button-and-fill-your-styrofoam cup machine. Fewer forms, more hot chocolate. So far the Bahamas is WINNING the waiting room experience.
- Personalized Care: As I was getting checked in, the nurse took my picture. Wet hair, no makeup, in front of a detailed diagram of a vagina. “Um, do you always take patients’ pictures in this spot??” I was laughing so hard that the picture was at least a smiley one. I’ve never had a doctor in the U.S. take a picture of me. There’s probably a law against it. I don’t have a reason to like this or dislike it, but it was interesting. Then, when I met the doctor, I mentioned that I heard he was part of a dramatic birth from a lady in my Bible study who had a placental abruption. He agreed with me that we were all so grateful for the amazing outcome (full return to health for mother and healthy baby due to fast action on his part). I’m not sure a doctor is supposed to talk about other patients (he didn’t tell me any details), but it felt very human to mention my respect for him because of that case. Also, he said he would call me personally with the results of the labwork he was ordering and wanted to know if I was OK with hearing the results over the phone.
- Insurance Verification: This is very strange. I’ve now been to the pediatrician, the dentist, the OB/Gyn, a medical laboratory, and a pharmacy. At each place where I show my insurance card, they call the benefits verification line on the spot in my presence so they can correctly calculate what I owe. Also, every time I have to sign a form detailing what procedures were performed and all of the codes that is to be submitted to insurance on my behalf. This all makes sense, I suppose, but it’s a little cumbersome and definitely not how it’s done 99% of the time in the U.S. Yet, I will call it a “pro” since it’s a much more straight-forward system than what I’ve experienced in the U.S. Also, the phone call and the whole process generally takes less than 5 minutes.
- Working Within the System: I didn’t ask for it, but along with seeing me for my symptoms Dr. D suggested doing my annual Pap Smear and billing my visit as my annual exam, which is no cost to the patient. I appreciated that.
- Outside Laboratories: No medical offices seem to have their own laboratories here. Our pediatrician and the midwives we saw in Texas had labs in-house, so there was no need to make another stop in the car for blood work. I also had to drop off another sample Dr. D took at the lab. This was my second time to get blood work here, and both times they had trouble getting the amount they needed. Not fun.
- Odd Costs: Medical care tends to be more expensive than you think it will be no matter where you are, but here there are some odd costs that come into play. My “free” preventative annual checkup cost $40 for the “transport fee” for the Pap Smear. They have to send it to the U.S. to get it processed, so the extra fee makes sense, but why does that cost get passed on to me? I was fine paying it, but it seemed illogical. Also, the costs at the lab were rather high, even with 80/20 cost sharing from the insurance company, likely because everything there also has to be sent to the U.S.
- International Medication: I came home without a firm diagnosis but with 5 (!) prescriptions. I told Dr. D that I might not take them, especially the two pain medications, but he prescribed them just in case. One of the two pain meds was out of stock, and the other isn’t FDA approved (though it’s legal in other countries). Eh, good thing I wasn’t really planning to take them anyway. The pharmacy silver lining: guess how much 5 prescriptions cost me with insurance coverage? $15.00.
- Cleanliness: I had heard this was true from others, and I can confirm now from my own experiences: most of the medical facilities seem a little dingy here. Bummer.
- Possible Missed Diagnosis: When I got home from this multiple hour medical extravaganza, complete with a momma stressed over her baby’s well-being and a malfunctioning cell phone, I had an interesting reply on my Facebook post. “Could you have hand foot and mouth disease? Has your child been sick?” Well now, I hadn’t thought of that. After Googling and trying but failing to get back in touch with the doctor, I am fairly sure that’s what KLC and I have. I didn’t bring KLC to the doctor because her case was mild, but she had a few bumps on her body as well. Thanks to medical friends SV in TX and TB in CT for helping us talk through the potentials and helping me feel good in my decision to hold off taking any of the medications for a couple of days. Hand, Foot, and Mouth resolves on its own in a few days, so I’d rather wait to see if my symptoms clear without the cocktail of medicines I was prescribed for a vague diagnosis.
- No After-Hours Call Line: This morning, when the office reopened, I learned that there is no after-hours call line and no way to send a message to a doctor unless he is in the office or has given you his cell number for when you’re close to having your child. Oh, well, then.
I actually have rather enjoyed this process of experiencing the Bahamian medical system, and I was very grateful for the support I had from my neighbors and T watching KLC while I went to my appointments. I would prefer to not have my symptoms, but they are fairly manageable. It helps to feel poorly on the weekend when your spouse is around as well. Also, having the diagnosis of Hand, Foot, and Mouth is much better than some of the potential diagnoses Dr. D suggested. I have been relieved since I began to read about the disease and I realized how much better my symptoms matched it than anything else I had considered.
Onward to health and sunny days!