Visiting a Panama medical clinic: is it expensive? a huge wait? effective?

  Forecast: 88°/76° with thundershowers likely; 
Humidity: 76%
Sunrise 6:09 am., Sunset 6:28 p.m.

"Medical tourism" is a thing, and there are definitely people who travel out of the U.S. to get medical work done in countries where it's cheaper and no less effective, one would hope.

I wasn't really planning to make use of the medical care system here in Panama if I could help it, but at the same time I was pretty curious about what the experience would be like.  So when my time in Chile gifted me with a mild-but-annoying cough and a low-grade fever that lasted a full week, I decided it was time to check it all out after all, for the sake of research.  Oh, and also to try to get better.

First visit

The "Clinica Albrook" is a 5-minute walk from my house, in a small shopping center (grandly called "Albrook Plaza") across from the vegetable market where I can pick up mangoes for 10¢ each and 30 eggs for $5.  The vegetable market is clearly a way to rock the low-cost good life; what about the medical center?

I showed up on a Monday at 12:15 with no appointment; since I wasn't already in their system, I was given a 4"x6" card with information to fill out: my name, passport number, address, age, etc. It took me about 5 minutes to fill out the form, largely because the first time I mixed up "cedula" and "celular" (ID # and cell phone #)--extra embarrassing, because the form was written in both Spanish and English.  Five minutes after that, I was already in with the doctor.  A 10-minute wait with no appointment? Pretty impressive.

The doctor spoke English even more fluidly than I speak Spanish, especially after I asked him to speak a bit more slowly.  He encouraged me to tell my friends how nice it is here; Panama is a melting pot and very welcome of its multinational inhabitants.

The doctor checked me over quickly: my throat gave it all away, he said: an infection.  He also checked my ears and lungs (surprisingly clear, given the amount of time I've been coughing, he noted).  He wrote out three prescriptions that I would take over the course of three days: an antibiotic, decongestant, and expectorant.  

Note what didn't happen: height, weight, full medical history, throat culture, blood work, blood pressure, temperature.  I was also a bit surprised by the 3-day regimen, because in the US I'm used to a week or more on antibiotics.

At any rate, I paid my bill ($16), pretty impressive -- in New York City, that could be the price of a dozen eggs, I hear!  The total time in the clinic? Twenty minutes.

I went next door to the Arrocha (the local drug store chain) and got my prescriptions filled right away.  Even with no insurance or copay or anything, the cost was $28.69.  

Note that the pills don't come in plastic bottles.
I'm supposed to take the pills with food, so the pizza was medicine, too.

Visit number two

I took my three-day course of meds on Monday, Tuesday, and Wednesday.  I started feeling better, maybe, but only marginally, so I decided to head back over on Thursday.

This time, when I showed up there were six people ahead of me in the waiting room.  I was already in the system, so I didn't need to fill out any forms (!), but I did need to wait 20 minute to see the doctor.  I explained my previous visit, showed her my meds, and described my current symptoms.  She was more thorough than the previous doctor, taking my pulse (normal), blood pressure (normal), temperature (normal), and looking at my throat ("whoa!").  Obviously, I still had a throat infection.  

She ordered a blood test, telling me it would take 20 minutes to get the results back.  I did the blood test in a little room across the hall; it was just like blood tests I've done elsewhere. I didn't have to wait at all to get the test done, and even though I was settling in for a 20-minute wait to get the results, after 5 minutes I was called back into the room with the doctor.  Sure enough, I still had a bacterial infection.  This time, she prescribed a two-day course of injectable penicillin, and gave me my first shot right away. She also renewed one of my decongestant medications.

This doctor spoke only Spanish, and a couple of times I had to ask her to slow down and repeat herself, but she was very careful to do so, and made sure I didn't have more questions before I left.  The whole visit -- waiting time, doctor time, lab time, consultation and injection, and visit to the next door pharmacy, was one hour.  This time the total cost was $45.  

Visit number three

Back, as preplanned, for shot number 2.  Again there were about 4 or 5 people ahead of me, and again it took about 15 or 20 minutes to get in to see the doctor -- the same one as I'd seen three days before on Monday. He noted that my throat looked much better than earlier, but wasn't healed yet, and agreed that if I wasn't all better by the next day (Saturday), I should come in again; he'd be there at 1 p.m.  He gave me my shot, which I then paid for, and sent me on my way.  

Visit number four

As I write that title ("Visit number four"), I realize it sounds much more annoying than it felt. Truth is, I was really getting to appreciate the chance to chat with my doctors in real time over the course of the week.  In the U.S., getting an appointment to see a doctor is a hassle, and the visits themselves are full of administrative questions ("Yes, I'm still on the same insurance as I was yesterday!"). In contrast, there was surprisingly little-to-zero paperwork in Panama, and the doctors seemed to really be focusing on me.  I liked the feedback on how I was doing and what to expect next.

Indeed, when I arrived Saturday for my fourth visit, the doctor was out in the reception area and he started singing a Disney song to me as he saw me; he then led me back into the consulting room.  He confirmed what we'd talked about yesterday; all was heading in a good direction down there in my throat, but the irritation from the infection would persist a bit beyond the infection.  He prescribed throat spray (with a bit of antibiotics) that I'd take for one more week.  When I said, "and if I'm not better in a week?", he immediately said, "Then come on back and we'll shoot you up with more drugs!".  

He also, because I asked, described the different philosophies regarding antibiotics in the U.S. and Panama. I was surprised at the short amount of time for my prescriptions, since I was used to taking antibiotics for one or even two weeks, not just two or three days.  What he said is that the U.S. tends to use weaker, more focused antibiotics (amoxicillin); in Panama they use broad shot powerful stuff, and you don't want to use it too long or it wipes out the good bacteria, too.  I'm not enough of a doctor to know how accurate this description was, but it does explain what I'd been curious about, which is the amount of time I was taking pills. 

I had been thinking of making a "Buy three visits, get one free" joke at the front desk, but when I stopped to pay, they waived me away, saying the re-consultation doesn't cost anything.  So I guess my joke was the truth!  The pharmacy filled my latest prescription, and I was home again within a half-hour or so of when I'd left.  

Visit number five

A week later, I went back for a follow-up, and all was looking much better. My anti-inflammatory prescription was renewed, but the doc said no more antibiotics were necessary.  It's such a relief to be on the mend.

Visit number six

Didn't happen.  I got better.

Summary

All in all, I had five different trips to the doctor/pharmacy in a tad more than one week.  The total amount of time I spent was less than five hours, and the total money I spent (consultations, lab test, shots, medications, and all) was $167.34.