Contrasts in Medical Practice

This week in Thailand, I had a minor medical issue for which I wanted to consult a professional.  I walked to see the local nurse, who practices out of a storefront.  I don’t know her qualifications.  She speaks some English.  I told her my symptoms.  She asked me a few questions, and then she told me I needed an antibiotic.  She explained why my particular symptoms merited an antibiotic.  She asked me if I had any drug allergies, and I told her no.  She did not create a file; she did not even ask me my name.  She gave me the appropriate antibiotic and charged me 200 baht.  This is the equivalent of roughly $5 U.S.  That’s $5 total, for both consultation and medicine.  The next day as I was walking past her store, she hailed me and asked me if I were better.  Yes, I was.  Thank you!  

Last summer in the USA, I developed a very minor medical issue for which I wanted to consult a professional.  There are no nurses practicing out of storefronts for minor medical issues!  Instead, I made an appointment with a physician who was board certified in Family Practice.  Since it was my first appointment with that particular doctor, I had to wait a few days, until there was room in the schedule for a new patient.  At the appointed hour, I showed up; but I had forgotten my wallet, which contained both my cash and my insurance information.  Although I told them I could bring payment before their office closed for the day, they refused to send me back to see the doctor until I could produce some form of monetary deposit.  Because I had no money on my person, I had to reschedule, get the money, then come back and wait again.  The doctor I originally had planned to see was no longer available for that day, so I agreed to see a different doctor.  Once I was called back, a nurse recorded my weight, height, temperature, blood pressure, medications taking, allergies, and symptoms.  She put all this information in a chart.  The nurse then took me back to a private room in a very expensive building, where the doctor spoke with me about my symptoms.  She looked in my throat and ears, etc.  She told me I needed an antibiotic.  She explained to me why my particular symptoms merited an antibiotic.  She asked me again if I had any drug allergies, and I told her no.  Everything is now written in my file, including my insurance information which is in its special place on the front page.  For this office visit, I paid a $25 U.S. “copay.”  My insurance company was billed for an additional $140 or so (though through some agreement they only paid about $90).  This cost did not include the antibiotic prescription, which I had filled at a pharmacy.  I don’t remember the cost of the antibiotic. 

This is only the tip of the iceberg, in describing the differences in medical practices – and costs – in different countries.  

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