Medically Alone in Paris

Written by admin on February 19, 2010 – 11:55 am -

It’s common knowledge that France has one of the best health care systems anywhere.  In 2009, the World Health Organization (WHO) declared it the best in the world.

Knowing that and considering my late husband experienced French medical care all too frequently, why did I fall apart over having cataract surgery last week? My English-speaking internist recommended the cabinet of renowned ophthalmologists in whom she has confidence.

I was able to get an appointment nearly immediately—a good thing because waiting for medical appointments is not good for my nerves or disposition. I sailed into Docteur Caputo’s office in the 16ème near the Trocadéro.  Immediately surveying his walls, there were zero framed diplomas attesting to where he attended school, whether or not he was a real doctor, much less one who was competent to make me see clearly again.

Plopping down in his chair, my first question was, “Do you speak English?” Not missing a beat, his response (with a French accent) was, “Yes, my mother’s from New York. She and my Italian father met in the U.S. and they moved to France.”

Georges (by now, we were on a first-name basis—or I was) assured me he goes to the U.S. at least twice a year. And yes, he was qualified to operate on me—for that matter, he makes his living constantly doing surgery and has the newest ultrasound equipment.

Already, I felt better, if still scoring high on the anxiety scale. Georges explained he’d remove the lens and replace it with a new synthetic one. An Acrosof IQ lens was inserted into the “pocket.”  What a coincidence it’s made in Fort Worth, Texas. I wouldn’t have known this if I hadn’t been handed a patient implant identification card as I was leaving the clinic after the outpatient surgery. The nurse instructed me to always keep it in my wallet because it contains the precise information about my new eye.

It’s amazing how the French and most Europeans keep every medical document and the results of all the tests and vaccinations they’ve ever had since they were born.  It’s a complete difference between Europeans and Americans. We’re so used to our primary care doctor keeping our records that when my Paris internist asked me about a surgery I had 20 years ago, I simply couldn’t answer and it was a quasi-major operation. But Nancy, the internist of enormous patience, will simply have to guess about the results.

Another difference between French and U.S. medical care is that it’s rarely one-stop shopping unless you’re a patient at the American Hospital of Paris.  In order to prepare for the surgery, I had to go to three different offices in various sections of Paris and Neuilly-sur-Seine.   Then there were the two trips to the pharmacy for pre- and post-surgery medications.

One of the other things I learned is unless you have family, surgery when you’re overseas and alone makes you feel vulnerable. When the admissions clerk at the clinic asked for an emergency contact, I gave her the name of my son, who was snowed in and under in Washington, D.C.

If there had been a problem, what could he possibly have done except to come and collect my body? I should note this surgery was done seven days after my first meeting with Docteur Caputo and perhaps my thoughts weren’t as organized as they should have been.

Prior to the cataract surgery, I surfed the web and then some. It’s a now-routine procedure with few complications.  But there are always some oo-la-las.

Another conclusion: if you’re at all language challenged, it’s important to have a doctor who can talk to you in your native language or take a translator. It’s essential patients understand all of the ramifications.

During the 35-minute-long procedure, I wanted to know precisely what was taking place, but Georges was having none of it and had draped the surgical area.  If only he and the people who were assisting him would speak up, I would have loved to ask questions.

When I was in the recovery room for observation because I’d had local anesthesia, I started firing off what’s and why’s immediately and guess what?  Amazingly, I was asking them in French. The staff responded in English.

OK, happily this was a simple surgery. But expats in foreign countries should examine their tolerance level and whether or not they should return home if they’re ill.

Patients tend to be nervous and aren’t always listening as well as they should. Line up your friends and support system. Undergoing  these types of procedures are enough to make a calm person nervous.

The morning after the surgery, the doctor wanted to check on how the procedure had gone.  He was pleased with the results. I was a bit tired, but was reassured about my vision since it didn’t slow down my tapping away on my BlackBerry. I stuck around the apartment, but that was more because of the sub-zero Celsius weather than because I didn’t feel well.

When I went for my second check-up, it was apparent I was the only patient who was alone. After all, this wasn’t a dance where it takes two to tango. I questioned Docteur Caputo if that were always the case, to which he responded I’d have to ask the other patients.

On my way out of his office, I told Georges I was writing an article and wasn’t he curious to see what I had to say about my brush with French medicine.  It was only then he gave me his email address. French doctors don’t do that! Hey, merci Georges. First, I can see and second, I realize I can navigate the French medical system and go at it alone. Does this mean I’m a grown-up who can operate nearly anywhere?

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Posted in Paris |

Medical tourism is booming

Written by admin on September 26, 2008 – 2:46 pm -

Don’t be shocked if some more affluent friends return from faraway trips looking extremely well rested. Look more carefully. There may be telltale scars. Medical tourism is booming.

Medical tourism is on the rise. Some noted destinations are India, Brazil, Argentina, Panama, and Malaysia. According to statistics by McKinsey & Company and the Confederation of India, it is forecast there will be an explosion of people heading overseas to save money to have certain procedures done.

In 2004, an estimated $40 billion was spent in the medical tourism industry. It’s forecast that by 2012, revenues will top $100 billion. Brazil is known as an international Mecca for cosmetic and plastic surgeries. Ivo Pitanguy, the world-renowned plastic surgeon who opened a clinic outside of Rio de Janeiro more than 40 years ago, catapulted the country into the limelight. He trained doctors from all over the world and if you were a disciple of the master, it was tantamount to the plastic surgery Good Housekeeping Seal of Approval.

Currently, Brazil is the second largest market for plastic surgery in the world after the U.S. That’s attributed to the high quality of service and its comparatively low cost.

Brazil is also becoming a medical tourism destination for other types of procedures. It has the most hospitals of any country outside the U.S. that are fully accredited by the Joint Commission (JCAHO), the largest U.S. hospital accreditation organization, according to MedRetreat, a website dedicated to medical tourism.

The flight time is approximately 8 to 12 hours from most US cities. That’s an additional reason that the country is predicted to become one of the world’s most dominant economies, according to Jim O’Neill of Goldman Sachs.

Panama is another country that’s hopped on the medical tourism bandwagon. The costs, on average, are 40 to 70 percent lower than costs for similar procedures in the U.S., according to a report on medical tourism published by the National Center for Policy Analysis (NCPA) last November. Hospitals catering to foreigners are clean and English is the lingua franca among the personnel. Many of its doctors have been trained in the US and the country views medical tourism as a way of bolstering the economy.

Costa Rica, like Panama, has become a popular destination among North American patients for inexpensive, high-quality medical care. Costs of procedures are generally cost less than half of the same procedures in the U.S.; the price of a dental veneer, for instance, is approximately $350 in Panama, whereas the same procedure is $1,250 in New York or Chicago. With those types of savings, you can afford to take a vacation.

Malaysia’s medical tourism industry has experienced staggering growth over recent years. According to the Association of Private Hospitals, the number of foreigners seeking healthcare services in Malaysia has grown from 75,210 patients in 2001 to 296,687 patients in 2006.

The large volume of patients in 2006 generated approximately $59 million of revenue. It’s projected that the number of foreigners seeking medical treatment in Malaysia will continue to grow at a rate of 30 percent a year until 2010.

There’s wide array of available medical procedures—including dental, cosmetic and cardiac surgeries—at significantly lower costs than in the U.S. In Malaysia, cardiac bypass surgery costs approximately $6,000 to $7,000.

India has become a well-known medical tourist destination for cardiac and orthopedic procedures. In the past, American patients have traveled to India for procedures such as Birmingham hip resurfacing, which wasn’t unavailable in the U.S. since it hadn’t been approved by the FDA until recently.

Medical tourists also journey to India for procedures that cost a small king’s ransom in the U.S.; for example, Apollo Hospital in New Delhi charges $4,000 for cardiac surgery while the same procedure would cost about $30,000 in an American hospital.

But not all US doctors are sanguine over people traveling abroad for medical care. If something goes wrong, they’re in far-away countries. And many people don’t allow enough time for extensive follow-up visits.

But unless medical care (and not just cosmetic surgery which is a luxury), are covered by insurance, there’s bound to be a surge of people traveling overseas for various surgeries. It may mean life or death.

(Listen to me discuss this issue on WTOP.)

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Posted in Consumer Traveler |