Saturday, May 11, 2013

Medical Care in a Former Soviet Bloc Country 2013

May 11, 2013

I don't know how other people's experiences have been regarding medical care in their host countries, but mine has been pretty darn good here in GdaƄsk.  Tricare found a medical facility for me when I got pregnant, and my local Polish friends say it's one of the best in the city. Most Poles rely on the national healthcare system, while a lucky few have private insurance. Private medical facilities like ours only take private insurance payments or cash.  They also tend to have the newest technology and draw more specialists than the state-run clinics and hospitals.  The national healthcare system now relies on these private facilities as contractors for more "specialty" medical procedures.  For example, the facility I use, SwissMed, has the one of the only heart cath labs in the area, so, anyone (private or public) who needs a heart cath goes to SwissMed hospital, and then the State foots the bill. 

There have been a few....cultural differences that I wasn't expecting regarding medical care here that I thought I might share with y'all.  For future Olmsted Scholars coming to Poland, please, take notes.

I've asked several of my Polish friends here about every one of these differences, and they all looked and said, "well, DUH, what did you expect? It's always like that."  My boss, who lived in Florida for 15 years, said, "oh yeah, I should have told you that you would have to do that, and it doesn't make sense to 'people like us' (AKA Americans)"......so, it sounds like this really is the way it is here and not just things happening to me!

1. Things are done very differently at Doctor's offices here than in the U.S.  I don't know if this extends to the rest of Europe or not.

2. The Doctor does not go from exam room to exam room. Doctors see patients in their own little "gabinet" or exam room.  The Doctor has their desk, computer, relevant equipment (ultrasound, EKG, etc), changing room, bathroom, and exam table in this one room. The patients line up outside the door and are seen one by one.
  
3. Labwork can be done wherever the patient chooses. Most people (even at State facilities) have their blood taken at the Doctor's office, and then they take the samples themselves (by car, bus or on foot) to the lab of their choice. They pay the lab, and drop off the samples.  It's their "responsibility" as the patient. The majority of veterinary practices are like this too, the vet draws the samples and sends them with the owner. 
Full-service private facilities will send the labwork off for you, and I have never had to do this.
I did it once though, since it was closer to our house and we could have the blood taken there too....and I'll never do it again. It takes too much time and too much driving.

4. Sterile urine collection cups must be purchased at a medical supply store or pharmacy by the patient. Doctor's offices and labs do not have them on hand for you. You must bring one with you to each Doctor's appointment just in case a urine sample is requested at the time of your visit (even at my fancy clinic).

5. The first person to see your labwork results is...YOU, the patient. You must show up in person to sign for your results at the Doctor's office or the lab itself, and then make an appointment to discuss said results with the Doctor in person. The doctors here will not discuss labwork with you on the phone or by email (this happened to me twice, two different doctors).

6. The only time your Doctor will see your labwork results before you is if you are hospitalized.

7. Most labs do not and will not fax or email results to you or your Doctor. If you ask them to do this, they look at you like you suddenly grew three heads.

8. If you are not able to physically pick up your results, you may sign a form so that someone else is authorized to do so (AKA....my husband).

9. Glucose Tolerance Test.  Most pregnant women have to do the 1-hour test as a routine screening.
In Poland, if you do not go to a fancy private clinic like I do, you will have to purchase your own bag of glucose powder (50g or 75g) at your local pharmacy or medical supply store BEFORE you show up to take the test.  Hopefully, you don't have to then provide your own water to mix it into when it's time to drink it....

Most of you will probably find these things simply ludicrous, but it's just normal life here. 

If you find yourself living in a foreign country and needing medical care, be sure to ask about things like this, no matter how off-the-wall it may seem. I had NO IDEA that I needed to do some of these things, and the Doctor never advised me otherwise (probably not aware of the cultural differences...she's only worked in Poland and in the UK).

I'm sure that his list will grow as my pregnancy progresses, but I'm learning quickly!

It may be a good thing that Tricare is forcing me to have the baby on base in Germany, at least there won't be any surprises at delivery time like "oh, you have to bring your own linens and surgical pack with you for the birth!"