standard of care

arturo · 10-11-12, 10:25 AM

When the Queso Grande created this section, instead of saying "Let there be light" he said
What I like about doctors down here is that when you find a good one and form a good relationship, they truly become like extended family. You get their home number, their cell number and they often make house calls when needed. My doc down here in San Quintin has become a close, personal friend. You can't put a price tag on that...

That makes such a great keynote to start on.

Last year I sat for the diplomado in medical tourism offered by the Health without Borders cluster and UABC. More than a hundred doctors and dentists showed up for the course. The organizer asked them all what they felt distinguished the practice of medicine in Mexico from that of the United States. They all agreed on the phrase "nuestra calidez". Now it's true they're warmer and friendlier but what's really interesting is that they have obviously made a conscious decision to be so as an integral part of their profession.

One gynecologist told me that the Mexican medical profession is determined to keep malpractice law out at all costs because of what it's done to medicine in the U.S. "We have to do what's best for our patient," he said, "not what's best for our malpractice insurance. We need the freedom to try new solutions and not worry about lawyers looking over our shoulders blaming us for not following precedent."

Here in Mexico malpractice is a felony, which has discouraged the ambulance-chasing attorneys, but it also sets the enforcement bar high. "The D.A. doesn't like prosecuting cases that don't involve serious injury or death," said that gynecologist, "because the punishment is too harsh." On the other hand, tort law in the U.S. has created a bloated, expensive, and mediocre health-care system.

Here we are on the border between those two systems. It will be interesting to see how people who have known both view each of them. When you consulted with a doctor on either side of the border, were your expectations different? What sort of results did you expect? And what sort of results did you get?

BajaGringo · 10-11-12, 10:51 AM

I totally agree with your post. When I go to the doctor in the states it often feels like I am talking to an attorney; the doctor carefully choosing the right words to answer my questions and often giving me answers that are so carefully construed they only leave me with more questions.

With my doc down here I feel like I can have an open, frank and honest conversation and discuss all the realities/probabilities. Maybe that isn't for everybody but for me, that is what works...

longlegsinlapaz · 10-11-12, 02:27 PM

arturo, just in case you missed it, there's another older medical thread here:

http://www.talkbaja.com/showthread.php?t=356

Like BG, I've thoroughly tested the medical system, just a lot farther south of the border area; I too feel the doctors are much more thorough & straightforward in their dealings with patients. They may not have all the latest diagnostic equipment in all instances, but they make up for that with their examinations & questions. Pricing here is also MUCH fairer than NOB!

Since I'm still alive, I guess that means my expectations have been met!

Woooosh · 10-11-12, 05:03 PM

Quote:

Originally Posted by longlegsinlapaz

arturo, just in case you missed it, there's another older medical thread here:

http://www.talkbaja.com/showthread.php?t=356

Like BG, I've thoroughly tested the medical system, just a lot farther south of the border area; I too feel the doctors are much more thorough & straightforward in their dealings with patients. They may not have all the latest diagnostic equipment in all instances, but they make up for that with their examinations & questions. Pricing here is also MUCH fairer than NOB!

Since I'm still alive, I guess that means my expectations have been met!

At what point would you seek a medical opinion/care on the other side or do you use the Mexican healthcare system and hope for the best? Are you too far south in BCS to even to even think about that.

kate · 10-11-12, 08:15 PM

Quote:

Originally Posted by Woooosh

Are you too far south in BCS to even to even think about that.

Bingo, at least personally speaking, though I doubt many folks move to La Paz and points south expecting to get medical care in the US. It's simply too far, and too expensive to get there. It's not really do-able. I do know of two people whose doctors sent them to Guadalajara for major issues like a rare cancer and a heart problem. I also know someone who goes to the San Diego VA clinic periodically for specialized treatment. But those are exceptions.

Many expats in BCS are snowbird types who probably get a good portion of their medical care handled wherever they live when they're not here. But judging by posts on the local expat Yahoo group, even those folks use the local system when they're here.

Woooosh · 10-12-12, 09:14 AM

In reality, I suppose only the fittest retirees plan to retire that far away from the border and their traditional healthcare providers. The part-time snowbirds have flexibility and head south when they are fit to fly.

longlegsinlapaz · 10-12-12, 10:01 AM

Quote:

Originally Posted by Woooosh

At what point would you seek a medical opinion/care on the other side or do you use the Mexican healthcare system and hope for the best? Are you too far south in BCS to even to even think about that.

Woooosh, I've made fairly extensive use of local healthcare professionals here in La Paz....and lived to tell about it!

To a certain degree, as Kate indicated, there's the financial, distance & time element that could be a consideration. But, based on my personal experiences, I sincerely do have faith in my doctors here & since this is my full-time home, I don't plan on making any trips NOB for medical....possibly only if recommended by my local docs. Much of my medical has been on an emergency basis; anaphylactic shock due to wasp stings, wind-blown sand embedded in eyeball, etc; but I have had a couple elective non-emergency procedures performed here as well, cataract surgery for instance.

I've been well satisfied with the level of care I've received locally; it's much more affordable & gas for a 10-mile drive into town beats the hell outta airfare, plus I have the convenience of recuperating in my own home! So while not saying never....it's doubtful that I'd head NOB unless there was a bona fide need, i.e., the required care was simply not available here.

As close to the border as you are, you have more options to decide between.

kate · 10-12-12, 11:21 AM

Quote:

Originally Posted by Woooosh

In reality, I suppose only the fittest retirees plan to retire that far away from the border and their traditional healthcare providers.

Maybe it's simply a case of not having any major health issues. Still, as mentioned, many people feel comfortable with or even prefer the care available here in Mexico. While it's tempting to compare the Fidepaz hospital in La Paz with (say) the Mayo Clinic, in real life many of us would be limited to Medicare providers if treated in the US. I know for sure I would be. Maybe that's okay I honestly have no idea but I don't necessarily assume it would be better than private care here.

I'm probably the last person who should be commenting on this thread, being sort of fatalistic and not having lived in the US for over 30 years. But based on the few occasions when I've needed medical care there while visiting, I'm not favorably impressed with how it has evolved since the '70s. It's unbelievably costly, and often you spend more time on paperwork than you do seeing the doctor. I can't help feeling that I'm paying mostly for accounting systems and malpractice protection, as Arturo mentioned.

Woooosh · 10-12-12, 08:09 PM

My family in Mexico prefers their Mexican caregivers for the reasons you stated- they take the time to talk with you. My mother in law recently recovered from a stroke in Torreon and she's doing well now. She is a US resident and we could have taken her NOB, but no one saw the need. The psychological aspects of healing are important in recovery and she has spent 80 years with mostly holistic care. Whatever works. Mexican doctors don't have the threat of malpractice suits over their heads. They don't have pushy pharmaceutical and medical sales reps out their doors. They don't have to beg for payment from Medicare or insurance companies. Must be nice. But they also don't have a lot of basic medical technology and diagnostics. Still sounds like most expat retirees are "sturdy" by nature, which def helps.