Medical Care When Traveling Abroad
Apart from traditional healing arts, which are often real hit or miss endeavors, there are two modes of receiving medical care abroad: the foreigner clinic way or the local hospital/ pharmacy way. You can either fork out the dough to soak yourself in what is suppose to be first world quality, English language medical care at a foreigner/ VIP clinic or you can go to the local hospital and pay next to nothing like everybody else in the country that you are traveling in.
After traveling for a long time, and, perhaps unfortunately, taking more than a few runs through foreign emergency rooms, it is my impression that the quality of care that you receive in either option is comparable, and it is only the price that is the biggest bottom-line difference.
Wade from Vagabond Journey.com
in Istanbul, Turkey- February 24, 2009
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Warning: this travel tip is based upon my experience alone. There are vastly different ideas of cleanliness, sanitation, and privacy in the medical setting from culture to culture. Foreigner clinics are often very clean, well ordered, and private, whereas local hospitals often look like disaster areas with half dead, bleeding, and groaning patients laying all over everything, operations virtually being performed in hallways, spectators watching you receive your medical care, long lines, and an incomprehensible order to everything. Be warned: going to a local hospital rather than a foreigner clinic is challenging, sometimes frustrating, often precarious, and always interesting. From my experience, going to local hospitals and pharmacies rather than foreigner clinics has always worked out for me, it might not for you.
My first reaction when needing medial care overseas use to be seeking out the nearest US Embassy sponsored, English speaking doctor. After trying this a few times in China and India, and always getting dubious results, doctors who really did not speak English, haphazard, run of the mill medical care, and a huge bill, I decided that I may be just as well off going to the local hospital.
So, leaving the VIP clinics behind, I went to a local hospital in Hangzhou. At the time my Chinese was shaky, and I did not expect the receptionists or doctors to speak English. So I walked into the hospital with a little note that a Chinese friend wrote for me indicating what hospital department I needed. I showed this note to the first receptionist I came to.
She said something in Chinese.
I looked at her blankly and tried to explain in gutted Mandarin what my problem was.
She looked confused, and then made way to find an English speaker.
This is the traveler’s ace in the hole when it comes to using local hospitals: doctors congregate in hospitals, doctors tend to be highly educated people, and highly educated people often speak English. In point, a traveler can usually get English language care at a local hospital for local prices, it just sometimes takes a little time for the staff to locate an English speaker to translate.
It is a myth that you need to go to a foreigner clinic to get English language medical service when abroad.
It is also a myth that you will not get quality care at a local hospital. A Westerner seeking medical care in a regular hospital in most regions of the world is a rare occurrence. It simple does not happen very often that a Westerner will attempt to brave the dirty, bassackwards medical systems of another land. Most foreigners tend to use the expensive VIP clinics and the upper class hospitals that are made for them. So when you walk into a regular hospital in a foreign country, you are usually well attended to. Often, you are treated like a true VIP.
Perhaps the doctors and staff want to give you a good impression of their country? Perhaps they know that Westerners have high standards for medical care and are worried about loosing face? Perhaps they are genuinely worried about you because you are ill in a foreign land and have no clue what is going on? Whatever the case, in my experiences, I have always been treated very well in local hospitals in foreign countries.
I remember one time when I had a small affliction way out in China’s Qinghai province. I contacted a friend who was a well respected teacher in the region, who phoned one of his doctor friends on my behalf. An appointment was arranged for me at the local hospital immediately.
The next day I strode in through the doors and was meet by the teacher’s doctor friend who spoke good English and lead me into the ward that I needed. We then walked into an examination room to find a doctor fixing up a man who had an incredibly huge gash running down his face.
At my entry, this doctor stopped what he was doing, abandoned the man whose face was torn up, and attended to my relatively minor affliction. The doctor even kicked the sliced up guy off of the examination table so that I would have a place to sit down.
Now that’s service.
The sliced up guy was pretty pissed off about it though.
The lack of cleanliness, the mayhem, and the confusion of using regular hospitals for medical care is often made up by the fact that foreigners are usually treated like guests, and the doctors and staff generally try to make your visit as quick and comfortable as possible. Every time that I have used a local hospital abroad I have been rushed to the front of the lines, attended to by English speakers or receptionists who generally lead me around the hospital making sure that I do not get lost and do everything correctly. This works out fine for me, as I probably could not figure out the seemingly complicated hospital systems myself.
And the hospital staff tends to know this.
Perhaps I have been continuously treated as a VIP in foreign hospitals not because I am from another country but because the hospital staff wants to ensure that I clog the wheels of their machinery as little as possible. In point, if I were left to my own devices in a hospital where I did not understand the language, I would probably screw everything up. A fellow who cannot speak the language of the country he is traveling in is like a small child: he requires supervision. It is my impression that it is better for everyone if a foreigner is rushed through their doctor visit as quickly as possible and then sent on their way.
There is a third option for receiving medical care abroad, and that is the pharmacy. In many countries, pharmacists act as intermediary doctors and proscribe and administer medication. If your affliction is minor, you can often visit a pharmacist prior to seeking out more expensive advanced care.
Oftentimes a traveler does not have a choice about what kind of medical care they receive abroad. If you screw yourself up out in the middle of nowhere, you take what care you can get. The option of the VIP/ foreigner/ upper class clinic is usually only reserved for the major cities of the world. If you are outside of one of these urban centers, you will have no choice but to use the local hospital. But, don’t worry, they are usually not so bad, and the cost is often very cheap.
In Hungary, Chaya and I went to a prenatal doctor that was recommended by the US Embassy, and this doctor spoke English and accompanied us o our hospital visit. The cost of this privilege was $400.
Foreigner clinics do not have to worry about reputation, as travelers are here today and gone tomorrow. Also, they tend to think that because you are from a country where medical expense are enormous (like the USA) that you can afford to pay anything for their service. In point, they will run you for all that you are worth.
In Turkey, Chaya and I went to a prenatal doctor at a local hospital, received English language care that was just as high quality as the Hungarian clinic, and received just as many test for a price of $40.
When it comes to selecting what form of medical care I receive abroad, I lean towards the cheaper option and go straight to the local hospital first. Being treated like a VIP in a run-down, dirty, and crowded hospital is often just as good as being treated like a rich idiot at a foreigner clinic.
Strategy for receiving medical care abroad
1. Try a pharmacy first- I have found that you can terminate medical problems at a pharmacy before going to a doctor or hospital. Be careful when using this option though, as a pharmacist is sure to try to sell you medication regardless if they know what is wrong with you or not. Be sure that the pharmacist knows what they are doing.
2. Try hard to find a connection- Find someone in the city that you are in who has a friend that is a doctor or who is a doctor themselves. Having a name to drop helps out immensely. It is much better to be some fellow’s foreign friend that just some guy who can’t speak the local language who wanders into a hospital one day. If you cannot find an “in-person” connection, use a social networking site like Couhsurfing by posting that you need a doctor on relevant message boards. Chaya and I did this for a prenatal doctor in Istanbul, and a doctor responded who hooked us up with his gynecologist colleague at a hospital.
3. Stand your ground- Do not be bullied by medical practitioners. If something is dirty, tell them to clean it. If you want the nurse to wear latex gloves before drawing your blood, then tell her. Don’t be a snob, just make sure that you are safe and get the care you need.
4. Make the hospital staff help you- Don’t take no for an answer. It is far easier to give you what you want than to have you clogging up the machinery with a drawn out problem.
5. Make sure you get the medical care that you need- Self-diagnose yourself to have a better idea of what you are dealing with.
6. Request an English speaker- In every instance that I have gone to a local hospital an English speaker has either been appointed to me or they have offered their services. But if this does not happen, then request an English speaker. Most hospitals have more than a few people working there who can speak English well.
7. Don’t make the visit drag on- The hospital staff wants you to get in and get out. So run behind the nurses (not joking) and get everything done quickly.
8. Don’t feel forced to buy all of th prescribed medication- In many countries doctors receive kickbacks on the medication they prescribe. If you do not think a certain medication is necessary, then hold the prescription until you are sure that you need it.
8. Get second opinions, try other options- If one visit to a medical center does not go the way you would have liked, try another. Also try other types of medicine. In China, try both Western medicine and Traditional Chinese Medicine; in India, try Ayurvedic medicine; in Tibet, try Tibetan medicine. I warn against placing traditional forms of medicine on an ideological pedestal, but don’t discard them on principal either.
In point, there are other options when receiving medial care abroad than paying Western prices out of your pocket. If you have travel insurance, then, by all means, use it! If you do not have insurance, then taking the cheaper road and going to a local hospital is often times just as good as the expensive clinics.
A traveler’s health is an optimum concern, but don’t allow yourself to be scared into paying outrageous prices at VIP clinics. The doctors and the care you will receive at these special clinics are often not any better than at the local hospital. Foreigner and VIP clinics thrive on a traveler’s preconceived fear that the local hospitals are horrible places (which they are), but more than often not you will be treated well at these reputed dungeons of health care, receive the care that you need, and be charged very little money.
Travel tip #31- Use local means of health care not foreigner clinics when traveling abroad.
As always, take this travel tip and use it, or drop three hundred dollars on a doctor’s visit at a foreigner clinic. The choice is yours.
But just remember to walk slow,
Medical Care When Traveling Abroad