The Doctor is IN

 One of the scariest parts of living in a country that doesn't speak your native language is getting sick.

How do you navigate the medical system in another country? How do you communicate? How is the process the same and how it is different? Will you go broke paying out of pocket and getting reimbursed later?

In two years of living in Spain, we have gone to both American and Spanish doctors.

We are lucky, too. Because I work on an American base, we have access to some medical care there. However, because I am not in the military, I have a longer wait time than someone who is active duty for some services, and there are some clinics, such as dental, that are all but impossible to get into.

Some of my American friends wait until they fly back to the U.S. in the summer to get yearly tests and checkups. However, what do you do if you get sick in the meanwhile?

You suck it up and go to the Spanish doctor.

Our first medical experience was going to a family doctor for sinus issues. Southern Spain is closer to Africa (Morocco) than the rest of Europe, and we get lots of dust from Africa that unfortunately triggers everyone in our family's allergies.

I realized on a Friday afternoon after work that I could not wait until Monday morning to call for an appointment on base (or take off a half day of work for a 30 minute appointment), and I didn't want to wait forever in the emergency room for what really wasn't an emergency. Instead, I sucked it up and walked to the local Spanish doctor's office.

Never mind that it was a Friday afternoon after 5 pm; office hours for doctors here are 11am-1 pm, 3:30-9pm.

Here is my experience: I've been to two doctors here, and for both, there is no receptionist. When you walk into the office, there is a small waiting room with a camera. The camera lets the doctor know that you are there. In both cases, there was also a buzzer to let the doctor know that I was waiting.

This is important because you don't want to barge into a closed door because (oops!) a patient will be in the room with a doctor.

At least in our Andalucian town, it is customary to say, "Buenas tardes" to everyone who comes in the waiting area.
¡Buenas tardes! 
¡Hola!
¡Buenas!
¡Hola!
Repeat as many times as it takes, ad nauseam until you are called into the doctor's office.

While greeting and waiting, you will notice that the walls are always covered with diplomas and certificates for the doctor, as well as my favorite decor, the doctor's university graduating class picture.

It reminds me a lot of that Norman Rockwell picture---you know the one. A boy is waiting to see the doctor, and is so engrossed in the diplomas that he doesn't notice the doctor has a shot in hand. 

Why don't more American doctors plaster their walls ceiling to floor with their credentials? It's so much more interesting than reading 4 year-old magazines.

Once the doctor sees you, you will go directly into describing the issue. Because Spanish doctors do not take American insurance, there are no forms to fill out, no medical history and insurance information to give.  Instead, you will go through a somewhat hilarious Spanglish description of the problem. Our doctor understands English better than he speaks it, so it helps that we speak Spanish. However, you can see most doctors here as an English-only speaker and get over the language barrier.

There will be many gesticulations: hand gestures, imitations of coughs, pointing to where it hurts, etc.

You get by.

For my sinus issues, he had me lean over and touch my toes. When I stood up, I was staggering like a drunk monkey and he exclaimed, "Yes, you have a sinus infection!"

After the obligatory look in my ears and throat, I got a prescription for an antibiotic and cold medication, and then he took my money. There is no receptionist. His nurse took care of the transaction on the computer and input my information for future visits.

Did I mention that I went to to doctor at 7 pm and didn't have to take off work? It's so convenient if you work, too.

It cost 25€ (about $28) and---the best part---he gave me his number to call if I didn't get better. "Call at night if you need to!" And this: "Please follow up in a week. It is included in the price."

Yep, your follow-up appointments are FREE. FREE. Let me say it again: it costs less than $30 to see a doctor without insurance AND the follow ups are FREE.

Pharmacies here don't require prescriptions for most medications and medication is cheap. My bill was less than 10€ for two drugs.

The follow up was quick and painless and FREE.

I can then claim the visit on my insurance, if I want to go through the pain of the paperwork.

Going to a specialist is much of the same way. My insurance does not require a referral to see a specialist, but I still went through the base doctor first because I ended up in the ER for severe back pain and sciatica on a Saturday. (Why don't I ever get sick during regular office hours?) After xrays and acupuncture, muscle relaxers and pain killers, my doctor suggested physical therapy--which is almost impossible to see if you are a civilian. More Spanish healthcare to the rescue! The base wrote a referral and translated it into Spanish so I could walk into the office with a diagnosis to help with the process.

I buzzed into the physical therapy office at 6 pm, waited for someone to come out into the waiting area to get me, and got all fixed up. Again, no receptionist, lots of ¡Buenos tardes!, awesome class photos. Much pantomiming, pointing, grunting, and Spanglish phrases later, I have less back pain and some exercises that will hopefully alleviate any future pain.

All for the cost of 25€ each visit. I also got a detailed receipt so I can claim it on my insurance and get reimbursed, if I so wish to do the paperwork.

Wow.

I have also had great experiences with the base doctors; I had major surgery and stayed two nights in the little GTMO hospital. I was the only patient in the wing and had excellent care leading up to surgery and afterwards.

However, I am still dealing with the nightmare that is military medical billing, so much that I would rather go to a doctor on the economy.  Knowing that I pay up front, get reimbursed later AND I won't have to claim medical bankruptcy should I have a major surgery here is a relief. Even major procedures cost about 1/2 of what they cost in the United States. It is unheard of for someone in Spain to go broke due to a medical procedure because they have free healthcare for all.

Dental care is a little different. Depending on the office, you may still have to be buzzed in to get into the office building. However, in our experiences with two dental offices, there are receptionists available, and in both cases, they spoke enough English to set up appointments.

It is SO nice to be able to get off work and go to a dentist at 7 pm.

For x-rays, a cleaning, and a look-over from the dentist, the bill comes to less than $100 U.S. Follow up appointments are also FREE.

Wow again.

I had a similar experience with an optometrist visit. Late hours, thorough exam, English speaking receptionists and doctor, and a very reasonable (less than $100US) appointment with the exact same contact lens I used to get online, but in stock and for a cheaper price.

If we were on Spanish work visas or a student visa, we could use free or almost-free state healthcare.

For Americans hesitant to see a doctor overseas, I'll say this: the quality is top-notch. I am enjoying it tremendously, and so is my pocketbook.

And in case some of my American friends are wondering about how to get solid healthcare at a fraction of the price, Spain is now touting itself as a medical travel destination. As I was leaving the plane from Italy at the Jerez, Spain airport, I was greeted by this poster:

Whether it's major surgery or a minor procedure, it will be much less expensive and there are much worse ways to recover than enjoying the food, drink, and culture of sunny southern Spain. 

Click here for our Cuban Adventure (2012-2017)