Healthcare rears its head...again

Bright yellow leaves stand out in stark contrast against a dark and menacing sky. The heat and humidity of late summer have been replaced by the sounds of rain in the gutters and children laughing as they trudge home through the semi-darkness from school.

Every now and then a loud cough from the street below punctuates the damp air as I work in my home office. Yes, it's that time of year again. Time for both the soccer and Influenza A seasons to get into full swing. And the Italian media has not disapointed in fanning the flames by breathlessly reporting on seemingly every admittance to the hospital for each new possible case of Swine flu.

Earlier this summer I posted an entry that explained how the Italian healthcare system worked overall. Now, I have personal experience to relate.

Not long ago, I skipped home from the mailbox when I received my Tessera Sanitaria or national healthcare card (above). Now I felt like a real Italian resident and not just some itinerant traveller with my old, ratty temporary card that was printed on flimsy cardboard.

So, this is how it works: My dottore is Dr. M***** in Crespellano, the village just down the road where Stefania's parents live. The whole family goes to this doctor and I would have the privilege of being the first to try out his new offices just off the town square. Dr. M***** banded together with five other practitioners to form a sort of group practice.

When it was time to go a few weeks ago, I showed up early at my inlaws' house. Stefania's father, Franco, had agreed to introduce me to Dr. M**** who had heard of me through other family members for years but we had never been formally introduced.

It was cold and raining as we walked through the square to his building. Once there, we went up two flights of stairs to the top floor where the offices were located. There was a mansard roof with exposed beams and high ceilings adorned with skylights giving the place a light and airy feeling. Not a bad start.

We were greeted at the door by a young receptionist who took appointments for the other doctors. I told her I was there to see Dr. M****. He is a bit old fashioned and still likes to have his patients take numbers. First come, first serve. So I took a number. Number 12. He was already on number six.

So, Franco and I decided to go to the bar across the street and have a cappuccino and a brioche to kill the time. The coffee was good and we all talked about skiing for a while with the proprietor of the establishment.

Back to the office and up the stairs. (There is an elevator but we decided to hoof it.) A couple more ladies to go before my turn.

Finally, the door opened. I nervously walked toward the office as if it were the green mile. It was my turn.

I entered a large corner office. Directly to my left Dr. M*** stood up from behind his desk and greeted me. Franco leaned into the room to formally introduce me. I shook the doctor's hand and Franco returned to the waiting room.

Dr. M**** was tall and slender. He had jet black curly hair peppered with gray and a thick beard and mustache. Rows of colorful little model airplanes lined the shelves behind his desk. He likes planes, he can't be that bad I thought.

"So what brings you here today?" he said. Doctor's small talk is the same the world over.

I replied that it was time for my yearly check up and rotation of the tires. At this point, I reached into my bag and pulled out a sheet of paper on which I had taken the liberty to write out my medical history. He took it and started tapping on his computer as we talked. After a moment, he paused and pulled out a three-ring binder from his cabinet.

"I like to write things down by hand," he said.

As he worked, I stared at the blood pressurre cuff on his desk. The silence was broken by the doctor requesting that I jump up on his table so he could auscultate my heart with his stethoscope. He tapped here and there, gave a listen and declared, " Sounds good to me."

I jumped down and buttoned up and returned to my perch in front of the cuff on his desk. I told him I was a cyclist and that I might want to do some organized rides next season. He replied that I would have to do an esame medico sportivo or sports exam to obtain a medical certificate in the Spring.

While I contemplated applying for the sports certificate the doctor pulled out a large pad of receipts and began writing "prescriptions" or referrals for my blood tests and sports exam. He then printed out some other forms and told me that I would have to take all this material to my local pharmacy. There, a technician would type my information into a computer and schedule a time for me to go to the lab at my loccal hospital which as down the street from where I live.

At this point, we chatted some more. I thanked him for patiently explaining everything that I needed to do. And I tried to explain the American system to him which left him scratching his head.

When I left the office, I stopped to ask the receptionist if I owed any money for the visit. She looked at me incredulously, like I was an alien, so I continued for the door before she changed her mind.

The vampire will see you now

I went back to the inlaws' house for lunch then proceded to return home to my village, Bazzano, to hit the pharmacy when it opened again at three.

The building was just completely remodeled. It's the nicest pharmacy I've ever seen. There is a circular floorplan with the pharmacists in the back. In the middle are booths where technicians make appointments for blood tests and other specialized exams. OTC products are located on perimiter shelving.

I had a prescription to fill so I took a number. When it was my turn I handed the form to the lady behind the register. She looked at it and went back behind the shelves. She handed me a commercial box with my medicine much like other OTC drugs; in Italy the pharmacists apparently don't count out pills from a bigger bottle to put into your own smaller one. I reached for my wallet. But she stopped me and said it was free. (If your medicine is medically necessary, a salva vita or life saver, it's free of charge.)

I then went to sit with the technician who typed in my information and gave me an appointment at the lab for Nov. 16 at 7:30 a.m.

I left with a new stack of forms. These contained the various tests to be performed along with the bill that had to be pre-paid either online or at a small machine at the lab. Lab tests are not completely free but depending on how much money is witheld from your paycheck you get most of it back on your taxes.

November 16 dawned cloudy and cold.  I got up bright and early and went over to the hospital with Stef. First we had to go downstairs to pay for the exams by swiping the bar code on my forms in the machine. You then pay with your debit card and take the receipt upstairs to the nurse in the lab. It cost me about 50 euros.

The lab itself was next door in a dimly lit building. There was a line of about ten, mostly elderly people, waiting to hand the nurse their various forms. People trotted by from the restroom with urine samples in their hands to give to a lab technician. I mentally implored them not to bump into me.

I got in line and had to wait a few minutes. When I got to the head of the line, the nurse took my forms and handed me a number. I was number 36. They were on 32.

So I paced back and forth for about 15 minutes until it was my turn to see the lab technician.

I walked past the nurse taking forms and parted a white curtain.

The back room looked like any lab or blood donation center. Several chairs were arranged against a wall in partioned little rooms. Lab technicians drew blood from various patients. I sat down in the corner room. A pleasnat young technician had me do the honors and roll up my sleeve and make a fist. Next, out came the butterfly needle and I filled up four or five of the little test tubes. The tech was very good. I didn't feel a thing and she hit pay dirt on the first try without leaving a hematoma.

That was it. Now I have to go back in about five days to pick up the results at which point I will take them to my doctor where we will go over them.

So far, so good with the Italian system. Everyone has been very courteous, kind and competent. People queue up and take a number without complaint and things seem to move along pretty efficiently. Smooth sailing.

Comments

[gerovital]

really is a much better system than the U.S....system in Europe is more human

[celestine]

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