Thursday, October 20, 2016

Healthcare Outside the US - Our First Dental Experience

We were early, nobody in the waiting room but us!
Bruce never complains.... unless it's serious!  So when he began to mention having some pain in one of his right side molars... I took notice.  A friend told us that there was a Dentist's office near the grocery store so on one of our recent grocery runs, we stopped by to make an appointment.  

The receptionist didn't speak much English, but with my limited Spanish, I was pretty sure she said that no appointment was needed, and that the Dentist was only there Thursday's through Saturdays... 

Long story short, after several aborted attempts (only open Thursdays AND Saturdays) due to my ignorance and several weather delays...  We finally made it to the office at 8 am on a Thursday... and the Doctor was IN!

We arrived all sweaty from a muggy bike ride but had plenty of time to cool off as the employees began to show up.  Our experience here was very different from what we were used to back in the US.

My experiences with Dental care/insurance have been long and varied.  I've been treated with and without dental insurance coverage, as has Bruce.  In my experience, it's nice to have dental coverage because after the first year it covers 100% of preventative services, then 80% of things like fillings and other basic things, then only 50% of the biggies like root canals and crowns...  The catch is that there is usually a yearly max of about $2,000.  If you have either really good teeth or really bad teeth, your premium costs can be more than the benefits received, or the only real benefit can be the discount you get for having the coverage...

Wouldn't it be much more sensible to just have reasonable costs in the first place???  That's what we found here in Puerto Rico...  No frills, just decent care at a fraction of the cost with no BS!!!  It began with the sign-in process.  Our names were placed on the first-come-first-served list... then we were asked to write our names and date of birth on one single sheet of paper that had the diagram of a set of teeth... that was our medical record.  That's it.  No other information was required of us.

They realized that Bruce and I were together, so we were called back to the exam room together.  I was asked to sit in the chair and a technician with limited English asked me what we were here for.  I told her we needed cleaning and exam, and that Bruce has had some pain recently.  

We waited as the office staff got going with their morning routine... turning on equipment and such.  I looked over the equipment in the room... There were only a few disposable items, the suction tube and some drapes were disposable, but most of the instruments were not.  

The lights and spit sink had all seen better days.  There was a good bit of rust around the bases of the larger equipment items and the x-ray machine was not protected by any means... It was just a simple machine over by the wall.

The Dentist came in and told us the cost for the cleaning and exam would be $40 each... OK?

We agreed and she left, but soon a receptionist returned with our receipt... Bruce forked over the $80 cash and our treatment commenced...sort of.
The x-ray machine...

The suction power supply was right there in my exam room...
There was a bit of a problem with the suction machine.  My technician flipped the breaker back and forth with no result... She excused herself and went off to another room, the Dentist came in and messed with it, then told me there would be no suction and handed me a small spit-cup.

Left alone for a bit to ponder this... I had to laugh when I thought about my friends back home and how they would take this latest development...  luckily before my cleaning began, I heard the suction tube kick into gear.  Hooray!  They got it worked out!

I was relieved to see my technician change to a new pair of gloves before she leaned me back, positioned the light, hung the suction tube in my mouth and got to work.  She was quick and thorough and as usual, my cleaning went without a hitch.  I am blessed with wonderfully strong teeth and no issues were found.  

Next it was Bruce's turn.  His cleaning went much faster and when the hygienist was done, the Dentist returned to take a look.  She asked us both if we had any problems and I told her about Bruce's recent complaints of pain, but that he was not feeling it presently. 

She took a look and said that she could see two cavities.  She advised x-rays, cost $10 and said that the cavities would cost $35 each to fill. We agreed and they asked Bruce to sit on the edge of the exam chair.

The brought the x-ray machine over put the slide into his mouth and simply took the x-ray.  No drape, no lead room... That was it.  He reclined once more as they disappeared to develop the film.  

Soon the Dentist returned and told us that the fillings would require a bit more... one was "two surface" and the other would be more involved with "three surface" filling required.  The added cost would be $45 and $55 respectively...  We agreed, a receipt was produced and we forked over the additional $110.  

We were moved to another exam room where the anesthesia was administered... We waited for it to take effect...  Meanwhile we watched as the staff moved efficiently and happily around the office.  Other patients were brought in and we could understand a little of their complaints and treatment.  There were no rooms, just simple stalls in which the chairs and equipment were really only partially hidden from general view.  Privacy was nonexistent, but then who cares???  We're at the Dentist's office... everyone can pretty much guess why we're here!!!

The staff were all very nice as they went about their morning routine, moving patients in and out as their cleanings and exams were executed... It all worked like a well-oiled machine...  The Dentist fluttered in and out of the different rooms checking this, exam here, instructions given there...  Finally it was Bruce's turn again and we were once more moved to a different chair. 

He leaned back and the Dentist got to work.  Her assistant stood on the other side with a syringe with which she irrigated the work area as the Dentist drilled.  I was actually glad for the blocked view!  All the while they kept up lighthearted conversation some in English and some in Spanish.  The Dentist questioned me about our life on the boat... she had recently sold her power boat because they never had time to use it.  Her husband started raising Lovebirds and they never went out to the boat anymore...  

The chit-chat was such a change from what we are used to back in the states, and I have to say that the overall atmosphere and level of happiness displayed by both office staff and patients alike, marked a startling difference compared to US offices.  It was all just so relaxed and free of politically correct, HIPAA BS...  Just get over it people!  

Bruce experienced no pain and very soon, we were almost done.  I hadn't had my exam yet.  The Dentist asked me if I was experiencing any pain, I referenced a couple of spots and relayed to her what I had been told previously about my one trouble spot.  She further explained some things to me and took a look.  She pronounced me cavity free and we were done!  

Things that would not have happened in the US:

There would have been a LOT more paperwork
We would have been separated into enclosed exam rooms
The x-rays would have been done in a different place and we probably both would have had x-rays before anything else was done.
We would not have witnessed any of the inner workings of the office equipment malfunctions
We would not have seen or heard any of the other patient's problems or care
The equipment would have been newer and more plentiful
We would have learned of the total cost after the visit
We would have been reschedule to come back for the fillings

There are people who may read this in horror!  It's not safe! It's not private!  But that is just evidence of the decades of propaganda we've all been bombarded with causing us to live in fear.  What we need is just simple care at a decent cost.  A total of about three hours of our time and $190 cash were the cost today.  We were both thrilled.  Once again the walls of a lifetime of medical propaganda are steadily crumbling down... 

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