Reach Beyond’s hospital, Hospital VozAndes, is like a medical center as doctors see patients there. I asked Jenny, Reach Beyond’s Ecuadorean secretary, to call and make me an appointment with Dr. Febres, an orthopedic surgeon.
You have to pay for your appointment ahead of time at one of the hospital’s cajas. I usually allow 30 minutes. After you pay, you’re given stickers with your patient information. If the doctor orders an x-ray or physical therapy or even surgery, he’ll use these stickers at the top of the form.
Each medical speciality has its own consultorios (examination rooms). The orthopedists are in Traumatología (Traumatology). You give your stickers to the nurse and she takes them in to the doctor. Then you wait. You never know long it will be until the doctor calls your name.
In Ecuador doctor appointments are a social occasion. Everyone seems to come with at least one other person. In a waiting room with 15 people, maybe only four or five are patients; the rest are providing moral support. When the patient is called, everyone goes in.
My pre-surgical appointment was stressful because almost everything is in Spanish and things didn’t go as expected. Not having command of the language is hard in ordinary situations, but in a medical situation it is much worse. I waited in line for 15 minutes at the normal caja but they couldn’t find my appointment. So I went to Traumatology and the nurse asked Dr. Febres if he could fit me in. He graciously said yes, so it was back to the caja for another 15 minute wait. They said I needed to go to the Emergency Room caja. They asked for a bunch of information that they should have already had in their system, and I paid for my appointment.
I realized later that they had assigned me a new Clinical History number, a number the hospital uses to track each patient’s unique medical history. The confusion probably arose because my previous Clinical History number was connected to my passport number. In November I got my resident visa and a cédula, a national identification card. When I got to the caja I gave them my name and cédula number, but presumed they would search for my appointment under my name.
In the meantime Scott had come to meet me for my appointment. He couldn’t find me in Traumatology, at the normal caja, at the second floor caja, or at rayos equis (x-ray). So he went back to his office for his phone (the Reach Beyond offices are across the street from the hospital). I heard his phone call but couldn’t answer in time, so I called him back. Scott found me in Traumatology and stayed for about half an hour. When patients who had come after me were being seen before me, we realized that the wait could be a long one and I sent him back to work.
Humorous note: that evening we couldn’t understand why the $10 of minutes Scott had just put on my phone was gone. Scott spent over an hour trying to get on-line access to my account with Claro, our cell phone provider. He finally succeeded and discovered that I had had a 56 minute call that morning with him. Neither one of us had hung up after our ten second call and the line stayed open until my phone ran out of minutes!
Thankfully Dr. Febres speaks good English and the appointment went fine. He filled out my admission slip and scheduled my surgery. I took another form to the information desk to get a cost estimate. Two different people asked me if I had seguro privado, which I thought meant private insurance (Ecuador has socialized medicine and the government provides healthcare to qualified individuals). I showed them my insurance card but they just asked again if I had seguro privado. I found out later that seguro privado means insurance purchased personally as opposed to insurance provided by an employer. Now I know.
The next day I submitted the pre-approval forms to our insurance, getting an email response that I should hear their decision in three to five business days. Soon after, a friend mentioned that it took her two weeks to receive pre-approval for her surgery. Yikes! I don’t have two weeks before the surgery.