Doctors And Hospitals in Mexico
by David Eidell
Several years ago I bumped into a friend in the checkout line of a local supermarket. This shouldn't have been a surprise except that "Jim" with fanfare and bon voyage party had "Struck out for Mexico - For the entire Winter" just a scant few weeks earlier. Listening to a story sheepishly told, it seems as though he woke up in the middle of the night with a sore throat and fever. "I guess it must have been the fever" he went on to explain "Because I really didn't know how to go see a Mexican doctor, and I can't speak Spanish, so at dawn I packed up and drove all the way home". "Home" was a thousand mile drive from the tropical beach where he had left a campsite most people only dream about.
There's an old saying in Mexico, that goes "When rich Mexicans get really sick they go to the United States for treatment -- When rich Americans get really sick, they come to Mexico for treatment".
My own observations of the medical profession in both countries has left me with the impression that there are as many mediocre doctors in Mexico as there are in the United States. Many people are reluctant to consult a doctor in the US and when they become a tourist in a strange land dealing with an unfamiliar tongue, reluctance sometimes turns to outright refusal.
When a Mexican physician or hospital is presented with an individual in need of first aid treatment or trauma triage, by law they must administer aid until such time as the patient is stabilized. This service is free to everyone. Upon stabilization the patient may be admitted to the hospital, transferred to a more appropriate facility or discharged if payment for continuing services is unavailable. This insures that no matter what, a tourist will receive prompt aid no matter what language or other cultural barriers may be perceived.
I try to use the same common sense approach to seeking medical aid in Mexico as I do in the US. For a cold, or sprained knee I'll see a private physician in his office. In the unlikely case of a more serious ailment like a broken bone, or chest pain, I'll head directly to the nearest hospital.
Mexico's quasi-government health care organization is organized into two separate hospital and clinic chains. Both are known by their acronyms: IMSS, and ISSSTE. There are thousands of IMSS and ISSSTE hospitals and clinics in Mexico. All of them will treat a first aid case or emergency case, and many "clinicas" in rural areas will treat everyday colds, coughs, and rashes if a private physician is in scarce supply.
Let's go on a real-life scenario voyage in which I the author have awakened in the middle of the night with a scary chest pain and weakness. Due to my love of camping in remote areas, I am faced with a challenge of getting to a doctor as fast as I can:
The Scenario
I realize that I may be having a heart attack and it's time to get to a hospital. If I were camped in an RV park, I would awaken one of my neighbors for help but the closest person is the owner of the nearby restaurant who has a house adjacent to the business. Even though I may not speak a word of Spanish the sight of me standing at the front door clutching my heart at three AM needs no interpreter. Soon I find myself seated in the family sedan roaring to the nearest medical facility. With an emergency it is far more important to obtain first-aid triage than it would be to seek top-level treatment at a distant facility.
A sleepy-eyed doctor is standing at his front door when we arrive. Hurriedly he listens to my heart through a stethoscope, and then extracts a pill out of a bottle and hands me a glass of water. I swallow the pill and he motions me to get back into the car. Now it's my neighbor, the doctor and I roaring around curves to the nearest hospital some forty miles away.
An hour later I am on a gurney and whisked from the emergency room into a treatment room where a heart monitoring machine is connected. A cardiologist has been summoned from home and will arrive in twenty minutes...
After spending a day or two being monitored while the cardiologist fine tunes the dosages of heart medicines, I am released. There is a strange person waiting by the door as I walk out of the room. It is the brother-in-law of the restaurant owner who speaks a little English. He accompanies me to the business office where I pay a total of ninety eight dollars for various services. Through "Juan" the brother-in-law, the doctor and I have a long conversation about what's next on the list as far as medical treatment is concerned. I thank the doctor and depart with Juan, eternally grateful for Mexican hospitality. Needless to say I ask Juan to pull into the nearest "gasolinera" where I fill his tank in gratitude. My next stop is at the private doctor's office where I insist he take a generous wad of pesos (A hundred dollar's worth).
I decide to rest up a day or two before departing back to the United States. The restaurant owner or one of his children now check on me several times a day. The children pantomime that they have been "guarding" my rig. What a nice feeling when I discover that these "strangers" treated me like a long lost uncle, instead of a "customer".
After a tearful goodbye I drive slowly out to the highway, a mixture of apprehension and sadness fills my heart -- It's a fifteen hundred mile drive back to the border, but with folks like this, It'll be a snap.
Note: In real life, I played the part of the restaurateur, and the local doctor insisted that I drive his station wagon while he administered to his patient who was stretched out in the back. The patient was saved and now comes the surprise: The patient was very wealthy, he could have afforded to be "Med-Evaced" home in a evacuation jetliner. Instead he spent five days in the hospital and upon his return he felt "better than ever". It turned out that he was being treated for a chronic heart arrhythmia and the Mexican cardiologist discovered a way to quickly bring it to normal. "This guy runs circles around my high priced cardiologist in Phoenix" he went on to explain, "and the hell of it is, I just purchased a month's worth of medicine for less than my deductible insurance charge". It wasn't more than a couple of years later when the man's wife took their toy poodle for a walk and managed to get her feet tangled up in the leash. Her fall was nasty, resulting in a multiple compound fracture of her right leg. She spent a week in the hospital and upon her return wearing a huge cast, she remarked about the quality of care. "The hospital had a bone specialist and an orthopedic surgeon there within one day. They are going to do follow ups until my leg heals completely".
It may be of note to learn that the gentleman and his spouse elected to buy a nearby house on the beach weighted heavily on the quality of medical care they both received.
The Quacks
I wish it weren't so, but Mexico has its share of bona fide quacks and lucky for we potential patients most of the quacks must avoid the medical limelight (hospitals) and stick to practicing out of small offices. Rather than trust to "The Luck Of The Draw" whenever I need the non-emergency services of a physician I'll try to rely on recommendations from fellow travelers or even from a stranger if they are a prominent member of the community (such as a restaurant or hotel owner). RV Parks tend to have a well-developed intelligence network in place (gossip) that almost unerringly leads to the most respectable doctor or medical facility in the area.
Air Evacuation
At first glance "Air Evacuation" sounds like a godsend. A quick call to an 800 number in the states has a private jet with onboard physicians winging it's way south to the jetport nearest you. In reality, the jet has to land in Mexico to establish a flight plan and pass customs, then it will be sent to the "nearest" airport to you that can handle a jet aircraft. After the patient is wheeled aboard the jet must land at an airport in the USA to pass customs and immigrations checks, and then the patient is taken to the hospital. This can take hours, and consideration should be given to compare the level of care given between the jetliner medical staff and a Mexican hospital. Does the Evac service include a cardiologist or specialist in dealing with strokes, or other life-threatening condition? It does little good to trade time for state-of-the-art treatment if the patient should expire in the process.
Don't Overlook The Obvious
It makes good sense to make arrangements with your US medical specialist for them to make themselves available for consultation (for a fee of course) before you leave home. If I had to, I would leave a blank credit card voucher with my US doctor to cover the cost of telephone calls, faxes, and consultation. I cannot imagine myself in a Mexican hospital where at least one person did not speak fluent English. US and Mexican doctors tend to distrust each other, but a medical chart sent by fax would be referred to for a fact.
Last But Not Least
Every RV'er or frequent traveler should consider taking along a copy of their medical records on journeys both inside and outside the country. An unfamiliar doctor can glance through the record and instantly form an impression of your overall medical history. Inside the folder can be a recognizable list of your allergies (especially to medications), and a list of your maintenance medicines, and dosages. If you decide to obtain your medical records, you should update it every year.