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Living in a foreign country means it’s in your best interest to learn the ropes. One of those ropes I wanted to become familiar with was the medical service in Panama.
I wanted to see how things flowed and have an idea of costs that were involved. I wanted to know what happens when you need to go to the hospital here.
If an emergency should happen while we’re here, being a little familiar with how things work here could prove extremely helpful.
That knowledge would obviously be beneficial to our family but, like the dedicated blogger I am, I thought this would be good information to share with you as well.
So I set out on a mission to test the medical service here.
But I needed something non-critical that I could schedule with the hospital. And that’s when I thought of an area good to roll with… the dermatologist!
Here’s the story of how things went – the confusion, the success, and then the weird win which was a failure for the mission.
The minor reason for medical service
Ok, keep in mind that the goal was to come up with a minor reason to go to the hospital. Thankfully, we’re generally a pretty healthy family so the need for medical service wasn’t something that comes along too often.
Instead, I had to do a little reaching. I had a mole on my head just above my hairline that had shown up a couple of years ago that I didn’t like. I also had another one appear on my forehead over the years as well.
So yeah, neither one of these is a big deal and they didn’t worry me medically. I just thought it would be nice to get rid of them so that became the perfect excuse to try out the system here.
Finding a dermatologist and making an appointment
Here in Boquete, Panama, we have a few doctors but no dermatologists that I was aware of. Most specialists are in the hospitals in David (about 45 minutes south of Boquete).
So I thought the best place to start researching would be on Facebook. There are a bunch of good Facebook groups here where you can usually find answers and recommendations for whatever’s on your mind. Here a just some of the expat groups I’m currently a member of:
- Boquete News
- Boquete Community Group
- Expats in Panama
- Young Expats in Boquete
- Expats in Boquete
- Young Expats in Panama
- ExPats in Panama
- ExPats in Panama – Active
- Expats in Panama – Conveniences
- Grupo de Boquete
And these groups don’t even count the ones dealing with food or buying and selling things here!
So I put a post up on the Boquete Community Group back in October of 2019 asking for recommendations for a dermatologist along with a few other areas of help:
I heard back almost immediately from a bunch of people and most everyone said the same thing along these lines…
“You want Dra. Karen Zapata at Chiriqui Hospital in David. She’s excellent, thorough, and speaks English extremely well.”
When everyone’s pointing to the same doctor as the way to go, I’ll take that as a good sign. As a side note, “Dra.” is the female title of the “Dr.” abbreviation in Spanish.
So it was time to make an appointment for some good-time medical service. This was on October 14, which is only a few months after we had moved to Panama, and let’s just say that my Spanish has improved a little bit since then.
I called Hospital Chiriquí and fumbled my way through the conversation. One of the reasons I love Panama so much though is how nice the Panamanians are – that wonderful lady worked with me for over 8 minutes as we tried to understand one another.
But all that matters is that I got an appointment scheduled for a couple of weeks later. It wasn’t the smoothest, but I was happy to pull it off. I’ve since learned that I could have called Rodny Direct for help with this. That’s an English-speaking subscription service we pay for to act as a liaison for medical emergencies. But he’s also able to help in a pinch for something like this.
Heading to Hospital Chiriquí
Being as we don’t have a car here, the city of David is close to an hour away by bus, and since I don’t know my way around the hospital area there, I decided to head out early. Even though my appointment wasn’t until late afternoon, I left mid-morning and figured I would do some shopping first at PriceSmart (Panama’s version of Costco).
It’s always a roll of the dice on the bus you get. Most of the busses are nice, newer, air-conditioned vehicles… and then there was the one I got on the crapshoot…
But for $1.75 for a 45-minute to an hour bus ride, it’s hard to complain. I got off in David about 11:30 am and took a taxi over to PriceSmart for $3. I did my shopping, enjoyed a couple of free wine samples, and then chowed down on an oversized hot dog while there for lunch…
Once I was done shopping, I took another short taxi ride to Hospital Chiriquí for $2.50. My appointment was at 3:20 pm and I got to the hospital around 2 pm. I was obviously very early, but with the unknowns, I wanted to give myself plenty of wiggle room.
I walked in and found the directory. I swear I stared at this thing for at least 5 minutes trying to find Dra. Zapata’s name on the board…
Was I missing something? Did she go by another name? Am I in the right place? Is there a different wing I should be in?
I was starting to get a little anxious, but not too horribly because of all that extra time I had given myself. After a little bit though, I discovered another directory in a different place … and much to my relief, this one had Dra. Zapata’s info on it!
So I headed up to the third floor.
Waiting for my little medical service
As I was looking for room 301, it kind of reminded me of a hotel or even a retirement home. It was just a long hallway with closed doors on each side.
Her office was on the right and I’m happy that it was the last room in the hallway. Why? Because apparently, you don’t walk right into any of these doors. I happened to notice that just past her door was a reception area. I wouldn’t have seen that if her office door wasn’t down at the end.
So I went over to the receptionist and talked to her as best I could. She didn’t speak English so we fumbled through things with my broken Spanish and got me checked in.
The waiting area was nice but nothing elaborate like the Cleveland Clinic hospitals I’m used to from back in Ohio. They don’t spend money here on all the fanciness that doesn’t matter. There was a wall A/C unit in the room but it was still quite warm there… not hot, just a little more uncomfortable than I’m used to.
Here’s what I thought was most interesting. Remember I’m a completely new patient for them and they have zero information on me thus far other than my name. The receptionist came over to me a couple of times. She needed my passport information and used a PDF copy of it that I have on my cell phone with no problems. She also asked for my email address which I provided. Then she asked if I had insurance. I replied “no” even though I do have expat insurance because I didn’t plan on using it.
And that was it.
In the U.S., this would have been the most complicated agenda ever. I would have had to fill out tons of forms asking way too much personal information like some giant inquisition. And if I had responded that I didn’t have insurance for medical service in the States, the sky would have definitely fallen.
But here, they took some basic info for identity, an email address for correspondence, and asked about insurance in case I wanted it sent through there. It was such a refreshing feeling compared to the over-complicatedness I’m used to.
Then I waited. I was told by others that doctors always run late here in Panama. So I brought along my Kindle Paperwhite, which is the best device ever invented, and continued to read Frank Herbert’s 1965 novel “Dune” – an excellent read if you haven’t checked it out!
An odd thing I noticed is that more than once someone would check-in with the receptionist and then sit down right next to me even though most of the waiting area was empty. That’s not a bad thing at all just a little strange compared to what I’m accustomed to in the U.S. where people tend to space themselves out away from each other.
I got called into Dra. Zapata’s office for my medical service just a minute or two after my scheduled time (so much for the lateness everyone told me about!).
The doctor’s office was a tiny room probably no bigger than 12′ x 12′. She was bilingual and asked me questions about my medical history just like any doctor would. She was friendly and also very informative.
For instance, she told me that we should always wear sunblock when we’re outside between 10 am and 3 pm. Being in the much hotter climate of David where the hospital was, I said, “But more so here in David than in Boquete, right?” Nope. She reminded me that David is almost at sea level whereas Boquete (in the mountains) is almost 4,000 feet above. Even though the climate is much cooler, being that high up means much higher UV rays. That makes sense but I never would have thought of that. It also explains why we get sunburned so quickly when out hiking.
Then she told me that we’d move into the exam room so she could examine the moles I have to start a history. The connected room was about the same size as the first room and had an exam table and the medical equipment she uses. She had an assistant there helping as needed.
Dra. Zapata had me take my shirt and shoes off and then spent probably 20 minutes examining any moles or marks she thought were important. She used a handheld microscope and took pictures with a regular smartphone which I thought was unusual. She laid a small ruler down next to each mole as she took the photos so she could build a history of size and shape to compare from later on down the line. She examined my head, neck, arms, back, stomach, legs, and feet. Then she even briefly checked inside my mouth. I didn’t even know it was possible to get melanoma or anything like that there. And, of course, she spent some time examining the mole on my forehead I told her I wanted to have removed.
In other words, she was very thorough, knowledgeable, and not rushed. After the exam, I put my shirt and shoes back on and we headed back over to the first room in the office.
The pictures she took had already uploaded from her phone to the computer and she was able to show me any skin abnormalities she thought worth discussing. We also talked about the mole on my forehead. She told me that it didn’t look like it was a problem and we could keep an eye on it. She made it very clear that she didn’t think it needed to be removed.
However, if I wanted it removed, it would be just for cosmetic reasons. She said it’s not a superficial one that could just be frozen or lasered off. Because it goes deeper, it would need to be done as minor surgery and would require a stitch or two.
The procedure would take 20 minutes or so and would cost $140… $140 with no insurance and that included the biopsy. Sounds like a plan. She said to just send an email to let them know if I wanted to schedule it. She also mentioned that she had some medical conferences and training over the next few weeks so we’d have to figure out a day that works then. Did you catch that? She was saying we could make the appointment in a couple of weeks versus the multiple months I’m familiar with in the States.
And that was it. I walked out of there after about 40 minutes total and paid for the service… $60. Again, this was with no insurance.
These prices might sound low if you don’t know health care outside of the U.S., but I was actually surprised by how high they were. Not in a bad way like it was ridiculous or something – it’s more than reasonable, but from what I had heard, I expected even lower prices.
Overall, I’ve never been to a dermatologist that was so thorough and spent that much time with me. She was friendly, didn’t rush, spoke great English, and provided excellent care. This was definitely worth the cost. And just remember, that’s without me having to pay any premiums for insurance along the way. Even employer-subsidized insurance can cost more than that in premiums along the way. I’m pleased with the costs and service I received.
I walked out and grabbed a taxi from the hospital to the bus terminal for $2.50. When we arrived, the bus was already heading out. My driver (a very nice guy) pulled up behind the bus and started honking, pulled to the side honking some more, and eventually flagged the bus driver to stop. I thanked the cab driver and then took the bus back to Boquete for another $1.75. By the way, I got one of the nice, newer, air-conditioned busses for the trip this time!
My big win but a failure to you
I planned to schedule a second appointment to have the mole on my forehead removed (and a couple of others) for sometime in January or February once we got back from our trip back to the U.S.
In fact, I sent emails to the doctor’s office that I didn’t hear back from to line it up. And then a friend of ours here chased them down over the phone. She speaks fluent Spanish so that was extremely nice of her to help with that. I finally had an appointment set for late February.
But, then a few events unfolded that made me cancel my appointment for medical service. The first and weirdest was that the mole on my head right about my hairline, um, disappeared.
Yeah, you heard that right. One day, I just noticed it was gone. I’m thinking that maybe on one of our hikes when I wore a ball cap (which I rarely do anymore), the brim rubbed it and knocked it off.
That’s gross to think about, right? Although I didn’t get a biopsy out of that though, it still saved me $140. Eh, Dra. Zapata said that was not one to be worried about anyway!
So then there was the one on my forehead to be removed. I was going to keep the appointment just for that, but then I started over-researching like I tend to do. Everything I read essentially said that I would be trading a mole for a scar based on the procedure. And although I didn’t like it, it was flesh-colored and didn’t stand out too much like it was.
I decided to cancel the appointment, which I somehow managed to handle in my broken Spanish over the phone.
Shortly thereafter, the COVID-19 pandemic hit and we went into lockdown here.
And that got me thinking which is always trouble.
I read several articles about duct tape for wart removal. It seemed like an interesting idea even though it doesn’t always work. And it can take up to 8 weeks to accomplish. I’d be walking around with duct tape on my forehead like an idiot for almost two months.
Hmm, wait a minute – we’re stuck in lockdown for God knows how long and can’t leave our place. There would likely never be a better time to try this than now!
So I did.
After a few weeks, it looked like we were making a little progress!
Then another week…
After a total of about a month, it had vanished completely!
So that, my friends, is how you do it! Two moles removed without the use of medical service!
Ok, yes I know – this was not the smartest idea and I didn’t get biopsies done on either. Feel free to yell at me in the comments. But at least the doctor had a chance to examine them before and didn’t think they were problematic. And now I don’t have to feel self-conscious anymore about them.
I didn’t get to take you through a run of a second appointment and minor surgery. However, I still think this was informative of what to expect in medical service here in Panama.
I feel a little more comfortable in knowing how the flow of things will work if ever needed while here. And it’s good to see that the doctor was knowledgeable and provided great care. Throw in the reasonable costs and this makes me feel more confident about the expected care here in Panama.
Would you feel comfortable with getting medical service in another country? More importantly, is there anything more disgusting than the idea of my mole falling off?
Thanks for reading!!