Fréjus, France

Fréjus, France
Aqueduc Romain

Thursday, August 7, 2008

My experience with the French medical system

Only in France for 3 weeks and I've already had a chance to compare how the U.S and the French medical systems operate. Lisa noticed a blotchy brown spot under my right big toe nail shortly before we left home. I had noticed it for at least a couple months, but figured it was a bruise (from skiing, playing basketball, or just being clumsy) that would grow out. After Lisa's comments I started paying more attention and by last week I was convinced it wasn't going anywhere. Lisa was very concerned and raised the prospect of melanoma and how serious that was. Frightening! But here we are in a foreign country, all its citizens on vacation, with an unknown (as of yet, unused) foreign insurance policy with a high deductible, and our dog Maggie was on the way. What to do? Even hearing Lisa describe a biopsy (because of the toe nail) made me nervous and wonder if I would be laid up for awhile, but it was clear we could not ignore it.

First, we called the woman from whom we're renting to see if she knew a dermatologist. She did. We called and got an appointment for Weds. Then we realized that Maggie was hopefully going to finally arrive that day. We waited to make sure and then cancelled the appt., getting a new one for Fri. at 4:45. At least that's how Lisa heard it, and she is the one doing all the hard work language-wise. We showed up to a fill-in Physician as it's August and so most Parisians are on vacation somewhere else, only to find that our appt. was scheduled for 2:45. The Doctor was very nice and saw us anyway. She did an examination of my toe and did not feel comfortable saying it was nothing, or that it was serious, so she called a colleague to make an appt. for a second opinion. She did not charge us for the appt. Again, all of this took place in French, and while I could comprehend enough to get the gist of what was being said, it was Lisa who was under pressure to understand and confirm the proceedings. And, yes, Lisa told her she was a physician too.

Today was the follow-up, at the Hospital Tarnier. A small hospital with one entrance, we walked around 90% of the building and 75% of a small park before finding our way in. Lisa again took charge with her French and for a moment I panicked when I realized I had forgotten my passport. My license did the job. After a short wait we (yes, "we" - everything here is a family experience due to language and child-care issues) were taken into an examination room where Lisa gave my medical history. Then it was time for the exam, and she had me strip down to my boxers. She did an examination of the toe, said it was clearly red blood cells and thus a bruise. Then she examined the rest of my skin and after some discussion with Lisa who was satisfied with her diagnosis..."Viola," we were done. She handed us the paperwork and told us to take it to the Caisse (cashier) on our way out. I was genuinely curious what such a visit would cost (and wondered about that first visit for which we had not been charged). I was charged 23 euros or about $35. I am clearly not a citizen, yet they never asked for my insurance or anything else beyond basic identification. Lisa is convinced a similar visit/examination in the U.S would have run at least $250 because of malpractice insurance costs. An American dermatologist would probably have leapt to a biopsy. This doctor could remain confident in her experience and skills without necessarily wondering "what will the jury think." Healthcare is also government subsidized, a "right", so she gets paid no matter who she sees, no matter what resources the patient has. We just had to pay a little into the system because we don't pay taxes here. At home we pay a lot into the system (Medicare) and don't get to use it at all. Ok, stepping off the soap box now.

I am thankful that it was nothing serious, that I am not sitting here in Paris with a ripped-off toenail, that I didn't go broke finding this out, and that we can now make plans for the weekend :) Most of all, thanks to my wonderful wife for having the French skills to get us through this in a thorough manner so we can enjoy the relief that we now feel!


Bren said...

Thank God everything is OK. Of course you wonder and worry but at least you found out and feel comfortable with the diagnosis. You can get on your "soap box" any time you want but, it's good to get off too! Love ya, Mom

Mom & Dad Browne said...

Always safe to have weird things checked. Amazing what the lawyers have done to costs in our health system.

Enjoy the rest of your time in Paris.

Mom & Dad Browne

ted and ruth said...

Good to hear all went well. Seems that the Europeans are smarter than we are with regards to health care and you would have had the same results in almost any other European country.
When we were in Italy a woman in our tour group broke her arm when she fell. The Italians would have taken care of it at no cost to her but she and her daughter opted to go back to the states for care. I would have stayed. You might think me a socialist but I still think insuring everyone through a single payer system would be a good idea. Take care and have a great time.

Rick said...

Yes, 50 million uninsured is a disgraceful amount, and we have the capability to do better, to be more compassionate and sane about it. We're talking about "health" something everyone has in one way or another. I think the U.S. way costs everyone more, for no better quality.

Anyway, I'm certainly glad that it's just a typical Rick-type bruise and we can get on with LIVING! This was a cloud hanging over us for awhile and we didn't feel right sharing it until we knew what it was we were dealing with. Onward...