Medical Emergencies on Panama Relocation Tour

Jackie Lange and I go way back.  She knew me, from reading my ESCAPE TO PARADISE  book before she came to Panama, and I’ve known her since she arrived.  A well-know and very successful real estate investor trainer in the States, when she relocated to Panama and an ex-pat lifestyle of course her friends and associates had questions!  “Why Panama?”  And they wanted to come down, visit and take a look for themselves. So she put together a mini-tour for a few friends.  More people got wind of “the tour” and wanted to visit.  One thing led to another and the result has been Jackie’s highly rated Panama Relocation Tour.  She’s been conducting these tours now for nine years, and I’d guess that half of the ex-pats who’ve moved to Boquete in the past nine years have come as a result of Jackie’s tours.  I don’t always have the same take on everything as Jackie does, but I’ve been on her tours several times and I don’t know of a better way to investigate Panama initially and decide if Panama is for you.  Panama isn’t “cheap” but you can live far better for less in Panama.

low-cost-medical-care-760x360Medical care of course is a prime concern when considering such a move. Panama uses, and has always used, the US dollar.  We call it the “Balboa” but it is in fact the same US dollar you use in the US.  As the US dollar has been devalued things cost more in the US, and, since Panama uses the US dollar, things cost more here as well.  Unfortunately greed, the medical term is “gringo bingo,” has set in, particularly with some of the local hospitals, Just like in the US, Europe, and elsewhere in the world, you can experience great medical care, or have a miserable, even deadly experience.

It’s in that context that I want to repeat Jackie’s report of the accounts of two recent participants in her Panama Relocation Tours who experienced medical emergencies while on tour.

Medical Emergencies During a Panama Relocation Tour

santiago panama public hospitalThis is our 9th year of offering Panama Relocation Tours.  In all that time, we’ve only had very few minor medical situations until the February 2019 tour when we had two major medical emergencies which required visits to a hospital emergency room.  I’m sharing details about these two emergencies so you can see the costs and quality of the care received at a public hospital and with doctors in Panama.

In Panama, there are public hospital and private hospitals.  The private hospitals cost more.  At the private hospitals, you’ll pay $15 – $20 for a routine doctor visit or $40 to $50 for a specialists.

But, the public hospitals are much more affordable.   Anyone can use the public hospitals.  There is no monthly fee to use the public hospitals, instead, you just pay when you go.  It is typically about $2 for a routine doctor visit or $5 for a specialists at a public hospital.  Interestingly, the doctors who work at the private hospitals are required to work a certain number of hours each week at the public hospitals so you could see the same doctor, but for a fraction of the costs, if you go to public hospital. However, unless it is an emergency situation, you might wait longer to see a doctor at a public hospital than a private hospital.

I have been to the small public hospital in Boquete for physical therapy a few times after messing up my shoulder with a weird yoga move called the Five Rites.  Even though I had an appointment at a specific time, I had to wait about 20-30 minutes for my treatment.  The doctor spoke perfect English and my treatment was $5.   The results were great!

Some expats who live in Panama decide to “self insure” (meaning they do not buy health insurance) because the costs of health care is so affordable at the public hospitals.   Instead of paying a health insurance premium, some expats set that money aside for any medical expenses.    You’ll understand why when you see the costs below.

Honestly, I think it is better to get health insurance if you can afford it because you will have more choices about which hospital and doctor you can go to.  You never know when a serious illness or accident could require a longer stay at a hospital or even surgery.   Don’t worry, there are affordable health insurance options in Panama too.  I’ll write about health insurance in a different article.

When considering a move to Panama, it is comforting to know that very affordable and quality health care are available for you in Panama. There are hospitals throughout Panama and more being built, or expanded, every year. Some hospitals are larger than others.  Only some of the larger hospitals are open 24/7.

EMERGENCY #1 – Vivian’s legs and feet were swelling.  She knew something was not right.  This is her write up about her experience with Panama medical care two times in Panama:

medical care in panamaUpon my arrival in Panama I noticed that my right ankle was swollen. Thinking that I must have banged it at some point during my trip preparations I spent the afternoon before the tour elevating and icing it. Unfortunately, my efforts did not decrease the swelling, which was advancing up my leg.

I had never experienced this so needless to say I was concerned and as we rolled into the second day of the tour I informed Jackie of my situation. We agreed that I would go to the hospital when we arrived at our stop that afternoon – which I think was Santiago.

My visit to urgent care was challenging in that the staff was not proficient in English. However, a combination of limited English, Spanish and Google Translate helped to weather the language barrier!

The process at this hospital was to first consult and then pay for the prescribed treatment. In my case it was meds via IV. Upon payment, the IV was set up. During the procedure there was a shift change and my follow up was with a doctor who spoke English well. She ordered a lab and an additional med. I paid no additional cost for the follow-up consult or meds. I was there several hours as is typical of urgent care/emergency. The total cost – $4.50!! See the receipt below

There was a slight improvement but unfortunately the treatment did not fully resolve my problem. At this point I was thinking of cutting my trip short in order to return home and get to the source of the problem. However, Jackie cautioned against traveling before the situation was under control and as we were now in Boquete, Jackie took me to her personal doctor. He not only spoke English but patiently explained to me initial concerns about the possibility of a DVT. Once he felt a DVT could be ruled out he focused on the blood pressure which was at 190/100. To bring it under control he prescribed a sublingual med and oxygen for 60 minutes. This resulted in significantly lowering my BP. He gave me a 10 day’s sample of medication to keep my blood pressure low and ordered a battery of labs. The cost for the visit and treatment: $65.00.

The next day Jackie took me to her preferred lab and returned with me the day after that to pick up the lab report. The cost for the labs was $57.00. A follow-up appointment with Jackie’s doctor to review the labs was $12.00. At this visit the doctor signed off on my travel and gave me a prescription which I didn’t fill because I still had samples.

Upon my arrival home my primary doctor continued the meds prescribed by Jackie’s doctor, and ordered a repeat of the same labs! An additional test she ordered was an ultrasound.

I share this experience for two reasons: 1) to provide a picture of the very reasonable out of pocket costs for emergency health care of this nature, provided by both a public hospital and a private doctor and 2) to express my gratitude to Jackie for her generous, PRICELESS care and support, including an invitation to stay at her house if my trip had to be extended!). THANK YOU, JACKIE.

I also want to thank my “angel ladies from Houston”, and the group in general for their well wishes. I hope all are well and thriving. 😊

Note that Vivian has been fine ever since but decided to ditch the meds and treat her high blood pressure with natural remedies!

emergency room bill in panama

EMERGENCY #2 – This one was very scary!  A tour client had a major seizure just before boarding the bus on the second day of the tour.  Luckily, her Uncle was with her.  This is his write up about their experience with the emergency room at a public hospital in Panama:

chitre panama pubic hospitalI’ve been back home for ten days, have caught up with things (if that ever actually happens), and now turn my attention to the Panama Relocation Tours (PRT).  I can only say that it was a great experience, that Jackie and her crew managed to provide a relaxed and comfortable environment while conducting a unique educational and experiential tour.  I believe the Panama Relocation Tours is the best possible way to experience Panama.  Jackie clearly knows Panama and is exuberant about it – it is beyond enjoyable to listen to her describe a country and a people she obviously loves and, after my experience, I can see why I would come to love them too.  Panama is a beautiful country, with much to offer (so much that my wife and I hope to be living there in a few months) and a people who love life.  You can tout the less expensive lifestyle, readily available fresh food, exceptional medical care or great weather.  These are all considerations but in the final analysis it has to be an environment you can live in, thrive in. Panama is the perfect confluence of good living and the Panama Relocation Tours will prepare you for living there.

Now, I have to apologize to Jackie and her crew and to everyone on the Panama Relocation Tours.  On the second day of the tour my niece, Brandy, had one of the most significant seizures I had seen up to that point.  She’d had a VNS (vagus nerve stimulator) implanted which was supposed to prevent her seizures a year prior to the tour, and there hadn’t been a seizure incident in that year, so I was very surprised.  But though I missed two days of the tour I had the benefit of being immersed in Panamanian culture and got a mini-tour of Panamanian medicine.

When she went down she was caught by some members of the tour. We were at the Sheraton Bijao and there were two staff members there immediately helping with her as we tried to keep her on her side so she wouldn’t aspirate.  Within two minutes there was a doctor also helping and we eventually got her cognizant enough that we could put her in a wheel chair and take her to the small aid room in the hotel.  Jackie was very calm and spoke to me suggesting that the best course of action would be to get her to a hospital.  All of the people on the tour were very supportive and promised to make sure all of our bags were loaded on the tour bus.

david panama public hospitalIn the aid room the doctor monitored Brandy’s oxygen levels and ran a short ekg strip, neither of which impressed him.  He decided we needed to go to a clinic and we jumped into a cab and headed to San Carlos (a town that warrants further investigation).  The hotel doctor rode with us and briefed the doctor in the clinic before leaving.  They immediately took Brandy back into the examination area and left me to figure out how things worked.  As it turned out, the Panamanians have great patience and took very good care of me.  Any of them could look at the paperwork I had and point me in the right direction.

The first stop was the check-in receptionist.  After a few minutes of gestures and sound alike words she suddenly picked up her cell phone and used it to translate.  It was smooth sailing after that.  She gave me the completed form and I walked down the hall to pay $1. I was then stopped by another clerk and she had another bill for lab work so I took that to another window to pay $42 dollars for a UA and complete blood workup.  We were in the clinic for three and a half hours and toward the end I was given a bill for IVs, three of which were used so I went to a different window to pay $6.82.  The labwork indicated that Brandy had a beginning UTI and I was sent to the pharmacy to pick up ten days worth of two medicines, $1.85.  The doctor examined or interacted with Brandy every step of the way and frequently called me in to explain (in perfect English) Brandy’s status.  When it was time to leave one of the clerks called a cab for us and waited with us on the curb and explained to the driver where we needed to go.  So it was three and a half hours of exemplary medical care (I was a medic in VietNam and an EMT all of my adult life), with very fine people (both the medical people and the patients) for a TOTAL of $49.67.

san carlos panamaSince we had left all contact information behind, we headed back to the Sheraton Bijao.  The manager immediately recognized us and offered any assistance he could render.  He put me on the phone with Jackie – still cool as always and we decided we could catch up with the tour by catching a bus on the highway near the hotel.  The hotel manager immediately had us in a taxi who got us to the highway just in time for him to jump out and flag down the bus to Santiago.  I had thought a car would have been more comfortable, especially for Brandy, but after we were on the bus we found it quite comfortable and again, everybody friendly and helpful.  It was a two and a half hour ride to Santiago which cost $15.00 for both of us.

The next day Brandy was not completely recovered and Jackie and I decided that it would be better to skip that day of the tour and take Brandy straight to Boquete where she could rest in the same hotel for several days.  Jackie, in her graciousness, paid for a car to take us to the Oasis Hotel and she had already called to inform them of our early arrival.  After a couple of days of rest Brandy was able to participate in a  couple of tours which she found delightful.

If I wasn’t convinced that Panama was the place to retire before this experience but am certainly convinced now. I can’t imagine retiring anywhere else.

I cannot thank Jackie and her crew enough.  This is a tour that was conducted very professionally and yet you were made to feel as though you were a personal friend and were there to have a great time. Thank you Jackie, and if ever I can do anything for you, you need only ask.

I met many wonderful people on the tour, all of whom I wished to talk with and all of whom I hope I see again.  Again, I apologize for any distress or inconvenience this incident may have caused.  I thank you all for your help and for your graciousness and concern. It was easy to get right back into the tour mode thanks to all of your support.

Terrance Davidson
Colorado

CAN YOU IMAGINE WHAT THESE EMERGENCIES WOULD COST WHERE YOU LIVE?

punta pacifica hospital panamaSo, why are the costs so low in Panama and so high where you live?  That’s a question I get asked often. The answer is that the costs, especially at a public hospital or clinic, are based on what a simple Panamanian worker can pay.  Someone like a gardener might only make $25 – $30 a day.

The other reason the costs are so low in Panama, compared to other countries, is because lawsuits are rare so doctors do not have to spend a fortune on malpractice insurance.   You’ll find that most doctors offices are simple but clean.

I’ve had two eye surgeries in Panama which my health insurance paid for.  My surgeon told me that when he filed the insurance claim for $2,200 in Panama, he gets paid $2,200.  But when his daughter, who is a doctor in Miami, files an insurance claim for $7,000 she will be lucky to get paid $3,500.

These are some of the reasons health care costs are more affordable in Panama.

CONCLUSION

As you can see from the two medical emergencies above, quality and affordable health care are available in Panama.   I don’t take any medications but I’ve been told that some medications are much more affordable in Panama too.

By Jackie Lange – Panama Relocation Tour