Over the past ten days or so I experienced a severe bout with tonsillitis. I’ve made three different trips to the hospital, and I was even hospitalized overnight so I could receive an IV with strong antibiotics.
As terrifying as this experience was for me (it was the first time I had ever been hospitalized or given an IV), it was even worse going through it in a foreign country. My fear of needles and injections is only increased when I don’t understand every single word that is being said to me about the process.
With all of this in mind, I have learned a lot over the past week or so. Most tangibly I know that I have oversized tonsils that should probably be taken out sometime after my return home. Perhaps more interestingly, however, I gained a great deal of cultural awareness about Spain’s medical system and socialized medicine in general.
As a short summary of Spain’s medical system, Spaniards pay a share of their taxes toward healthcare and anyone who needs medical attention can receive it free of charge, including foreigners like myself. The system is clearly more complicated than that, but that is the working knowledge I have about the way all of my treatment was funded.
In honor of full transparency, if someone had asked me before coming to Spain what I thought about the whole private market vs. socialized medicine debate I would have sided with the private market. Everyone is entitled to their own opinion of course, and what follows is my attempt at providing objective observations of how the socialized medical system works in Spain. I had a very positive experience, but everyone can make up their own mind as to what type of system they prefer or think is best for a given society.
Things are made slightly easier for those of us studying at the Georgetown Program in Madrid because we have international insurance and we have access to a hospital with medical interpreters that are with us for almost every step of the way. With that said, there are still plenty of unknowns when facing the medical world of a foreign country.
For example, I was told I was going to be hospitalized overnight nearly moments after seeing the doctor. I was in near-disbelief, as I have had swollen tonsils before and usually just receive pills and am on my way. She made the decision with a few click glances down my throat and was having absolutely none of my argument that it seemed highly unnecessary to have to stay at the hospital.
What I didn’t know at the time, however, was that being hospitalized overnight in Spain is not nearly the deal that it is in the United States. Because the costs of sleeping in the hospital and of having all the tests done that such an experience entails are so high, doctors and patients in the United States are much less prone to hospital stays due to the insurance system and subsequent out-of-pocket expenses. In Spain, there is no additional charge for receiving such treatment due to the structure of their medical system.
As a result, I received very strong antibiotics through an IV that reduced the swelling in my tonsils past the point that two months of antibiotics in the United States had been able to achieve. This was very much a positive for me. On the flipside, however, the system is not as efficient as one would hope it would be.
I was not discharged until around 8 pm the following night, as the wait for each doctor to see me or provide me with results was very arduous. This is in part, however, to the cultural differences regarding hospitalization. Spanish doctors, unlike American doctors, are in no hurry to discharge their patients because there is no cost factor in the amount of time that the patient is hospitalized. I felt fine (and looked fine, according to my interpreter) the next morning, but it took nearly an entire day just to get the one specific doctor I needed to have speak with me so I could be discharged to finally do so.
Additionally, receiving the results of my blood tests took two days longer than anticipated. I had been promised a call if my results weren’t ready, but I instead went all the way to the hospital (a more than 30 minute commute on public transportation) and waited for the doctor to see me only to tell me that my results weren’t in. I had to wait another two days before I could see my results (all of which came back negative) and be cleared to resume normal daily activities.
This was only so frustrating because I had been put on bed rest until I received my results. For me this is another cultural difference between Spain and the United States. The pace of life is much faster in the States; confining someone to their house for a full week would be considered a high level of punishment / torture for many. In Spain, however, the pace of life is slower and the medical system is more concerned with being careful about one’s health than about allowing one to resume all of their normal obligations as quickly as possible.
My observations basically come down to perceived cultural differences between the United States and Spain dealing with the pace of treatment and the willingness to spend money on more intrusive, yet usually effective, methods. The whole medical world is very much about time and money. Again, these are just my observations, but they have very much called into question some of my personal beliefs about the medical system in the United States. Sometimes it takes such a foreign experience to truly realize what the life one has always been used to is really all about.
