A big reason we moved out of the US was the cost of health care. Well, insurance anyway. We’ve heard great things about the Portugal health care system (it’s ranked higher than the US!).
Here’s what our experiences have been like thus far.
Before we go there, we need to explain that Portugal has two different health care systems: the public and the private. The public is funded mainly by taxes paid by employers and employees (sort of like Medicare is funded by those who are working in the US, except that in this case, everyone benefits from those taxes, not just those who are elderly or disabled). The hospitals are first rate. There might be lines, you will likely have to wait to see a specialist. (Frankly, we’ve had to wait an awful long time to see some of the specialists in St. Louis, so there’s that.) If you want to not wait or - and here’s the biggie - you want English speaking doctors - the private system is for you. Which means it’s for us, as our português is not that good yet.
First up was finding a GP for Amy. After a LOT of searching for the scant reviews and doing deep dives in various expat Facebook groups, she made an appointment with a doctor. Most doctors are with one of the main hospital networks, which, it turns out, means they are actually in the hospital building.
Appointment day found us at the Hospital da Luz (there’s a metro station right nearby!) and … it is a building that prides itself on design. But not as much on signage. It took interrupting many queues to beg information on where to go from receptionists whose English varied widely. Eventually we found the room. No time for celebrating, though, as we had to brave the desk. We are embarrassed to say we did the stupid interrupt-the-nice-people-at-the-desk thing again. Frankly, we simply hadn’t budgeted enough time for trying to figure out where to go. We now know that you get a ticket from a machine and then watch a board on a wall for your number to come up.
The white board is first (Letter A for Admissão). When your number comes up - 106, say - you find you are to see receptionist #6. Pony up your 88€ for a GP (98€ for a specialist) with no insurance, get another ticket and you can watch the blue board (Letter C for Consultório). When your number comes up, you go to that Consultório room to see your doctor. It’s the advanced deli counter system. You might note that the blue board numbers are not sequential. Fortunately, when a new number appears on the board, a ding sounds. Over and over. While this makes a ton of sense and is very orderly, it’s also not calm.
Here’s where things got trippy: Amy’s number came up, giving her the room number, and at the room she found her doctor seated behind a desk, waiting for her. Mind blown, they proceeded with an almost normal doctor appointment. She asked questions, she took Amy’s blood pressure. There were striking differences though. No listening to lungs, no stethoscope, or asking about … well, much of anything.
And that was it. An inverted experience: instead of the doctors doing the moving to the patients, the patients move to the doctors. The doctors don’t seem to ask for the same information or to touch the patients. And not a form to be filled out in the entire process. No “what happened to you when you were 6?” and “what’s the deal with your mother’s aunt on the paternal side?” It’s fine. It’s just different.
Since then, we have experienced amazing and wonderful doctors. And doctors who are are not. Just like the US ;-)
What’s different is we can’t contact our doctors outside of an appointment. We needed a “medical record” to submit to insurance. To get one we need to make another appointment. Question about a medication? Need a refill? Make an appointment. And spend the extra 88 (or 98)€.
We had the opportunity to try a doctor outside the hospital system when Amy sprained her ankle. She’s not in the habit of going to a doctor when she does this, mind you, but this was an unusual injury. The podiatrist was in the classic store front, receptionist type office, no ticket machines to be found. He diagnosed very well what seemed to us to be a tricky thing, and then spent an hour taping it very carefully so it was able to heal the most quickly. He charged 50€.
If this is of interest, we’ll post on this as we have further engagements with the medical system. We already say getting prescriptions, whew. On the other hand, maybe we’d better wait until we’re recovered from that saga!
That’s all for now.
Love from Lisbon,
Scott & Amy
The number portion reminds me of my motor vehicle visit last week.
My experience was somewhat the same but somewhat different, so I don't think some of those points are universal. I needed to see a GI, so like you I sought out a private one based on recommendations from a local expats group (Expats Cascais). Like your experience, I found him awaiting me in his office, seated behind a desk. Unlike your experience, we talked quite a bit about my history - and he hand-wrote notes on a sheet of paper (no long patient history form to complete upon arrival). He also had an exam table in his office, where he did a physical exam. Also, I emailed the clinic a few days later with a question, and apparently the receptionist forwarded it to him, because he emailed me the answer directly (that very evening)! So my contact with him outside of the appointment was far better than my ability to reach my doctors in the U.S., where I never would have had my doctor's direct email address. Excellent experience over all.