Health care: when you're sick

There appear to be some gaps in the system

A random sunset, while we’ve been hanging mainly inside.

We’ve recently had some new-to-us experiences with the Portugal medical system, and thought you might find it interesting.

Previously, we’ve figured out the queuing system, the public/private dance, and where to go in an emergency. We’ve gotten Covid, scarier diseases, and seen world-class doctors. We’ve had procedures and tests of all manner. In general, we’ve had good to spectacular experiences with health care here.

At the tail end of the marathon push to get Scott’s last play put to bed, he caught a nasty chest cold. When he became short of breath to the point where he had to take a breath after every word, Amy said enough, and made him an appointment for the doctor the next day at a nearby private clinic that specializes in foreign residents.

The doctor was nice and thorough. She didn’t think he needed antibiotics, but she wasn’t sure. So she ordered a chest x-ray and asked Scott to send in the results by email (you can email with this clinic!). She could then write him a prescription.

If we were in the US, they would take us down the hall to the x-ray machine. You’d wait a bit back in the exam room afterwards for the doctor to get the results, and then get your prescription, or not.

Instead, Scott received a print-out of three places he could get the x-ray. It was a Tuesday. He walked to the first place and they said they could make an appointment for Friday. Off he walked to another place farther away that said they did same-day x-ray results. They had an appointment available on Monday. We knew of a different place, not on the list. They could make an appointment for him the next day. Yay! When, he asked, would the results be available? Five working days later. He sent an email to the clinic saying he couldn’t get an x-ray, but there was no response.

We decided with that kind of delay, we’d either already have been to the ER, or he’d be better. So we gambled, and won. Another two weeks later and he’s almost completely better.¹

When Amy got sick with an illness, to remain unnamed, she followed the same route. Same doctor, since she wanted to check her out. At this clinic, the GPs don’t last very long, and Amy needed a new one, and Scott liked her…. The doc said yes, it sounds like the illness you think you have, but I want a test, to be sure.

Word to the wise: If you get diarrhea after taking antibiotics, take it seriously. It could be C. diff., which if untreated, can be fatal.

Naturally, the doctor sent Amy to an outside lab to get the test. Which she did and returned the sample to them, same day. As the prescription for the test² was written rush, she got the results that day, instead of the usual 2 - 7 days. She sent off the results by email and they emailed her a prescription!

Apropos of nothing, for those of you who are familiar with what “Poop in the hat” means, they don’t give you a hat here.
They say “don’t get the sample wet” and leave it to your ingenuity.

Scott went to our usual pharmacy - they didn’t have the medicine and suggested he try the nearest hospital, which is a public hospital. That pharmacy was closed so he went to the pharmacy at a different nearby public hospital. They also didn’t have it. They thought it was possible their urgent care clinic might but they said it would be unlikely to give it to him because he wasn’t Amy. Turns out this medicine is only available at private hospitals for some reason.

Side note: Prescriptions here are awesome because they often list the maximum amount that you can be charged for the medication. It’s usually 5.68€ or 1.27€. This time it said 1.550.09€. That’s more than $1,824.68. EEK. Not sure we wanted that medication!

On Saturday, Amy spent the day emailing and calling the clinic - open on Saturdays! - to get a different prescription. She didn’t get one. So she made an appointment with mobidoctor.eu for late that night. He gave me another prescription which she could actually fill! Yay! Relief at last!

Or, not. It seems with all the delay, she’d tipped into the severe category, so we went off to a private hospital ER. We’ve heard their waits are horrendous. Eight hours kind of horrendous. Hospital da Luz’s wait was long, too - we were told 3 1/2 hours to see a doctor! After 10 minutes, we were called to triage. Pro tip: Lie your head on their desk and moan. We were told we’d been seen in 1 hour. A half hour later, we saw the doctor.

You know how in the US, when you get admitted to the ER, they take you back and put you on a bed with curtains around? Not quite the same experience here. You go to a doctor’s office. Where you sit in a chair. The doctor then takes you to the back of her office and has you lie down to do an exam but then back to the chair you go. Finally she says you can be taken to a room. Where hopefully the elusive hospital bed will appear. In Amy’s case, she was sent to an Isolation Room as C. diff is very challenging in health institutions. The bed is not quite like your normal bed. It’s about an inch thick. You don’t get a blanket or sheets or pillow. Actually, it’s not a bed at all: it’s an exam table. And you know how if you get sent for, say, a CT scan, you get wheeled, either in the bed or in a wheelchair, over to the imaging area? Here you stagger up off of your “bed” and trudge. You sit on a chair in an open hallway and wait. Like us, you might think hey, you were in an isolation room. What are you doing in the main hallway? We had the same question.

After all the tests, and a small amount of saline was given (it’s clear they are much less aggressive with dehydration), we were given medicine and sent home, a mere 6 1/2 hours after arriving. We were also given an appointment with the same emergency room doctor that we had had to follow up with in 3 days.

You may be thinking to yourself: Hello? Just go to an Urgent Care. In our dreams. No urgent care clinics in Portugal.

The net net is that we are both getting better. But that the process was much more difficult than we are used to. We will plan accordingly, and in the future, for things that will require tests and are somewhat urgent, we will go to the ER first.

Stay well!

That’s all for now.

Love from Lisbon,

Amy & Scott

Today’s Weather: Solid blue skies, strong sun, 57f/42f

1. If you are used to getting a note after going to the doctor that says what you have and what to do about it, you won’t get that here. Unless you ask: Should I eat this or that? Should I use steam/heat/rest? you won’t know what to do.

2. Yes, every test you get here requires a prescription. And for you to fill it, you make the appointment.