Tuesday, January 8, 2013

Tuesday Topic: Medical questions

Ashley asks: Since many countries have differing medical philosophies, how do you approach medical care for your family overseas? Do you avoid it? Do you trust it? Do you double check every prescription before following treatment plans? When we first arrived in Russia, I was so afraid of Russian medical care, but the more we've experienced it, the more we've realized that often times the phrase "It's not wrong, just different" actually does apply. BUT, then there are the times when we've gotten prescriptions or have been prescribed therapies that would never be recommended in the US, or there are times where our US doctors are telling us to pursue treatments that don't exist where we are. How have your families dealt with the different medical systems and figured out when to have faith in the available medicine?

(If you have a “Tuesday Topic” question, please email it to me at fylliska@gmail.com. Provide your blog address if you would like to be linked to, or specify if you would like to remain anonymous. Thanks!)


  1. In Russia we never could get into the medical system. When we still lived in Moscow, we went around and around trying to register at our local polyclinic and never did find a way. We tried private clinics (not Russian!) twice and had bad experiences both times. I eventually went so far as to do my own prenatal care and births. We were always just thankful that we didn't have any emergencies.

    Here it's been the other way around: I've been trying to run away from the system! They just wouldn't leave me alone. I have been very pleased with the care that we've gotten when we've needed it, though. What they lack in beside manner and equipment, they make up for with knowledge and frugalness. :-)

    In general, I avoid medical stuff, and I would in the states, too. I think I tend more toward Russian ideas of medicine, though, so I'm pretty comfortable. I do double check everything and make my own decisions, but I would do that with American doctors.

  2. We've chosen to work with the medical system here, for the most part, and things have gone OK. I did return to the states for the delivery of one child, but that was following the recommendation of the doctors here. And one time, allergy testing not available in country waited until we were back in the States. That said, it is a choice we've made that many of our fellow expat workers haven't. There is one physician for every 30 000 people and their level of training/expertise is not always a guarantee. There is also very much of the attitude "I'm the doctor. You do what I say, no questions, no explanations and if you even hesitate, I'll no longer treat you."

    We've found relationship to be a very big part of our strategy to deal with medical care here. I'd like to say we mostly avoid the doctor, but in a malaria endemic area with 8 kids, it just doesn't happen. We've gone to the same clinic, same GP now for 12 years - we have that doctor's cell phone number and can call day or night, if we really believe we have need. If we don't understand what one of her medical employees is doing or why, we can talk to her and she no longer gets offended or looks at us as non compliant. Bedside manner is a lot different, but we do know that this particular doctor, in her way, does care about our kids, their health and our family.

    Doctors here do tend to medicate massively and immediately - but I think that is the nature of the beast b/c the often don't see people until they are so sick it is almost too late so they tend to pull out the really powerful stuff right away. So it is always a balance between working with the local doctors and still making informed decisions.

    It definitely has been a faith building opportunity that God has used in our lives.

  3. We have done just about everything you could do here -- gone through the local, public healthcare in our host country, used local private doctors in our small town, seen private doctors in the capital city, and seen doctors in the States. What we do most often is see doctors in the private hospitals in the capital city. We have found doctors we are confident in and have had good experiences with throughout our years here. They are significantly cheaper than any healthcare in the States, and they are well-trained and spend a lot of time with us, even giving us their cell phone numbers and email addresses. Once, one of them even offered to Skype with us to see a rash so that we wouldn't have to drive in to the capital! Of course, we still research everything as I think we would in the States, too.

    We do see local doctors in our small town for small issues, but we tend to pick and choose from what they prescribe to us because the tendency is to overprescribe and to use very strong medications, even for children. We joke about "the injection" everyone seems to get every time they go to the doctor here, no matter what they are going for. We decline "the injection". =)

    We have had minor procedures done here in the private hospitals, but have returned to the States for bigger surgeries, although that was partly to have family's help with our small children during the recovery time. I did have a high risk pregnancy here, and it was a little scary to have our baby come early and be in the NICU (which wasn't at all like a NICU in the States), but I still think I would prefer to deliver here rather than in the States.

    We have had many more medical issues living here than we ever did in the States, and God has blessed abundantly through giving us good doctors and peace as we see them!

  4. We live in the capital so we do have access to private hospitals if a major emergency arises. I had minor surgery here without any problems. I agree with Sarah (I think it's a Central American thing) that the tendency is to over-prescribe, and everyone gets the "injection" everytime they get sick. We still haven't figured out what it is and we also decline.

  5. Thank you so much for sharing all of your experiences! It is encouraging to hear the different ways of going about things and to know that everyone wades through this issue. I wish there were a "prescription" for how to navigate overseas healthcare, but each situation seems to really just require individual consideration. I ended up in the ER in Russia in early December and then again in the US exactly a month later(two totally unrelated things!), and the experience and my feelings about it all were so different! I am thankful that we have pretty good medical care in Russia, even though I disagree with some of it. We're headed back to Russia on Saturday and will be delivering our baby there a couple of months later. Ironically, I freak out about all of the medicines that the Russian doctors prescribe for illnesses, but I feel better about having a baby there than here in the US after having experienced both. It doesn't really make sense logically, but for some reason that's how I feel! =)

    1. Ashley ~ After having babies both places, I agree. I much preferred delivering babies here than back in the States. Probably part of that was a simple comparison of the amount of "pennies" involved... But here also involved so much less intervention, time in the hospital, etc. The one pregnancy with complications - hubby decided pretty quickly that he'd rather me there wishing to be here than here needing to be there. So I went home, took half the kids with me and had baby without hubby around at all - God was good through that experience, but we aren't hoping to repeat that experience... ever.