Ok so some musings on work as a GP here, sorry for all of you non-medical types. More than anything I want to record some of the bigger differences practicing here vs in the US. Granted I realize this is no 3rd world country, but good to see and document the differences.
AS I mentioned, cervical screening is so different, most PAPs are done by the nurses, I have done only a handful in a month compared to my usual 5-9 daily. No stirrups on the beds, never thought I would appreciate these so much. Instead women lie on their sides, backs to me, and I place the speculum as they hold one leg in the air. Not that having or doing a PAP to begin with was ever the most exciting procedure, but feels a bit more awkward for all involved.
I see pts every 15", much busier than at home. Yesterday I saw 28 total and still had two tea breaks and lunch and time to visit with Jack who showed up at work after his rowing when Noah took off with the bus money, leaving Jack to fend for himself. Ugh!! As for the doctor/pt interactions, not sure this is the best model indeed, but what I do like is the expectation most pts have that they are coming to the doctor for 1, maybe 2, things and that is all. So far no one with a list of 12 or more complaints to bring my way. There are many med refills, 3 months being the longest we can prescribe meds for, though some will call in for refills. no emailing the MD, which is good in ways, saves time perhaps. Makes me realize how much time we do spend with the emailing and phone visits.
Still getting used to all of the meds, same drugs, different meds. Many are gov't funded and so if I can prescribe one of these, the cost is very reduced for everyone. Crestor, for example, one of the more costly statin meds in the US, ends up costly only $3/month here. If not funded, than the cost is more.
Everyone has insurance of some kind. In fact most services are more like a fee for service model. If you have private insurance on top of that you may get procedures sooner than if you have to wait for the hospital to call you.
Colon CA screening: barely anyone gets a colonoscopy here, must be in higher risk group w personal or family history of such. Not just because you are 50 do you get one.
They take Cardiovascular risk history very serious in terms of follow up and want everyone's Framingham equivalent to be under 10%. No well child exams, Rns see kids more regularly for immunizations, but a kids may see an MD only a few times before age 18 if s/he is healthy.
GPs dont do any OB. Bummer for me!
The average person here does seem more health conscious, active and willing to take responsibility for their health. I can not tell you how many older patients over 75-80 I have seen who look 15-20 years younger than stated age. Living the good life here for sure!
Not that is doesn't exist, but WAY lower incidence of pain medicine use here. I have written one rx for oxycodone in a month! Most are totally opposed to pain meds and want off as soon as they can. Tramadol is the strongest med I see most often. No hydrocodone at all. Imagine that!
Manuka honey, every heard of it? Special kind from here that is used medicinally on wounds. Comes from the Maunka, or Tea Tree, tree. In fact when treating a man for a large open stasis wound on his leg the other day in acute care clinic, the only thing we put on the wound was this honey, medicinal grade, and gauze bandage. Lots of science behind the healing and antimicrobial benefits of honey in general, and this Manuka is the best!! Esp good for burns. Way better than Apple Cider Vinegar, Lynn!
Enough for now, off to the beach with Maggie for yet more shell collecting!
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