We wanted to write about our experiences with the doctors here in Puerto Rico because it is so different from Minnesota. We knew it was going to be different. The cost of healthcare here is a lot less than in the states, but it can take a lot longer to be seen. What follows is the story of three doctor visits over the past three months.
Jake visited the doctor for the first time during his second week of work. Honeywell has a doctor on site certain days of the week, usually Monday and Wednesday, but not always. He was able to make an appointment and fill out the necessary forms, and thought the process was going smoothly. The doctor was the wife of the man who owns the shop where we have our mail PO box.
When he went in for his appointment, he was greeted with Spanish. Jake said "No habla Espanol." The doctor said "My English is not good." What pursued after that was a game of charades back and forth between Jake and the doctor while Jake tried to explain some pretty basic health conditions. Jake has been on the prescription he is trying to get for the past 15 years. Luckily he had brought his previous prescriptions with him so she was able to write a prescription based on that. Jake had the prescription and achieved his goal of visiting the doctor...or so he thought.
Around 6:30 that night, we went to Walgreens to fill the prescription. We dropped it off, and the tech said it would be ready in 15 minutes. So, we drove to Ace Hardware to see if we could find the missing piece to fix our door. Unfortunately, Ace was closed. Then we drove to National Lumber, and they were closed too. Now we know why shopping is always so crazy on Saturdays, nothing is open at night here...
We were feeling pretty good about our experience at Walgreens...the prescription was filled and it seemed like this was going to be a tolerable process. Jake should have opened the prescription at Walgreens. Instead of the three month (or even one month) supply he was expecting, there were 15 pills. He called Walgreens and they said our insurance only allows you to get 15 pills at a time...and that I would have to come back once I used those. Over the course of the following week, Jake investigated and found out the real story was that the insurance company did not consider it a "maintenance" medication so they were choosing not to fill the prescription. The insurance company sent Jake a letter explaining this (in Spanish of course). Jake took the letter to the doctor and first asked for a prescription with the word "maintenance" in it. That didn't work either! The doctor also provided the name of a specialist he could see in order to get a prescription that they would fill.
Doctor visit number two - there was a different specialist Jake needed to see in San Juan. Jake called many, many times over the course of a month or more and only got through a few times. When he did get through they spoke very broken English. He was ready to give up, but decided to give it one last try. When he called, someone picked up and after a short wait, he was actually speaking to someone who spoke English well. After telling his story, he picked a day in early March and they offered available appointment times. We needed to drive from Isabela to San Juan, so Jake picked 11am.
Jake took the appointment day off and worked for an hour in the morning before we left around 8:15am to give us enough time to get to the appointment. We had to pick up KC's sister from the San Juan airport later that afternoon, so we were planning on going to the doctor and then spending the afternoon in Old San Juan visiting the forts and eating at one of our favorite places. Everything was going smoothly on the way there. As we approached the hospital complex the traffic turned horrible. People everywhere and cars stopped. It took about 20 minutes just to get to the parking garage, and another 10 minutes to find a parking spot.
We went into the Hospital's main entrance and tried to communicate with someone at the front desk. They tried to explain that the doctor was in a building on the other side of the parking ramp. We went back outside and realized there were several parking ramps. After wandering through what must have been the doctors parking lot because it was filled with Mercedes, Jaguars, Lexuses, and BMWs, we found the name of the building we were looking for. We finally arrived, and were 10 minutes early!
We went into the office and checked in. It was once again a game of charades trying to communicate. Jake had to fill out a form, which luckily was in English, and they wanted us to write our name down on a list. This was a little scary, because they told us we had an 11am appointment, and there was a room full of people waiting. We sat back on a couch and pretended to watch some Spanish television in between checking our phones. After about 50 minutes of waiting, we started to realize that this was going to be a long day. Jake went back to the car to get the cooler with our lunches. We sat and ate lunch and waited some more. By this time it was after 1 pm. Two hours after our appointment. KC went up and asked how much longer and they said only two more patients ahead of Jake. She asked about the appointment, but they said they don't make appointments on Tuesdays (What??). Other days they do. We waited and waited and waited. Finally they called Jake's name at 2:30 pm, three and half hours after our supposed appointment time. We finally left at 4:30 pm.
KC's sister's flight landed at 3:55pm, so we were already late, and headed straight to the airport. We decided to avoid the traffic and stop in Old San Juan for dinner and to walk around a little. We ate at our favorite place, La Cueva del Mar, and had fish tacos and empanadas. After dinner, we stopped at Starbucks as a "reward" for dealing with such a crazy day! :)
Doctor visit number three - back to seeing the specialist for the prescription. After five tries calling the specialist's office over the course of a week or so, Jake was able to get through. Their English was broken, but we were able to communicate. They set up an appointment for the beginning of March and said we should come between 7 am and 11 am to put our name in and fill out the paperwork and we would be seen no later than 1:30pm. We have to give up an entire day to see this doctor? We accepted it and moved on.
At this point, we were expecting the absolute worst after the doctor appointment in San Juan. We showed up to the office at 10:30. There was an office full of people waiting. The office was located inside the Aguada Medical Center which is about 35 minutes south of where we live.
We went inside and checked in. They told us we could leave and come back no later than noon. So we walked over to the strip mall across the street. We were able to find a coffee shop, which is hard to do in Puerto Rico. It's not like it was in Minnesota where there's a coffee shop almost anywhere you turn. Jake was able to get a hit off of their internet and catch up on a few work emails and KC read her Kindle. We once again rewarded ourselves with treats - strawberry and mango frappes.
We got back to the doctor's office before noon and waited, and waited. He was sitting in a room just off the waiting area. The doctor was basically rooming the patients himself. He sat back in a chair with his feet up and called people's names. One person would leave and he would call the next person on the list. The door usually closed in between patients. One time, the patient didn't come and he had to get up and open the door and call the patient. He didn't seem too happy about being disturbed. We put this doctor in his late 20's, and the BMW sports car outside was probably his. He called Jake in and the appointment went pretty smooth. There was one break during the appointment while the doctor talked to one of his buddies on speaker phone in Spanish. The appointment lasted about 10 mins. Jake showed the specialist doctor the note from the insurance company and he left in hand with a prescription that should take care of the everything, we hoped.
We stopped at Walgreens over the weekend to drop off the new prescription. The pharmacist read the letter from the insurance company which was in Spanish and said that we also needed a letter from the doctor indicating why Jake needed to be on the medication. WHAT???!!!! They said they would try to submit it, but didn't know what the insurance company would say. So, the saga continues...just to get a simple medication that Jake has been on for the last 15 years.
