“Never go to a doctor whose office plants have died!”
Erma Bombeck
Inspiration to write comes when you least expect it. It’s Tuesday morning, and I am in the waiting room of a medical clinic in Torino, Italy, to get a thyroid prescription refilled. I’m anxious, but hoping the visit is quick, and the doctor is generous with his prescription pad.
I have copies of my health history, prescriptions, reports and doctor notes. Either the doctor is going to appreciate my thoroughness, or I’m going to scare the hell out of him with some very interesting doctor notes. My doctor in California recorded everything I ever told her in those nice office “chats.” You could follow my life events in disturbing detail: a case of jock itch, bunions, a misdiagnosed trigger-finger, the risk of hemorrhoids with vegetarian diets, chronic heartburn, and a healthy discussion on STDs for mature individuals. I’ve never had an STD, but apparently 48-year old widows are at a higher-risk than widows over 60. I think that is terribly unfair. Individuals over 60 should have equal opportunity to catch an STD just like the rest of us. I’m a bit embarrassed, but this is my first experience with Italian healthcare, I have no idea what to expect. Let’s see how this goes!
The women who check me in are pleasant. When I approach them to discuss my situation, they are friendly and show genuine concern for my needs. They assign me a number and inform me the doctor will see me shortly. There is no discussion of insurance or financial responsibility. They appear to be unconcerned despite me informing them I am not covered by the national health plan and will pay for my visit. Their lack of concern gives me the impression this medical clinic is driven by care and not economics. I take my number, find a seat and open up my MacBook. I need to capture this experience in words.
There’s a smoking section outside the entrance to the clinic. When the door opens, a faint smell of smoke wafts into the waiting room and mixes with the smell of disinfectant. A radio station plays loudly over the speakers. It offers up hip-hop, electric dance, and pop. The song playing now has a repeating line, “Get up off your ass…thump…Get up off your ass… thump…Get up off your…Get up off your…Get up off your ass…thump!” I’m not sure everyone in the waiting room understands the words, but I let a laugh burst forth. In California, the only people saying, “Get up off your ass!”, are the frustrated patients talking to the office staff. Here everyone is orderly and patiently waiting for their number to be called. I am deep in thought on my MacBook when I hear my number called, “Settantatre, Settantatre!” That’s me, 73.
The doctor meets me at the door, greets me warmly in English and escorts me down a hallway. We enter the exam room, which looks more like a business office. As I enter, I immediately scan the room for familiar signs to calm me: doctorate degree from Oxford-check, family pictures on the desk-check, no painful probes in the immediate vicinity-check. There are two chairs on one side of a desk facing the doctor’s chair and a large monitor and keyboard standing ready.
We sit and discuss the reason for my visit. I subdue my habit of rambling and just give him simple answers. I explain my status as a pending citizen and my need for a simple prescription refill. I hope to avoid my elaborate medical history, when he says, “I’d like to your physician’s notes from the United States?” Oh shit, here we go!
I sheepishly show him my documents, lab reports, prescriptions, and less enthusiastically, my physician’s notes. He reaches for the notes first and begins reading. This is going to take a while. I wait and watch his eyes for any signs of shock or amusement. This guy has a poker face. He reveals nothing other than an occasional faint twitch in his right eyebrow. After what feels like twenty minutes of silence, he simply says, “Ok, so Italy has a different philosophy than the United States when it comes to medical care. Where do you want me to begin?” I have no idea what is about to unfold. Either I’m going out of this office in a biohazard suit, or he’s going to school me on everything I never wanted to know about medical care.
We have a lengthy discussion about my thyroid. Thankfully, he doesn’t ask about about jock itch, hemorrhoids, STD risks, etc. His only advice to me is when it’s time for a colonoscopy in Italy, choose your doctor wisely. Apparently, the Italian health system likes to keep you wide awake during the procedure. Seriously? He tells me that the US overmedicates everyone. I agree with him in hopes to show solidarity. He informs me of the dangers of ibuprofen, aspirin, and his particularly dislike of acetaminophen (Tylenol) mixed with alcohol. I happily volunteer that I never touch the stuff…Tylenol that is.
We talk about my former career in health care, his education and the different approach to medicine in Europe. After what seems like minutes, I look at my watch and realize it’s been over an hour! This discussion was a medical visit, an educational overview of European health care, downed with a chaser of psychotherapy. I thank him, and he walks me back to the waiting room and writes my prescription. He wishes me a good day and leaves. I have my prescription, a healthy view of the Italian health care system, and comfort that when I need medical care, I’ll be in good hands with this doctor.
In 2000, Italy was ranked by the World Health Organization as #2 in developed countries for overall efficacy among 152 participating countries. France was #1. The United States ranked #37. (https://www.who.int/whr/2000/en/) A primary care doctor in Italy earns on average $84,000, 1/3 of the average in the United States at $230,000. (https://www.expatfocus.com/destinations/italy/guide/salaries). Thank you for following The Spaghetti Diaries. Please subscribe to receive notifications of my latest posts.