A shot in the arm – not a good thing if it is the WRONG shot!

Blog entry created by: Teresa

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Having only experienced the US health care system, with lots of red tape, double checking, and regulations, I was enjoying the more relaxed systems of other countries, until…

Sick in Peru? $20 and 5 minutes put me on the road to recovery :-) no health insurance needed

It was nice when I got sick in Peru from eating or drinking something I shouldn’t have to be able to pop into the pharmacy, explain the problem in English, Spanish and some miming, pay $20 for the health consultation and the medicine, and be on my way.  No making an appointment, driving to the doctor, going to the pharmacy, insurance issues, etc.  So efficient!

Prescriptions in Rome – 275 days of Malaria medication in a few days

Even in Rome, when we needed to pick up Malaria medication, and some other scripts, they didn’t need to see the actual scripts (who is going to buy Malaria medication except someone who is trying to avoid getting Malaria).  The drugs were less than half the cost.

Prescriptions in the US – six weeks of frustration and still no malaria medication

This compared to home where I spent six weeks going back and forth from pharmacy to doctors to the health insurance company trying to get our medicines in advance of travel.  The insurance company doesn’t want to let you have more than 30 days of a drug at one time, we had four different doctors because of the different meds and because my travel doctor doesn’t see children and our regular doctors don’t do travel meds.  When I got the insurance company to approve 90 days, I found out that my pharmacy is one of the few in the US that only fills 30 day scripts. They can’t even fill a 90 day script in three parts, they needed all of the scripts rewritten.  After 6 weeks, I finally got them all to agree to three 30 day scripts and then it turned out that the pharmacy could not order the meds before we left and would not mail them to us, so we left the US without several of our prescriptions.

Doctor’s office appointment in Rome – can you come in right now?

We needed to get a few travel vaccine boosters while in Rome.  The woman at the front desk of our hotel called a travel clinic for me, and surprise, surprise, they could take me right away and the shots cost 1/2 of the US cost, with a doctor’s fee of only about $20 per person.  I knew that the kids needed the older Japanese Encephalitis as the newer one is not yet approved for people under 17 years old.  Funny, they only had the newer one and they use it for children.  Hmmm – oh yeah, it is the FDA that hasn’t yet approved it for kids, and that is only in the US.  The new one has far fewer side effects – I wondered which country was providing the better care in this case.

Hmmm, no FDA jurisdiction here

The hotel clerk and I told the woman at the clinic that I would come in for my Hepatitis B because they didn’t have the right vaccine that the kids needed.  When I checked in at the clinic, the woman was talking about Japanese Encephalitis and I told her, no, that is the wrong one, I was only there to get Hep-B.  She told me the doctor said that since the kids had the first two shots of the older Jap-E, they could get the third of the newer one.  It seemed pretty reasonable and kids in Rome get the new one, so I said, “okay”.  I gave her my immunization record and she reviewed it and I told her that it was the second Hep-B shot that I needed.

Something is terribly wrong!  …or where do you want your SECOND shot?

The kids were nervous, so I said I would take my shot first.  She gave it to me and then asked me if I wanted the second shot in the same arm or the other arm.  Such an odd question given that I was only getting one shot…but there is a language barrier.  I asked if she had just given me the Hep-B.  She said, “no, I gave you the Japanese Encephalitis”.

In that moment all the care that goes into the US health care system flashed before my eyes.  My travel clinic appointments: “Are you Teresa Keller?”, “You are about to get the Hep-B, is that correct?”, “Read this and sign here.” Why hadn’t I realized this?  Why had I just assumed that she would give me the right vaccine without checking it myself?  Of course, there is no way to get the offending vaccine out of my body.

Happy to pay for getting the wrong medicine shot into my body…

I closed my mouth.  She explained that it wouldn’t hurt me to have an extra dose and gave me the Hep-B in the other arm.  The kids got their vaccines – and this time I carefully looked at the vaccine name on the boxes before she gave the shots.  I paid for the extra shot I shouldn’t have gotten.  She was filling in at that clinic and she was nice enough to take us at the last minute.  It was really an innocent mistake.  I didn’t want her to collect less money and then have to explain why to her boss.  I could sort of see how she might have misunderstood.

Emotional response – how can you possibly give someone the wrong shot!?!

Part of me inside is still thinking – how could she have possibly shot the wrong drug into my arm?!?  She had the record showing that I already had all of the doses of that drug!  It never would have happened in the US.  This is medicine for goodness sake!  What if it had been a mistake with far worse consequences?  And, even though I believe it was the right thing to pay her for it, I can’t believe that I paid $100 to have the wrong medicine in my body.

Rational response – it was a big learning experience – take more responsibility for your own care wherever you are

Regulations are looser in other countries, and although it is often convenient, it means there is a higher chance for mistakes and you have to take more responsibility yourself.  Looking up medicines that are prescribed, watching what doctors and nurses are doing, speaking up if it doesn’t seem right and yes, accepting that sometimes things will go wrong.  When you think about it, health care is never perfect – even with all the regulation we have in the US, and taking as much responsibility as we can for our own care is a great policy wherever we are.  It’s funny, I have always been a big believer in that, but there is nothing like a health care mistake to drive that point home.

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Posted on: September 15, 2010 | Categories: Health Care, Italy, USA


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