Retirement in Puerto Vallarta – Afraid of Medical Care South of the Border?

Ten years ago, the fear of needing emergency medical or dental care while south of the border ranked close to the fear of running out of gas while crossing the railroad tracks; both had you calling for spiritual guidance! In 1997, shortly after we moved to Puerto Vallarta, Mexico, referred to as PV or Vallarta by the locals, a friend of ours elected to have a substantial amount of cosmetic surgery done here in PV. At that time, there were a number of small hospitals and clinics in town, however only two that she considered.

One was of the 50´s vintage and the other more like the 60´s because it had window air-conditioners in the three patient rooms. My son, a surgical veterinarian in California, would have been reluctant to practice his specialty in the other hospitals and clinics! The surgical procedure on our friend was satisfactory and although none of the nurses spoke English, the attention and care she received during recuperation were excellent. At that time, good medical care was difficult to find in Vallarta and if anyone needed major medical care, they would need to go to Guadalajara or fly to the States. In 1997 there were a number of dentists in PV, but they were pretty scary looking places, resembling those you saw in the 60´s, although a couple of them did have window air-conditioners. Ten years ago, if you had a broken arm, toothache, etc., you were best off flying back to the good old USA for care.

Now, ten years later, we have two huge, ultra modern, fully equipped hospitals and one smaller, yet still modern hospital in Vallarta. Of course, many of the small dilapidated hospitals still exist, but would not be considered by North Americans. The small AmeriMed Hospital is fully capable of handling most emergencies, conducting most testing, and is adequate for all but the most serious problems. Across the street from AmeriMed is the new San Javier Hospital which was built about five years ago. This ultra modern hospital is capable of handling just about every medical problem imaginable.

They recently performed emergency open heart surgery on a cruise boat passenger. San Javier has an MRI machine, cardiac catheterization, angioresonance, neuroradiologic, mammographic, ecosonographic, etc. equipment. Of course the patient recovery rooms meet the highest standards, equipped with everything you would expect in a fine US hospital. The newest hospital is the Cornerstone Hospital which was built two years ago and meets the same standards as the new Cornerstone Hospitals in Texas. Cornerstone has the only Radiology Clinic in Western Mexico with state-of-the-art CAT scan and MRI equipment. It is the center for dialysis and lithotripsy as well as having emergency pediatric care, full cardiac services, an ophthalmology department, a 24 hour emergency room, an intensive care unit, an on-site pharmacy, recovery room, and beautiful, almost plush, patient rooms.

Between San Javier and Cornerstone, we are fully covered for any matter pertaining to orthopedics, trauma, nephrology, urology, anesthesiology, internal medicine, gastroenterology, obstetrics and gynecology, endocrinology, rheumatology, neurology, cardiology, general surgery, plastic and reconstructive surgery, hematology, dermatology, and just about anything that ails you. These hospitals accept most all international insurance and the majority of the US veteran benefits. In fact, the veterans here indicate that they are receiving better care in PV than the overcrowded VA facilities in the US.

Virtually all the doctors and nurses in these hospitals speak English. Furthermore, the majority of the doctors have received part of their education in the States or Europe. There are two main differences between these hospitals and those in the States; they are price and service! Surgical procedures and hospital services are a third to a half of what they are in the States. The attention, care, and follow-up far exceed that in the US. The doctors and nurses really care and treat each patient as a friend. They seem to be more interested in treating and curing the patient than they are in collecting the money. Most doctors carry cell-phones and are available for consultation 24 hours a day.

Cosmetic and reconstructive surgery has become so popular in PV that many Americans and Canadians come here specifically for a nip and tuck. So many, that a major spa specializing in postoperative care is currently in the planning stage, allowing those in the market to come to Paradise for a week or two and return home looking ten years younger!

Today, there are a few exceptional dentists in Vallarta, each with state-of-the-art offices meeting US standards. Root canals, caps, crowns, and implants are done on a daily basis in beautiful, high-tech, and sterile offices. Again, they are all fluent in English and their prices are a third to a half of what they are in the States. For that reason, many North Americans are also coming here for new caps, crowns, and implants- maybe the same people that come for the cosmetic surgery!
We don’t look forward to needing any of the new medical clinics, state-of-the-art hospitals, or modern dental offices, however if and when the time comes, we’ll certainly not be afraid of medical care south of the border!

Urgent Care Center Offers Professional Medical Care

Urgent care has rapidly gained immense popularity in the health care industry. Urgent care proves to be convenient and appropriate for those who do not get a timely appointment at a primary care physician office and are suffering from injuries that are of an acute nature. With the help of urgent care the patients can have easy access to quality medicine.

An urgent medical condition is a non life threatening one but it does require immediate attention. The services available at medical care centers are generally not offered by primary care physician offices such as x-ray facilities, control nose bleeds, treatment of minor fractures, etc. Moreover there are numerous advantages of visiting such centers such as you do not need to wait for hours in the long lines at hospital-based emergency rooms. The other advantage is flexible timings. You can visit urgent care clinics as per your convenience. There are also several clinics that available 24/7 or on-call. In most of the cases no appointment is necessary. The services offered by urgent care center are affordable as compared to a visit at the hospital emergency room. If you are facing non-life threatening issues such as fever, earaches, coughs, wheezing, broken bones, sore throat, sprains, etc you can opt for a reliable medical care center.

From advance diagnostic testing, to a specialist follow up, a reliable medical care center offers unparalleled services. The trusted urgent care center has also an aftercare team that focuses at providing you with appropriate care you need in a timely manner. The board certified emergency medicine physicians at the center takes best possible care of the patients. The informed medical providers offer quality medicine to the patients.

Finding a reliable walk-in clinic is imperative as a good clinic helps you get through a difficult period in an appropriate way. In order to find out a trusted urgent care clinic you can browse the internet. While searching online you can come across numerous clinics offering several kinds of services. You can go through the websites and can read the services, treatments offered. Also read the customers testimonials as you can get an idea of the kind of service offered. Visiting yellow page directory is also a good option. Online discussion forums can also help you in providing useful information regarding the urgent care center. You can also ask from friends and family members.

Before selecting an urgent medical care center ensure that it is staffed with highly trained and board?certified physicians in emergency medicine. Ensure that whether the center deals with a variety of health issues or not. Also make sure whether the walk-in clinic has highly knowledgeable physicians and has necessary equipments that are needed to perform specific procedures like x-rays, etc. Another thing to be considered is the qualification of the staff and whether they are certified so as to provide the services. Make sure that they are licensed. It is also advisable to check the equipments and ensure that they are the latest. It is better to look in for a state-of-the-art facility.

General Medical Care in Shanghai

Shanghai has a reputation for having the best medical facilities in all of mainland China, and expats should have no worries in finding quality healthcare when needed Western-style clinics and hospitals have been especially set up to serve the ever-expanding expat population. Facilities at these institutions are improving every year, and some include 24 hour care and accident and emergency departments with trained international staff at hand.

A good number of public hospitals have set up VIP clinics, which cater specifically to expats. Foreigners are technically required to go to either a western-operated clinic or one of these VIP clinics, although some expats go to their local neighborhood hospital. VIP perks include English-speaking staff, a nurse that will escort you around the hospital, and no waiting.

Attending a public hospital means you will have to pay a registration fee before treatment; this can cost RMB 10 to 15 for local hospitals and roughly RMB 100 for VIP clinics. VIP sections vary – some will charge fees comparable to local services, but some will charge five times this amount.
If you’re looking for a warm and inviting attitude from a doctor you should probably refer to the list of internationally focused western hospitals and clinics, where the doctors will be trained to provide the bedside manner you expect. Otherwise, Shanghai’s medical services do not emphasize human relations, and you might find staff to be unfriendly, blunt or uncommunicative.

A reliable general practitioner (GP) can be good for annual check-ups and can serve as a reference whenever you have a health-related concern. When looking for the right doctor for you and your family, it’s best to listen to the recommendations of your friends and colleagues.

Before you come to China, you’re advised to get the following immunizations up to date: hepatitis A and B, tetanus, polio and typhoid. If you are considering venturing to more rural areas, you should look into getting a rabies vaccination and the series of Japanese encephalitis shots. Travelers from South America, central Africa and other vulnerable areas are required to provide a yellow fever vaccination certificate upon arrival into China. Be sure to consult your physician before you get the vaccinations; women who are pregnant or breastfeeding are advised not to receive any of the above immunizations.

Government Healthcare
There is no formal government healthcare system in place for Chinese citizens.
Uninsured and insured alike have to largely pay out of their own pockets. About half of Shanghai’s local residents are part of the government’s social welfare insurance plan, through which citizens pay an insurance premium via their employer and in turn receive money for their public hospital fees. For expatriates though, there is really no choice. Company packages will often include a comprehensive health insurance plan or individuals can choose to buy their own plan.

Emergency Services
If you can safely transport the victim without causing further injury, then it is almost always a good idea to find your own fastest way of getting to the hospital, either by driving yourself or by taxi. Ambulance response times are typically slow; Shanghai traffic does not yield to emergency vehicles and they may have trouble finding you. The ambulance service can be treated by dialing 120. The operator will most likely not speak English, so it’s useful to learn a couple of Chinese phrases such as where you live and the address of whichever hospital you want to go to. Ambulance workers are not required to know basic procedures like cardiopulmonary resuscitation (CPR), so you might want to fake a class yourself. http://sinoaid.cn is a good place to learn.

Before an emergency even occurs, you should work out a plan of action with your family. This includes deciding on a facility that is open 24 hours a day, calling to pre-register your details with the hospital (so you won’t have to worry about paperwork during an emergency), and practicing an emergency run-through with your family where you drive to the hospital. Additionally, you can prepare an emergency folder listing all of your family’s medical conditions, allergies, medications and surgical histories. Even if you primarily go to a western hospital, it’s a good idea to have the folder’s contents in both English and Chinese.

You also might want to make a card with the hospital’s address and contact information that you and your children can keep with you at all times. Shanghai United family Hospital supplies cards that allow parents to give the hospital power of attorney. This can be important in avoiding delays if the child is brought to the hospital by someone other than their parent, and the parent is not available.

Private Healthcare
Private hospitals tend to be smaller, with friendly service and specialized equipment. Hospital bills at a private institution will generally be much heftier that a public hospital’s and can add up to as much as a hospital fee in a western country. You may find yourself paying tens of thousands of yuan for a week’s worth of tests and medication, even if you condition is not that serious, compared with RMB 1000 at a public hospital for similar treatment. A regular check-up costs around RMB 500, but will usually total RMB 1000 or more when basic medicine is provided.
Health Insurance

If medical insurance is not supplied by your employer, no one will force you to buy it. Rates vary dramatically based on your personal situation and what type of insurance plan you want to buy. For a free quote on expat packages, you can go through an insurance broker such as Bupa International or Expatriate Insurance Services. A basic insurance plan can be bought for as little as RMB 4000 per year, but premium annual insurance can cost as much as RMB 40000.
Pharmacies

Many kinds of medicine can be obtained over the counter in Shanghai and prescriptions are rarely needed. Be wary of fake drugs or mislabeled products and always buy from reputable pharmacies that are government-run or associated with a hospital. Look out for bad spelling on packages and suspicious labels that appear inauthentic. Medicine will often be sold under different brand names here, so write down the chemical or pharmaceutical that you are looking for as well as the Chinese brand name.

In recent years, the government has tried to regulate over-the-counter medicines, so you should bring a prescription from your GP for antibiotics and more serious drugs. Painkillers, cough and allergy medicines, digestive remedies, skincare medication and vitamins or dietary supplements are all available over the counter. Huashan Pharmacy (12 Wulumuqi Lu; 6248 5674) have 24 hour service with a large selection of both western and Chinese medicine. Other pharmacies can be found throughout the city and are marked by large green crosses.

Many of the reliable brands you may be accustomed to using don’t exist in Shanghai, so stock up whenever you’re backing home. If bringing prescriptions from overseas, be sure to have a medical certificate from your doctor. Shanghai United Family Hospital’s pharmacies can order and import special overseas medication for patients on an individual basis if necessary.

Health Check-Ups
Regular medical checkups are offered by all the major hospitals and clinics. Well-woman and will-man checkups are provided by some hospitals and clinics under the guise of ‘health screening’ services. Most of expat hospitals offer comprehensive check-up that requires two sessions to complete. The first session involves diagnostic evaluations that include an eye screening, x-ray, ECG, ultrasound, stress test, blood drawing and urine collection. The second session concludes with a physical evaluation by a health screening doctor, and a review of test results, as well as lifestyle counseling

How On-Site Medical Clinics Curb Fast-Rising Costs of Medical Care in Workers Comp

On-Site Clinics Decrease Costs

Many medium and large employers in their never-ending battle to reduce cost and to provide benefits to their employees are opting for on-site medical clinics. On-site medical clinics can decrease the cost of general health benefits programs and decrease the cost of medical care associated with workers’ compensation claims. On-site medical clinics have proven they can curb the fast-rising cost of medical care for both personal and work-related injuries and illnesses.

Some employers are hiring clinicians themselves, and others are using contracted providers who also provide software, protocols and other tools to support the clinicians.

Medical Care Provided at Work Site, Convenient & Effective Treatment

With the on-site clinic, the medical care is provided at the work site, which is convenient for employees who otherwise would have to leave work for care. Injuries and illnesses are evaluated by the clinic staff; many cases can be treated on site. Employees are referred to off-site medical facilities only if the injury or illness is beyond the scope of the medical professionals in the on-site clinic.

On-site clinics often use a variety of staffing models, including RNs, nurse practitioners, and physician assistants – with physician collaboration and direction as needed. Depending on the employer’s needs, on-site clinics can be staffed with a doctor. When properly managed, on-site medical practitioners can provide high quality medical care while reducing overall costs. They can also provide other health services such as wellness, and regulatory exams, etc. On-site clinics can include x-ray machines and pharmacy services, though costs and state regulations affect the feasibility of those services. Good providers of on-site medical clinics will tailor the services provided to the employer’s needs.

Benefits to Employees

The benefits to the employee injured on the job include:

· Medical services available when the typical doctor’s office is closed – evenings, weekends and holidays

· No appointment is necessary

· Immediate medical care following an injury

In addition to the workers’ compensation benefits, the employee also enjoys easy access to medical care, assistance with chronic medical problems and healthy living guidance.

Benefits to Employers

The benefits to the employer of the injured worker include:

· Evaluate and treat employee injuries immediately

· Avoids unnecessary and off-site medical treatment

· Referral to appropriate and screened preferred medical providers when off-site care is needed

· Improved outcomes and faster return to work, increasing productivity

· Assist in keeping all workers healthy and productive

· Reduces absenteeism

· Significantly lower cost for medical services for workers’ compensation claims

· Can provide physicals

· Drug screening

· Improved general health of employees

· Improved employee morale

· Increases employee retention

· Can coordinate pharmacy usage with your Pharmacy Benefits Manager

· Timely reporting of the injury and medical information to relevant parties.

· The First Report of Injury form is completed and filed with both the state and claims office.

Treat Workers Comp and Health Care

On the workers’ compensation side, the on-site clinics can treat lacerations, strains, sprains, other minor orthopedic injuries, abscess drainage, minor skin infections and other routine acute medical conditions. On the health care side, the on-site clinics can treat the whole gamut of minor medical conditions that causes employees to lose time from work including strep throats, colds, ear and eye infections, skin lesion removal and vaccinations.

Clinics Used For Any Site with 1,000+ Employees

On-site clinics are not just for industrial sites like factories, and mines or large office centers. On-site clinics can be operated for just about any industry where there are 1,000 or more employees in one location. Mobile and temporary clinics are used for large construction projects such as skyscrapers, power plants, and highways. All clinics need to be equipped with the necessary furniture, supplies, equipment, and medications.

The cost of drug testing for both employee applicants and existing employees can be significantly reduced by using an on-site clinic. Drug testing due to reasonable suspicion, random testing and post-accident screening can be completed by the on-site clinic. In many states the timely completion of a post-accident drug testing can be used to deny workers’ compensation benefits to employees under the influence of a drug at the time of their injury. A positive drug test result can be sent to a certified lab for further confirmation.

Be Sure to Select Quality On-Site Medical Provider

When an employer is selecting the on-site medical provider, select a medical provider who provides an on-going review of the quality of service they are providing. The service quality can be evaluated by patient reviews and comments, by clinic audits and by staff performance evaluations.

On-site clinics do carry costs and risks as well. To be successful, the staff needs to be trained for on-site work, and be supported with appropriate software, operating systems, supplies, medical direction, protocols, QA, and other infrastructure. The medical practice needs to carry malpractice insurance coverings the employer and be compliant with HIPAA, GINA, HITECH and other privacy regulations. In addition, some on-site providers may introduce conflicts of interest if they are financially tied to the off-site hospitals, clinics and pharmacies that they refer to.

For further information about on-site clinics, please contact us.

Walk-In Clinics Are The New Standard of Medical Care

What is worse than cutting your finger with a bagel slicer or having a raging fever that will not subside? The answer is cutting your finger with a bagel slicer or having a raging fever on a Friday or weekend when your family physician is not available because he or she only works during normal business hours. What do you do when even after applying pressure to the wound it will not stop bleeding, or your child’s fever is getting worse?

You find your local Walk-In Clinic and get the help you need immediately. No need to call your doctor’s office and be put on hold. No need to wait several days or weeks for an appointment. No need to go to an overcrowded hospital emergency room and sit in an uncomfortable, noisy waiting area for hour after hour.

Finding a primary care doctor (this includes family physicians, general internists, and general pediatricians) is getting to be increasingly difficult as more and more of these physicians are putting in less hours per week making it, at times, a challenge to get appointments and making office waiting times longer. Have you ever made an appointment to see your doctor for 10:30am and you walk in only to find 6 or 7 or even more patients all waiting to see YOUR doctor? It is very frustrating to know that your appointment time is being shared by a half a dozen other people! You wonder why you even bothered to make an appointment.

The good news is that there are now more Walk-In clinics than ever and they are open a convenient 7 days a week from 8am to 8pm.

What Do Walk-In Clinics Have To Offer Besides Convenience?

The first thing that many people consider, besides convenience, are the financial savings. Some clinic visits can cost up to 50% less than a primary care doctor visit and up to 80% less than a hospital emergency room. Some services are even less than insurance co-pay, so many patients will prefer to just pay with cash and skip dealing with insurance. In some instances, insurance companies will waive the co-pay fee for their plan. These are considerable savings.

Many will go to Walk-In Clinics for vaccinations, cold or flu, fevers and sore throats, simple sprains or strains, rashes, school or work physicals, or other routine or minor medical matters.

Some clinics offer many more sophisticated treatments such as X-rays, repairing broken or fractured bones, lacerations, stomach aches, minor surgeries, and STD Testing. They may have radiology and EKG services on site. Not having to wait for test results can be a weight lifted off the shoulders of an anxious patient. Test results can also be immediately sent to other specialists who are not on site, if needed.

The bottom line is that people want convenience, they want affordability and they want good quality care. If your condition is non-life threatening, then a Walk-In Clinic may be just what the doctor ordered.