Going to the Doctor

We are lucky that we are both fairly healthy individuals.  But even the healthiest person in the world is bound to need a doctor from time to time.  We’ve had a few experiences at the clinic now, and overall I am impressed with both the quality of health care and how it is administered.

Our very first experience with a doctor was early in the fall.  Micah had some pain in his foot, so much so that he couldn’t really walk comfortably.  In the U.S., in a new city, we would consult our insurance website to find a doctor near us.  So that’s what we did.  We found a doctor in private practice a few blocks away.  Micah called and tried to make an appointment, but they told him to just show up, so we did.  Apparently it’s first come first serve.  I don’t really know if there are considerations for severity of illness, but it didn’t seem like it.  As it turned out, Micah saw the doc within about 10 or 15 minutes of arriving and registering, had a consultation/exam, got some recommendations for care, and some prescriptions.  They filled the prescriptions on the spot and were included in the overall cost for the visit.  Because we didn’t make an appointment in advance, we had to pay out of pocket and then submit it to the insurance to be reimbursed.  I don’t remember the total cost, but it was less than $30 USD.  Not the cost to us, after insurance…the total cost for the visit and the medications.  We were both really impressed.

The next experience was shortly after we returned from Thailand.  Micah had what looked like an infected bug bite on his leg.  It was spreading and clearly getting worse.  We decided to try a different clinic, closer to our hotel, in the mall at the base of the Petronas Towers.  (Surprise!  Malls are for medical care, too!)  Again, it was all walk-in.  There were several doctors on call, and I assume there was some triage procedure, at least in terms of matching doctors and patients.  After registration, you are handed a slip of paper with a four digit number and directed to the waiting room.  You monitor the giant TV screens to see when your number comes up, and it tells you which room to report to.  Unlike in the U.S., the doctors sit in their office/exam room and the patients are brought to them.  From an efficiency standpoint, that makes a lot of sense.  Patients aren’t waiting in an exam room for a long time, and they don’t spend 10 minutes taking your weight and blood pressure unless it’s relevant to your symptoms.  After you see the doctor, you go back to the waiting room to wait for your number to be called to the pharmacy (or “dispensary”) and/or to billing.  Again, you get whatever medication the doctor has prescribed right there and it is included in your final bill.  This clinic was a little more expensive than the doctor in private practice, but for convenience it was worth it.  I think the wait time was less, too, since there are more doctors to see the various patients.

As I wrote in my last post, I had a sinus infection last week.  (It’s cleared up now and I’m feeling much better!)  After two days of regular cold symptoms, I woke up with much more severe congestion and painful sinus pressure and decided it was time to see the doctor. I went to the clinic at the mall.  It was more convenient and there was less of a language barrier- both important factors in going to the doctor!  I checked in, got my number, and waited about 5 minutes to see the doctor.  I was examined, diagnosed with a sinus infection (shocking!), and the doctor explained what medications she would give me and what else I could do to help alleviate the symptoms.  Back to the waiting room, I waited another 5 minutes or less and was called to the pharmacy and billing.  I was prescribed an antibiotic, an antihistamine, and something that was basically Mucinex.  From walking in to the clinic to walking back out the door, it was less than 30 minutes.  I don’t think you’d have that same time at a walk-in clinic in the U.S., but I could be wrong and/or unlucky in my past dealings with clinics.  When you are miserable and feel like your face is swollen to gigantic proportions, being able to get in and out really quickly is an excellent benefit.  It cost me about $40 USD before submitting to the insurance to be reimbursed.  After insurance, I think I will end up with about a $10 or $15 co-pay.  I’ve been thinking that this is really affordable, in terms of cost of healthcare in the U.S.  But we are living above the average Malaysian income, so the sticker price is very affordable for us whereas it might be less so for many Malaysians.  But it’s probably also true that the average Malaysian is going to a doctor in their neighborhood, not in the mall at the Twin Towers, and I think it would cost less.

Malaysia and Kuala Lumpur more specifically are top destinations for medical tourism.  I was curious what the state of the healthcare system is in Malaysia, whether they have universal healthcare or a private healthcare system.  With all of the medical tourism that exists, I thought there would be at least some private healthcare.  I can’t imagine the government is subsidizing procedures for people from all over Southeast Asia and Asia in general.  Wikipedia informs me that Malaysia does in fact have universal healthcare AND a private healthcare system.  They co-exist quite nicely!  Take note, policy makers in the U.S., it can be done and the world does not end.

With our several experiences now seeing doctors, I am overall very impressed with the healthcare system here.  I am mostly impressed with the low cost (low for us, anyway), but the efficiency and lack of any serious wait time is also really nice.  One thing I am less than impressed with is the lack of over the counter cold medicine.  In the U.S., I would have used decongestant from the beginning of the cold and hopefully avoided the sinus infection.  Here, what counts as OTC cold medicine is basically designed to relieve fever, aches and pains.  For decongestant, you can get a nasal spray or eucalyptus oil to inhale, but nothing that’s really “heavy lifting.”  I haven’t found anything like Sudafed here at all, and while there is cough syrup, there are very few choices.  This is one thing I think the U.S. does better: availability and variety of OTC medicine.  True, there could be problems with self-diagnosing and self-medicating.  But at some point, an adult knows what sinus congestion feels like and it would be nice to be able to get some medicine to relieve it without taking the time and expense to see a doctor.  Although, if you can get in and out in 30 minutes and you don’t have to pay very much, why not just do that and get the meds you need packaged up for you in exactly the right dosage?