Puerto Vallarta has so much to offer the visitor and expatriate: Amazing beauty, friendly people, world-class dining and so much more. But (there always is a “but,” isn’t there?), to comfortably and safely enjoy all that PV has to offer, you have to accept the realization that the only consistency here is its inconsistency.
What worked on Tuesday, won’t work on Friday. The one-way street you took to the beach goes the other way when you came back. Products on the shelf at the market this morning are gone in the afternoon and nobody in the store can remember having them in the first place. Mexican immigration rules? Forgetaboutit!
Its consistently inconsistent culture shows up in Puerto Vallarta’s health care delivery system, too. We are blessed with quality, affordable health care, but the delivery system is nothing like we got used to up north.
To feel comfortable here is to expect consistent inconsistencies and using your common sense to manage your health care. That’s right. You are responsible to manage your health care!
Here are a few common sense solutions to frequent health care problems in Puerto Vallarta:
1. Have a relationship with a doctor before you need it! Many outstanding practitioners will provide a free consult to get to know you and establish the all-important relationship of mutual trust and respect.
2. Just as you need to know where the emergency exits are on the jet you fly on, you also need to know where the hospitals closest to you are. Take a tour of the hospital to see if you would feel comfortable being treated there.
3. Do not expect that your doctor will keep records of your visits, lab and test results, diagnosis and treatment regimes. You absolutely must obtain and keep copies of all medical records, lab reports, prescriptions and receipts for care received in Puerto Vallarta!
4. Do not expect your doctor to accept credit cards for payment. Expect to pay cash and expect to have to ask for a receipt. You’ll need the receipt to file a claim with your insurance, but you won’t get one unless you ask for it.
5. Typically, hospitals will accept credit cards and – sometimes – insurance for payment. Getting them to accept insurance will take some effort. Until the hospital has a payment guarantee from the insurance company, you will not be allowed to leave the premises. Know what (if anything), your health insurance pays outside your home country and if they have direct-pay agreements with local hospitals.
6. Labs (x-ray, MRI, blood work, etc.) do not accept insurance for payment. Sometimes they accept credit cards, often they do not. Ask before you have the procedure.
7. Most domestic health insurance (especially Medicare and Canadian Provincial Care), is all but useless here. Carry international health insurance! Ask me. I can help.
8. Do not expect the doctor or his staff to speak perfect English. Carry a card with your name, local address and phone number printed on it. I have a very common name in the USA, but “Mike” sounds like gobbledygook to a Mexican. When I have any lab work done, handing out my cards makes sure they can identify the sample and the test results. Simple common sense!
9. When you see the doctor, give him or her a list of all the medications you are taking. Make sure to accurately identify the drug and dosage. Keep this list updated and accurate.
10. When you see the doctor, describe your complaint as accurately and as completely as possible. You would do this back home, but here the practitioner helping you is not speaking in their first language so you need to be responsible for being understood.
11. Take your time with the doctor. Unlike up north, the doctors here will spend as much time with you as you need to get all of your questions answered. Come to the visit with a checklist of questions. One of the great strengths of the medical system here is that doctors are generous with their time and dedicated to treating people as patients, not as cases.
After a while, Puerto Vallarta’s consistently inconsistent character becomes part of its endearing culture. While it can be aggravating, it is also part of its charm. For me, an important part of the expat lifestyle is the expectation of “I’ll never get it right” and “I’ll never understand it completely.” Making friends with chaos and inconsistency keeps me young – or, at least, it keeps me on my toes!