Thursday, April 28, 2011

Doctor Update

A helpful commenter on a very old post pointed me to a useful website for multi-lingual doctors in Istanbul. I figured it deserved a bump.

Good luck!

My luck since that post has improved somewhat with doctors, which could be either because of experience or from relaxing a bit, but I sure have managed to land on a few decent, reasonably-priced ones over the years who are sincerely happy when someone starts requesting alternatives to antibiotics. Turns out a lot of the antibiotics thing is pressure from the customers, I mean patients, who want nothing less than powerful medicine for their money, and will just shop elsewhere if the doc doesn't deliver. It's very last century. The part of the last century before I was born, I mean.

Accordingly, the doctor the in-laws take LE to whenever he has a cough or a sniffle loads him up on at least four kinds of medicine every time. There's always one super-powerful, multi-spectrum antibiotic in there, or other signs of bizarre overkill, like Ventolin for a mild cough or Zyrtec for a stuffy nose. He knows better than to send fretful grandparents home empty-handed. Plus, he always gives LE a lollipop, so it's all good in his book. He loves going to the doctor and all the attention and candy it entails. The medicines pile up in our cupboard because it's the getting them that makes everyone happy, not the using them. I can just give them away, so that's fine.

And it's just possible I've cracked the doctor thing somewhat since I wrote that old post. I humbly offer you these tricks.

Hospital Trick Number One: Unless you really want some serious treatment and lots of tests, avoid hospitals with shiny front foyers that look like hotels. Stick with the middle-of-the-road hospitals that are a couple steps up from state but quite a few steps down from Acibadem or American Hospital. If you have private health insurance, don't mention it until things start looking costly. Despite that one ENT at Medi-Life who wanted to give me the laser surgery for a deviated septum I didn't know I had (he knew I had private health, and my husband wasn't with me, more on that later), other doctors there were fine. In particular, there was one pediatrician who was absolutely thrilled I didn't want to give LE another round of antibiotics for a recurrent ear infection. He ordered a blood test for white blood cell count first. LE didn't care for the finger-pricking, not one bit, not even when he got to have chips afterwards, but at least when the antibiotics were advisable I felt much better about the whole thing because I'd been informed and treated like a relatively intelligent individual. The doctor even thanked me for asking, and said he was fed up with people insisting on antibiotics.

Aren't Pictures Neat?
Which brings me to Hospital Trick Number Two: If you can wait until the weekend or an off-time and you don't need a specialist, try an emergency room. Those docs are usually quite good, and most hospitals are pretty empty. They'll treat you and leave the follow-up in your court. The emergency room isn't always best for babies, as some emergency room docs aren't comfortable with the very little ones (at least they'll tell you though!), but for most grown-ups it's just fine. When I had swine flu, they just gave me a shot of powerful fever reducer (Tylenol wasn't working at that point and the fever was reaching 105F) and sent me on my way with a relaxing cough suppressant I was happy to have. At a middle-of-the-road hospital, a trip to the emergency room plus treatment rarely runs more than 50 TL.

Loving the new Blogger editor for pictures...
Then there's Hospital Trick Number Three: Take your Turkish spouse, or if you're not married, bring an opposite-sex Turk to pretend to be your spouse (preferably someone that's good at negotiating, and make sure ahead of time you're on the same page about tests and stuff). This seems to stop them from going overboard to impress you with their expensive machines that go ping! and also, it helps with the language barrier. I'm not sure why a Turkish spouse seems to be more effective than a Turkish friend at stopping unnecessary costs, but it is.

The language barrier is another problem, which brings me to Hospital Trick Number Four: If a doctor sells him or herself as foreign language-speaking, you can expect to add about 200 TL to the bill because their offices are in parts of town where the parking is a gouge might cost you a day's salary, if you can find any. In any case, a lot of doctors actually speak quite decent English, but they're not very confident about using it. I think one reason is that they're uncomfortable with the way a second language shifts the power balance between doctor and patient. They're used to being the very best of the best, and it's not easy feeling stupid muddling through a foreign language with a native speaker. It isn't just for pedagogical reasons that I refuse to use Turkish with students, so I kind of get that. But if you figure out the doc speaks some English you can at least negotiate the language thing a little by showing yourself as stupid in Turkish and then meet in the middle somewhere.

So there you are, then. Thanks again to the commenter for the link. And while I'm at it, I re-read another comment on there from a doctor taking me to task for saying crappy things about doctors. The longer I've been here, the more I see how right she is, and I'm not sure if it's me that's changed or the world around me (probably a bit of both), but the whole doctor thing seems a helluva lot better than it used to be.


vicky said...

I must say, we were realy impressed by the government kids hospital here. we dont have SSK or Bagkur so had to pay but only for xrays for 22tl, and the doctor we had who checked the xrays was fantastic - spoke english, explained things very clearly to us, answered my panicky mum questions with thought and care and was generally brilliant. downside - hanging around and realising that AKP will never lose an election in Bursa.

Stranger said...

It's good to hear, Vicky. The last thing you needed in your situation was a stressful hospital visit!

I think state hospitals often do have the potential to be quite good-- usually the problem is overcrowding because there aren't enough of them. We went to a local state poliklinik recently-- absolutely zero frills, but the doctor (ped) was lovely, articulate (she was hiding how much English she knew though), and thorough. I liked her approach too, very conservative, "let's wait and see," and natural treatments.

I don't think AKP is going to lose anywhere anytime soon...