Many of my American friends wonder what visiting the doctor in a country with universal healthcare is like. I tell them that it’s mostly the same except that there are decidedly less frills, by which I mean there are no robes at the gynocologist’s office.
To be clear, that’s a compromise I’m willing to make. If I have to choose between a paper robe and a health plan that has a $50 co-pay and a $2000 deductible or one that is “free” but necessitates a brief walk through an exam room completely naked, then I will choose the latter every time.
But still. I will admit that I surprised by that and I did not particularly enjoy it. That scrap of paper always feels so cheap and pointless at the time, but let me tell you—once they take it away you miss it.
To be even more clear, I didn’t exactly have to walk through the exam room naked. That’s just something I did on accident.
When I arrived, the doctor pointed to a small changing area and told me to take off my top so that she could do a breast exam. When she was done, she sent me back into the changing area and told me to remove my trousers. When I came back out in only my socks, she looked a little shocked.
“Normally people put their tops back on,” she said.
I guess I could have turned around and corrected my mistake, but I decided to lean in instead.
“Why?” I asked. “What’s the point?”
“Please sit on the table,” the doctor replied, which was not an answer.
For the record, I believe she ignored that question because she had to. There is simply no way to explain how walking around like a human version of Porky Pig looks any less ridiculous than being naked. If it makes people feel better to put their shirt back on for a Pap smear – fine. To each their own. But I’m not a prude. The naked body is a natural thing. A body in a t-shirt and a pair of sweat socks, on the other hand… that’s either a cartoon character or a criminal.
My doctor seemed pretty interested in how the American healthcare system works. Like anyone playing for the opposing team, she seemed to have something to prove.
“Your IUD,” she said. “Who put that in?”
“You mean, the name of the doctor?” I asked, puzzled.
“Oh so it was a doctor,” she replied.
“Oh, no,” I said. “It wasn’t a doctor. It was a nurse practitioner.”
“A NURSE?” the woman screamed at me.
I didn’t appreciate this. If a doctor is going to ask potentially shocking questions, I would prefer she not do so when she doesn’t have anything inserted in my vagina.
“No, not a nurse,” I said. “A nurse practitioner. It’s something between a nurse and a doctor.”
“We have that too,” she replied. Then, just to prove it, she said a word that was so long and complex it sounded like she had put a handful of loose change in her mouth and tried to name her favourite Christmas carol.
“Interesting,” I said.
“I tell the girls in the office they should go back to school for that,” she said. “It would be a good career for them.”
I looked over my shoulder at the closed exam room door, behind which was the receptionist’s desk. “The women outside?” I asked.
“Yes,” she replied.
“The ones here today?” I asked.
Trust me when I say that I was doing a public service by asking. When I arrived for my appointment, the women working at the desk were having trouble operating a three-ring binder. Keep in mind there were two of them, and that is rarely a two-person job. Ten minutes later, the younger of the pair couldn’t find a pen and took an entire tray of office supplies and dumped it on the desk. Two pairs of scissors, a bottle of glue, a tape dispenser and at least a dozen highlighters went flying everywhere. From this mess, the woman plucked a pen and then began making a note. Around the same time, the phone rang; she answered it, asked the caller to hold, and then went back to writing her note. I’m not saying she’s not good at her current job, I’m just saying I don’t think she’s someone who should be allowed to implant medical devices in the cervix.
“That would be exciting,” I said. “Definitely let me know if that happens.”
Another thing my doctor my doctor wanted me to know is that she is allowed to perform an ultrasound.
“Does your doctor in the States do the ultrasound?” she asked, judgment dripping from her voice. “Or does a technician do it?”
“A technician,” I replied.
“Here the doctor does it,” she said. “I will do it.”
This was hardly a perk for me. I didn’t want an ultrasound in the first place and having someone higher up the chain didn’t make it any more appealing. But I knew it was going to happen. One of the women at the desk had already explained that the doctor will need to do that procedure to check the position of my IUD. It was not covered under the public plan and would cost €45.
“And why does she need to do that?” I asked.
“To check its position,” she replied.
This is something that my doctor in the States always says too. Every year she wants to make sure my IUD is where she left it. I’m not sure why. If my Mirena had packed its bags and decided to stay in Canada last fall, I’m pretty sure I would have noticed. Feel free to correct me in the comments, but I can’t imagine an IUD would get very far without my knowing.
I sighed. “Fine,” I said. “Do I at least get a picture?”
The woman looked confused. “Of the Mirena?”
I sighed again. In America, I usually ask for a print out of the ultrasound so that I can show up to some social engagement, flash it like a badge and then say something obnoxious like, “Now that I have your attention—if you haven’t subscribed to my blog yet, can you please do so? It’s cheaper than buying a shower gift.” I suppose this is a cultural difference.
But seriously. Can you? Can you subscribe? Email the word “subscribe” to mousesnaps@gmail.com.
By the way, my doctor seemed really impressed with her ability to perform that ultrasound. I don’t know why. Of all the things she did, that seemed the least complicated. I mean, give me the user manual (in English) and I could probably figure it out too.
Besides, there was no point to even doing it. My IUD, as expected, was exactly where it should be. That took all of six seconds. But I guess to give me my money’s worth, my doctor then took a quick lap around my lady parts, during which she pointed out some other doctor facts like that I have two ovaries—one on each side. She seemed to think this was brand new information for me. I guess she’s heard things about American healthcare and our education system.
Before I finish the story, allow me to get serious for a moment. Because while I am poking fun at some of the things my doctor said during my appointment, perhaps it’s more important to call out what she didn’t say: She didn’t apologize for being late or having a crazy busy day. She didn’t rush through the appointment as though she had four babies to deliver later that day. She didn’t use the phrase “pre-existing condition” or “continuation of benefits.” She just sat there and listened to me speak (in English, I should add) and let me take a few jabs at her office about the lack of robes.
And that’s why it’s better. Not because the visit was “free”—because technically it isn’t. I make health contributions every pay period, just as I do in the States. I paid for the visit in advance. It’s because I had the feeling that this appointment was the most important thing both of us were doing that day. And that’s a real difference.
While I had to shell out an extra €45 for the ultrasound, I was left with the impression that paying for supplemental health services isn’t something that happens very often in Germany. I say that because when I returned to the desk to settle my bill, the woman sitting there asked if I would pay with cash or card. I decided to use a credit card and after running it twice without success, I switched to my debit card. When that also didn’t work, we figured there was a problem with the machine. Rather than wait for her to sort it out, I gave her cash. And because I live in Munich, where the ATMs like to dispense money in the most inconvenient and ostentatious denominations possible, I had to pay with a €100 note.
I could barely contain myself as the receptionist padded through her tray of office supplies and produced a key to something that looked suspiciously like a lunch box. She then took out all the money, including coins, which came to €40.
In a doctor’s office. They had €40 cash on hand. And a broken credit card machine.
“What should we do?” one woman asked the other, switching to German.
“I have some money,” the other replied.
And together, they cobbled together the remaining €15 in small notes and loose change and sent me on my way, back to the centre of town by way of the No. 17 tram which pretty much offered door-to-door service between my apartment and their office.
“In Germany, you come to the gynocologist every six months,” one of them pointed out as I was leaving. “Do you want to make an appointment now?”
This didn’t surprise me only because the doctor had already told me the same thing. She looked properly appalled when I told her that in the States everyone goes just once a year. Maybe two check ups are better than one, but I’m still not totally sure I’ll make it back in March as directed, or if I’ll put it off for a few more months. But rest assured, when I do, I’ll be wearing a tunic that day.
Already subscribed, my dear. I LOVE seeing this in my Inbox. Always entertaining, always informative.
THANK YOU!!! appreciate it :) glad you enjoy
When I went to the doctor for my annual this year, I was told that pap smears are now only recommended every 3-5 YEARS!
yes, that’s something my doctor mentioned to me years ago too. but I think that is for people who have low risk for cervical cancer or other health issues. the way it was explained to me is that having frequent Pap smears for women with no health issues or low risk HPV strains is actually damaging… your body is more likely to self-heal/neutralize the HPV if you aren’t in there scraping around every few months. like many women, I have a high risk strain of HPV that requires more frequent monitoring. it will probably turn into a problem at some point, and the sooner you know, the better. but still… every 6 months sounds excessive. that doctor is asking me to visit her more than I do my family!!
I wish that I had been able to go 2x a year when I had an IUD inserted and get an ultrasound to make sure it was where it was supposed to be. This was over 30 years ago mind you, but it decided to travel up into one of my ovaries and I had to have a D&C to get it out. Not fun. I never got another one after that.
oh wow – I’m so sorry. that sounds terrible. I’d like to think that IUDs have come a long way in the past 30 years… and yet I know I have little reason to believe that! Women’s health is notoriously underfunded and under-researched. in any case, I really love having an IUD. but if it found its way into an ovary? yeah, probably wouldn’t do it again either. thanks for reading. xx
I went to the doctor for my annual this year, I was told that pap smears are now only recommended every 3-5 YEARS!