Cigna Part II:Yearly Exam

Yesterday was a rather disembodied experience in the best possible way. My body was scanned, pricked, and examined. Usually, when I go to the doctor’s office, I have just one appointment, one doctor, one waiting room, and one time to disrobe. In Chile, there is something called a yearly, which means that you can get every personally appropriate test and doctor’s visit done in one all day marathon. I had the appointments and payment ($0) all arranged. Cigna covers the entire bill, and I received my guaranty of payment well in advance. One week after the exams, I will return to my primary care doctor, which I will also seen on this date to discuss the results holistically, that is in terms of my overall wellness with all of the pertinent and timely data. By the time it was 2:30 pm, I had been in six blue disposable body gowns and seen five doctors.

In order to set up the day, I made a single email request in English with International Patient services at Clinica Alemana, a hospital about 10 minutes away. I showed up at 8:10 am to find Gustavo holding a large red-leather binder with my name on it. He opened it and showed me my schedule for the day. Based on my age, gender, and concerns my appointments had been all pre-arranged. First, he sent me to the lab for blood work. I told him that I also wanted to add a test for thyroid levels, and he obliged. Then, I returned to him, and he sent me off to mammography. I had a regular mammogram and then an ultrasound type mammogram. The doctor performed the ultrasound and told me immediately that I had nothing to be concerned about. Afterwards, Gustavo sent me to get a scan of my internal organs. After the technician performed the next ultrasound, a doctor read the results going back over my liver and gall bladder, which I can only assume may have been hard to see or had potential issues. She confirmed that my internal organs were normal. Then, I saw my primary care physician. She took a full history. When I shared with her a problem I have been having for years with my lower back and abdomen, she made a recommendation to see another specialist. She told me not to give up about resolving this issue. I have never had success solving this problem for years because I stop searching for answers after a few costly exams that basically rule out appendicitis and tumors. The problem persists and no one seems to believe that such a chronic pain could be that serious. My new physician had Gustavo schedule an appointment for the next day. She had already seen the results of several other tests that I had previously done, including a colonoscopy at a different facility in front of her, to guide her decision. I then had an echocardiogram, pap smear, and full body scan by a dermatologist. Most of the exams were in Spanish, though if the doctor could speak English, he/she tried. My primary care doctor speaks English. I did leave one appointment with a prescription that I had to ask another physician what exactly it was for.

Before leaving the hospital, Gustavo asked me if I needed my parking validated. At the information desk, the woman helped me to set up my online account (mi pagina de salud), so that I can see all of my past and future appointments, tests, images, and results. I had some time to check out this page. It includes images, notes from the doctors, pathology reports, and blood work.

This could not have been more efficient or made more sense to me. I know exactly when and how I will get all of my results. My health care will be managed cohesively by one doctor based on all of this information taken together. What is so difficult about getting this kind of top level of care and service in the United States? What are the critical differences? I have never had a conversation with my primary care physician about all of my combined tests and exams until this visit. I have never had all of my costs entirely covered. Thus, when a physician recommended a test I never had to think about whether I should have it or not due to cost. There will be no further co-pays. All payment is due in full or guaranteed in full by the insurance provider at the time of service. How efficient for the hospital, too. Next year around the same time, I will set up the same yearly exam and have tests to make comparisons. I will not have to stagger the appointments based on last year’s appointments and availability. I have never had every test and physician under the same roof. The kids’ pediatrician is in the adjacent building. Alemana Sport (the orthopedist) is also next door. Is this the experience of all Chileans? Most definitely not, but the model exists, and it works.