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Sunday, January 15, 2012

I Experience Finnish Medicine

As some of you know, about the second week in December I got this nasty cough and raspy breathing that just hasn't gone away.  The bad part was that I spent all of Christmas just hanging out, being lazy, and sleeping when it suited instead of traveling around (I'd really wanted to go to Tailinn over the break, for example).  The good part is that I never felt dopy, like you so often do with a cold, and it was slowly getting better.  In other words, I didn't feel like I'd wasted a month of my time here.

The key word there is "slowly," so after a long talk with a friend and waking up with chesty coughs the next morning, I decided to brace myself and go to a Finnish doctor.

Now when I say "brace myself," it has nothing to do with the all-too-common American stupidity about "socialized medicine."  I LOVE socialized medicine!  I LOVE semi-socialized medicine!   I think no one in the modern world should be in danger of losing their home and life savings because they happen to get sick!  I especially think that no one should be the victim of the billing agencies and business-model medical care that plagues modern American medicine!  (And, yes, I chose that verb intentionally.)

No, "brace myself" has to do with going to the doctor's office in a country where I don't speak the language, don't know the system, and don't have some sort of direct connection to walk me through things.  Talk about a situation where you know you'll have culture shock and you know you'll be stupid.  You just hope you aren't too offensive.

So, after checking with the Collegium staff about what I was supposed to do, I phoned the appointments desk for Mehiläinen, one of the big, somewhat posh (from what I understand) medical corporations here in Finland.  For those of you from California, think Kaiser.  As a university employee, we have a medical "contract" with them and a set place we're supposed to go for care.

Well, I thought the first challenge would be dealing with the operator or receptionist, but she did a pretty good job with her English, especially since it's REALLY difficult to speak a foreign language on the phone (You never realize how much you rely on context and visual clues for understanding until you speak on the phone.)  The thing that blew me away, though, was where she told me to go to the doctor.  Now, when I spoke to the Collegium staff, they told me that I had to go to the "Occupational Health Center" and a Mehiläinen hospital across town.  Granted, that's not especially far away in Helsinki, but it would've taken me 2 tram rides or a bus and a walk, and I didn't want to get sicker from having gone to the doctor, if that makes any sense.  In fact, the distance is part of why I'd put off seeing the doctor until January.

In any case, when I gave her my name and Finnish ID number (the Finnish version of the SSN), she entered me into the computer and told me that I'd already been assigned to a Doctor Metso in the Meihläinen building 2 buildings down from where I lived.  I just sat and blinked.  I already HAD a doctor?  I could go to the building that is incredibly convenient without an extra charge?  Then she asked me if I wanted an appointment that same day.  Well, that was just too much to take in at once, so I scheduled an appointment for noon the next day.

Come 11:40 am that day I'm walking up the sidewalk to the building 2 buildings down (seriously, it's closer than the tram stop).  I, of course, am being a good, dutiful American planning to get there 15 minutes early to fill out paperwork, and I have brought my UH id card, my Finnish SSN form, and myriad IDs and credit cards.  I should've brought an extra pen, but I wasn't thinking that clearly.

When I walked into the door I'd been directed to, there was nothing but a 15x15 entryway and a few signs in Finnish.  Uh oh.  I knew it had to be an official building, though, because the walls were off-white and the floor was that polished cement that seems ubiquitous here.  Since I'd been told to go to the 5th floor and I knew the word for elevator, I aimed for the hissi and took my chances.

Slowly I moved up the 1950s hissi ... step by step ... inch by inch ... no musak playing ... no inlayed marble ... no  fancy, shiny, polished surfaces ... Just a basic elevator that let me out in the 5th floor stairwell.

Yes, the stairwell.

I did see one door, so I dove for it to find myself in a long, narrow corridor that stretched the length of the building.  I figured I'd hit the hospital because there were medical equipment and basic chairs all along the hallway walls.  Unfortunately there was no receptionist, no nursing station, and no orientation signs around; even the signs in Finnish were small and only in Finnish--so much for dual-language.

Thus, began my aimless wandering down the corridor.  At one stage I noticed my doctor's name beside one door, so I figured I'd entered into their office corridor by mistake, somehow bypassing the exam rooms, but I didn't know what I should do with that info.  Then I noticed this scanner terminal in the hall.  Finally something I could read (it was in Finnish, Swedish, and English)!  It turns out I was supposed to scan my Kela (medical insurance) card into that terminal and take a seat outside my doctor's office.

Problem #1: I don't have a Kela card.

Problem #2: Aren't a doctor's office and an examination room two different things?

By now I was frantic enough that a Finnish lady waiting in one of the chairs noticed me and said something to me.  When I told her I didn't speak Finnish, she broke into English, we chatted a bit, and she suggested that I go to the other end of the building and ask what I should do.  As I headed back down the hall, I saw someone walk out of my doctor's office.  Eureka!  I took a chance and knocked, which freaked out the nice, helpful lady to no end.

Well, out of the office after just a few seconds came this petite blond dynamo asking how she could help--that is, once we got through the usual formalities of me being unable to speak any of the languages of the country I was living in!  Agh!  In any case, she didn''t have any problem that I hadn't checked in and took me into her office for my appointment.

Yes, into her office.  At this Mehiläinen at least they have one very big office that serves as a combination examination room, data entry center, and personal office, each with spacious and discreet spaces.  No big reception area with a bazillion staff and individual nurses assigned to doctors.  I sit at a chair on the other side of her desk, fully clothed, like a grown person, and she pulls up her appointment calendar on her computer to find my medical record.  She then takes a brief history while I continue to sit there like a grown-up--no aide doing this for her--checks my breathing, blood pressure, ears, and throat, and tells me that she thinks I have walking pneumonia.  To be sure, she's sending me down for a chest x-ray, and she transmits the request directly to the x-ray department from her computer.  She then prints out a prescription, explains to me how I should take care of myself, get my prescription filled, and get to x-ray.  She answers any and all of my questions patiently and promises to call the next day when she gets the x-ray results (and she did).  I'm in and out of her office by 12:30 pm.

At x-ray I fear that I may be returning to the world I'm more familiar with; there are about 8 people ahead of me.  Well, within 15 minutes, I'm in getting my chest x-ray.  Here I get another giggle about the completely different way modesty is handled in Finland.  When I walk into the x-ray room, I'm shown where I can hang my clothes and place my stuff, while the tech just stays in the room.  When I'm undressed, I just walk over to the machine.  No flimsy paper coat that pretends its covering you.  The room itself, like most of the hospital, is very definitely old-fashioned looking: think 1950s space and colors rather than the bright, more posh settings of American medicine.  On the other hand, it was meticulously clean, so I'm happy not to pay for marble, color consultants, and updates.

Speaking of paying, I didn't pay a thing.  NOTHING, NADA, NICHTS, NE ... PAS, etc.  Hell, I never even officially checked in, so I guess it wasn't a problem.

I did, however, have to pay for my prescriptions: $40 for everything at the local pharmacy.  Yes, about half what it would've cost me in SC even with medical insurance.  Even then it was pretty funny, because one of the prescriptions my doctor had written was for this really effective, codeine-laced cough syrup.  I didn't pay any attention to the quantity the doctor had prescribed; instead, when the pharmacist asked if I wanted all of it, I said sure.  After all, you get everything a doctor will give you, right?, so that you have it for later, right?  Well, my pharmacist reaches into her drawer and pulls out a quart-- yes, a QUART!--of cough syrup.  At that stage, I started laughing so hard that I couldn't stop coughing.  Between giggles and gasps, I got her to exchange the QUART for an ordinary 8 oz bottle, although she told me that I could get the rest of my QUART anytime in the next year!

I still giggle about it, but I no longer gasp.

Given that this whole process took less than 80 minutes and that I didn't have to walk more than 4 blocks total, including the distances in the hospital, I went home and did some school work.  I certainly wasn't tired enough for a nap.

Yes, the evils of socialized medicine.  Must remember that the next time I fight with Blue Cross over billing, can't get an appointment with my doctor for a month, find out that I needed to call ahead to get approval for a doctor to see me, etc., etc.  But don't we have pretty, marble-inlayed elevators?

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