Hospitals; a pain in the back

The hospital system in Turkey is different to Australia. In fact, in Australia I would not visit a hospital for an illness other than in the case of an emergency. Here, most people attend at a hospital in the first instance.

When you talk about public and private hospitals in Turkey, people tend to be fairly negative and do not speak highly of the public system. They say they are unclean, crowded, and I have heard stories of people having to care for their own family members by bringing meals and changing sheets. I have visited one once to see a relative of my husband's and I was shocked to see a drainage bag draining blood was wrapped up in a white plastic shopping bag sitting on the bed.

When people talk of private hospitals though, I some of them are referred to as "commercial hospitals", money big making for doctors who order unnecessary tests and operations knowing for patients knowing they can bill the private health insurer and be paid for it without question. I have also heard people question what doctors tell them and my friends always advise in obtaining a second and third opinion for any diagnosis given as people tend to be skeptical about what doctors tell them. Other people have told me to "see someone you know" in order not to get ripped off and to also get a proper diagnosis. At first, I didn't really buy into this that much as I would hear people say that the hospitals are on par with those in other major European cities and that most of the doctors have trained abroad and are very well educated.

This week however, I have had my own taste of the private hospital system which has made me question the system just a little. I spent the last 10 days laid up at home trying to deal with the pain from two degenerative discs I have in my lower back. I have spent much of that time in a drug induced stupor which has caused insomnia, loss of appetite, night sweats, lack of concentration as well as general mind numbing boredom, among other things. I have had trips back and forward to the hospital to administer various pain injections, and to undertake scans and x-rays and doctor appointments. Dealing with a hospital system is never easy, particularly one in a foreign country where you never really know how it works. I am thankful, however, that my private health insurance was in place to help cover the cost of the various scans and doctors visits as well as drugs and injections, otherwise we would have seen the cost go into the thousands.

When I moaning in pain last week I decided that I really did need to get the hospital. When we reached the consulting rooms my husband had the following conversation with the receptionist:

Receptionist: Welcome. How can I help you?

Husband: My wife has hurt her back and needs to see a doctor

Receptionist: Do you have insurance?

Husband: Yes.

Receptionist: Which kind (which fund?): Husband gave the name.

Receptionist: At 10:20am Dr. X is available for TL 175 or in 5 minutes at 9:30 Dr. Y is available for TL 375. Which one would you like to see?

Husband: (turning to me to ask what I want to do)

Me: Not sure I can wait an hour, so lets see the one in 5 minutes.

I wondered to myself it it was normal to have a conversation about money so early on in the piece? I guess it was. So, we waited and after a couple of minutes an orthopedic doctor (professor) greets us and shows us to his rooms. I tell him that the night before I had a sudden acute pain in my lower back which almost caused me to lose feeling in my legs and as a result I nearly fell to the floor. He proceeded to ask me three questions; my age, do I smoke and has this happened before. Once I answered these questions he advised I should have an MRI and x-ray. So off I went. While I was having the MRI, the doctor spoke with my husband and reported what he saw on the screen. He told my husband he had to leave to conduct a surgery but would be in touch with us.

He wrote me up for some pain killers, advised that I not run or power walk on the treadmill anymore, take up swimming and consult a neurologist if the same things happens again with the view to having surgery as this is the only thing that can fix the problem. And that was it.

The suggestion of surgery was a little bit frightening and was enough to prompt me to call the doctors office to chat about this and ask some other questions. However, after leaving a couple of messages for the good doctor, it became clear that he was not going to respond. Not only was I annoyed, I was disappointed at the level of follow up given he so loosely talked about surgery and consulting a neurologist.

A couple of days later, I returned and saw another doctor who suggested I visit the physio for a minimum of 15 sessions. He advised that the only fix for my back was surgery (surprise, surprise!)but I could try physio. But why didn't the last doctor advise physio, I wondered?

Today, by co-incidence as I read through the Hurriyet online, I came across this article about a job advertisement for a cardiology expert that featured in last weeks paper. The article talks about the advert as well as the private hospital system and makes claims of corruption amongst some private hospitals. The article "slammed doctors in private hospitals for performing unnecessary procedures for extra cash, calling into question the reliability of the country's health sector".

The article goes on and quotes the head cardiologist at the German Hospital as saying "All private hospitals are not like this,” Soylu said. “Some patients who consulted our hospitals after they were told at another hospital that they needed to have an operation turned out to be wrongly diagnosed. In some cases, they actually did not need any operation, and we tell them the truth. These people can sue those hospitals.”

Well, well, I though to myself. Interesting.

I guess statements such as these support the truth behind the fact that private health insurance is the country's fastest developing form of insurance and because of that, people are offered the false sense of security in the fact that if they have insurance, they are therefore offered only the best service, treatments and advice money can buy, even if the doctors are earning an extra few husband or thousand lira from ordering lots of tests and writing you up for a handful of drugs you don't really need.

So I guess I should follow my friends advice - it always pays to get that second and third opinion to avoid any potential unwanted surgery or procedures.

May we all have good health!