Saturday, March 20, 2010

French Healthcare Experience #1

I'm sure I'll lose count eventually but today was our first experience with the French healthcare system since becoming official recipients of coverage.

It was totally my fault and I'm still feeling a bit overwhelmed and guilty so please forgive any rambling. I'm posting as much for my own mental health as I am to describe the cultural experience.

This weekend Sean is playing in his first frisbee tournament with 33 tours, Bordeaux's ultimate team. I took Owen in the afternoon to watch daddy play frisbee. As the final point of the final game was being scored (Sean's team lost), I must have pulled a bit awkwardly on Owen's arm. I heard a clicking noise like a knuckle cracking, a delayed pause, and Owen started crying. When I asked him where it hurt he pointed to his arm. He continued to cry every time I touched his arm (which I did a lot while trying to figure out if it was broken) and he wanted to go home. We took him home but noticed that he refused to use his left arm for anything, including holding a truck so you know it had to hurt. We decided to take him the hospital. Bordeaux has a fairly prestigious university hospital with a children's urgent care center. So, we hopped in the car and drove the 20 or so minutes to get there.

The Children's Urgent Care (Urgence d'Enfants) Center is located downstairs from the parking lot. When we arrived there were about 5 or 6 other families there. But not a single fussy child. Even Owen was calm and we brought the computer with the Cars Movie DVD to keep him entertained since we didn't know how long it would take.

Our first experience was checking in. Just like an Urgent Care facility in the US (in which we had several experiences during Owen's first 21 months of life), you have to sign in at the desk. They ask for the purpose of your visit and a signature from a parent and then send you to the a different person to handle insurance.

So, step 2, insurance. We haven't received our carte vitale (health insurance card) yet. This card has a microchip in it that contains information about your social security number and health insurance provider. While France does have national healthcare, the social security system does not pay the full cost of the services (usually only covers 70%) so most people, including us, have supplemental insurance. We have been filling out forms for over 3 months and all we have to prove that we have supplemental health insurance in France is a letter from our provider. We're still waiting for the correct paperwork to be processed so we can receive our cards. Anyway, naturally, in our eagerness to get Owen to the hospital, we forgot this letter at home so all we had was the card from the insurance provider with their phone number on it. When we handed it to the lady at the hospital she said it was basically useless. We told her we had just moved to Bordeaux so were still waiting for the cards and she said, "D'accord" (Okay) and told us to take a seat.

Steps 1 + 2 took a total of 4 minutes.

Step 3: Waiting. Okay, so any one who's been to an urgent care center expects to wait. As I mentioned, we had a DVD to keep Owen occupied but I was really impressed at how calm everyone seemed. Even the parents. There was a separate entrance for the kid brought by ambulance to the facility but still, no one seemed to be in a hurry. No one was going up to the desk to ask when their turn would be. They just sat and waited. We waited too. For about 45 minutes. Then a nurse came out and to gather some more details about the "incident" and then told us the doctor would be ready for us in a few minutes. Less than a minute later the nurse came to get us.

Of note for anyone reading this who is involved in healthcare in the states, when the nurses would come out to get the kids, they would call the first name and if no one responded they would call out the kiddo's full name. And here I spent so much time over the past 5 years learning about the HIPAA regulations! In France, no one seemed to care about privacy!

Which brings me to Step 4: The examination, diagnosis, and treatment
We were taken through automatic doors into, what I thought would be, a hall of examination rooms. Nope. We were told to put Owen on a gurney bed right next to the door, in the hallway, where the doctor came and looked at him. There were several other similar beds in the hallway. And an examination table in a room off to the left with the doors wide open and I could see an older boy, maybe 6 or 7, lying on the table.

The doctor felt Owen's arm then started telling Owen in French what he would be doing and then started taking off Owen's shirt. Since Owen didn't understand the doctor, he freaked when his arm was touched. And since Owen was crying so loud, neither Sean nor I was really listening to what the doctor said. And then the nurse tried to take George (Owen's Lion wubbanub soothie). Owen grabbed George, crying hysterically, and repeating, "Owen take him away"). Sean and I could not figure out why the nurse, who seemed so nice, was being so mean. But then we noticed that Owen was holding onto George with his left, injured hand! Clearly, the doctor had already fixed Owen's arm and was making sure that everything was in order! Literally, we were there for less than 5 minutes! When we noticed that his arm was better we told Owen and that made him stop crying and look at his arm. It was really cute. He kept saying, "Owen's all better". Then the nurse handed us Owen's shirt.

This was all done in the hallway. After we had Owen's shirt back on, the doctor told us not to pull too hard on a child's arm. That he should be fine but we could give him doliprane (tylenol) if he seemed to be in pain. I've been telling Sean not to pull Owen up by the hands since Owen was born so I can't really explain why I have started playing this way with him now other than he always laughs and wants more. But not anymore! The official diagnosis was Nursemaid's Elbow, or at least that's what Sean and I came up with from an internet search since the doctor didn't tell us a name. All he said was "yes" when Sean asked whether it was the ligament.

Step 5: We're free to go?
The doctor spent all of 5 minutes with us and then abruptly leaves with the nurse to go see the next kiddo. We sit on the gurney for a minute, not sure whether we can go. Remember we haven't paid anything yet. So, Owen and I go out the Sortie (Exit) door and Sean goes back to the waiting room to ask the lady at the desk if we can go. We're given the all clear and we leave. We didn't pay a single cent but we also didn't show a useful piece of identification. So, now we're waiting to see if we get a bill or anything. I'll keep you posted.

In the meantime, Owen is a totally different kid! As we go up the stairs to the car, Owen wants to run and hold toys in both hands. When we get to the parking lot, I tell him to take my hand to cross and he grabs my hand with his left (previously injured) and pulls me across the street at full speed. I, of course, have images of a relapse just outside the hospital doors but Owen is fine. And happy. And, really, that's the most important part. Thank goodness we trusted our instincts and took him to the hospital instead of waiting to see how he felt in the morning. It wouldn't have gotten better on its own.

We spent almost as much time getting to and from the hospital as we spent there! I have to say, it was quite a good experience as far as hospital trips go.

Since, I still feel immensely guilty, we spoiled Owen by letting him finish the Cars DVD at home while eating dinner. And now that he's asleep, I'm trying to soothe myself with a glass of wine. And an early bedtime.

1 comment:

  1. Glad that everything turned out okay! What did the doctor actually do to fix his arm?