The Private Sector

After living in Gabs for almost two years I had never had any interaction with the private health sector nor had I visited either of the two private hospitals in town. In the past few months I have been trying to take better care of myself and do all the checkups that I have been neglecting since moving here. So I finally got a chance to see what the private health sector is like and how it compares to the pubic health sector.

I first visited a pulmonology specialist at the Gaborone Private Hospital. I was amazed at how nice his office was! It was really quite shocking to me because all I had seen is the tiny cramped clinic rooms I am forced to work in. His office looked like it could be a study or den in a nice home. Off to the side behind a curtain, he had an exam table. He was very thorough and was even able to do pulmonary function testing for me on the spot in the office. His nurses were well trained and kind. Again all very shocking compared to the people I work with in the public sector. Most shocking of all is that he didn’t charge me for the visit. The consultation and PFT testing could have been over $500 in the US. I think he felt sorry for me because I work in such a difficult environment at PMH. But this is quite a rarity because most people just see me as a white person who should have a lot of money to spend. I thought it was quite a kind gesture.

The second private hospital in Gabs is Bokamoso. I needed to get an endoscopy to monitor some GI problems I have. But there is not a GI specialist in Gabs so the general surgeons do the scopes. I found the set up of specialist clinics in Bokamoso to be a bit strange. It looks like they took a floor of the hospital and turned each hospital room into a different specialist clinic office. The specialist sits in one room and the secretary checks you in next door. I was not a fan of this doctor. He kept me waiting to see him for 2 hours. Then told me I should just go back to the US to get my procedure. Since when do doctors turn down cash paying patients! I found out that they only do endoscopies in the Theatre (what they call the OR here) which means they have to fully admit you.  Very annoying because my prior endoscopy was done in the office in 30 minutes and I was able to return to work the same day. But there was no choice….. so we set up the procedure.

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I have never been fully admitted as an inpatient at a hospital so this was a really new experience. And especially interesting to see how things work in another country. It really gives you a different perspective on what your patients go through and is a useful reminder of how terrible it is to be sick. I thought the nurses were really attentive, caring and skilled – which was soo refreshing! They really seemed to care about me and my comfort. I have not seen a nurse in the public sector give this kind of attention to patients. The procedure was over quickly, then I spent a long time in the post op area. I never saw the doctor before or after. They finally wheeled me up to my room and told me I just had to rest and wait for the doctor to come see me. Apparently, he liked to finish all his procedures before he discussing the findings with his patients. I was also told I couldn’t eat until he came to see me.

So we waited for 4 more hours. Then I started to get really antsy. I was starving and had a ton of work to do. I needed to get back to the hospital to take care of some things before I left for the US the following day. I felt like I was trapped and started to panic. I told them we just had to leave. It took another hour to sort out the bill. They took us to what looked like a broom closet in a random corner of the hospital to pay the bill. In the morning they had made us pay a deposit of $500 but then the actual bill ended up being less than that! So instead of being able to refund us the money onto our credit card, they said we had to fill out some paper work that would be processed then we could come pick up a check later. That just seemed insane! Why should I have to be the one putting in extra work to get refunded! I have a feeling they like to keep people admitted for a full day so they can maximize the amount charged. It definitely seemed like a racket. No way you need to be kept all day for an endoscopy!

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I also wasn’t sure when I would get to hear anything about the results. I figured I would just have to go to his office when I got back in town. Thankfully, he ended up calling me at 9pm that evening to let me know what he found during the procedure. Hopefully I won’t have to be seeing him again!

It took a while for me to figure out how the private sector works and how to find different specialists. They don’t have web pages or phone numbers listed anywhere so you just have to figure out who to see by word or mouth or just by calling the hospitals and asking what specialists are available and how to reach them. We have been able to get everything we need done here and surprisingly have really good coverage of everything through our international cigna plan. Everything is much cheaper than it is in the US. And for the most part you can get scheduled within the same day or at least a week – I guess because the population that can pay for these services is so small. If I need lab tests I can just go to the private lab and order whatever I need myself and get it done on the spot. I can prescribe whatever medicines we need and buy them at the pharmacy. We pay for everything in cash up front them submit receipts for reimbursement. It seems like that would be annoying but it is actually so easy. I prefer this type of insurance and wish we could stay on this plan forever!

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