In keeping with talking about how modern and unbelievable Chile is (in this post about how we pay taxes), which makes at least one of my friends think that the whole shebang is part of a giant conspiracy, puppet-goverment style, I want to talk to you about medical records management.
When I had my first contact with the Chilean medical establishment it was after a very hard splat upon the pavement, having been sprung from verticality by the quick application of a 4x4's side view mirror against my bicycle handlebars. This joyous event was covered by Chilean worker's comp, as it happened on my way home from work, even on a Saturday. I was, in fact, on my way home from classes which I'd been teaching at the Universidad Central, a four-hour behemoth of a class with jumping up and down and occasional glove removal to draw a particularly sticky diagram on the board. It was cold, oh yes, it was cold, even in the days before I'd given up Nescafe with its mysterious thick layer of froth on top (what is that? surfactant?)
So my first contact with the Chilean medical system was with ACHS, La Asociacón Chilena de Seguridad, under which I was covered through my employer's insurance, and which conveniently has offices right downtown, a stone's throw from the place that had sent me to the University to begin with. Not that it was their fault.
Over the course of several months, I was treated to ultrasound, electrostimulation, xrays, sonograms, an MRI, a cortisone shot, a free sling, lots of physical therapy and the whole previous year of Cosas and Caras magazines, which I think you only get if you subscribe to certain newspapers, and it was a very educational time there in the "box" (what they call the booth where the doc sees you and where some of those treatments take place). I also met a guy who was regaining mobility in his fingers by putting them into an elastic net and squeezing them shut. I wondered how he'd sustained his work-related injury at the Casa de Cambios (money exchange), where he worked but then maybe he wondered how I'd managed to wrench my shoulder so badly teaching English. We exchanged email addresses, but he WROTE ME IN ALL CAPS, and well, you can see how annoying that is, so we broke off communication as quickly as we started, and his hand injury will just have to remain a mystery. Quickly-slammed cash register? Repetitive stress from bill-counting? The mind boggles.
What was surprising to me about the whole system, aside from the fact that my name was now "Señora Barbara" and that my doctor tried to poach me over to his holistic medical center he was starting, was the computerizedness of everything. When I had the sonogram, I had to go to a different location of ACHS (the one on Ramon Carnicer, if you're wondering). I'd seen people walking down the street with giant art-project-sized envelopes bringing scan results and xrays from doctor to doctor, so I expected to be given the same. Oh no, my doctor said, your doctor can see this online.
Wha? Ditto your bloodwork or annual exam (Pap) results (though not HIV test). You can just log onto your clinic's website with your RUT (national ID number) and your payment number and get your results. Most people still go to the desk to get the printout and the many be-windowed envelopes so they can have a printed record and maybe feel more official. But are you serious? I can manage my cholesterol lowering success (strangely, gave up the fish oil capsules and saw a drop) from the comfort of my office/living room/satellite kitchen/bicycle parking area? This, I think is a maravilla (wonder).
I also have to give Chile a shoutout for being able to access all my records and my health insurance affiliation with a simple touch of my right index finger on the eerie red-lit lector (reader). With insurance, you can show up at any clinic (this is at least true for Integramédica, Santa María and Arauco Salud, anyone else know different?) press your finger to the lector and be trusted that your insurance is really real. There is no photocopying of id and health insurance card, no calling of your provider to find out how much of your visit will be covered.
Let's all say it again: una maravilla (a wonder/marvel). I just hope that when I'm in the states in a few months (just a visit, worry not Chilean blog reading addicts, and you are many) a) I have no contact with the health system and b) that the system is 1/2 as modern in what we have going on down here in the nobody-knows-us experimental puppet society. Gotta go, my strings are getting tangled.