This past December I got smacked with a bizarre malady – perpetual dizziness. Now, I know that I have been called a “dizzy broad” but this was terrible. A hospital admission, followed by the alphabet list of tests and the mystery dizziness continues. Leaving the hospital they told me to see my Primary Care Physician. So I called my PCP and the gatekeeper said “We can see you in 10 days.” Ten days?! Are you f’n kidding me. I’m dizzy today.
I may be dizzy but during this insanity I saw clearly one of the differences between health care in Pontelandolfo and New Jersey. Need to see my Primary Care Physician in Pontelandolfo – no appointment necessary! Right, NO waiting ten days after a hospital stay to see your PCP – just walk in!
There are other parts of the Italian Health Care system that may not be so easy to wrangle – we’ll save those stories for another day. Today, I want to talk about Dottore Pasquale Palumbo.
HIs studio medico is on the third floor of Piazza Roma 1 – correct, there is no elevator. I know what you’re thinking. How the hell is a doctor whose office on the third floor of a ancient building with no elevator accessible? HE MAKES HOUSE CALLS! Remember those? When I was a wee one – when the dinosaurs roamed the earth – Doc Husted came to the house. Now you need a concierge doctor on retainer if you want that. In Pontelandolfo, the charming Dottore Palumbo regularly visits his patients in their homes. The first time we met him he was visiting our landlady – he pops in to check her blood pressure. He recognized Jack and said – “I know you, you’re the crazy man who walks at noon – walk earlier.” Every time I see him, he reminds me to tell Jack to walk before noon.
When I first got accepted into the Italian Health Care System, the administrator at the Azienda Sanitaria Locale asked me to be honest and tell them whenever I was leaving the country. That way, no practitioner would be paid for me when I wasn’t in the country. Apparently, there are folks on the list who immigrated and never took themselves off the list – what a lousy thing to do. Pontelandolfo is part of the Distretto Sanitario Benevento Nord-Est – Morcone ASL and I made sure to stop by and tell them we were heading to the USA.
Dottore Palumbo practices Medico generico. Since he is in our home town, I picked him as my general practitioner. That means, I’m on his list as a patient and he gets paid regularly for me. He is my primary care physician.
My first visit to Dottore Palumbo had me huffing and puffing up those three flights. When I got to the top and looked at the view, I raised my victory fist in the air. The steps are a great free cardio workout!
Yoo Hoo Can You See Me Up Here?
When you go through the door to the office, the most noticeable thing is the absence of staff. There is no receptionist, no nurse, no billing department – niente! What a great way to cut those costs. I walked into the waiting room, looked at who sat waiting in the chairs and knew I went after them. An elderly gentleman peeked in the room and said, Chi è il prossimo? The next person went in – we didn’t need a receptionist. When it was my turn, I proudly walked in and gave him my new Tessera Sanitaria.
My Tessera Sanitaria and Codice Fiscal. Health Care and Social Security Cards
Dotter Palumbo didn’t ask me my name, he knew who I was – this is a very small village – asked me about my cousins, husband and myself. Pulled my new record up on his laptop and asked me why I was there. Bronchitis. After the exam he gave me my ricetta. No euro changed hands. I will not be billed – visits are part of the health care system.
I walked down the stairs across the piazza to la farmacia and got my drugs. ( Here’s the link to a pharmacy story – http://wp.me/p3rc2m-bh) When patients call Dottore Palumbo for refills he writes the prescriptions and when he goes home for lunch, he carries them across the piazza himself.
He is a great man and everyone loves him. What is not to love, a doctor who comes to your house, has great office hours and is always smiling. Now, I don’t want to be sick, but when I get back to town I will be sure to stop by and bring the good doctor a caffè.
(TRUTH TIME – when the gatekeeper in NJ told me it would be ten days before I could see my PCP after a wretched time in the hospital I promptly hung up. Having learned how to work the medical system, I called back, hacked into the phone, talked through my nose, coughed repeatedly and got in the next day.)
Nonna's Mulberry Tree 
I just had my first appointment with a Doctor here in The Netherlands. It wasn’t as informal as your experience (I live in a city not a village) but, as you described, SO much more efficient.
LikeLike
George, I hope all is well. It is interesting how “less can be more” when it comes to healthcare.
LikeLike
Doctors who specialize in care for the housebound elderly still make house calls in the US and, so far, medicare pays for it.
LikeLike
Kathy, That is so true. I used those services for My Aunt Cat – I didn’t think Medicare paid but her super duper Federal secondary. I hope Medicare pays for that service. It is great that Doc’s who care for the elderly are setting up the at home service.
LikeLike
Today I had my first encounter with the Dutch health care system. Here you only go when there is an issue. No yearly checkups, you’re responsible for maintaining your own health. If things need to be looked at you make an appointment.
I made that appointment at 10 am yesterday morning and was seen at 9 am today. Amazing. The waiting room was packed and I thought, “Oh no. The stories about waiting for health care in Europe are true”. I was 10 minutes early to fill out forms at at exactly 9 am my name was called, by the Doctor himself, and I followed him into his office/examining room. He read the medical records I had brought from the U.S. I explained why I was there. I had a quick examination which included pictures from internet sites to show me what might be going on, a prescription for blood work, another for an ultra-sound, and 15 minutes later I was out the door. I walked there and back, getting home less than an hour later.
I go back for blood work to the same office tomorrow after fasting. One receptionist at a desk, one nurse practitioner for follow ups, and a lab tech. That’s it.
I THINK that is how you keep health care costs down in one of the healthiest places on the planet. I know I now live amongst evil socialist who are clearly set out to destroy capitalism and redefine democracy, but it all seems to working just fine from my point of view. So far.
I now open the floor for my friends to once again lecture me on how social democracy isn’t sustainable. I’m not worried though. I think I’ll be dead before it all falls apart. As long as other countries don’t join in to unravel the fabric of the European Union. Yeah, I’m talking to you, Greece. That type of socialism has it’s citizens so spoiled that they refuse to comply with the austerity measures that have been imposed on the entire EU. Balance, people, balance. Actually that sounds rather funny coming from me. I’ve never been Mr. Austere.
LikeLike
George, there is so much to learn! Thanks for sharing your story.
LikeLike