Health Care In Panama—The Good, The Bad, And The Dysfunctional
Panama offers international-standard health care, and medical tourism is a booming industry here. Panama City is home to Punta Pacífica Hospital, the only hospital in Latin America affiliated with and managed by Johns Hopkins Medicine International.
The cost of medical care here is a bargain. Like everything, medical costs are higher in Panama City than elsewhere in the country, but, even in the capital, a doctor’s visit costs US$50 or less. In Panama City, clinics are a great value (US$30 per consultation) and offer excellent, full-service care.
Many doctors in Panama are trained in the United States, speak English, and are well-versed in all prescriptions and ailments. Private health insurance and prescription drugs are readily available and much less expensive than their U.S. equivalents. American private health insurance policies are even accepted in some Panamanian hospitals.
All that said, there are some potential downsides that all expats should be aware of when navigating Panama’s health care services…
I recently sat down to speak with Shai Gold, a seasoned, international health care professional, to talk about the quality, costs, and potential risks of medical services in Panama. “I would call myself a great but balanced advocate for Panama’s health care system,” Gold explains. “Nobody knows the pitfalls better than this gringo.”
Until recently, Gold lived in Panama, working for four and a half years as the general manager of International-Triage Medical Networks. He is currently CEO of Soteria Diagnostic Solutions and a principal and senior consultant of International-Triage LLC, establishing all their cross-border networks in Panama, the Dominican Republic, Argentina, Mexico, and the United States.
Gold told me three stories in order to illustrate the ins and outs, the pros and the cons of Panama’s medical system. Each scenario offers its own lesson that expats should take advantage of…
I love these three examples because to me they humanize health care. Doctors aren’t infallible, and everybody makes mistakes. And in the absence of malpractice laws, you should never take anything for granted.
Panama’s health care services are not necessarily governed as closely as yours were back home. Practitioners are expected to self-track and report any medical errors or quality-control issues to the Ministry of Health, which means a patient is relying heavily on individual professional ethics… and ethics vary practitioner to practitioner.
“Someone might claim Panama has great medical resources. We have several brilliant doctors and a few modern hospitals with good medical technology,” says Gold. “And compared to any other Central American country, they are correct. One can certainly find a good doctor and medical services in Panama for 90% of what one needs.”
Hospitals in Panama are modern; they have state-of-the-art technology and frontline medications. Like anywhere else, though, hospitals are only as good as their “cultural standards.” The quality of the doctoral and nursing care within each hospital may not match the high-quality of the technology it boasts.
“I have met some great doctors in Panama,” Gold says, “but I have also met below-average nurses. They mean well, but they are generally underpaid, undereducated, and without mandates for continuing education. Most are not bilingual. If you’re working in medicine and don’t know even fundamental English, you’re going to be at a disadvantage—all the equipment, much of the medication—everything—is in English.
“The top tier of physicians and those working in the private and high-end public hospitals in Panama really go out of their way to do the right thing. I’ve seen exceptional commitment at the personal, professional, and ethical level that, at times, goes beyond what I have seen in the United States. They care on a personal level.”
Case Study #1: When Nurses Do More Harm Than Good
Two and a half years ago, a doctor from a well-known Panama hospital had his son hospitalized overnight for observation due to a diagnosis of dengue. A nurse gave the boy medication meant for another patient, almost costing the boy his life.
Even in the case of the son of a senior physician in their own institution, considered the crème de la crème of hospitals in Panama, an avoidable medical error was made due to the nursing staff.
While medication errors can happen anywhere, they are more likely to happen where there is an absence of well-educated nurses, no continuing medical-education requirements for the nursing staff, and, perhaps most worrying of all, a serious lack of oversight.
Case Study #2: Why You Should Always Get A Second (And Maybe Third) Opinion
There are about 15 neurosurgeons in Panama, all of them well-schooled, qualified, and highly skilled professionals.
“I saw a case that required facial neurosurgery a while back,” Gold says. “One doctor said he’d do the procedure for US$50,000; the second doctor for US$25,000; the third doctor, however, explained that the protocol for the condition was no longer surgical intervention, it simply called for radiation therapy.”
Never take for granted that what you’re being told is the best and only option. Always get a second medical opinion, and if the second opinion is radically different from the first opinion, get a third opinion.
Case Study #3 And #4: Panama’s Top Medical Minds Offer Incredible Levels Of Care
Six months ago, a life-saving neurological procedure in an ICU setting saved a car-crash patient’s life. Dr. Guillermo Castillo, a dedicated neurointensivist, made a flash decision to administer a rarely used “brain cooling” technique in an effort to avert a massive stroke due to brain swelling.
“Dr. Castillo is one of the most caring and most professional physicians I know,” says Gold. “His quick thinking and diligent application of the treatment saved the patient’s life and assured his recovery with limited damage to cognitive and motor skills.”
The treatment was by no means cheap. “The bill for putting this patient back together in Panama was almost US$350,000. In the States the same case would have easily surpassed the US$2-million mark.”
And while care outside of Panama City is generally thought to be of a lesser quality (and often is), that’s not necessarily always true…
“A procedure to recreate a human bladder often fails when performed at top hospitals in the United States. Nevertheless, for Dr. Pinzon in the small Cuatro Altos Hospital in Colón, bladder reconstruction surgery is routinely accomplished with 100% success.”
These are just two specific examples of Panama’s top doctors achieving great things in the face of difficult procedures… but they are by no means unique.
And when it comes to run-of-the-mill care, you’ll find that Panama offers an excellent standard at a bargain cost. It’s no wonder that Panama’s medical tourism industry is booming and draws more patients from around the world every year.