Senor and Linda Lou have been in Pueblo Alamos, Sonora, Mexico for 10 years.
Every day brings a new discovery.
They are still working on the casa............Senor says, it won't be long.........but Linda Lou says, it won't be long until what..............stay tuned to find out what's next.

Saturday, February 9, 2013

Just waiting in Line


A few health issues, all very minor and fixable, have sent me to IMSS, where I spend most of my time just waiting in line.
I need to wait in line at the IMSS clinic here in Alamos to see the doctor so he or she can determine if I need to see a specialist. The Alamos doctor then sends me to the Alamos reception desk where I wait in line to make the appointment to see the specialist in Navajoa, at the IMSS hospital, which is where all the specialists are located. The day before an appointment with a Navajoa specialist I have to return to the Alamos clinic where I will wait in line to pick up the paper work required by the specialist.

I find the Alamos IMSS clinic to be fairly easy and uncomplicated. It has taken time and patience to learn the system and as I have discovered, clinic systems are different from hospital systems. When you have an appointment at the clinic in Alamos, you walk in, sit down and wait for the patient who is just leaving the doctor's office to call your name and then, you go right into the office. Keeping in mind that I have most likely previously waited in line on another day to even make this appointment, and that often I have to sit and wait for up to half an hour to be called, I don't usually find it to be a problem. I almost always know a few of the other people waiting. We talk about our health, our families, our houses, and they talk a lot about other things that I don't understand at all, but I am a patient listener and before I know it, my thirty minutes of waiting are over. Waiting at the Alamos clinic can be somewhat similar to a social event. And I am in this clinic every month because I have high blood pressure. With IMSS, you are required to go each month to receive a check up and any regular medication. You don't get a six month supply. 

I recently mentioned to someone the amount of time I have spent waiting in line for these visits and he suggested that I just go to the private hospital where one does not have to wait in line and you get the best care and equipment.

Senor and I have chosen to have Mexican health insurance, which is a part of the Institute of Mexico Social Security, or IMSS, and we feel pretty lucky as Americans to be given this option. Even if it does mean waiting in line for long periods of time, it also means paying about three hundred USD each for a year of medical coverage, which then covers everything, including visits, hospitalization and medicines. IMSS doctors are very professional and equipment seems to be adequate. We do not take having this insurance lightly, we respect it and the ability to have it. However, having this insurance requires a considerable amount of patience and time.

Upon my first visit to the Navajoa IMSS hospital, I had no idea where to check in, there were so many unmarked windows with lines that twisted up and down wide hallways that were filled with chairs, lines that I thought were short until I went around corners, and there were so many people, mothers and fathers and grandparents and twice as many children running in and out of those lines. In Mexico, when one family member has an appointment, the entire family goes. It is an outing. And almost everyone stands in line with the patient, often giving the illusion that lines are even much longer than they really are.

On that visit I saw at least fifteen unmarked doors and a narrow hallway filled with chairs and a lot of people in lines that seemed to have no beginning or end. I asked a nurse walking in the hall way where my office was and after glancing at my medical book she said.....this door. I sat in front of it. I finally concluded that what I thought was the right office for me could actually be the wrong one. Most people going in were taking what looked like samples of things and paper or plastic bags. I waited to be called. I watched and learned that the lines with the most children were probably for pediatric offices, pregnant women were for the gynecology offices, people in wheel chairs were most likely waiting for an intern or trauma office.  I talked to the woman next to me and learned that unlike the Alamos clinic, you need to stand and wait in a line to check in for your appointment. She pointed to a window and I went and stood in a long line of about thirty people, and when I got to the window I was told that my appointment was an hour ago............... but, i have been here an hour and one half, i said politely.............she was very kind, checked me in and took me to a chair by another door................wait here, she said.

After half an hour, I finally caught the attention of the nurse coming in and out of that, this is not the door you want, she said................She took me to a different door, where I stood and waited because all the chairs were filled with old grandmothers, and I quickly learned that a door means an office, it is not the door to an office. It is just a door. You go to a door. I was getting tired but my spirits were good, I finally had a chair and I told myself......any minute I will go to my door.

I should have brought a book, i thought...........And I quickly realized that would draw too much attention to myself and I did not need more of that. Everybody else was reading their little medical book. So I started reading mine and soon I noticed the man next to me was reading mine, too. So, I put it away. A lady standing in the line that went along side my chair told me I had nice skin and I thanked her and felt pretty good considering I was there to see the dermatologist about a skin condition which had me worried. Another lady came and asked me if my name was Monica and even though I said no, we continued on with a conversation, the subject of which I will never know and she called me Monica at least five times. A man came through the seating areas handing out papers saying he had a heart condition and was raising money for an operation. The ladies on either side of me got out five pesos, so I got out five pesos, too, and when he quickly went back through the area, everyone returned the papers and he took a lot of five pesos and left.

A new lady sat beside me. She asked me when my appointment was and with which doctor. I told her and her eyes got very big and I asked when hers was. It was two hours after mine. She got called into the door next and I was out of my seat like it was a hot plate on fire. I knocked on the door just like I had seen so many others do and then, taking a risk, I opened it. She was sitting there and so were about four men, all in white doctor's jackets, along with the nurse................embarrassed, but motivated by time or the furthering lack of time............. i said............i had an appointment at this door two hours ago..................They just stared at me.................i think, i said........i think i had an appointment? They all got up and took turns looking at my little booklet and almost in unison, they are at the wrong door.

I looked at the reception desk, there were at least thirty people in the line there. So I just did what I had seen so many others do. I busted into the very front of the line and stood at the window and said.................WHICH DOOR DO I GO TO, I AM SO SORRY BUT I HAVE BEEN HERE FOR THREE HOURS................Of course everyone stared at me, again. But, it was a kind and sympathetic stare, and they smiled and shook their heads like they really understood and someone in line stepped out of line and looked at my book and took me to a door and knocked on the door and told the doctor inside that I was here for my appointment. The doctor said, in English, oh, come in...............So, I did and I had my appointment.......................sorry for the inconvenience, he said, in English........oh, it is not problem, i said.

Most of my office visits have been handled in English. Many IMSS doctors have studied both in the United States, and at the best equipped hospitals in Mexico. The doctors I have seen appear to be very interested in my health and send me out the door with what I think must be prescriptions for proper medications and a tiny piece of paper that tells the receptionist to make me a follow up appointment. So, once again, I am in a line of many people, waiting to make another appointment. After an hour or so, I then go to the office of prescriptions where I wait in that long line for the medicine.

I have been to the hospital now for five visits. I can expect my visit to last a minimum of three or four hours. But I have learned a lot and I have become quite good at figuring out the system. I spend a lot of time composing emails I have not sent, planning  future trips, and watching babies cry and wondering also which person of that group of people is in line for the door or just in line for the outing. I always ask myself if I really had anything better to do back at the casa.

 I went to the hospital on Wednesday at nine. I immediately by passed the line and went directly to the window where I waited politely for the the person there to finish being i need to stand in this line before my appointment..............i have an appointment at ten.................yes, you need to stand in this line. After standing in this line for more than half an hour, I ask the lady next to me why she is in line, and a person is either there to check in or to make an appointment, she is making an appointment and I am beginning to worry about missing mine. I ask her to hold my place..............i will be right back. I went to the front of the line and leaned politely in to the window to ask if I need to stay in the, you can go to the door.  I sit down at my door because I now know what is behind each of them, and I read my medical booklet and then I try to read the booklet of the person next to me to find out if we are seeing the same doctor.............when is your appointment, i asked because i could not see the time in her booklet...........The man next to me is wearing the watch this day and I sneak a quick look, half past eleven. Not too bad today. The woman to my side is called and I am starting to feel my blood pressure rise and decide to take a nap. I close my eyes, and a man next to me nudges me. I look over and the man with the watch is gone and another man sitting there asks if I am Linda Lee, which is what they call me at IMSS. He points to the door and says...........linda lee. I have almost dozed through my door.

After this visit I am having to make a follow up and get prescriptions, and you do not leave the hospital without both of these. I follow the line at the window for making an appointment and  for checking in. I walk through the chairs, around some beautiful old chattering grandmothers, down the narrow hall way and around the corner and around another corner. This line will take two hours I tell myself. I walk instead to the prescription window where there are around forty people in line. Suddenly testing the system becomes important.

I go outside the hospital and take a leisurely walk three blocks to where I had been able to find a parking spot and get in the car, and drive home, enjoying the breeze and the scenery. The next morning I return to IMSS in Navajoa at seven thirty am where I find lines of people standing outside at pastry trucks and taco stands and juice stalls. I am one of only a few people even inside the hospital. It is extremely quiet and calm. I stand in line at the check in and follow up appointment window for five minutes, get my appointment written in my booklet and walk to the prescription window. I have my medicine within five minutes and am back outside in the cool morning breeze. A lovely peaceful drive gets me parked on the street in front of the casa in forty minutes.

So, of course, I have not been able to resolve all the issues of waiting in line and never will. I have to return to the Navajoa IMSS for a follow up in March. I am a patient person.

Below is a photo of me, relaxing at home, and not waiting in line.....................


Carlos Q and Pat Q said...

Thanks for the description of using the IMSS. I have wondered how it works! I agree with you that's it a wonderful option for many of us expats.

Brenda Maas said...

Yikes that is a long time waiting in line ups.
I have IMSS also; but have never used it. When I need to see a Dr. I just go to the ones at the farmacias for 25 or 30 pesos.
I wanted the IMSS in case of an accident or heart attack or something catastrophic. I have no idea how it all works lol; but if it is that busy there I can only imagine what it is like here.
I do think that they assigned me a door number for a Dr. when I went for my initial visit that I had to go for; but I have never seen who is behind that door lol.
Hope all is well.

Linda Lou and Senor, Too said...

Just a few more comments from me. Senor burned his hand with a flame torch when he was soldering some copper. Twice he has gotten something in his eye. Once he needed antibiotic shots. Each time he went to the local general hospital (there is not an IMSS hospital in Alamos) and never paid a penny, except when he had to have the shots. He had to buy the shots at the farmacia and take them to the hospital where they injected him. So, it is definitely all very interesting. Many different ways, I think, of taking care of your health here in Mexico. For IMSS insurance you need your passport, visa, proof of residency, birth and marriage certificate and license and several infantil photos. I have heard stories of needing the certificate and license translated and apostilled, and stories of having to have a physical but we did not have to do that. You will take all of those things to the local Seguro Social office and apply. Once you are accepted and pay, you will need to renew each year, but with an easier process. LL

Jacqui said...

What a patient patient you are! I think they would be treating me for stress along with whatever complaint I was there for.

Tancho said...

Man...I got tired just reading about your day...
I hope they don't treat emergencies in the same procedural way.
We have been lucky, only time I needed something we went into one of these local clinics and got a prescription and check up for 200 pesos....

Linda Lou and Senor, Too said...

Hola Jacqui, I do sometimes practice deep breathing and lol, no, Tancho, the emergencies go straight into the emergency door.

sparks_mex said...

I do have a few other things to do in my life but basically have always been in line.

Is the only other option wanting(being able) to pay to go to the head of the line ... so you can wait in the next. I'll think about that

Trish said...

First of all, THAT is a lovely photo of you "relaxing at home"
And: The telling of your IMSS adventure was fun to read except for when I tried to imagine myself in the same position....well, "No WAY Jose" & no WONDER you have high blood pressure! You have the patience of a saint & I love your attitude about the whole thing.

I really appreciate the time you take to post so that we can all enjoy your life in Mexico. WHAT an adventure!