In short, I have mixed feelings. In some ways, the system over here is much better than in the US:
- You can walk into a clinic and see a specialist in just a few minutes.
- Many things are much cheaper here.
- Private clinics are not crowded and easy to get into.
In other ways, though, both from our own experiences and from what others have told us, there seem to be problems:
- Some doctors have an agenda to promote pharmaceutical companies (i.e. diet pills).
- If you go to a second doctor about an issue, he’ll just blame your problem on the incompetency of the previous doctor.
- Sometimes the discrepancy in price makes one wonder about a discrepancy in quality.
- Public clinics are crowded, drab and depressing.
These are just some of the ideas that first come to my head. Since I have Type I Diabetes, medical care was an important deciding factor in choosing to come to Bulgaria, and it has obviously continued to be an important part of our life. One of our main goals over the past months has been to do what we need to so that I can get insulin prescriptions. We started working on this in December, and we didn’t resolve the issue until just a few days ago.
The first time that we set foot in a clinic here, we went to the Greenberg Clinic just down the road, and we were taken aback. First of all, it seemed really nice in there, so that was a plus. We were just trying to make contact with a doctor to initiate the process of finding an endocrinologist. When I spoke with the receptionist, I expressed my need in broken Bulgarian, and she called over an English-speaking doctor, who gave us some consultation. She told us that no one in Bulgaria pays for insulin (how could they?), and that neither would we. She said we’d need our residency cards before we could move forward, though. Skeptical of this too-good-to-be-true news, we left without having to pay a dime. Months later, after numerous phone calls, wild goose chases and meetings with different doctors, it turns out that this first assumption (that we wouldn’t have to pay for insulin) caused us all of this wasted time and needless work. I now have a prescription in my desk from the endocrinologist from Greenberg for the insulin that I need, and I still didn’t pay a dime to get it (Not sure how that works).
Two other experiences at Greenberg were fairly good. In January we needed to get our last Hepatitis shots, and we walked in and explained this. The nurse at the reception table seemed a little miffed that we didn’t have our vaccination cards with us, but again, a doctor stepped up and took control of the matter, saying: Obviously they need the last shot. They know when they got the other ones, or they wouldn’t be here. We paid 1/3 of what it would cost to get the same shots in the States. And again this last week I had to go to the doctor because of the food poisoning I got in Istanbul, and I was able to walk in and see a gastrointestinologist, who prescribed some medicine that helped me get better quickly. Between the two prescriptions and the doctor’s visit, I only paid about $30. After insurance reimburses us, it will only be $6.
Partly why the medical care at Greenberg seems to be so good is because it’s a private clinic. I think that the Bulgarians can’t go there without paying something, whereas they can go to the public health centers and get lots of treatment for free. Another thing about the doctor’s office that is strange for an American is that when you have gotten the office number of the doctor you want to see, you just go up and knock on his door. It just feels wrong. There’s no waiting area where a nurse comes and calls your name. In the public clinics where it’s much more crowded, there are tons of people waiting outside of the doctor’s door, and you have to figure out who else is in line and what number you are, unless you want to let other people cut in front of you. This will take a little while to get used to.
Another strange thing happened when I went to get test strips a month or so ago. The secretary for the drug company where I buy the supplies recognized that I am a returning customer and told me that if I continue to buy three boxes of test strips every month, they’ll give me a discount (they had already given me a discount a month or so back). Anyway, they gave me another 10% off. This is strange, because in the US, things are just a set price, and pharmacy loyalty doesn’t get you anything. Also, when I went to the pharmacy a few weeks ago to buy some needles, I had an interesting encounter:
Me: Do you have needles for an insulin pen?
Pharmacist: Yes, just a moment. (She goes back to get something and returns with a box of needles.)
Me: How many needles come in a box?
Pharmacist: (Silence. She does something on the computer.) 74.
Me: (74? Why 74 and not a round number like 75 or 100?) Ok. In that case, I’ll take two boxes.
Pharmacist: (Gives me a weird look). No, this box is all we have.
Me: (You’ve got to be kidding me!) Okay, I’ll take them all, then.
Pharmacist: All of them?!
Me: Yes, all of them.
It was only after I left that I remembered someone telling us that you can buy individual pills, or just what you need for a day at the pharmacy, if you want. Apparently I was doing something out of the ordinary to buy enough for three weeks all at once.
Despite the differences, health care in Bulgaria will definitely suffice for our needs, and we’re very happy about the price cut on so many things.
-James, the younger brother