American Vs. Italian Healthcare – Part 2

Ok, so yesterday I shared the background of what we’d experienced in the US with M’s diagnosis – the good, the bad, and the ugly. Once she was established with doctors, things certainly went better – we found good doctors – but it still wasn’t completely smooth. She was (is) on about 14 different prescriptions, still has a fair amount of breakthrough symptoms – she’s doing better, but not great. That brings us to getting healthcare in Italy. Keep in mind – our experience here is still limited.

American vs Italian Healthcare Pt 2 | Midsummer Life Dream

Medicines In Italy

Since being here, we had to get refills of different meds, and we were putting off finding a doctor until we felt more comfortable in the area. That meant we tried to get prescription medications – without a prescription. Doesn’t sound like it would work, does it?

Let me tell you – if you walk into a pharmacy and say “I’m American and I have Parkinson’s and need more meds”, the very nice Italian pharmacists will ask what your dosage is and come back with boxes of name-brand Sinemet. It’s just that simple. We haven’t had any issues with getting any of the medications, and name-brand in Italy (out of pocket) is cheaper than generic in America (with a copay). One medication for a whole month was 83 cents!

And, as a side note, when I had a cold, or when the cat was sick, the pharmacist gave us appropriate meds for those issues as well, no problem whatsoever.

The Doctor

We put it off as long as we could, but we had to find a doctor. We decided to go straight to the neurologist, rather than find a general doctor first, and I started researching. We wanted someone who spoke English, because weird symptoms and a language barrier is just going to be a bigger problem than I’m prepared to handle, and I insisted on someone who has a lot of experience with Parkinson’s, is involved in research, top of their field. I was searching through the whole country, even though we wanted someone close – it’s so easy to travel, there was no real benefit to ruling out other provinces. Anyway, we narrowed it down to two people, both in Bari, and we were able to get an appointment with our second choice in just a week (2 months it took in the states – 2 months). This doctor is known in three countries, is involved in a lot of research papers on motor disorders and gene manipulation, and speaks English. He seemed perfect!

Doctor offices in Italy are nothing like the cold, gray, clinical rooms you see in America. We walked in and it was like we were in a friend’s living room. The walls were gold, there were sofas and plush armchairs, and we were offered drinks from the minifridge – good drinks like iced tea and cold coffees. We waited for about 10 minutes and the doctor came out to show us into his office. Not an exam table in sight – just comfortable chairs and a big desk. We explained that M was diagnosed with Parkinson’s and I handed over her medical binder, which he flipped through. Since we always have to defend that yes, she really was diagnosed with Parkinson’s, I started on the spiel that she has had a Datscan and the medications and… but he just said, “well, of course she does.” Just that simple. It shut me up for a good minute, because no one has ever just accepted it!

Then he asked about any other conditions and I launched into the laundry list, but he said that (from a European standpoint) American doctors tend to overdiagnose and most of her conditions are symptoms of Parkinson’s, not stand-alone diseases. He continued that he doesn’t think she needs to be on all the medication she’s on, and would probably be better served with less medication, and more meds that are designed for Parkinson’s. So he wants to completely revamp her entire medication regimen. We’re on board with that! Then we discussed the MTHFR gene. Now while in America, the doctors – even specialists – knew very little about it, he knew plenty. For once (and I say this with all respect for our American medical team, because they really were great), but I wasn’t the one in the room who knew the most about this stupid mutation! I wasn’t the one fighting for an actual diagnosis!

The appointment lasted for about an hour or so, and at no point did we feel rushed. He took scans of some of the medical binder, said he wanted to really comb through her medications and diagnosis, and would get back to us in a few days. We walked out, feeling really, really optimistic, and I’m only more positive now that moving to Italy was the right decision, at least from a medical standpoint. And did I mention the appointment cost was less than the copay in America?

Where We’re At Now

So it’s a week and a half later now, and he hasn’t gotten back to us with the new regimen, but that’s my own fault. I’m a worrier, and I wanted to make sure he had all the information, so I sent him an email with all of M’s diagnosed conditions, the symptoms we attribute to each diagnosis, and the meds she takes for each diagnosis or symptom, as well as exactly what she takes broken down by time. It was a lot of information, and he has said that he’s still sorting through it. But we’re trying to be patient (I still can’t get used to Italian time), and we can’t wait to see what he comes up with. (Follow me on Twitter for updates on this – I’m probably going to be shocked about how many meds he eliminates!)

M is supposed to see him again in two months, but he’ll be in regular email contact with us while we adjust her meds. It may be hard to get an earlier appointment if we have an issue though – in America, doctors work mainly out of just one office, but here in Italy, it seems they work out of numerous clinics. This doctor, for instance, works out of about 4 different cities in Puglia, as well as Rome and Germany! But that’s a bridge we’ll hopefully never have to cross – I hope M never has such a big issue that we can’t wait for him to be in Bari again.

So at this point, we haven’t had a single bad second with healthcare in Italy, and we’ve already encountered more up-to-date knowledge and some of the new ideas and options that we’d been hoping for. And we’re not even on the national insurance yet (which this doctor does accept). I took a major cut in income to do this move, but we’re saving so much money on healthcare that it’s certainly balancing out. Basically, don’t ever tell me that national healthcare is bad or that American healthcare is the best, because it’s simply not accurate. The entire system here is different, and it works. Soon, I have to find a doctor for my endometriosis, and I’m more optimistic about that than I’ve been in the 8 years since my last gynocologist retired. I love Italy!

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