The disappearance of the GP in Chile

Dr. Romulo Bernal was our family doctor when I was growing up.  He had some to the states from Brazil and his practice was quite near to us.  I remember him being everything that I thought a doctor should be: kind, caring and with that way of putting you at ease that some doctors seem to have mastered.  I remember him even coming to the house if one of my grandparents was too sick to go to his office.  It was a time when you could still have a relationship with your physician.

Now?  Forget it.  As an adult, I have been in the Army Tricare and VA system and, only since coming to Chile, have truly experienced what it is like to be in a system run by the insurance companies.  Doctors move you in and out as quickly as possible, often in 5-10 minute intervals.  Because of my age (damn fertility), my insurance is incredibly expensive and covers very little (unfortunately Tricare doesn´t extend internationally).

I have been seeing a doctor who specializes in internal medicine and nutrition.  He has been my nutritionist for nearly 8 months now.  It isn´t very common here to have a nutritionist who is also a doctor, so it is a special thing.  Aside from that, he is definitely not the typical doctor.  Consults are scheduled for 30 minutes and I have never had the feeling of being rushed.  He asks questions and knows about you as a person, not just a file or one of hundreds of patients.  Hell, the other day I had a control appointment at the end of the day and ended up being there for an hour and a half (fair enough, 30 minutes of appointment and an hour talking..).

As I am preparing for Kilimanjaro next week, I have been under his care in more of a GP role.  He signed my physicians certificate (after putting me through loads of tests in the altitude chamber), helped me with all my prescriptions for more than a month in Africa, and recently saw me for a nasty cold/infection I picked up.  He is an amazing doctor and I am lucky to have found him…but it begs the question of why I need to go to my nutritionist for this?

GPs have all but disappeared from Santiago.  If you want a GP, you must first go to the Emergency room.  Yes, the emergency room.  So, for my infection, I would need to go to the ER to explain to a doctor why I needed to get better ASAP for my trip…a doctor that likely doesn´t give a shit about me…or…I can go to a doctor who legitimately cares what happens.  This is a special case, I am lucky to have found a doctor who is doing what he is doing because he loves it and cares about his patients.

The point of this?  Not much other than to point out the sad state of affairs.  Gone is the relationship you could once have with your doctor here (so much for preventative medicine)….it is all replaced by the all-mighty dollar sign and instead of going forward, we have managed to take a step back.

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