Doctor's Appointments A Guide for Full-time Travelers
Just because you’re out living a life of adventure, that doesn’t mean you won’t occasionally need to find a doctor who’s willing to work on the occasionally broken bits of your body.
Appendixes burst, babies need checkups, kids fall down and bust their heads open. In fact, all of these things have happened to us. If anything, living a life of adventure might make one more prone to accidents: falling off of hiking trail cliffs and catching diseases from parts of the world you’re body hasn’t learned to fight just yet. Here we’ll provide a little advice to those travelers who find themselves in just these situations.
Visiting Doctors, Dentists and Optometrists
The thing about most doctors is that they want you to come in for an initial meeting, kind of a “get to know you”, before they’re willing to do much else. This is even more common with optometrists and dentists. They want you to become patients on paper before officially becoming a patient through practicing medicine on you. So how do you get around this? Simple.
Call around.
Let me backtrack here a moment, though. How do you even find a doctor that you can go in and see? If you’ve managed to make friends or are traveling somewhere you already know people, word of mouth is the oldest and best form of recommendation. When that isn’t an option, I typically turn to Yelp. Look for doctors with the highest stars and the most reviews. A 3.7 with 200 reviews is vastly better than a 5 star rating with only a couple of reviews, it shows that enough people are reviewing the physician to ensure it’s not just clever internet marketing, and also shows that, like with any business, while there may be some bad experiences, there were a lot of experiences. If they came out above average over many reviews, they’re probably a safe bet.
Make a list, and then start calling. You can tell a ton about a business by how the receptionist handles you on the phone.
“Hi, I’m a full-time traveler and will only be in the area for a couple of weeks. Would I be able to schedule a teeth cleaning?” Great way to just get it all out in the open right from the start. Don’t stress if they reply with a little bit of, “Huh? Full-what time-who?” but more or less you’ll know right from the start if they’re happy to see you knowing that you won’t be a longterm patient or not. When you find one who will, you’re likely going to be in good shape.
Another great idea is to be prepared ahead of time, when you can. If you need to get a new prescription in order to buy contact lenses online–and you know you’ll be in Austin, Texas a few weeks from now–find your preferred optometrist before you arrive, and get in touch with the last person who checked on your eyes. Chances are, the new eye doctor will want records from your previous one, and this provides plenty of time to get everything faxed over. Remember, for whatever reason, it typically takes a few days for one doctors office to fax a document, they nearly always get somehow lost in transmission, and then another few days to get the process going all over again.
If only we lived in a world where there was a more reliable means of moving documents long distances than faxing…hmmm.
So plan ahead. If you can, just keep your records with you as you go, particularly if you have some type of ongoing illness that regularly needs attention. The space a manilla folder will take up is well worth losing in place of the frustration that contacting short-tempered receptionists on a regular basis creates.
Regular Checkups for Children
Not everyone believes that children need regularly be injected with all the reported necessary immunizations, or that kids really even need regular checkups at all. That stance, I suppose, is for each individual family to decide. If you do want to get regular checkups for your kids, the good news is, it doesn’t matter if it’s the same office that’s doing it on a regular basis.
We’ve gone the “get all the shots” route with our two and a half year old. We’ve had these done by doctors in Oregon and New York and North Carolina. As long as you can manage to keep track of what they’ve had, or get in touch with the last doctor to make them cry in the name of immunization, you can safely go into see a doc, tell them what’s been done, ask what they still need, and be good to go on your merry way (even if junior isn’t quite so happy himself).
So let me repeat that: There is nothing wrong with taking your kid to a different doctor each time.
Use your best judgement, find a good pediatrician via Yelp or word of mouth, and feel confident that if your kid is running around and kicking butt at the playground, he or she is probably a-okay.
On the other hand, with our youngest son, we haven’t given him any immunizations yet, save for a couple of shots they convinced us were absolutely necessary at birth. And you know what? A year later, he’s not grown a third arm, no one has broken out in malaria, and while we’re still debating how much if any more of the stuff we’ll give him, it’s really not as big a deal as the world makes it seem. The great thing about an over-immunized nation is that you can sort of let your own kid dodge it all, with the assumption that he won’t be the zero patient, and will therefore make it through his youth just fine.
Getting New Contacts and Glasses
I have the kind of eyes that, every couple of years, change enough that I need a new prescription. I use ShipMyContacts.com and without a regularly updated prescription, they won’t continue to send me new contacts. This is only about once every two years, but the times I’ve had to do it, the process has been relatively simple. Unlike many general practitioners and dentists, optometrists are usually happy to see just about anyone.
What you will need to take into consideration though, is that unlike getting a routine checkup or a teeth cleaning, glasses and contacts typically require a couple of weeks to organize, and a lot of that is after the appointment. Unless you have a really simple prescription–that is, no astigmatism or bifocal needs–they won’t just have what you need in the store. So you’ve got to wait for them to order what you wanted, the contacts or glasses come in, you go back in for another round of “Better left or right, one or two” and then, assuming you both got it right the first time around, you’re ready to hit the road again.
Of course, if something wasn’t diagnosed properly the first go round, or the manufacturer flubbed up the order, or whatever, you might be hanging around a little longer than you expected.
Dental Work
We’re just getting to the point with our oldest son, who recently turned 12, where he’s going to start needing to get braces. We found a wonderful dentist in a town we knew we’d be hanging around for a month so that we could get acquainted with what we might be looking into, and told him our entire situation.
“We travel full-time, can we get some braces on this kid?”
While the dentist was incredibly friendly and wonderfully informative, given that I found him using my tried and true Yelp methodology, he was pretty clear about what I really already knew: braces take at least a year, if not significantly longer.
The only thing I can think of in this scenario, because I don’t know that you really do want to just skip around from orthodontist to orthodontist hoping they get what the last guy was trying to do, is to have a sort of circuit. Some place you feel comfortable that you can return to multiple times a year if necessary to get things adjusted.
Not exactly ideal, but hey, kids don’t tend to be exactly ideal anyway.
Surgery
Finally, there’s the big stuff. If you’re somehow lucky enough to know ahead of time that you’ll need surgery, you can plan accordingly. Six months of bed rest in a tiki hut off the Gulf Coast of Florida might not be so bad. You can figure out where you’ll want to be, and who you might want for your surgeon.
However, it’s been my experience that most surgery is a result of some unforeseen accident or complication, like a ruptured appendix or your dog lunged for a passing bicyclist and your kid didn’t think to let go of the leash, resulting in a massive head wound 80 miles and a border patrol check away from the nearest hospital.
In these instances, you do what you would if you lived in a stick house: rush to the emergency room and see what cards you’re dealt.
The last bit of advice I might give here is that–and I’m not a doctor and this is not official medical advice, just my own theory–living a healthy life full of balanced meals, a decent deal of exercise, and positive thoughts is far better than regularly scheduled trips to doctors, dentists and optometrists.
Certainly, as you age, I have no doubt that getting checked out to see if your prostate is busted or you’ve got cancer in your elbows is a good idea, but for the most part, this has been my experience.
As a teenager, I had cavities every single time I went to the dentist. I brushed my teeth twice a day back then. I now brush my teeth every morning and never more than that, and I have been to the dentist twice in fifteen years. I’ve had zero cavities in that time. Dentists and Colgate, so my conspiracy theory goes, are in cahoots to actually give you more work than you need, bust up your teeth more than fix them. Don’t go, and take care of your teeth appropriately, you’ll be fine.
Similarly, studies show that people who have minor vision problems, further deterioration happens at a slower rate if they don’t immediately jump into glasses, indeed it can even improve. This is because your eyes must work harder to see clearly. Throw on the glasses, and it’s like a wheelchair for your eyeballs. Suddenly they have no reason to work, and get weaker and weaker.
Be strong and live a healthy life, don’t simply rely on medicine and regular approval by doctors, but when you have to, hopefully the tips above will help make things a bit easier for you.
Final Thoughts on Healthcare
Everyone knows there’s a lot going on with healthcare in this nation. Plenty of sick people are denied treatment. Obamacare is trying to quell that, but in the short term nothing much will change. I have two strong opinions on obtaining healthcare, neither of which are probably very popular.
Firstly, don’t use it if you don’t need it. The more Americans abuse the healthcare system by running to their doctor every time they scrape their arm or are feeling blue, the more it costs us all. If you’re going to die, yeah, get some help. Otherwise, figure it out on your own.
Secondly, fuck the healthcare system. If you don’t have insurance because you can’t get it, or can’t afford it, by all means, if you break your arm or need some type of surgery that’s life threatening, head into an ER, give them your information, get fixed up, and change your address.
Once while I was in Austin, Texas, my appendix burst. It’s a very long story full of love and hope and betrayal and friendship. Long story short, I waited 16 hours to get the surgery I needed, which resulted in an infection, which laid me up for a month while I couldn’t eat or barely move. I had a bag hooked into my belly button to suck the infection out. I lost forty pounds. I was charged $36,000 for the operation. When I told them I had no health insurance and could never pay that amount, they dropped it to $17,000 on a whim.
What does it say about a healthcare system that bills insurance companies $36,000 for a procedure which they could afford to only charge $17,000 for? It says it’s broken. That was five years ago, and the blemish has already been removed from my credit record. Did the hospital go out of business because me and a thousand other people did the same? No. Did the insurance companies lose out on a bunch of money? Definitely. Did the doctors and nurses who worked on me forego their pay? I highly doubt it.
In another example, my oldest son fell forehead first onto a rock, removing a quarter sized chunk of his skin down to the bone in the deserts of West Texas. We rushed him 80 miles to the nearest emergency room, where in 35 minutes he was stitched up and ready to head back into the adventuring life.
The bill? $16,000 even. Really? It required $16,000 dollars of time for three stitches (which I eventually removed myself for fear of doubling that debt), 15 minutes of a doctor’s time and 20 minutes of combined nurse and secretarial effort. No overnight stay. No CAT scans or X-Rays. Thank you very much, that’ll be $16,000.
For the most part, I honor my debts. On the rare occasion I need money I don’t have, I pay it back, whether it’s to family, credit cards or my student loan. But when it comes to a system which can reduce payments in half on a whim or charge nearly $30,000 an hour for minor procedures like stitching a kid’s head back together, I use and abuse at will.
Perhaps Obamacare, by requiring we all have insurance, will solve this. Or perhaps our nation might do well to consider that we have plenty of “welfare state” institutions in place that we all use every day, that are paid for with our taxes, and for which are otherwise “free” to use. I’m thinking about the US highway system in particular. Most of us drive on it several times a day, and yeah, we pay taxes on gas and the occasional toll, but none of us look at highways as a nanny state situation.
Is keeping people healthy and alive really less important than the freedom to drive to strip malls all the day long?