An American in Portugal - To your health!

My husband had inadvertently inhaled the fumes of a cleaning substance. His lungs had strongly objected. We sped down the hill to the health center of our nearby town, Penela. Five minutes and five euros later, we were advised to immediately head to the University Hospital in Coimbra. There he went through the triage process, then to imaging, was seen twice by the doctor, and received an envelope with his X-rays and doctor’s notes included. Forty-five minutes and twelve euros later, we were on our way home. Such was our introduction to Portugal’s efficient and economical health system.

Over the years we had further opportunities to sample its offerings: MRIs, EKGs, and other X-rays. Depending on whether it was a private or public venue, and if our insurance (Fidelidade and Automóvel Club de Portugal) was applicable, we usually paid from five to 50 euros, with 200 euros a one-time maximum for services rendered. Thanks to the EU Blue Card, when I landed head first on an icy sidewalk in Sweden, my hospital treatment, which included meeting with a neurologist and a CAT scan within 30 minutes of admission, cost a mere 40 euros. (The card is available on request to full-time residents of EU countries through their respective Social Security systems.)

Last summer, when I knew I needed a hip replacement, I had a decision to make. Seven years before I’d had SuperPATH surgery, performed by Phoenix orthopedic surgeon Dr. Jimmy Chow. The minimally invasive procedure resulted in no pain and a speedy recovery, so it was my choice again, for my other hip. But when I inquired about a consultation, I learned that my doctor no longer took Medicare. There was also the cost of airfare to consider, and my Arizona friend, past post-op caretaker, had moved. These factors, together with past positive experiences, led me to opt for the Serviço Nacional de Saúde.

I located one of the Portuguese orthopedic surgeons who performed the same procedure, Dr. Diogo Pascoal, in Cova da Beira. In September he told me it was a three- to six-month wait for a surgery date in the public system, not bad considering I waited seven months for my surgery in the US at that time.

Five months passed. Then one day I received an email and learned about the SNS’s “Vale de Cirugia” system. The translation read, “In order to ensure that the SNS responds to your need for surgery, please find enclosed a Surgery Voucher, which will allow you to be operated on at another National Health Service (SNS) institution, whether public, private or in the social sector. We suggest that you carefully read the contents of this Surgery Voucher and the accompanying letter so that you can decide whether to accept or reject it. If the voucher is activated, you can forward the email with the Surgery Voucher to your chosen hospital, once you have confirmed that the procedure will take place there.”

Chosen venue

My chosen venue was Hospital da Luz in Coimbra, the city in which we had settled. Through an excellent liaison, Céu, I learned I would be scheduled for surgery within a couple of months. I would first meet with the surgeon, Dr. Francisco Alpoim (who also performs minimally invasive surgery in the form of direct anterior arthroplasty); the anesthesiologist; have appointments for blood work, current X-rays, and an EKG; and be given a week’s notice of my surgery date.

On 15 May I arrived at the hospital at 11:00, was assigned a room at 13:00, and wheeled to pre-op at 16:30. At 17:40 I told my anesthesiologist, Dr. Nuno, who was about to put me under sedation, that I was going to write an article for The Portugal News about my health care experiences in Portugal. His eyes crinkled in a smile above his mask as he said, “Well, then, I guess we have to do a good job.” And that they did. By 7:00 the following morning I was able to take a selfie and was feeling quite well.

In retrospect, I would have liked a few things done differently. I was never told the hour of my surgery, unexpectedly changed rooms, and was sent home the afternoon post-surgery, rather than spending the night under observation as I had expected. These changes, combined with the continued effect of intravenous medication, led to my confusion regarding post-op instructions.

Yet while this experience was different from my past one, there’s much to be said for the competency and professionalism with which I was treated. And frankly, a warmth that surpassed my expectations from my surgeon, anesthesiologist, and post-op aide, Tiago. I will never forget how gracious they all were, and what that meant to my emotional balance and physical healing. That’s the part of health care that is priceless.

Native New Yorker Tricia Pimental left the US in 2012, later becoming International Living’s first Portugal Correspondent. The award-winning author and her husband, now Portuguese citizens, currently live in Coimbra.

Tricia Pimental