Medical care in the Philippines

Many people worry about the adequacy of medical care in “less developed” countries. My experiences may not be typical, but I’ve actually received better care here than in the United States. Both physicians I’ve had occasion to visit here are at least as well trained as their American counterparts and both recognized conditions that US doctors missed. Here are the two critical incidents that shaped my perceptions.
While my wife and I were still courting—a delightfully archaic term—I visited Manila to meet her son and some of her relatives. Shortly before I left New Mexico, I began experiencing a persistent pain in my right leg. My own physician’s assistant—the doctor himself was too busy to see me—diagnosed a “nonspecific muscle soreness” and prescribed a powerful painkiller. The painkiller got me through the first couple days in Manila, but the pain grew steadily worse. When the pain became unbearable, relatives took me to the emergency room at the Asian Hospital. Although it was 10:30 on a Saturday night, it took just 5 minutes for the on-call internist to arrive. He quickly recognized the problem as a deep tissue infection and commented that I would probably have lost the leg if it had gone untreated for another day.
Treatment was pretty straight forward; intravenous antibiotic for 3 days coupled with two sets of X-rays to insure that there was no bone damage. I spent a total of 4 nights in a semiprivate room with round the clock care—very pretty nurses when my wife wasn’t there—followed by two weeks of tabular antibiotic. When I checked out, the doctor sent along both sets of X-rays for my personal physician to check (turns out, he wasn’t interested and suggested they could be interesting souvenirs).
The second example may be more typical of the aches and pains us “mature” folks experience. I had been experiencing sporadic gout attacks for a year or two before moving to the Philippines. After I got settled in here, I went to Manila Doctors Hospital and was referred to a Harvard-trained hematologist. He recognized that my hypertension medication was triggering the attacks. It took a week or so for tests to confirm his diagnosis, but he changed my hypertension medication immediately and I haven’t had a gout attack since. And it worth noting that 3 physicians and 2 physician assistants in the US all missed the medication problem.
How much did this first-rate care cost me? My stay at the Asian Hospital including X-rays, doctor visits, and medication cost just over $400, about twice what I paid for the appointments with my personal physician and the inappropriately prescribed painkillers. I visited the hematologist at Manila Doctors Hospital twice. Neighbors told me that doctors there were “the most expensive” in the Philippines and I paid a total of 1,000 pesos for his services, around $20 at current exchange rates.
You can see why I’m not concerned about medical care here. Of course, my experiences may not be typical. Care in rural areas is episodic. A doctor visits the remote village where my in-laws live just once a week. Most emergencies are handled by a registered nurse at the local clinic, but there is a modern, fully-staffed hospital an hour away. The other potential problem is that “self medication” is common here. Many drugs that require prescriptions in the US are available on demand here. Pharmacists may try to advise patients, but deliver the drugs without question if someone is insistent. Of course, anyone who chooses to treat themselves without seeing a doctor can only blame themselves for any complications.
I haven’t been back to the United States for 20 months. News reports tell me that I’m just as well off as I would be there and spending a lot less money.