In Which I Call Upon the Doctor’s Surgery: Part the Second

Despite myself, I arrived at the Doctors Surgery the next day five minutes early. I tried the door all the same, and, lo and behold… it opened. I followed the signs for my doctor’s office and came into a reception area. It was empty except for one other patient. There was no one at the reception desk. It was quiet. It was the complete opposite of any doctors office I’ve visited in the U.S. No noise, no bustle, and no receptionist. After a couple of minutes someone did come to the desk. She gave me one tiny form to fill out– name and local address. So much for the reams of paperwork I was suspecting. A little while later there was the sound of a buzzer.

“You can go in now. Room 6. Down the hall and to the left.”

I walk down a quiet hallway of closed doors. Door 6 was also closed and I knocked just in case. I was expecting this to be the initial examination room, where I would meet with a nurse first. But no. When a pleasant voice calls out, “Come in!” I walk in and find the doctor herself.

Her surgery consisted of a large room with an examination table, a desk with a computer, and a couple of chairs. The back wall was a sliding glass door that gave onto a balcony. The good doctor had a magnificent view of the Pavilion. She was seated at the desk and greeted me cordially.

I’ll spare you the details of the examination. I do have a sinus infection. When it came time to talking about treatment, however, the good doctor appeared a bit hesitant. I was afraid that she was going to tell me that they don’t issue antibiotics unless you’ve been sick for a month.

“I’m not sure how it is in other countries, where… erm… the patient pays for services. Doctors may have a tendency to order lots of tests and MRIs and such because they will be paid…” she paused, “But in cases such as yours, we tend to treat first with antibiotics and see how that goes.”

I nodded in relief and suppressed a laugh. The good doctor does not appear to know much about Health Management Companies in the US. “I certainly didn’t want or expect an MRI,” I said, “The antibiotic will be fine.”

The good doctor was relieved. That sticky business was over. Now she said, “Right, well, the saying goes that when the patient pays, the doctors order everything. We don’t pay for anything and so we do nothing.” She laughed.

But she did write me a prescription. Because I am a private patient and not in their computer system she had to run down the hall to get a paper tablet. Then she explained how to take the medicine and told me that I could get the script filled at any chemist’s shop.

“If you don’t feel better in a week, just pop round again, all right?”

It was a very calm, unrushed, and civilized visit. I was cheered.

Back at the receptionist’s desk I asked about chemists shops nearby. The receptionist told me of a few, but warned me that the shops would not be open until 9AM. Then she looked uncomfortable.

“I’m afraid that will be £20 for the visit. Is that all right?”

Is that all right? Did she expect me to refuse to pay? I’m a visitor here. £20 (about $30) is a deal as far as I’m concerned. And yet the receptionist looked as though she had just told me that I have to pay with my first born.

So fascinating, the different reflexes that develop in a society unused to paying directly for medical care.*

I quickly produced my £20 note and with the unpleasantness of the bill behind us, the receptionist visibly relaxed and bade me farewell.

Precious prescription in hand, I left the surgery, marveling at how easy it had been.

The chemists shop, of course, was another story.

*Of course, UK residents do pay for health care through individual, payroll, and sales taxes. The sales tax (VAT) was just this month reduced from 17.5% to 15%, to try to spur economic recovery here. According to Wikipedia, the individual tax rate ranges from 0-40%, and the payroll tax is 23.8%