Although I have thankfully not yet fallen ill on this trip, I do feel that I have become well aquatinted with the Bolivian health care system. My first experience was in going with Laura for her follow-up visit to a clinic in Obrajes. The clinic looked very much like any doctors office in the States, but as I soon discovered it functioned quite differently. The most prominent difference was in the facility with which things were done. In the US, if you need to have labs run, the nurse or doctor writes the order for the lab, takes whatever samples they need, and then sends them off to the lab to be tested, and when the tests results come back, they bring them to you and present them. I found that in Bolivia, the doctor tells you what tests you need to have, but then you have to take the order to the lab yourself, have the test done, wait for the results, and then take them back to the doctor so they can interpret them for you. Initially, I was surprised by this, but then I realized that it is probably quite a bit more efficient, as it has the patient doing the busy work for themselves, rather than the one doctor having to do it for every single patient.
I noticed a similar do-it-yourself approach after going to the dentist with Mcclellan yesterday. After her root canal was finished, she was prescribed an oral antibiotic and a painkiller, as well as two injections. However, rather than sending the prescription to a pharmacy, and administering the injections at the dental office, we were handed a piece of notebook paper with the four prescriptions on it, and expected to not only find a pharmacy that could fill them but also figure out how to administer the injections ourselves. We went to a pharmacy and picked up the medication, and then took it to a local clinic where they helped us to administer the two shots for a very small fee. This once again demonstrated the emphasis on the responsibility of the patient for their own care here. Although this was a bit difficult to navigate for me (and the two patients respectively), I would guess that it prompts patients here to be more involved in their own health, and creates an atmosphere of responsibility and ownership of their treatment. This could not only potentially expedite healthcare but also improve patient attitudes about efficacy in medical care.