06 August 2013

Fun finn facts #4: healthcare

weve had a few visits to doctors and dentists since being here and so i have some level of ability to discuss the healthcare system here, i think.

- your medical information is associated with your social security number. your health card has this number on it and a barcode (the health card is called the Kela card). some might say this is a centralized, government-directly-in-my-personal-business kind of thing and i suppose you could look at it like that, but it hasnt felt invasive at all so far. in fact, it means i dont have to keep as many records and be in charge of as many health related things as i would in another country. you arrive anywhere, with your kela card, and they can get your whole damn health file staring at them on the computer in a matter of seconds.

- it also means public health analyses are phenomenal (so ive heard), because the government has access to health data on essentially all of its citizens. theyve basically got census-level data on all health conditions, and can thus be very informed on the state and degree of health issues of their people.

- kids are covered for basically everything up until age 12, i think. this means eyes, dental, everything (as far as i know).

- there are health centers planted in each neighborhood (or sometimes a few neighborhoods share a health center), and while they used to require you to get non-urgent medical attention only from your nearest health center, they changed the rule and now you can go to any health center you want for your general health care needs. these centers provide walk-in/urgent health visits, prenatal monitoring, well-visit appointments, dental, and laboratory services all in one building. you call one number for children well-visit needs and another number for walk-in/adult well-visit needs. you listen to a recording and it saves your phone number and calls you back when a nurse is available (call backs have usually been within a couple hours, and have all been able to speak english). well-visit appointments for kids are usually scheduled within 1-2 weeks of calling. adult well-visits are usually within 2-4 weeks of calling (in my short experience). this was a tad longer than the waits in canada i suppose, but it feels fine to me. you are of course always able to go to a private clinic and get an appointment sooner.

- doctor/nurse/lab visits done through the public health (kela card) system are free, theres not even a co-pay. and from what weve seen, for the most part you dont check in with an administrative person, you are assigned your appointment day and time and the room number that you are to wait outside of. the doctor comes out at the appointed time and takes you straight in and checks you in through his/her computer system when your card is scanned.

- for kids, well-visits are done by public health nurses at preschool ages (starting at age 4, we went this year for age 3, but its not a regularly scheduled year). they get doctor well-visits at certain ages too (4-6 weeks, 4 months, 8 months, 1.5 years, and 4 years). for sick visits, they assess the need on the phone and schedule an appointment based on urgency.

- for women with no history of issues, paps are only recommended every 2 years, or if you are a finnish citizen, they will call you every 5 years to remind you...if you let it go that long. for men they dont really do physicals until later years, unless there are smoking, heavy drinking, drug issues, or a family history of severe illnesses that would bring the person in earlier or more frequently. in the 30-40 year age range, men need only come in a few times for cholesterol and blood pressure checks.

- due to daycare, we required a doctor visit about Xs food sensitivities. the doctor ordered an allergy test and a blood test to be done. the allergy test was set up 2 weeks after it was suggested (the appointment info was sent in the mail) and was easy to reschedule to another upcoming day. once the doctor input the blood draw request into the system, it meant we could walk in to any blood draw station and have her blood drawn. the results of all tests become available for the regular doctor as they are processed (and we are sent a copy of results as well), and she had them at her fingertips on our appointment day to discuss results. it all seems so easy, and yet their doctor offices are not fancy, high tech spaces. they are comfortable and average, and i dont feel rushed, and so far having someone speak to us in english has been easy.

- as for the allergy test specifically, it was quick and easy and the lady was very kind. the blood draw in the same building was frightening though. i assume they must fairly regularly draw on kids, but the lady used an adult gauge needle and had it dripping into an open topped tube. it was bizarre and horrible. i was trying to stay cool for X but her poor arms were bruised (they had to poke the other arm to try for more blood) and they had to move the needle around a bunch to try to get blood to come out. i still shudder thinking about it, but a friends daughter needed blood drawn here and said it was fine, a little butterfly needle was used and it went well. so, i HOPE we never encounter that again.

- X had her 3 year old dental visit. this is a regularly scheduled visit performed by a hygienist (they do them at ages 1, 3, 5, and then more regularly as the children start losing their baby teeth). she basically makes sure all milk teeth have erupted and that no dental or orthodontic work needs to be done for the child yet. she surveyed our success at teeth cleaning and gave some standard, age-appropriate advice about dental care.

- i went for a check-up at some point too. the lady spoke english and was very helpful with answering my "this is my first adult encounter with the finnish medical system, how does this work" questions. i basically wanted the annual lady exam. *TMI alert * she had me get up on ye old medical table and take off my bottoms. it was different in that there wasnt a big charade with privacy curtains or leaving the room or getting out a huge drop cloth. she wasnt staring at me or anything and i felt like i had privacy to disrobe, it just wasnt a big production. also, though she did do other parts of the exam at this visit, i still needed to do the pap smear part down at the lab. so, she entered the pap request into the system and i just showed up later at the lab with my health card and they knew what test i needed. the results got put in the system so when my doctor called me back for our (pre-arranged) phone appointment in a few weeks, she had all the info she needed. easy peasy.

- my follow-up phone appointment was helpful and fast. she ordered a blood test for me as i requested (ive been inexplicably fatigued for several months). she also mentioned that i could go to the health center and sign a consent to allow for electronic communication with the doctor about the blood results. as it turned out i actually couldnt do the electronic message system because i have no ability to acceptably validate my identity in order to get on the secured health website (i would need to have my own bank account), but i was able to go to the health center and quickly get a print out of the test result message from the doctor.

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