We recently had a client move from the Boquete area to David because there are no hospitals in Boquete.

 

David has two very well equipped and staffed private hospitals and Cuesta del Sol Offers a group plan at one of them, Hospital Chiriqui. The hospital was expanded three years ago and again last year with new operating theaters and intensive care ward. There are more than 140 doctors and specialists working with the hospital.
 

In Boquete, there is no medical facility to spend the night. There are only clinics and that is even for the Panamanians. There might be a couple of overnight beds  for women who are giving birth and cannot make it to David, which is the provincial capital. In general, there are only clinics and no overnight stays.

In Boquete there are around five or six private doctors.  Some of them come and go. Most of them tend to speak some English and those are the doctors that the gringos go to mostly.

There are two medical systems for Panamanians. The health department system, which is the clinics, and the social security system, which is for people and their families who are covered under a health plan for laborers or workers. So if you are covered by social security or if you are in a family that is covered by social security, you will go to a social security clinic for medical attention. If you are not covered by any health plan, you will go to the health department for medical attention.

Occasionally, gringos go to one of those systems if they are destitute. Most of us feel that, if we can pay, we should not take advantage of the Panamanian welfare system because this is a poor country and already it is hard for them to cover just their own people.  There are, however, some gringos out here who are destitute and they will be treated within these systems and the payment is very minimal.

Often times in these systems the wait is very long. It could take you eight hours in the waiting room. The conditions are not the most sterile, which is what you would expect in most public facilities. Most gringos would prefer to "bite the bullet" and pay for going to one of the private clinics or hospitals in David.

The private hospitals in David are very good. There are two major hospitals there. My insurance plan is with Hospital Chiriqui, which is the biggest hospital in David. They have clinics for almost all the medical specialties. They have high-end medical equipment such as MRIs and CAT scans. They can cover pretty much everything. But I think, if you need to undergo an open-heart surgery or if you have a very rare condition, they will send you to Panama City. There is a hospital in Panama City that is affiliated with Johns Hopkins Hospital in the US and therefore, they have to maintain the standards of the facilities and the equipment that Johns Hopkins requires.

If you are a gringo who lives in Boquete, you can go to the clinics if you need some minor medical attention. If you really need care in a hospital, you have to go to David, which is only 30 minutes away. If it is a serious case, they may send you to Panama City, and if worse comes to worst, you have to go back to the US.

One challenge for us in Boquete if we need to be taken to David is the ambulance is sometimes very slow to arrive. Or sometimes, they have a hard time finding the address where you live. Overall, however, in Boquete, we are very lucky. Even if we cannot speak Spanish well enough to give directions to the ambulance, we have a system in place that compensates for that. We have a guy who is a bilingual Panamanian, who answers the phone 24 hours a day.  We are all registered with him so he has the directions each of our houses. When we call him in an emergency, we just have to say our registration number, so he can look it up and then give directions to our house in Spanish to the ambulance. This is a free service, supported by charitable contributions.

For the future, they’re building a brand new medical center about midway between David and Boquete that will have 24-hour emergency care.  

Just before Christmas my wife had a very serious illness diagnosed.  We live in Boquete.  After much deliberation, we chose not to go to the local hospital in David (the city with the biggest medical center outside of Panama City, and less than an hour from Boquete), but rather, for this operation and recovery, to go to Panama City.
 
If I had a broken leg or a knee problem something similar that didn’t need really extensive and complicated surgery, there’s no question about it; I would have it done in David, at a local private hospital.  They are very, very good.
 
The hospitals in David serve not only David, but the entire greater Chiriqui area, including Boquete, Volcan, Cerro Punta, and many other, smaller communities.  There are three hospitals in David, two of which are private: Mae Lewis and Chiriquí Hospital.  I’m familiar with Chiriquí Hospital.  I recently had a knee rebuilt for $5,250.  This was an operation I was going to have to wait 18 months to get in Canada and 6 months just to get an MRI in Canada.  (The joke in Canada is that, if you’re pregnant, it takes 10 months to get in.)

 
Chiriquí Hospital has its own insurance plan (which I described in this website under “What is the cost for health insurance in Panama and how does it work?”).  In order to determine if you have any pre-existing conditions, Chiriquí Hospital will give you a very thorough physical; in fact, one of the most complete physicals I ever had.  I would recommend to anybody that they get their insurance just to get such a good exam!  (By the way, you don’t pay anything for it initially.) 

Seven years ago my doctor in Boquete suggested I go to the Chiriqui Hospital for a CAT scan.  I argued and lost and we found a tumor in my liver.  This definitely put a damper on the CAT scan party. However in America my doctor would never have suggested a CAT scan out of the blue and Blue Cross probably wouldn't have allowed it. In Boquete I paid $300 for the scan and $5 to Dr Pretelt, and I am now here to answer this question.

I don't have all the information on the new medical facilities but we have a new poly clinic being erected in Alto Boquete that is supposed to house an emergency unit.  There is also a new, much larger facility going up near Dolaga that I believe will also be a hospital.

     My wife and I came to Panama last November for a second time, for a planned 3 1/2 month stay to 'test the waters' in Boquete for a longer period. We have since returned a month ago permanently.

     Our trip was all planned for some time, and about 2 weeks before we were to leave my wife broke both bones above her ankle tearing up ligaments, etc. We decided to come anyway. Our hosts we were renting from referred us to an orthopedic surgeon in David for follow up care before we left for Panama. Both she and her husband had different procedures done by him.

     A few days after arriving (the doctor had been gone) we visited him. After viewing her X-rays he determined a 2 inch long screw thru both bones for stability needed to be removed. Something our US doctor indicated was probable after surgery.

     The doctor wanted new X-rays. Hospital Chiriqui sent a staff member and wheel chair across the street to his office, and took her in the back entrance, up to Emergency where we waited in a full reception area. About 20 minutes later she was taken for the digital X-rays. $22. By the time we returned to the doctor's office 15 minutes later, the X-rays were on the computer screen in his office. We discussed the time frame for healing and surgery in January. My wife had a 45 minute intensive physical therapy session, 45 minutes with the doctor over the 2 sessions, and the bill was $45.

     My wife had weekly therapy sessions, $15, until and after the surgery until we returned to the US. We conferred with the doctor prior to surgery, and following surgery. The doctor AND hospital bill was $1,500 total. My wife's ambulance ride at home in the US, 2 miles to the hospital was over $1,200, and insured surgery over $11,000.

     Another incident required medical attention and lab test. We walked into the lab, asked for the test, and left 15 minutes later with the typed report. Walked up the street a couple blocks to the doctor's office. He suggested medication which he wrote on a piece of paper so we would know what to ask for (not a prescription). Doctor office visit, $10.

     At the pharmacy they looked at the note, grabbed the medication from their stock, another $8. Many, not all, medications are available over the counter by request. Comparison prices to other meds we were familiar with were not greatly different than home.

     In short we had 1st World Care and treatment without insurance. The orthopedic doctor was a well known and respected specialist, who we later found travels frequently, performs surgeries in Panama City, and apparently lectures in his 'off time'......once in China while we were there.