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.