A couple of the more tolerant/lame/PC/weak Costa Rica forums have a recurring theme, if you will allow me to label this particular phenomenon as such. That theme has to do with requests for referrals to various English speaking medical specialists. Now, as an experienced RN, I have always recommended that everyone should have a primary (as in family) doc. Let him or her decide if you have a medical need for a specialist consultation or not, and if you do need such a thing, then let your family doctor choose for you! How could you think to ask perfect strangers (the members of an online forum, a goodly portion of whom are just as phony as a three dollar bill), to offer you suggestions in an area that should be so personal, and important?! Worse, how dare you (or I) presume to know if or when we need to see a specialist?
Now, some folks will try to tell us that they have this need because they were under the care of such a specialist back in the states, so they want this for ongoing care. But, that's drivel. How did they come under the care of that specialist in the first place, if not through a referral from another doc? And, if they left the care of their primary physician simply because they gained a medical diagnosis of a heart condition, or diabetes, or whatever, then who the hell told them to do such a foolish thing (stop seeing their primary physician)? You can bet it was NOT that specialist, nor was it their family doc! You still need that primary physician!
Beyond that, if you are or were under the care of a specialist in the states, before you make the decision to move to a foreign country (actually, this should apply even if you're moving across town, or to another town or state), you should discuss the move with your specialist prior to making that decision. Ask them questions about what their recommendation is for your ongoing care. Ask them to make the actual referral for you! You might be surprised at the international contacts good physicians have. Ask them for a copy of your patient records to bring with you to provide to your new physician. Don't worry if they're in English, and you're moving to a place where Spanish is the preferred language. You'd be surprised how many English language Medical Texts are studied in foreign countries, simply because there is not enough market for publishers to pay for translations.
When talking about ongoing health care, the first step is always to choose your primary physician. If you are in the Caja, then let the doc you see at the clinic decide whether or not you need to see a specialist! Then, follow his instructions, and give the system a chance to work. Why complicate your life? If you do not speak adequate Spanish, then for cryin' out loud – LEARN! Or, take someone with you to translate (this is a courteous thing for you to do not just for yourself, but for the clinic staff) when you go to the clinic! And, please, please, please! Stop whining about they don't speak English! That is not their language, and this is – after all - their country! It is upon us to adjust to their ways, not up to them to accommodate our shortcomings.
Now, if you don't like the specialist they send you to see, go back and tell them so. But, remember, if you're part of the Caja, this will do you no good, because there are only so many specialists available to Caja patients, under the best of circumstances. So, once in a while, suck it up! Take it like a man (or woman). If all else fails, go ahead on back to the states, and find somebody there who speaks your language (like a doc from Pakistan, or India), and pay through the nose, if you can afford it.
But, whatever you do, please don't ask me – or any other stranger – to suggest or recommend any kind of specialist for you. I know the big advantage of doing something in this manner (asking strangers to guide your life) may well offer you the opportunity to evade your own responsibility for your actions, but that is just plain stupid. Oh, yeah, "I died because that stranger over there on the forum sent me to the wrong doctor"! Oh, no……I won't be part of that.