El Subcentro de Cochapamba – A day at the office

So Thursday was an ordinary day at the office for Dra. Sancho.  She saw her patients in her office the entire morning.  And when I say she saw them in her office, I mean she actually saw them in her office.  Every doctor’s office I have seen in the United States has multiple exam rooms and the doctor and nurses rotate around and serve the patients in the exam rooms.  However in Ecuador doctor does not leave her office because her office serves as both an office and an exam room.  

 I can only assume that the patients are seen by the nurse in the nurse’s room first before being sent on to the doctor’s office.  An advantage to this process is that it is more space efficient.  As far as disadvantages to this process, I can’t find many.  It’s hardly more time efficient to have separate exams rooms because ultimately, you will be waiting in the exam room for the doctor to see you.  Sanitary issues will be the same, because you can wash and replace bed sheets just as easy.  Perhaps it’s just the fact that doctors in America don’t want to have people entering their personal office.  But, I think it makes the visit more informal, because it’s like the patients is coming to see the doctor in his or her own personal space.

Regardless of the reason, this is how Dra. Sancho saw her patients, but I am inclined to believe that limited space played a role in why it was all in her office.  Her office was about a 7’x 14’ room jam packed with a desk, short filing cabinet, sink, exam bed, bench, and a few chairs.  It was small and crammed but fully functional.  [See photos]

Anyway, we saw eleven patients in about three hours.  So it wasn’t the busiest of days, but then again a little local clinic such as this one does not have a huge population of people to attend to.  Some of the patients were sick, a couple were pregnant, and others came for normal checkups.  One lady came in and wanted to cut in ‘line’ to see the doctor.  Dra. Sancho didn’t allow it.  We saw the lady later on and she just had complaints of osteroporosis pain in her shoulder and leg.  Dra. Sancho prescribed an analgesic and hot compression.

One thing I learned from Dr. Sancho is to always look at the face while doing abdominal palpations because although the patient may say they have no pain, you can see for yourself if they make any sort of wince when you are applying pressure to a specific region.  I also learned that in Ecuador all the babies are given iron twice a week from the age of four months in order to prevent anemia even if the baby isn’t anemic.  This practice doesn’t seem to be as common to me in the United States.  Perhaps this is because our drinking water already has enough iron content or because our diets contain more iron.