Factory Derma-tology

Photo: My carte vitale (for the French healthcare system), photoshopped to remove my number, of course © 2011 Samuel Michael Bell, all rights reserved

One of the great benefits of living in France is the socialized health care system. One of the great headaches of moving to France is the initial application process for it. My story (and, believe me, there is one) is just too exhausting and too long to recount in this post, so suffice it to say that I eventually got what I needed: Couverture Maladie Universelle (“CMU”), complete with my very own French social security number printed on a Carte Vitale. Until the end of November, my CMU was even “complémentaire” because my income was low enough in 2010 to qualify for coverage without any out-of-pocket fees. Vive le socialisme français! You might think that with that kind of coverage, I’d have used my CMU whenever I had a stuffy nose, but I didn’t. In fact, the first time I ever used it was just a few weeks ago, when I needed to get a cavity filled.

That experience can best be described as “factory dentistry“: intake at a big dental clinic without an appointment, lots of waiting, sixteen … count ’em SIXTEEN … bitewing x-rays plus a 360º head scan, followed by quick, no-nonsense filling of that little hole in my molar. After all of that, I walked out without paying for a single thing. I can’t complain about that. So, when I went for a dermatology appointment yesterday evening, I was expecting something similar … but that’s not at all what I got.

My appointment was at 5:30 pm, and I was running late because of a problem in the Métro. I asked Michel to call the office to let them know I was on my way; I didn’t want the dermatologist to pack up and go home before I could get there. Once I got off the Métro, it was relatively easy to find the address. I hurried past several medical offices en route so it seemed I was in the right neighborhood, but once I arrived I started to have doubts.

The office was located on the first floor of a poorly-lit, high-rise apartment building. Now, there’s nothing really out of the ordinary in that. After all, my dentist back in DC had the same kind of office arrangement. What was out of the ordinary was that I couldn’t find the office once I got inside the building. I walked back and forth along the first floor corridor searching for a little plaque with the doctor’s name … something … anything to distinguish her office from the rest of the doors that obviously led to residential apartments. Finally, after a few passes, I located it: the dermatologist’s name scribbled by hand on a tiny sticker (the kind you’d put on the tab of a file folder) just above the doorbell.

“Okay, that’s a little odd,” I thought.

I rang the doorbell and waited. The door opened halfway, and I was greeted by the visage of a short, frizzy-haired woman in a white doctor’s coat peering at me almost suspiciously from inside.

Good evening.

Good evening. I have an appointment at 5:30.

Your name?

Samuel Bell.

Come in.

“Okay, that’s a little odd,” I thought again.

When she opened the door, I caught my first glimpse of the waiting “room.” Frankly, it was more like a waiting “closet” … maybe 72 square feet … already occupied by 2 adults and 2 kids. I made my way over to the corner, sat down in the only available seat, and looked around: four dingy walls and four doors, each (except for the door through which I had come) marked with a hand-written sign denoting what lay behind it. I could hear the doctor with her patient behind the sliding door to the “examination room.” There were at least two more patients ahead of me, it seemed, so this was going to be a long wait, and for what, I was not quite sure.

After about 20 minutes, feeling ill at ease, I started searching for an excuse to leave … and then I found it. In her typical professional manner, the dermatologist had taped a handwritten notice to the wall. Just below the request to turn off our cell phones were the magic words:

Bank cards not accepted. Please pay the exact amount. Cartes Vitales not accepted (only CMU sheets).

“Okay, that’s a just too odd,” I decided.

I had no idea what a CMU sheet was, but as far as I was concerned, any dermatologist who couldn’t swipe my Carte Vitale and wanted payment in cash wouldn’t be curing my acne! I packed up my things and left, shaking my head.

All that’s to say that I’m still looking for the right dermatologist in Paris, preferably one whose office doesn’t evoke some underground medical operation. I won’t even mind if what I get is “factory dermatology” as long as I’m not hanging out in someone’s apartment and paying cash under the kitchen table.

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© 2011 Samuel Michael Bell, all rights reserved