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The Quality of Healthcare in Mexico

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Illustration of a hospital building
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Most expats know that healthcare in Mexico is generally half the cost of similar services in the United States. But is the quality of healthcare in Mexico comparable to the U.S. and Canada?

According to the World Health Organization (WHO), Mexico’s healthcare system ranked sixty-first out of 190 countries it studied. By contrast, Canada ranked thirtieth and the United States thirty-seventh. Average spending on healthcare in the country is about US$1,062 per capita, which is less than the global average of US$1,273.

To better understand healthcare in Mexico, we spoke with a native son from Michoacán who moved to Chicago at the age of 2, graduated from Indiana University with degrees in Biology and Spanish, received his medical degree from the Autonomous University of Guadalajara, practiced medicine in Chicago and then returned to Mexico to open his own medical practice along the shores of Lake Chapala in 2012.

Dr. Santiago Hernandez at Lake Chapala, Mexico
Dr. Santiago Hernandez

Dr. Santiago Hernandez is a successful primary care doctor who attends to nearly 1,000 expat patients in his Chapala Med offices in Chapala and Guadalajara.

“I am the medical director and primary care physician and have a dedicated network of medical specialists in my referral network,“ Dr. Hernandez said. “Most of them are board certified in the United States. For example, the ear, nose and throat (ENT) physician was trained at Harvard and the neurosurgeon has had fellowships at the University of Washington.”

Dr. Hernandez said one of the healthcare differences between the U.S. and Mexico is that primary care doctor referrals are not necessary in Mexico, although he has adopted the U.S. practice of vetting specialists and including them in his referral network.

“In Mexico,” he said, “you can find your own healthcare specialist without a referral from your primary doctor. You can also get testing done on your own. If you woke up with a headache and felt you needed an MRI, you could get one without a doctor’s order. That can be a very expensive way to manage your healthcare. At Chapala Med we follow the same standards of care and diagnostic and treatment steps as the U.S. About 90 percent of my patients are expats, primarily from the U.S. and Canada.”

Image credit: Jkraft5 | Fotolia
Image credit: Jkraft5 | Fotolia

Dr. Hernandez told us many expat come to Mexico from smaller communities and often use colloquialisms that are not in any textbook, which can make it difficult for those doctors not fluent in English or grounded in American culture to understand. He views his roots in America and fluency in English as a significant added value for his patients.

“There is a large percentage of expats in Mexico who do not speak Spanish or have limited Spanish skills and find it difficult to communicate their healthcare needs,” he said. “They also feel somewhat lost in the healthcare system in Mexico and are looking for guidance, and that is what we do. We guide them through the healthcare system to get the best possible outcomes for them.”

We asked Dr. Hernandez if the level of healthcare in the rest of the country is comparable to the Guadalajara-Lake Chapala area.

“Like the United States, the quality of healthcare services vary,” he said. “If you live in more rural areas, higher quality care can be more difficult. But healthcare access in Mexico tends to be better than the U.S. Mexico’s public healthcare system – which includes IMSS and Seguro Popular – is widespread and inexpensive but the sheer volume of patients and sometimes antiquated equipment delivers poorer results.”

Instituto Mexicano de Seguro Social (IMSS) provides both Mexican citizens and expats legally residing in Mexico with medical insurance and healthcare services. Nearly two-thirds of the country is enrolled in the IMSS healthcare program. The service provides complete coverage, including prescriptions, but facilities are often overcrowded.

Seguro Popular is a public health insurance that covers a wide range of services without co-pays for its affiliates. The government of Mexico established it in an effort to expand healthcare to those without health insurance and reduce health inequities.

Image credit: Ryan McVay | Thinkstock

The best-equipped hospitals in Mexico tend to be in major cities. Dr. Hernandez pointed out San Javier and Puerta de Hierro, two private hospitals in Guadalajara, as examples of medical facilities that have the same amenities and technology that a university hospital would have in the U.S. Some of the larger IMSS hospitals – Centro Medico (civil hospital) – often have the same modern technology. But access to the technology can be painfully slow because of overcrowding at the public institution.

Becoming a physician in Mexico is as rigorous as the U.S., Canada or other developed countries, requiring four years of medical school, a year of internship at a hospital and a year of public service serving as a small town doctor. After passing national medical exams, physicians are granted their medical license.

The qualifications to become a nurse are not comparable to the U.S. A nursing degree in Mexico is considered more of a technical or vocational degree and requires completion of just a two-year program. The overall quality of nursing care in the country generally is very good, according to Dr. Hernandez.

Medical procedures also can sometimes differ from the U.S. Dr. Hernandez believes that often more novel and experimental procedures are used in Mexico.

“We tend to experiment more often with the European school of thought in mind,” he said. “As an example, when a patient is having a heart attack they go into the catheter lab and historically we have put guide wires and stents through one of the vessels in the lower leg to reach the heart. Here, I noticed doctors using the radial artery in the hand, not the lower leg. It is a European procedure that has not yet been widely adopted in the U.S. because of training costs and equipment.”

For emergencies, some expats carry health insurance that pays for an air evacuation to a U.S. hospital. Dr. Hernandez does not believe that is necessary.

“We can handle just about everything locally,” he said. “In fact, in can be problematic in evacuating someone to the U.S. The patient must be very stable and it is very expensive.”

Some retirees on a limited budget return to the U.S for expensive procedures that are covered under Medicare, if they do not carry adequate health insurance in Mexico. Medicare does not cover the cost of healthcare in Mexico, although expat organizations have been trying to persuade the U.S. government to do so for years.

“I had a patient who had severe cardiac problems,” Dr. Hernandez said. “Rather than take care of his problem here, he decided to jump on a plane and fly to a Veterans Administration hospital in Oklahoma because he was living on a limited income. He could not afford health insurance in Mexico, so the overall expense of the procedure was too much for him. It could have been done locally, but the VA was a lower cost solution for him.”

One of the significant differences between U.S. and Mexico healthcare services is cost. Generally, healthcare services are at least 50 percent lower than north of the border.

“I am one of the most expensive doctors in the area,” Dr. Hernandez said, “but my initial visit is still just US$65. The first visit is one hour and it includes a complete medical history workup. Subsequent visits are just US$45. I also maintain electronic medical records for the patient, which is unusual in Mexico. Most doctors require their patients to keep their own medical records.”

If you are looking for the very least expensive medical care, look no further than your local pharmacy. Most provide a doctor in residence at the pharmacy for about US$3. Doctors at pharmacies, though, make a commission on the medications they prescribe for you.

Dr. Hernandez said Mexico is trying to place more medications under government control, much like the Federal Drug Administration does in the U.S. But for now, only sedatives, hypnotics, opioids and pain medications require a prescription from your doctor. If you are looking for erectile dysfunction, hypertension, diabetes and other similar medications, you just have to ask for it.

Image credit: Monkeybusinessimages | Thinkstock

After four years of building his practice, Dr. Hernandez has good advice for expats in Mexico who are seeking the very best health care.

“Look for someone who will spend time getting to know you and who you can trust to guide you through the healthcare system,” he said. “When you find that person, you can benefit from Mexico’s healthcare system and live a very long and prosperous life.”

20 COMMENTS

  1. Hello,
    I have been living in mexico now for 25 yrs and have worked as a medical tourism translater for many of those years.
    Although i agree with some of your article , most i disagree with.
    The medical system in mexico is far better to that of the USA.
    I also woild like to mention that a doc. Tbat is charging 65 usd for a check up is way over the standard charge.
    In most larger cities they run between 25 to 30 usd for a general doc and between 50- 100 usd for a specialist.
    Anyways i would love to dicuss more at any time.

    • Hi, Roxanne and thanks for commenting. Not sure what you are disagreeing with, other than your comment that the healthcare system in Mexico is better than the U.S. And, I believe Dr. Hernandez mentioned that his rate is higher than most. We’ll have another article on healthcare in Mexico coming up in November. Look for it and let us know what you think.

    • Patricia,

      As a professional who has invested well over $250,000 USD and +20 years of higher education in his career as well as continuing medical education, the honoraries I set for my time are very accessible. I (as well as many colleagues) do offer income-based discounts.

      I think that a doctor who offers you care in another country with no language or cultural barriers is invaluable. In the U.S. there are medical interpreters who help patients whose primary language is not English. Unfortunately, here in Mexico that is not the case. But the good news is that there are a growing number of healthcare providers whose English proficiency is excellent.

      I do make it public knowledge that I see patients for free at the TEPEHUA COMMUNITY CLINIC – http://www.tepehua.org. For those who chose me as their doctor, financial constraints are never a barrier when it comes to me providing care to them.

  2. We have called and emailed chapala med. Apparently the practice is so busy, they do not return calls or emails. You could do everyone a service and list other professionals in your articles.

    • Hello,

      I apologize for the difficulty in getting in contact with me. Due to construction and the heavy rains in the area lately, our phone lines have been down.

      These are our numbers that HAVE BEEN WORKING:

      OFFICE – (376)765 – 6399
      URGENT – (331)605 – 9645
      U.S. – (312)912 – 9087

      You can also email me at : chapalamed@gmail.com

      Kind regards,

      Santiago Hernandez M.D.

  3. Thanks for your comment, EAK. If you have a list of doctors in the Chapala-area that you think are great, please send and we will include in our Lake Chapala profile under Cities.

  4. I too live in Mexico and believe me Mexican Emergency rooms are dysfunctional. On May 5th I entered the Hospital General Emergency room in Ensenada with severe pneumonia. I begged and begged for medical help for 2 hours IN PERFECT SPANISH but they just ignored me. So I left and went to a pharmacy doctor who put me on prescriptions which helped a lot, but she didn’t cure it. So exactly a week later I went back to the Emergency room and had to really act out until they decided to see me. Once inside the diagnosis and treatment were excellent. I’m got heart failure, so pneumonia can lead to death. After 21 days on levofloxin and inhalers and injections, my pneumonia was cured. The Ensenada Hospital General Emergency room has very few doctors and even fewer BEDS. BEWARE!
    P.S. All antibiotics here require prescriptions, which makes sense. Thanks!

    • Even though “pneumonia can lead to death” you were not an emergent case and should have gone to a clinic in the first place instead of to emergency. And when you finally did, you chose to follow up with emergency instead of the clinic doctor who treated you. WTF? You and others like you, are the reason emergency departments are “dysfunctional”. Stop using them like the local clinic and there will be more resources available for those that really need them. I worked in a Canadian hospital for 10 years and have seen millions spent on emergency department capacity upgrades that would never be necessary if people would stop treating them like a walk-in clinic.

    • EN, the quality of care in emergency rooms in Mexico will vary widely. I’ve had two occasions to seek care in hospital emergency rooms, and it was quick, inexpensive, competent in a high-tech environment. So…depends on where you go. My visits were at Star Medica in Morelia. Sounds like you went to a government facility.

  5. We Moved to the state of Colima from the West Coast of Canada 11 years ago as we wished to retire to a good quality of life and one of the things we were very pleased with was the quality of health care compared to Canada. With waits of 3 years or more to see specialists and long hours of waiting for care in emergency rooms and the cost continually going up for monthly premiums and drugs. Mexico is refreshing in short waits for specialists, emegency visits and we have a great IMSS doctor we see monthly.

    • We are thinking to move to Ajijic. Do you pay a monthly premium for IMSS. Although we have used walk in clinics in Mexico that are extremely good and not expensive, we would like to have some assurance that should something serious happen it would not cost many thousands If you are able to pay a premium, how much does it usually cost. . Any info would be greatly appreciated.
      Thanks Judy

  6. If one can afford the hospitals they often are equal or better than USA top notch facilities. We use the CIMA Hospital in Hermosillo and have never been disappointed. Knowledgeable Physicians who care! All of he latest equipment. I am told their Cath Lab is the best in Latin America. However going to an IMSS facility is akin to visiting a 3rd world facility. Dirty, crowded and totally uncaring. Public Health at it’s worst.

  7. i have lived here 15 years and had great health care. a couple of operations at imss and cataracts done at a privite hospital. my heart doctor here is friends with my heart doctor back in the states.

  8. I went to Dr. Hernandez also, recently, and my experience was horrific financially. I had seen him at the beginning of the month to establish a relationship with him. Three weeks later I had an episode of a combination of food poisoning and dehydration. He sent in a nurse to my home, who was excellent, to hydrate me and keep a watch over me. After about four hours or so I was fine. I saw him a day or two later for a check up on how I was doing. Because of what appeared as a major weight loss and a sore stomach he sent me to Guadalajara from his Chapia office for an immediate Cat-scan at the best and most expensive facility in the city. He show up just before I went into the scan so he could have immediate results. I did not have cancer, or anything else other than what I already knew I had. As it turned out I did not have the big weight loss, the inaccurate reading was because his scales batteries were too low and new batteries show my correct weight, which was the same as when I first went to see him. So the total cost of two office visits, 2nd and 3rd visits, were 800 pesos each = 1600 pesos, Cat-scan of just under 6,000 pesos, car gas of about 600 pesos really hurt my below US poverty level social security and significantly diminished a very minor savings for emergencies. On my original visit I asked for a referral to a good rhumetologist who could help me understand progress of my advancing Ankylosing Spondylitis and help me with pain relief. I have never gotten the referral. I am left confused and broke. In my many years of living off and on in Mexico has been really good medical care, this is the first time I have ever gone through such an experience. I was surprised that he wanted an additional charge of 800 pesos for the visit to give the full Cat-scan report and where we established the reason for what appeared as such a weight loss. Since then I have been warned that there are doctors who speak both languages fluently who are know to fleece ex-pats they think have money. I told the doctor I was only receiving poverty level social security and did not have a lot of money. I was recently new in the area and was in the process of getting the national health insurance. I don’t really know what to think at this point.

    • Patricia,

      As a professional who has invested well over $250,000 USD and +20 years of higher education in his career as well as continuing medical education, the honoraries I set for my time are very accessible. I (as well as many colleagues) do offer income-based discounts. In addition to the office visits, I spent another 3 hours of my time on your case as well as other resources that were invested in your case. I don’t think that this forum is the place to argue the specifics of your case. I am very comfortable with the manner it was handled and I followed the STANDARDS OF CARE according to the AAFP(American Academy of Family Physicians) and ABIM(American Board of Internal Medicine).

      In regards to your referral, I think that we can discuss this and your Ankylosing Spondylitis and the natural progression of this disease further in my office.

      I assure you that the $1600 pesos (which amounts today to approx $80 USD) for 5 hours or my time will not make me any richer. It may only pay for the gas in my for for 1 week for my daily commute from Guadalajara.

      I do make it public knowledge that I see patients for free at the TEPEHUA COMMUNITY CLINIC – http://www.tepehua.org. For those who chose me as their doctor, financial constraints are never a barrier when it comes to me providing care to them.

  9. I’ll take Mexican healthcare any day over US.
    Case in point…fractured my ankle, wife drives me to H+, a private hospital in San Miguel de Allende.
    Was barely out of our vehicle before a hospital attendant was there with a wheelchair.
    Rolled me right into examination table in the ER.
    Was seen by a doctor within 2 min.
    Had an X-ray within 10 min.
    Long story short…had X-Ray, was examined by attending physician (who just happened to be an orthopedic doctor/surgeon), analysis by the radiologists, a fiberglass cast was put on my ankle/foot, (no surgery needed), gave me pain meds, and pain med prescription, filled Rx a the hospital pharmacy.
    Was in and out within one hour.
    Total cost for all the above…about $315 USD.

  10. We live north of Puerto Vallarta and use a dermatologist named Patricia Garcia at AmeriMed Hospetal. She is the best I have ever used and a joy to see and talk to. Her office charge is 500 pesos and often treats my wife at the same time for the same charge. She is the best!

  11. This is a difficult situation upon which to comment. Considering that a crisis triggered the need for further investigation. There is no excuse for bad batteries in a scale that is used daily to weigh patients. Everyone makes a mistake and regular scheduled battery changes can avoid errors in this area. I clearly understand Dr. Hernandez’s reaction in pursuing a cancer diagnosis with further studies, such as lab and CT scanning. Cancer is all too common in the population treated here at lakeside. One in three people are diagnosed with cancer at some time or another.

    As far as cost goes, for someone living at or below the poverty level in the US, any expenditure seems to be too much. Negotiating a reduced price based on a financial interview is possible with Dr. Hernandez. Consider that The actual price for care, even Santiago’s fees are actually 1/2 of those in the US. Often doctors around here live at below the US poverty line. I know physicians who earn only $11,000 to 15,000 pesos a month. This is not a professional wage. A doctor earning this low income is not inclined to do continuing education and stay on top of current thought in medicine. The doctor that charges $300 pesos is now earning around $16.00 USD a visit. To earn enough to near a professional wage, she would need to see many more patients which lowers the quality of care. $6000.00 pesos (now around $350.00 USD) for a CT scan is a steal. A CT in the USA would cost $1,500 USD on a good day. A well paid good doctor here makes about 1/3 the income as he would in the US. Luckily it is less expensive to live here for the doctor as well as the patient. I know that Dr. Hernandez keeps up with his continuing education. I know that he would rather err on the side of caution.

    Consider this: The real cost in US dollars of the patient above would be no more than $800.00 here. Think now about how much would be spent on similar care in the USA. I know too many patients with whom Dr. Santiago, in his maybe over cautious manner have been diagnosed with cancer with his help. I have also seen patients with a history of cancer, become irate when due to some symptoms or findings, be told by the doctor that it must be ruled out at the present. Consider this: the greatest cause of malpractice suits in the USA is “failure to diagnose”. Consider the stress on a doctor whose patients are mostly senior citizens, with the highest incidence of cancer and other degenerative diseases.

  12. Greetings On the subject if medical care in Mexico, Let me state that I love the care and attention I and my family receive from the wonderful doctors here in Merida Yucatan. I true do place most of the above any in the USA. Of course you will have to wade thru a few ( I do mean only a few ) that are not so caring BUT the end results of the care you can receive here in the Yucatan is fantastic at a cost that is pleasingly good.

    • William Darvelle, me and my wife are planning on moving to Chuburna in the next few months. As you probably know, it is 45 minutes away from Merida. Would you be able to give me a list of the physicians and/or hospitals, clinics that you would recommend? Also, I am turning 65 this year and am wondering what to do about Medicare. Keep it? Get a supplemental plan? Of forget the whole thing? Any and all advice appreciated!!

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