Today was a very exciting day, as we were touring the first two hospitals of the trip! We started the morning off with a lecture from doctor Josefina Medrano, the former provincial minister of health for Salta, a province at the northern tip of Argentina. She gave us insight into the challenges of managing a healthcare system for a province where many communities are extremely isolated and difficult to reach. To be able to provide care to these remote places, doctors, nurses, and other trained medical professionals would travel on a regular schedule to permanent clinics (that are normally empty) in the areas they need to access. Once they arrived, locals could come and receive basic medical care. Some of these areas require horseback or motorbike to access, so it is a large challenge to provide care outside of the main cities. Another insight from Dr. Medrano I thought was really interesting was the interaction of gender on her work. In a more misogynistic (or machismo) province such as Salta, she faced a lot of additional pressures from her co-workers and citizens. Overall I really enjoyed this lecture and the information she had about the difficulties of running the public sector in a province.

Our next stop was Hospital Juan A Fernandez, one of the largest and most well known public (meaning accessible to anyone free of cost) hospitals in Buenos Aires. We met with the former medical director and discussed the organization and history of the hospital. It was first created as a syphilis treatment center, and over time was transitioned into the general hospital it is today. The hospital is equipped with 400 beds and almost any department you could think of (ED, obstetrics, surgery, diagnostic, internal medicine, imaging, and more). Walking into the hospital was definitely very different from any hospital in the US. The building was showing its age, but as we began to walk through and look at some of the different wards, it was clear that what made the hospital special was the people working there, not the building or equipment. Every floor was well staffed with physicians and nurses who were all very knowledgeable. We were able to see the ICU and dialysis center, and both floors, despite their humble appearances, were fully equipped with all the equipment you could need. Hemodialysis and peritoneal dialysis machines, ventilators, BIPAP machines, and more were in no shortage. Despite its unassuming appearances, Fernandez Hospital was more than capable for caring for its patients.

After a quick detour for lunch, we next headed to Sanatorio de los Arcos, a private hospital run by Swiss Medical Group. Before we even went through the doors, it was clear that this facility was more modern than the public hospital. We spoke with the medical director about the challenges of running a private hospital and how it is funded. In this particular case, there is an interesting interaction between Swiss Medical Group’s insurance company and hospitals. While they are under the same parent company, they still exchange money as if they were separate entities. Beyond the business aspect of the hospital, we learned that private insurance and providers function very similarly to the US. Members make pay a monthly premium to access the proprietary physicians and facilities, and the hospitals and doctors will bill the insurance company if any care is provided. Interestingly, there is no deductible or copayment, so there can be overuse of the system as there is no financial incentive to not seek out care. We were able to visit an empty room, and it was nicer than most US hospitals! Not only was there a room for the patient with a pull-out couch for family, there was also a large bathroom with a shower and a separate living area. This was probably one of the largest differences between the public and private hospital. Where in the public hospital, some patients were in the hallways on beds, at Sanatorio de los Arcos, every patient had a whole suite. I had so much fun today visiting these two hospitals, and I can’t wait to see more of the healthcare system as our time here continues!