Clinica Esperanza

The clinic set up on the island is pretty sweet. An average of 40 patients are seen a day, for only 70 Limpera per person (about $3.50) which includes their visit as well as any medications they may need that the on-site pharmacy has in stock. It is not uncommon for a diabetic patient with underlying hypertension and depression to walk out of the clinic with over $100 of meds (usually 3 for blood pressure control, two for diabetes control, one antidepressant, and a multivitamin). Then they come back 30 days later when their meds need refilling, thus promoting a once monthly check up. The downside of this system is that sometimes the budget becomes unbalanced and there are not enough medicines to help every patient. This means that I’ve gained lots of experience in how to change medications but stay within the same family. For example, my patient today was on a blood pressure med from the beta blocker family that we are temporarily out of (until the next med order in a month). So instead, I gave her the option of buying it at the pharmacy in town (the patients usually don’t go for this option) or having me change her onto a different medicine at a different dose but still in the beta blocker family and still functions to lower her blood pressure. She ended up going for this option. This isn’t the ideal way to function, technically, but it is better than having no control at all. I really like working in the pharmacy because I get to see exactly what it is I’m using to treat my patients. For example, metformin pills for blood sugar control are seriously large horse pills. I never knew! It used to be easy enough for me to say, yeah, take one of these pills two times a day for your diabetes. Now though, I feel a little more connected to what I’m making my patients go through. I think my favorite pill is 50mg of atenolol for blood pressure because it’s small and bright yellow. It just makes me happy to look at it  That or the light and dark green Cephalexin tablets. Those are neat too. Until next time, your PA turned pharmacist is sending you all my love