Medical Treatment While Traveling

I've been struggling with a persistent case of plantar fasciitis for quite a while now. Before we left for Vienna in early September, I'd been getting treatment (unsuccessfully) but still had several treatment options that I just hadn't gotten to yet. My podiatrist in Florida set me up with custom orthotic shoe inserts a few days before we left and I had a follow up appointment scheduled for right after we came back to Florida (last week).

Well, after 2 weeks or so of the custom orthotics, I wasn't seeing any improvement (FWIW, I had tried semi-custom already a few months ago and saw a big improvement, just not cured). I didn't want to wait 5 more weeks before taking the next step, so I found a podiatrist in Vienna. Over the next several weeks, he did a series of shockwave treatments, sent me to a physical therapist, prescribed low dose radiation treatment, and referred me for an MRI.

Admit it. You’ve always wanted to see the inside of my foot.

Eventually, I plan to discuss how we deal with health insurance while traveling inside the US as well as when we're out of the country. But today I'm not getting into that. Suffice to say that, for all practical purposes, when we are out of the country we are self-pay, private patients. Of course, for all practical purposes, I'm self-pay even in the US because of how high my deductible is, as well. But at least my insurance gets me a negotiated discount so I'm not paying list rates.

But in Austria, being self-pay meant that I had no negotiating leverage, except that I could see any provider I wanted. This experience was definitely interesting. For instance, when I was looking for providers, I found that it was more common (though definitely not universal) for the providers to publish their rates on their websites. I find this to be rare to non-existent in the US.

The cost of my doctor visits were probably pretty comparable to in the US. It's hard for me to compare exactly since I don't have any concrete pricing for the shockwave treatment. I paid about $310 for a series of three shockwave treatments in Vienna. My doctor in Florida had said that his office would charge about “$300-400.”

My physical therapy was also pretty comparable to the US. It worked out to about $90 for a 45 minute one-on-one session. The physical therapist I'd used in Florida had charged $65 but would bounce between me and one or two other patients at the same time.

I have no idea what three low dose radiation treatments would cost in the US, but it cost me a total of $95 in Vienna. The MRI was the big savings. It cost me only $220, compared to a “fair price” in the US of $595 quoted by the Healthcare Blue Book. Overall, I think that most costs were a wash but the MRI probably saved me almost $400.

The flip side though is that, when I called to schedule my MRI, the wait time was so long that the next appointment wasn't until after I was to leave Vienna. Fortunately a cancelation allowed me to squeeze in my MRI in just two weeks, while I was still in Vienna. The radiation facility got me right in a few days after I called for an appointment. The podiatrist and physical therapist were both booked about a week out, which seemed pretty comparable to my experiences in the US.

Language wasn't much of a problem for me. I do speak a decent amount of German, and I did have to rely on it with the reception staff sometimes. However, all of the providers themselves spoke very good English. If I didn't speak any German, getting appointments scheduled definitely would have been challenging, but I think do-able.

Overall, I'm very happy that I didn't wait until I got back to the US to continue treatment. I'm now starting to see some significant improvement! Getting treatment in Vienna wasn't very difficult, it avoided a delay in treatment, and probably saved me about $400. Overall, I'd call that a win. Indeed, for non-urgent medical treatment, I'm seriously thinking that I may avoid getting treatment in the US whenever possible. I fully expect that in developing countries there will be many opportunities to see quality doctors at much lower prices, with no hassle dealing with insurance.