It's that time of year again, and I'm dreading it. No, not the holiday season. I'm talking about my annual gynecologist appointment. I am not one of those women who fears the gyno or who is particularly bashful. I've even gotten used to the fact that here they give you no gown or blanket (paper, cloth or otherwise) and I must disrobe behind a little screen and then pad across the room in all my glory so as to be lying completely nude on the table when the doctor comes in. Sometimes the doctor comes in as I'm still streaking across the room, and that doesn't even particularly bother me anymore.
My problem arises at the end of the visit when it's all said and done and I'm sitting fully clothed on the other side of my gynecologist's desk and I've got to do the "[wink, wink] Let's negotiate the price of my pap smear" thing. You see, my gynecologist is private (for a variety of reasons, many people in Italy tend to forego the public health care system for private gynecologists and dentists, which means that you must pay out of pocket). At the end of the visit, I'm supposed to pay her and she's supposed to give me a fiscal receipt as a proof of my payment and as proof to the government that she's paying taxes on her earnings. My problem is that awkward moment whereby the patient is supposed to say something, such as "You know. I really DON'T need a fiscal receipt" and the doctor (happy to not have to pay taxes on the earnings and complete the transaction under the table) is supposed to reply "Well, that's mighty kind of you. I'll give you a discount." OK, I'm bad at these things and I'd rather just do it by the book and not have to go through the whole song-and-dance. But what ends up happening is that my gynecologist tends to put me on the spot with "Do you need a fiscal receipt?" making me the "bad guy" (or am I??) if I say "Yes." The first time I went I didn't know about this whole thing and when she asked me if I needed a receipt I said "No, that's OK." NOT because I wanted a discount but just because this was the person whose gloved hands two minutes before had been, um, examining me. It may sound silly but I felt awkward putting money directly into the doctor's bejeweled (evading taxes has served her well!) hands and I just wanted to get out of there quickly. But then when I got home Cristiano was livid that not only had I not gotten a receipt but the doctor had not given me a discount, meaning she was profiting twice. He marched back there demanding a receipt. Ever since then I've felt really uncomfortable during the whole transaction phase. I really like her as a doctor so it would be silly to change just for that (and then have to go through all of this with some other doctor who will inevitably play the "Do you need a fiscal receipt?" game), but I'm not sure I'll ever get used to this. Where I come from, you talk medical stuff with the doctor and then pay the receptionist on the way out.
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7 comments:
When I went to the dentist last he said to me "if you need a reciept can you come back later" :D Yeah, like I was going to go back hours later to get the reciept.
I remember recently in the news they mentioned that somewhere in Italy, offically dentists earn less than a factory line worker or similar - all for tax evasion, terrible.
The dentists are even shadier than the gynos! And aren't a lot of them not really dentists but dental technicians running dental studios (I know it's illegal but they do it anyway)? Any time I need my dentist, he's on vacation in the Maldives or somewhere! No factory worker salary for him...
Aaargh! I hate this too - round here all the dentists I know have managed to get their children into state nurseries whereas I couldn't get mine in (they base entrance on your salary - the lower it is the more likely you are to get a place). Obviously dentists are really poor then and EFL teachers are rolling in it.....
I'm going to show my basic cable viewing tendencies here (where's that hides behind the couch thingie?), but I saw something on Striscia la Notizia about the fake dentists here. Appalling! I'm lucky that I have a decent public gyno (and I do some work for ASL so they're extra nice sometimes), but I'd be the same as you, Michelle, feeling awkward about the receipt. This is just the type of cultural difference that I don't think I'll ever get used to.
Yes, I too hope that lying, cheating and "furbizia" will never become second nature to me. And it's also unfortunate that not only do these dentists not report their earnings, they benefit from their supposed low income by getting their kids into asilo before others more deserving.
yep.. we have a similar situation with our medico della mutua.. Though all the doctors in Italy were supposed to choose sides a few years back --public or private-- this escaped our physician's notice. So when DH "needed" an ecografia.. well, we just stepped around the corner from the Dr.'s "public" office to his "private" one and he did his ecografia thing.
When DH asked how much he owed.. the doc just said "let's say 50".. and slipped the bill into his top desk drawer. Thanks!.. Bye, bye..
Since we live in such a small town it would be very awkward indeed to change doctors, and he's the only one who provides certain services.
I'm pretty sure that in the US it'd cost a lot more than $65 for a doctor's visit plus 3 ecografie (neck arteries, kidneys, prostate). DH is also usually a stickler for receipts, but you have to choose your battles at times.
here (in sicily) they tell you, it will be x if you want a receipt and Y if you don't. v matter of fact and no shame seems to be involved. obviously the x amount is less than the y, but it doesn't seem to me to be such a difference. Apparently only people with medical insurance want the receipts since they can get reimbursed.
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