Ian80

Short of it is this: recently arrived in USA for 2 months as part of a short visiting fellowship. Neither the institution I'm visiting, or the fellowship I'm on, provide insurance, so I arranged gap-year travel insurance (more below). Only 2 weeks in to my visit I've started to develop tonsillitis. No clue about US health system, especially in Washington DC. Advice sought...

Long is this: I'm here to do research with a US university. They required that I have insurance, and accepted the travel insurance I arranged in the UK. This is through Endsleigh and is gap-year travel insurance. Endsleigh advised me to take this for the two months I'm here as the 'gap-year' policy covers people like me who are not working here (I have no contract with the university), but nor are they just visiting as tourists. Policy provides what I think is the same as for most tourist coverage, so emergencies involving in-patient treatment, repatriation etc.

This morning I noticed what I think are the early signs of tonsillitis. I've had it before, but not for several years. If it does develop into tonsillitis then it's more than likely I'll need a prescription for penicillin. I'll be flying home in 6 weeks, so this isn't something that can wait. But nor can I see it being classified as an emergency!

I recognize there will be a bill for this. I've hardly had time to acclimatize to the humidity of DC, so know very little about the US medical system. I'd therefore be grateful for any advice about doctors or pharmacists in the Washington DC area, probable costs etc. Many thanks!

Speedwell

First, it could easily be allergy or a summer cold, or even the flu, especially in DC. Don't diagnose yourself over the Internet. If your tonsils are just inflamed, then you can treat it at home unless it gets worse. If there are patches, then you may be prescribed an antibiotic if the infection is bacterial (replace your toothbrush two days after starting the antibiotic).

I think your best bet is to go to one of those walk-in "urgent care clinics" that are set up in many chemists and grocery stores. They can provide a basic examination, and, if necessary, they can refer you to a doctor for further treatment. The urgent care clinic will charge a set rate (79 dollars is typical). You can and should ask how much further treatment and testing will cost, and whether there are cheaper but equally effective alternatives.

notonuksoil

I'd try a walk in clinic at a pharmacy. They usually swab the back of your throat and call you back the next day to confirm what it is. They call tonsillitis here strep throat and if thats what you have they tend to hand out antibiotics like candy - well the Drs around here do! You should be able to get a generic brand antibiotic prescription for about $25-$40.

My F-I-L got sick while visiting us and went to see our regular Dr and was charged $200 for just an appointment when he went to pick up his prescription they said next time just go to the walk in clinic!

Jerseygirl

Tonsilitis is not called strep throat here...nor is it the same illness. Strep throat is caused by the streptococcus bacteria...tonsilitis is inflammation or infection of the tonsils.

notonuksoil

My OH has had quinsy 3 times as an adult which is a complication of tonsillitis, twice in the UK he was admitted into hospital and had to have intravenous antibiotics/ penicillin. They were reluctant to remove his tonsils as an adult as its not as straight forward an operation as it is with a child.

A few years ago he got tonsilitis here in NY and the Dr. was having none of it, insisted after two tests it was strep throat got the usual super strengh American antibiotics - guess what it turned into quinsy again. The Dr and the test lab didn't have a diagnosis for tonsilitis and to this day they insist on calling tonsilitis strep throat.

Jerseygirl

Quinsy is a complication of tonsillitis that is true...but AFAIK it is not strep throat. Complications of strep are much more severe...ie kidney and heart valve damage etc. Perhaps if one of our resident docs (Ozzio) see this they will comment.

MarylandNed

Isn't there a student medical center/clinic at the university? I would try there first.

yellowroom

im a bit further south than you and use Patient First, which is a walk in urgent care clinic. This means they do every thing from GP type queries to more urgent not-quite ER cases. They have labs and pharmacy on site so everything usually gets sorted in one trip.

They are easy to use, you go in, see the receptionist who then usually wants to see ID and your insurance and you fill in a bunch of paperwork about medical history etc. you then get called through and you will be weighed and get your height and blood pressure measured, no matter why you're there. Then you're shown to a cubicle, and you see the doctor. I usually go in the evenings and last time I went for a bad back it took about an hour all in including x-rays.

I see they have some clinics in outer DC, but not in the centre. There must be similar clinics near to you if you google for urgent care or walk in.

Finally (although maybe it should be first), what about the university medical clinic where you are doing your fellowship?

scrubbedexpat091

http://www.webmd.com/oral-health/gui...and-treatments

Tonsillitis appears to be a generic term to reference an infection of some sort of the tonsils.

A common cause is Streptococcus (strep) bacteria. Other common causes include:

Adenoviruses
Influenza virus
Epstein-Barr virus
Parainfluenza viruses
Enteroviruses
Herpes simplex virus


Most citys have affordable walk in clinics, when I was in California last summer, saw a doctor at one for 65 dollars.

Bob

José anyone?

penguinsix

Many of the universities have a "school nurse" or even a health center with doctors (both GWU and Georgetown have full-blown and highly rated hospitals actually). You should see if the school has a "health center" or find an "urgent care clinic" somewhere near by (they are all over the place).

You may have to pay cash for your treatment and then submit the receipts to your insurance company for reimbursement. Not sure how many of the places support billing to your insurance company.

Ian80

Many thanks for all the comments and help. In the UK my GPs always referred to it as tonsillitis, but yes, there are variations out there. Several years ago I went through a phase of having it every 3-4 months, but thought I'd managed to shake it off. I think I can already see the white spots on the tonsils, so looks like I'll need penicillin. I'm pretty sure I'll know in the morning whether it's time to seek help. If so then I'll go to one of the urgent care clinics and take the financial hit (I'm pretty certain my travel insurance will NOT cover what I expect will be a $79 consultation charge), but will ask for a generic brand of penicillin. There are quite a few places nearby, the nearest one being a CVS 'Minute Clinic'. Should I risk it!

Ian80

BTW, the university I'm connected to is not in DC. I'm just based here working on a project connected to the uni. I'd have to travel 200 miles to visit there medical centre. But yes, visiting them would have been my first thought!

RICH

In short, if a sore throat has you calling for medical attention, USA is not for you.

retzie

Be aware that they will probably prescribe other (useless) things. The first time I got bad strep throat here, I was sent away with prescriptions for penicillin, codeine cough syrup*, and some sort of throat lozenge thing "to coat the back of [my] throat" . Needless to say, I only filled the penicillin one. (I get throat infections enough that I normally won't medicate at all unless it's at the 'swallowing razor blades' stage.)

Also, regarding university health clinics: in my experience, they usually do not treat non-students at the student clinic. At my first university, there was a separate wellness center for faculty/staff; at my current one, there is nothing on the main campus for non-students - you'd need to drive miles to the hospital campus.

In other news: for my second bout of strep throat in the US, I was told the swab tested negative and was sent home with nothing at all. I proceeded to recover very slowly, only to receive a phone call from the clinic several days later "just checking in to see how you're going". Riiiiiiiiiight. The in-house lab was notoriously bad and I'm assuming got my sample confused with someone else's. They never did admit it, though.


*This has been highly recommended to me since, btw.