Since February of this year, the Nosara EBAIS clinic hasn’t had set hours or regular staff members to serve the Nosara population. The clinic’s general practitioner has been on disability since 2020 and her substitute resigned at the beginning of February, confirmed the head of the Nicoya Health Area, Luis Carlos Villalobos.
At this time, the clinic is working depending on the availability of substitute medical personnel registered with the Costa Rican Social Security Fund (CCSS).
According to Villalobos, none of them have remained in the position for more than a week, alleging reasons such as distance, costs or offers of other positions in health centers closer to the municipal seats of the province’s cantons.
A general practitioner is a doctor who maintains a full-time position with the CCSS, such as the main doctor of a regional health center. The substitute is someone who works for professional services and covers disability leaves or vacations for general practitioners.
Those who do agree to go to Nosara propose specific, reduced schedules because they can’t travel daily to that coastal town, said Villalobos. This instability creates uncertainty about whether the clinic will be open each day and whether patients will receive care within a suitable time frame.
At the beginning of February, the health area transferred other doctors from clinics near Nosara, but they abandoned that measure because the waiting lists also began to increase in other areas.
“It was like taking the clothes off of one saint to put them on another. It wasn’t a real solution,” Villalobos said.
The Nicoya Health Area made a request to CCSS for a second position for another full-time doctor in Nosara, not only because of the current problem in the clinic but also because the number of people who are insured in the town is increasing more and more.
This request is being processed at CCSS’s central offices, Villalobos said. The Voice consulted the CCSS press office about the Nosara clinic’s situation. As of the deadline for this article, the institution hadn’t replied.
We know that it’s not fair for any patient to get there one day and realize that the center is closed. That’s why we’re working to find a substitute who stays permanently in the clinic,” said Villalobos, who also specified that the general practitioner who is on disability leave still doesn’t have a date to return.
Although the health area hired a new substitute doctor this week to work at the clinic until the end of March, Villalobos said that he can’t guarantee that he won’t leave the post beforehand, which has already happened with other substitutes.
“At any point in time, a circumstance can arise and suddenly there’s no substitute who can help us,” he added.
Long Wait Lists
The problem caused a backlog of medical appointments in the district, so clinic officials suggest that the community’s residents go to get medical attention in the medical centers in Nicoya, 60 kilometers (about 37 miles) from the town. Several residents reported this to The Voice.
One of them is Xiugeidy Peña, from Nosara, who went to the clinic a month ago to request care for her mother, who suffers from hypertension and diabetes. According to her, the doctor at that time told her that she’d have to travel to the central district to get the necessary medication since there wasn’t room on the waiting list.
Another community resident, Jo McKenzie, went to the health center twice and wasn’t able to get care either time. The first time, she recounted, she went for an emergency mid-morning but found the clinic closed. On that occasion, the guard recommended that they visit the hospital in Nicoya.
A week later, she and her husband went to request an appointment for general check-ups and the doctor told her that they weren’t doing that type of consultation. On both occasions, McKenzie had to pay for private medical care, despite being insured with CCSS.
Villalobos stated that they are aware of the backlog and that some doctors are suggesting that patients go to Nicoya. He hopes that with the newly appointed substitute doctor, the situation will become more normal little by little until another professional is appointed in a permanent position.