Between Appointments and Disregard: The Daily Chaos in the Dominican Health System
Recently, I had to take my younger son to several doctors, including a pediatric neurologist. These visits, which should have been experiences of support and solution-seeking, turned into a painful lesson about what hundreds of parents face every week in our health system. In this text, I share four real moments that reveal different failures of the system: dehumanizing wait times, uncontrolled fees, lack of protocols, and institutional neglect. Different experiences, but all tied together by the same frustration — the feeling that healthcare in our country isn’t always designed with the patient in mind.
In theory, many private practices operate under an appointment-based system, suggesting order, planning, and respect for patients' time. But in practice, when you arrive, you're told patients will be seen on a first-come, first-served basis. This forces entire families—many traveling from distant provinces—to leave their homes in the early hours of the morning just to get a decent spot in line. Some arrive as early as 3:00 a.m. with children who have neurological, motor, or developmental conditions and then have to wait for hours in an overcrowded waiting room.
During our wait for test results, I witnessed a scene that still weighs on me. It was around 10:30 a.m. when a child—accompanied by his father and grandmother—began to lose control. They told us they had left home at 3:00 a.m. The child was hitting himself, screaming, walking in circles. The grandmother tried to hold him; the father tried to calm him. But he couldn't take it anymore.
Other children began crying. Parents became visibly upset. The waiting room descended into chaos.
Out loud, I asked: "Would it be so hard to work with real appointments, like any other professional?"
A murmur of agreement filled the room.
I'm not against charging fees—quite the opposite. I firmly believe every profession deserves fair compensation. I completely understand a specialist charging RD$3,000 to review test results and prescribe treatment, even after charging RD$3,000 for the initial consultation.
What shouldn't be included in the "package" is disorder, endless waiting, and depersonalized treatment. Especially when we're talking about health. And even more so when it comes to children's health.
Health as a Business: Surgery with a Parallel Price Tag
Another alarming reality is what happens when a doctor tells you the surgery is "covered by insurance" but you still need to come up with RD$300,000 more for fees: RD$100,000 for the surgeon, RD$100,000 for the anesthesiologist, and RD$100,000 for the assistant. All of this, without an invoice, without a breakdown, without oversight. A system that should bring relief ends up suffocating you.
And even more so when it comes to children's health.
Health as a Business: Surgery with a Parallel Price Tag
Another alarming reality is what happens when a doctor tells you the surgery is "covered by insurance" but you still need to come up with RD$300,000 more for fees: RD$100,000 for the surgeon, RD$100,000 for the anesthesiologist, and RD$100,000 for the assistant. All of this, without an invoice, without a breakdown, without oversight. A system that should bring relief ends up suffocating you.
Emergencies Without Protocols: My Son's Case
My oldest son is a competitive swimmer. A few weeks ago, he fell off a bicycle and hurt his shoulder. We took him to the emergency room, where we waited for hours. Eventually, they treated him, stitched his chin, and followed a basic protocol for falls, including an X-ray to rule out fractures. On the surface, everything seemed fine.
But weeks later, a physiatrist—thankfully independent from major clinics—diagnosed a labrum tear, a critical structure for shoulder movement. That was when we realized the initial protocol had been incomplete. The physiatrist questioned why his athletic background wasn’t considered and why more specific imaging hadn’t been ordered.
There are no differentiated protocols for athletes, nor any clinical criteria that anticipate injuries beyond the obvious. And in medicine, that lack of foresight comes at a cost: time, money, and unnecessary risk.
Meanwhile, the Public Sector is on Strike... Again
As if all of this weren’t enough, the public health sector is in a constant state of strike. Medical unions call for walkouts with no regard for the people who depend on them. Millions are left without care, without appointments, without medicine. No one takes responsibility. No one offers compensation. No one restructures the system.
Who doesn’t know someone who went to a clinic on a Friday night with chest pain and was sent home because "there's no cardiologist"? Who hasn’t heard of someone who was sent away with a prescription, only to die the next day from a misdiagnosed heart attack? These are no longer isolated stories. They are symptoms of a system in ruins.
What Now?
This is not a text written in anger. It is a call for reflection.
As a lawyer, I understand that every system has rules. As a mother, I know a child’s health can't wait.
As a citizen, I demand the basics: respect, order, ethics, empathy.
This is not about free services or perfect efficiency. It's about dignity.
And sadly, in our Dominican health system, dignity is something you pay for by the turn—if you're lucky enough to get one.