Guide to Pediatrics & Pediatricians in the Cayman Islands
We are a team of three pediatricians in the Cayman Islands, and like all private pediatricians in the Cayman Islands, we all moved here from other countries. The system here is different to most and so we thought a brief guide might be helpful.
Understanding Paediatrician versus Pediatricians in the Cayman Islands
Let’s start with something very straight forward. Our team comes from the United Kingdom (Dr Sara Watkin and Dr Jasmina Marinova) and New Zealand (Dr Sarah Newton). One of the first things we had to all do was get used to both terms being used – pediatrician being the US spelling and paediatrician being the UK spelling. We are a British Overseas Territory but our priximity to the US means you’ll see both used interchangeably.
Most importantly, there’s no difference and the system here is unique, neither UK nor US. If you are an expat, it is probably a little closer to the US system. We will explain.
Understanding the System
The system here is in two halves, with some overlap. Many Caymanians have pediatric services provided through Cayman Islands National Insurance Company and its main provider, the Health Services Authority (HSA) that runs the main local hospital, called Cayman Islands Hospital (or frequently just called George Town Hospital), in George Town.
However, if you are here on a work permit i.e. expat, then you are required to maintain private health insurance and generally your care will be provided by one of the many private practices here in Grand Cayman. However, life is not that clear cut because we are a 22-mile island, with a current population estimated to be around 71,000, split roughly evenly between local and expat, and we cannot run lots of duplication. Let’s expand…
Private Pediatricians in the Cayman Islands
Here’s our team. We are based out of Grand Pavilion on West Bay Road, in the heart of the Seven Mile Beach area. Our pediatric practice sits within a multispecialty practice covering family medicine, obstetrics & gynaecology and dermatology. Besides straight pediatrics, we are privileged to also have a pediatric-trained dermatologist and a gynecologist with a special interest in child & adolescent gynecology. That makes us extremely comprehensive compared to what’s more common.
The private system for pediatrics is predominantly made up of practices that have a single pediatrician, either on their own entirely, or with other adult doctors. Obviously that presents its own challenges when it comes to holidays and illness (yes, even doctors suffer illness) but it is also a function of being on a small island. We are obviosuly unique in the level of cross-cover that we have and that’s a decision we took to ensure that our patients also had continuity of care.
Pediatrics is not one thing. Let’s look at the types.
This is pretty much always provided out of the private clinics, such as ours at Grand Pavilion. They are all very different and it is worth visiting. We have a dedicated pediatric section, with play area and breastfeeding facilities, as well as pediatric nurses.
There are many things to consider when choosing pediatricians in the Cayman Islands and you are going to have a long relationship with them, so it is a good idea to do your research to find the right one for you. Find our about their credentials, training and experience. For instance, Dr Sara Watkin and Dr Jasmina Marinova worked for many years as consultants in the UK, so if that is important to you then it’s worth visiting us.
A key consideration is that many children have more complex needs over time. Do make sure that the practice you choose has the breadth of capability of access to the advice that may be necessary.
Urgent & Emergency Care
We operate an out-of-hours number for pediatrics but that is relatively unique. Emergency care generally means presenting yourself to George Town Hospital Emergency Department. They will handle immediate care and asssessment but if your child needs admitting to the pediatric ward, they’ll call the private pediatricians in the Cayman Islands. All 3 of our team have admitting rights to the hospital pediatric ward.
Our team will often admit directly onto the pediatric ward if problems are identified in clinic or through our out-of-hours service.
There are urgent care facilities on island too. However, one of these doesn’t have a pediatrician and the other tends to use GPs and only call in a pediatrician for more complex things when treating out of hours.
Newborn & Neonatal Care
The majority of private deliveries in the Cayman Islands have a private pediatrician in attendance. It’s mandatory for a caesarean section and optional for a regular delivery. Deliveries take place at George Town Hospital (the majority) and also at CTMH Doctors Hospital, a small private hospital. Only George Town Hospital has a Neonatal Intensive Care Unit (NICU) in case of complications and so that is a consideration for many when choosing where to have their baby.
Different pediatricians have different admitting rights to these locations. Some have both, some don’t have rights to NICU etc and it is important to check. In our team, all 3 attend deliveries at both locations and all 3 have admitting rights to the NICU (in fact, Dr Sara Watkin was Chief of Service of the world-renowned NICU in University College London Hospitals and so provides neonatal intensive care for both private and the more preterm or complex HSA babies too, which just illustrates the overlap).
How to Access Private Pediatricians in the Cayman Islands
If you come from the United Kingdom, you’ll be used to access all specialist care through your GP, and your GP will probably handle many things to do with children too. It’s different here.
Almost all pediatrics, especially in the age range say 0 – 10 years, is handled directly by pediatricians in the Cayman Islands, rather than a GP. You do not need to go through a GP and simple need to register with a practice. Typically, parents will find the right practice and stay with them for all services that they provide (a compelling reason to make sure they provide the right services). Other considerations are:
- Do they take your private insurance? (we accept all insurers providers, for instance)
- Do they charge standard fees? (see below, but we do for virtually all services)
Whether it is for a delivery, general paediatrics or urgent care, you are perfectly at liberty to choose any pediatrician that suits you and your child’s needs or preferences, and you are under absolutely no obligation to say choose the pediatrician that works in the same practice as your obstetrician. You may also change, without restriction or penalty too.
Guide to Charges by Pediatricians in the Cayman Islands
Care charges are managed in a system that is very similar to the US one. It uses disease codes and procedure codes for each item of service. The charges against those CPT codes are set by Cayman Islands Government and are called the Standard Health Insurance Fee schedule or SHIF. A practice can charge more than the SHIF but your insurance company will only pay up to the SHIF rate.
Each insurance is different – some have a co-pay element and some cover 100%. Almost all practices have terms and conditions that require you to agree to cover any charges not covered by your insurer. It is standard and not something to worry about. You can worry less the better your insurance, of course.
However, it is important to ensure you choose a practice with an attitude to tests, prescriptions and procedures that sits comfortably with your ability to pay and also to enquire whether they charge SHIF or SHIF plus extra. For instance, we have a practice policy to do what is necessary and not order every test under the sun. We also charge SHIF rates for everything except for a few tests that actually cost us more than SHIF reimburses and for delivery, in common with pretty much all private pediatricians in the Cayman Islands, simply because the rates do not cover the costs of the service. However, that’s it. Everything else is at SHIF rates and we have an explicit policy of informing you before doing something outside of that.
Choosing a Paediatrician in Grand Cayman
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