meet a medical professional Meet a Medical Professional - Teofilo Gozaine, MD, ENT

[Doug and Jo]

Meet a Medical Professional-- Teofilo Gozaine, MD, ENT

(by Jo Johnson)

The first time I met Dr. Teofilo Gozaine, I knew I wanted to find out more about him.  I think our readers will find him to be extremely qualified, competent, accessible, and handsome (a quality that never hurts!)

 

Dr. Gozaine was born in David, Panama.  When he was a youngster, his father was the Senator representing Chiriqui, and today his brother is the current Senator representing David.  His parents still live in David, as well as his two brothers. The Gozaine family is involved in several business enterprises.  They are the producers of Rum Carta Vieja in Chiriqui.  They also sell real estate, mostly in the Paso Canoas area, near Costa Rica. Besides his primary residence he maintains in David, Dr. Gozaine has land in the Boquete area, where he produces tomatoes and peppers and sells to the local markets.  He and his three sons spend a lot of time in Boquete, as they do have a second home in the Volcancito area.

Dr. Gozaine attended High School at Colegio Nuestra Senora de los Angeles in David.  Following graduation, and seeking to become a physician, he moved to the United States to continue his education. He enrolled for a semester at Georgetown University in Washington, D.C., which required vastly improving his English skills in a short time (up until this time he had had very little English language training).  With three months of practice of speaking English, he then transferred to Creighton University in Omaha, Nebraska.  He says that the first semester at Creighton he still struggled a bit with the language, but after that it was not a problem.  (The interviewer wishes she had that ability to learn a new language in six months!)  He majored in Chemistry as an undergraduate student, and later applied and was accepted into the highly-acclaimed Medical School at the same university for his medical school training.  This is a huge honor as they only admit their brightest students from the undergraduate program. 

Deciding that he wanted to do his residency in Otolaryngology, (Ears, Nose, Throat) he applied and was accepted at the University of Oklahoma, in Oklahoma City.  The residency is an additional five years.  Upon completing all the requirements and passing his medical boards, he decided to set up his private practice in Leesville, Louisiana, which is very close to the Fort Polk army base and not far from Beaumont, Texas.   He had privileges with three hospitals in the area. 

Two years ago, after 11 years of a solo practice, Dr. Gozaine felt the desire to return to Panama to be close to his family and to offer his services in an area of great need.  He first set up a practice in David, where he currently is working out of Dr. Villareal's office in the Chiriqui Hospital, 2nd floor.  He hopes to move to his own office in the lobby level of the new tower being built at hospital Chiriqui.  He also sees patients at Alfa clinic, usually on Thursdays, if he has appointments scheduled.  He can be reached for an appointment by phone at 6675-3268 (for his location at Chiriqui Hospital). For Boquete, by calling the main number at Alfa clinic (720-2434) or (6949-5998).   You will need to have an appointment to see him. 

While his specialty is ENT, I wasn't aware of all the types of procedures he performs here.  I asked him if he was able to do all the things he was trained to do in the United States here in Chiriqui Province.  He said "yes, except for performing surgeries using laser, which are actually rarely required".  His general philosophy on medical care is to give his patients several options while giving his opinion on the efficiency and outcome of each option.  He treats cases both medically and surgically.  If there is a better treatment that can be done without surgery, he always advises they choose that option rather than surgery. 

His practice encompasses all areas of this training and includes pediatrics to adults.  His most common clinical presentation here is kids with tonsillitis.  The second most common is dizziness in adults.  One ailment he finds very prevalent here, but not too much in the U.S., are airway difficulties.  He has performed many reconstructive throat surgeries to remove tracheotomies in children, thus allowing them to live normal lives.  So far, he has been 100% successful in removing tracheotomies from his pediatric patients. 

Additionally, his practice involves all levels of complexity of ear surgery, head and neck cancer, surgeries of the throat, thyroid, parathyroid, tonsils and adenoids, sinus, skin cancer, nose reconstruction and rhinoplasty, salivary gland, facial fractures and lacerations. 

While he is a very busy physician, he does like to relax occasionally.  He enjoys tennis, golfing and travelling to new places. 

[Uncle Doug]

I wonder why tracheotomies are apparently commonplace in Panama. I thought this was an emergency procedure only.

Edited January 1, 2018 by Uncle Doug

[Palo Alto Jo]

Dr. Gozaine agreed to answer reader questions that arise from his profile here.  I'm telling you, he is a jewel!!

Excellent question Uncle Doug, and one I should have asked in my initial interview with him.  Here is his answer:

Quote

In the U. S. pediatric tracheotomies are often associated with emergency procedures such as a child choking on a hot dog, etc.  Here it is a bit different.  The tracheotomies are still performed as emergency procedures but not for the same reason as in the U. S.  The most common reason is a poor child, often indigenous (Ngobe) child,  who was taken in critical condition to a hospital in David.  Often the government hospital Obaldia.  The children are barely able  to breathe due to pneumonia.  To save them, the doctors have no option but to ventilate them, and then the tracheotomy is left in place when they are discharged, as they don't stay long enough to be "weaned off" ventilation like they might be in the U. S. or somewhere else.  Even if the care is free, the people want their children out of the hospital, and the government cannot afford the extra cost of a long-term stay either.  So they are discharged with indwelling tracheotomies.  Dr. Gozaine says in he has seen this more here, in 2 years,  than in his 5 years of residency that included a rotation at Oklahoma Children's hospital.  

Again, thanks for the question and interest.  Dr. Gozaine will be heading to Louisiana for a few days, but says he is quite willing to take more questions as he travels, via whatsapp.  Ever try to get that kind of service in the U. S?.!!  Thanks Dr. Gozaine!

[Bonnie]

I am delighted to see that he has made time to come to Boquete to see those of us who no longer relish going to David except in an emergency situation. Thank you, Jo, for this thorough report.

I’m a bit curious about the treatment for skin cancer and rhinoplasty. Aren’t these usually handled by dermatologists and plastic surgeons?

[Palo Alto Jo]

12 hours ago, Bonnie said:

I am delighted to see that he has made time to come to Boquete to see those of us who no longer relish going to David except in an emergency situation. Thank you, Jo, for this thorough report.

I’m a bit curious about the treatment for skin cancer and rhinoplasty. Aren’t these usually handled by dermatologists and plastic surgeons?

Good question Bonnie.  I forwarded your question to Dr. Gozaine who wrote me back in a timely manner.  He says he treats skin cancers surgically, and actually did much more of it in Louisiana than he does here, due to the darker pigmented skin in most patients here.    Rhinoplasty he does for both functional and cosmetic reasons.  Again this was true in his practice in Louisiana.   It's the same basic procedure, but obviously adjusted for the needs of the individual. 

Makes sense to me once he explained it.  It's easy to forget that plastic surgeons also do rhinoplasty for function, not always cosmetics, and they are not as specialized on the functionality of the  ear, nose and throat area as an ENT .  I can see how the two over-lap.

[Palo Alto Jo]

13 hours ago, Uncle Doug said:

I wonder why tracheotomies are apparently commonplace in Panama. I thought this was an emergency procedure only.

Uncle Doug, a bit of an update on the answer.  Dr. Gozaine wrote me again to say I didn't exactly convey what the problem is, my error not his!!  

 

I'll try again.  The children are put on ventilators, with tubes down the throat, on presenting at the hospital in critical condition with pneumonia.  After their pneumonia is treated, about 10 days, they are taken off the ventilator, and airtube down the throat is removed as it causes scarring to the inner airway.  At that time he is asked to place a tracheotomy,  not remove it.  It helps them wean off the the ventilator.  He later removes the tracheotomy and any scar tissues that have been caused by both, to return the children to a normal life, and this they try to do before the child leaves the hospital.