Panama’s Social Security Fund is conducting an internal investigation after more than 2,300 patients overwhelmed the City of Health facility on Monday, November 24, 2025. The unexpected crowd created long lines and tense scenes as people sought medical appointments for 2026. CSS Director Dino Mon personally intervened to manage the logistics, calling the situation a potential internal sabotage while acknowledging systemic healthcare challenges.
The chaos began early Monday morning when patients arrived at the facility after hearing through informal channels that 2026 appointments were opening. Director Mon confirmed the institution never authorized this specific date for scheduling. He attributed the massive turnout to information that accumulated since October, spread largely by word of mouth without official coordination.
“Apparently there was an accumulation of information from October until yesterday. People were told by word of mouth to come to the main atrium to seek appointments when the process was not really organized,” said Mon. [Translated from Spanish] He emphasized that the CSS had not authorized the opening of schedules for that day.
Systemic Failures and Patient Testimonies
Mon detailed that the institution detected an irregular opening of schedules performed without following proper protocols. The director confirmed that officials have already identified employees who might be involved in these irregularities. A formal investigation is now underway to determine responsibility for what the CSS is calling an internal boycott.
Authorities found the massive turnout particularly striking. The facility typically handles approximately 400 appointments for such processes. Monday’s crowd of more than 2,300 patients represented nearly six times the normal demand. This overwhelming response highlighted both misinformation problems and organizational deficiencies at the start of the workday.
Despite the initial chaos, Mon stated that every patient who arrived ultimately received an appointment. Staff worked extended hours into the late evening to accommodate everyone. The director acknowledged the situation required his personal intervention to bring under control.
“We stayed late giving all the appointments. Today the situation is different because we took control,” Mon stated. [Translated from Spanish]
The institutional narrative contrasts sharply with patient experiences. Many individuals reported receiving direct instructions from CSS staff to return on November 24 specifically. One patient named Mirna explained that on October 28, when her daughter was seen by a neurologist, they received a reference for the next appointment. Window staff explicitly told them to return on November 24 to schedule it. She followed these instructions, arrived at 5:00 a.m., received number 406, and secured her appointment three hours later.
Broader Healthcare System Challenges
Director Mon acknowledged that the official opening should have occurred by specialty and in a controlled manner. He admitted this did not happen according to plan. The incident revealed deeper structural problems within Panama’s healthcare system, particularly the critical shortage of medical specialists that directly affects appointment availability.
“We do not have a sufficient quantity of specialists. In Neurology, for example, I believe there are eight in the entire Fund to attend to the demand,” Mon revealed. [Translated from Spanish]
The director also responded to insured individuals’ criticisms about the available scheduling systems. Patients consistently report that the Raisa platform, WhatsApp, SMS, and call center options do not effectively allow them to secure appointments. Mon identified 2026 as the year the institution will confront this fundamental problem, though he cautioned that solutions require deep systemic changes beyond simply opening more appointment slots.
This incident follows previous concerns about Panama’s seguro social system. The Social Security Fund faces mounting pressure to improve its services and ensure proper medication distribution alongside appointment accessibility.
“This is the most complicated problem that the Fund has. It is not resolved only by opening schedules. It requires personnel, legal changes, bringing specialists from abroad, and activating telemedicine. We are going to work step by step and ask for a little patience,” Mon expressed. [Translated from Spanish]
The CSS continued the appointment assignment process on Tuesday, November 25 with reinforced protocols. These measures included reorganization of patient flows, increased staffing, and constant communication with users. Meanwhile, internal investigations continue to determine whether Monday’s events resulted from operational error, deliberate sabotage, or a combination of both factors.
This situation highlights the ongoing challenges in Panama’s pursuit of effective universal health care. The massive patient turnout este lunes demonstrates both the critical demand for medical services and the vulnerabilities in the current system. As the investigation progresses, patients and healthcare advocates await meaningful reforms that address both immediate scheduling problems and long-term specialist shortages.