Be Well San Miguel

Taking care of your healthcare needs in Mexico

Our Services

Our role is to help you receive the best health care possible on both sides of the border.

Medical Care

We do not practice medicine but can help you find the best medical care available in the area and assist you in making an appointment. We have connections to excellent physicians and other care providers. Our understanding of their specialties and available technologies will be important in ensuring that you receive the best possible care.

In Home Nursing Care

We organize and supervise home health services with a well-trained team of nurses, home health providers, respiratory therapists, and other professionals. Our knowledgeable staff can locate and procure home health equipment such as beds, oxygen, toilet facilities, etc. A care team can be arranged for within 12 to 24 hours. Costs for services are reasonable, based on fair labor practices.


We help you prepare for health emergencies, and ensure that family and household help know what to do in an emergency situation.

In the event that you need urgent care or hospitalization while in Mexico we can:
• Meet you at the hospital or care facility
• Assist you in the admission process
• Remain at your bedside at key times during hospitalization
• Assist with discharge planning
• Provide post-operative medication advice


We can, when needed, do thorough background research on your diagnosis and its treatment, ensure the fairness and accuracy of billing by medical providers and hospitals, and help you decide what medical insurance is best suited to your needs.


We provide health and medical education on the management of acute events, chronic conditions, and wellness care.

Care Abroad

We help you determine if you can safely receive care locally or need to seek care elsewhere in Mexico or abroad.


We help you prepare for a meaningful meeting with your health care provider. We review your medical history in advance, so that your health concerns can be communicated as fully and clearly as possible.

Advance Health Directives

We can help facilitate advance directives and end of life decisions. We often serve as the designated patient advocate for legal advanced directives and can assist in communication between the patient and concerned family members, friends, and community.


We have an excellent bilingual assistants who can translate documents for use by clinicians north of the border, as well as to perform translations at the time of visits with Spanish speaking clinicians.

Mediating and Communicating with Family and Friends

Often it is confusing for family members when one is injured or ill in Mexico. We are experienced at helping loved ones make appropriate and helpful decisions.


Understanding and reviewing your medication is vital to your overall health. We help you recognize and avoid potential side effects and drug interactions while organizing a system to simplify your medication schedule.


We are happy to arrange for transportation to and from your medical visits.

The sick and the aged have priorities beyond merely being safe and living longer. (We must) sustain meaning in life and transform the possibilities for the last chapters of all of our lives.

- Dr. Atul Gawande -

Our Team

Deborah Bickel

As the founder of Be Well San Miguel, I utilize my extensive knowledge and experience as an international health worker to ensure that every need of each one our clients is met with utmost professionalism, compassion, and confidentiality.

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I am a graduate of the Stanford University Physician Assistant program, and hold a Master’s degree in Public Health from the University of California at Berkeley. I have lived and worked in many countries including the United States, the Netherlands, Mexico, Guatemala, Cuba, Nicaragua, Zambia and Mozambique…

I moved to San Miguel in March of 2014 and am delighted to call this community my home. Previously, I practiced medicine in a busy inner city clinic for nine years while teaching medicine at Stanford. I also did post graduate work in nutrition at the Tropical Institute in Amsterdam. I am fluent in Spanish and have practiced medicine in the United States, Mexico and Guatemala.

I have a particular interest in geriatrics and helping people choose the highest quality of living even when that may mean shortening our span of years but vastly improving our experiences moment by moment.

Phone : +52 (415) 115-7815
Email :


Dr. Emilio Ramirez

Dr. Emilio Ramirez is the director of critical care medicine at Joya hospital. He also works as an Emergency physican and sees patients in his own consultorio.

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A very popular doctor and excellent colleague,  he is a welcome addition to our team. He is a specialist and board-certified emergency physician with more than 22 years of experience in emergency rooms, 17 of those years in private medicine working as an ER physician in an American hospital in Puerto Vallarta (Amerimed), and as the chairman of Emergency Services in the IMSS hospital in Puerto Vallarta.

As an Emergency Physician, he is committed to ensuring that an ER physician is available at all times at MAC Hospital because, as everyone knows, in an emergency… TIME IS LIFE.

Emergency Medicine is one of the most complete and critical medical specialties because it is the only one that needs to know how to manage an acute  crisis across all medical disciplines. To adequately prepare for this challenge the training and skills of an ER physician are much broader and deeper than for other specialty physicians.

Some of the most critical situations it covers are stroke, cardiac arrest, heart attack, GI bleeding, trauma (all varieties – car accidents, gunshots, stab wounds, fractures, head trauma, etc) Uncontrolled hypertension, complications related to diabetes, respiratory failure, coma and shock  among many others.

The entire Be Well Team have worked with him for five years now and have developed a deep respect for his medical knowledge, his ability to recruit the finest specialists, and his commitment to the oversight of each and every Be Well patient.

We were delighted when he agreed to join our team as he has been the glue that has kept us assured that our patients were getting the very best care. We consult him or a specialist referred by him on all our patients when they are sick or injured. We have not had a single case in these five years of a complaint about his treatment of our patients nor the courtesy he shows everyone from fellow physicians to the other Be Well Staff and most especially his patients. If you get to know him very well you will find he has a great sense of humor and endless energy for being a fine physician.

Mobile Phone : +52 (322) 109 1414




I had the opportunity to see how Deborah Bickel works..and believe me, she is in a league of her own. I was so amazed and impressed how she handles herself. Her professionalism and her compassion are rare. As said by others, SMA is so lucky to have her. There is nobody in town whom I would recommend more highly!

- Jackie Brummund -

I had to take a friend to the hospital and called Be Well San Miguel to walk me through the process. Be Well Staff was incredible. A member came to the friend’s house, called the ambulance and we took him to UNIMED. Be Well has stayed on top of this situation and I can’t say enough good things about them. If ever you are in a medical situation and need help, I would highly recommend Deborah Bickel and Be Well.

- Louise -

Deborah’s talk at St. Paul’s made me choose her as my care manager. I also have some friends without adult children who will need a care manager in the future. Most of these children know nothing about healthcare in SMA and will need a care manager to advise. Having a savvy and qualified person like Deborah in our community is a blessing.

- Ellie -

Deborah Bickel was a great asset…she stepped into the breach with great advice and on the scene presence.

- John Hunger -

Deborah, it was a delight to meet you, and what an amazing service you offer!
Best to you!

- Christine -

Nothing quite like the awareness that you are in serious trouble at 1 AM on New Year’s Eve! After a failed attempt to get care at the hospital, a member of Be Well San Miguel met me back at the hospital the next day. She stayed with me and advocated for me to get the care I needed until surgery was scheduled. She was with me for the next few days, either by phone or in person and answered my many questions. Yes, I would have stumbled my way through this shocking life event, alone, defensive and in so much pain, but having Be Well in my corner, smoothing the path ahead for me, gave me great comfort.

- Victoria Schneider -

Recently I was diagnosed with coronary heart disease. Be Well San Miguel helped me cope with it by attending appointments with a cardiologist with me, answering my emails with questions about my new medications, exercise, and myriad other things. Be Well members provided timely support when I needed it as well as solid medical knowledge and experience that gave me confidence to deal with the physical and psychological adjustments necessary. With Be Well’s help, I could relax and know that I was in charge. The team member was warm, encouraging, and there when I needed her.

- Susan Deveaux -


Fees are based on the amount of time required for services and take into consideration local medical costs.

Fees are payable by US check, cash, or Paypal for an hour of our time. An initial evaluation and intake has an extra cost. As our fees are subject to change based on peso to dollar rates and other factors, please contact us for the most up to date information.

Payment is due at the time of service. For services exceeding an hour of our time, we reserve the right to ask for payment in advance.

We also offer an annual retainer at a set fee. For those needing more service and those who want to create medical directive, this option can save money over the year. Ask us about it!

We also provide Skype sessions as a slightly reduced cost.

Be Safe: 24/7 emergency alert

How “Be Safe” Works

“Be Safe” is a medical alert system that provides its wearer with 24/7 medical intervention via a proprietary electronic pendent or key chain and wireless phone system.

When the need arises, all that is required is pressing a button on the pendent to summon help. Once pressed, the button automatically generates a call to a Be Well San Miguel staff member, day or night seven days a week for as long as one’s subscription is in place. When answered, the user will be in direct telephone contact with Be Well San Miguel and the nature of the emergency can be described. If the button is pressed and there is no caller someone will go to your home to ensure you are in no danger. (false alarms do happen.)

At that time a decision will be made and a call placed to: send a paramedic team and ambulance, an MD or a Be Well San Miguel staff member such as Deborah Bickel, Sue Leonard or other medically trained first responder. And, when necessary, a Be Well San Miguel staff person will meet you upon arrival at the hospital of your choice.

Beyond having your location and directions, we will maintain an up to date file containing all of your critical information including who has keys to your residence and how emergency personnel can gain entrance. All necessary details will be collected at the time your subscription begins.

Data Storage and Collection

Along with the radio unit and panic button is your extensive medical history stored on a thumb drive in Spanish and English to be available for any treatment
following your call. You can also print it out so that you will have it anytime you are traveling outside the area.

Users of the Be Safe system will automatically be part of Be Well San Miguel making this a home alert system run by patient advocates and medical professionals. If ever you press the button and make the call you can be assured that you will connect to a medically trained staff member, not an anonymous hourly employee.

Whomever you speak with at Be Safe will have a background in healthcare. In the emergency situation it will not fall upon you to know precisely what level of response is required. Our medically trained phone triage staff will be in touch with you immediately and help guide your decision.

For more information, e-mail Deborah!

Quick Be Safe Facts









As members of your health care team, we are committed to the highest standards of professionalism and confidentiality. You may be absolutely confident that no personal information will ever be shared without your explicit permission.


Patient Advocacy

Deborah Bickel, Sue Leonard, and Dr. Emilio Ramirez have decades of combined clinical experience and medical training that are put to use on your behalf. We don’t just provide information, we help you understand your important health and wellness options.

In the event of an illness or injury, finding an English-speaking physician may not be enough. While many physicians in the area do speak English, few are completely fluent and even fewer have an English speaking staff. We bring to our practice both fluency in Spanish, English and a professional understanding of both US and Mexican medical services, which can dramatically improve the quality of care you receive in Mexico.

It is important to note that medical practices can vary greatly from one country to another, and at times the medical culture of Mexico will be quite different than in the US or Canada. An example of this is that private practice physicians in Mexico are not required to keep patient records beyond the patient’s name and day of the visit. Having a fluent and medically capable advocate at such times will be critical to your continuity of care and your peace of mind. As with any visit to a physician or other health practitioner the right outcome will depend upon clear communication and understanding between patient and practitioner.

A short phone call will help us identify what your needs may be and is usually followed by an hour-long appointment to orient you to medicine, health and well-being in San Miguel de Allende.

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Our Blog
Feb 24

Be Well San Miguel February 2021 Newsletter

I would like to start our newsletter with a warm, but rather belated, welcome to our very able Office Manager Cristina Aguilar. She has done a tremendous amount behind the…

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Update on COVID-19 Vaccines

January 16. 2021 Ellie Burleigh (MPH, Phd) This update includes new information and guidance from US and Mexican sources regarding vaccine approvals, vaccine availability, answers to FAQs, descriptions of vaccine…

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Jan 22
Dec 15

What information saves lives in these dangerous times – December 2020

Dec 2020 Update on COVID-19 in Mexico A patient of Dra. Flores reportedly spread the note below via an unofficial email chain (one colleague reportedly received it three times): I…

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Home management of COVID – October 2020

Many people with COVID are going to have to take care of themselves at home either alone or if they are lucky with a partner or friend. Be Well can…

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Oct 16
Aug 25

Aug 25 2020 update on Mexico’s response to the pandemic

Deborah Bickel reporting from SMA, August 25, 2020 “Tis the times of' plague, when madmen lead the blind.” - King Lear, Shakespeare   Mexico has continued down a path that…

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Latest Report from San Miguel de Allende. July 12 2020

Joan Didion famously wrote, “We tell ourselves stories in order to live”. In time, we will need poets and writers of the imagination to look through the looking glass –…

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Jul 16
Jun 4

COVID 19 UPDATE Newsletter. June 4, 2020

COVID 19 UPDATE Newsletter. June 4, 2020 Deborah Bickel – In residence in San Miguel Private hospital care services for COVID patients are soon going to run out. The time has…

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COVID 19 UPDATE Newsletter. May 19, 2020

  COVID 19 UPDATE Newsletter. May 19, 2020 Deborah Bickel – In residence in San Miguel It was a shock for all of us in San Miguel de Allende to wake…

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May 1
Mar 31

Tips for Staying Safe

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We’ve aged a generation in the past three weeks.

What matters has sharply come into focus. Family matters. Love matters. Kindness matters. Health matters. Generosity matters. People matter. Community matters. The rest is just noise. Aside from physical distancing,…

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Mar 31