Friday, January 18, 2013

The Thai Hospital Experience continued... part 2

Going to a foreign country and hospital might concern a first-time patient, but any fears
were quickly put to rest as the time drew near.
My first appointment with an eye specialist had been reconfirmed via e-mail prior to departure.
I was impressed with the detail and efficiency of all communications.  For instance, I would be
seeing a different doctor than originally named due to a death in the family.
Everything was explained and I was assured of good care.
On arrival at Bumrungrad Hospital, I was courteously greeted with the traditional Wai...
hands in prayer position and a slight bow...with a sincere Thai smile.
The hospital was quite modern with a soft, calming atmosphere.
I was taken by an attendant to meet the doctor after a brief check-in.
The doctor was ready to see me, took an excellent history and prepared for tests.
I showed him the US test results that I had brought along.
He looked things over a bit quizzically and politely remarked, "I think you may find
that there are better tests and more up to date equipment here.  Let's have a look."
I had a thorough work-up with all the necessary tests and then we sat down for some 40 minutes
to talk things over. (I WAS impressed by the tests and the equipment, as well as
the professionalism of the hospital staff )
He explained everything in good detail, answered all my questions and hashed out a few issues
with me regarding the cause of the problem and probable outcomes.  I felt like I was finally able
to get a clear picture.  He was even-handed and factual.  He met me at my level of understanding.
He educated me, gave good advice and gently urged me to be patient and not to worry too much.
"Let the body heal.   Don't do anything extra.    Just live.  That's all.   Just live..."

What a difference!  I was so surprised by the difference in tone and bedside manner.
So opposite of what I had experienced a few days before on the other side of the planet.

In addition, there was some discussion of having cataracts removed while there.
In America, one doctor advised waiting while his associate wanted to rush me in to surgery asap.
A bit confusing... 
I looked at the cost in Bangkok...it is about 25-30% of what we pay in the States.
I had budgeted for the possibility and we talked things over.
Though I had the time and the funds, the doctor advised against it.
"They are not serious at all.  Glasses will help you more. No need to be worried."  
That advice was echoed by 3 specialists over the course of the trip.
Quite simply, they were not going to perform an unnecessary procedure
that was not in the patient's best interest.

I left the doctor's office feeling so much more knowledgeable and calm.
I was able to shed much of the distress and tension from the American experience.
All it took was a little time and focused attention.
At the end, I thanked the Doctor and went to pay the bill.  There had to be some mistake!
The whole examination, testing and consultation tallied up to just $94.24.  Impossible!
In this beautiful, state of the art facility?! How could that be?
The smiling attendants checked the bill and assured me that there was no mistake. 

As I left, I was given a complete packet containing all the photos and test results.
By contast, I had had to fight for every scrap of info to take to Thailand from my American doctors.

There is simply no comparison to what I was charged in the states for inferior attention,
care and work.
I paid several thousand dollars to cover less ground over the course of 3 weeks.
The cost in terms of stress alone was pretty hefty, as well.
Everything seemed to be such a hassle in the States. Test results were delayed
and not explained.  Several appointments were scheduled when one would suffice.
There was a kind of air of superiority and self-importance and a constant busyness
that speaks volumes to patients about their worth and their place in the scheme of things.
The quality of care cannot be compared. Thailand was as wonderful as the States was dreadful.

A few days later, as we were walking around Bangkok, we passed by Rutnin Eye Hospital.
We walked in out of curiosity and were very impressed by the sleek, modern facility.
We found that the Queen of Thailand was treated there, as were foreign diplomats and the like.
I asked if I might have an appointment some morning over the next 2 weeks.
"Would 7:30am tomorrow be alright?" came the reply.  I was delighted!
The next morning I had another full exam and had a very similar excellent experience.
I received consistent advice and good support.
Another factor to consider was the holistic mindset, where your problem was viewed
in relation to your overall health, lifestyle, diet and stress levels.
The doctor is less eager to impress the patient with technical diagnoses
and more willing to help patients to understand and resolve their conditions.
Once again, a return to calm and a gentle, hopeful, patient attitude was encouraged.
Good health is connected to a good spirit...   
As before, cataract surgery, though possible, was discouraged.
The bill for this excellent care was $102.78.
In light of all that was done, I again questioned the charges, but was assured that all was correct. 
We were amazed at the state of the art facility and the great care given to each patient. 
There was no stress in staff or physicians. There was instead a sense of calm and happiness
in the way they were able to care for patients. An air of kindness and great courtesy was felt
in every encounter.  It was completely lovely!

next post...A physical exam at Bumrumgrad Hospital

Thursday, January 17, 2013

The Thai Hospital Experience


As we were preparing for our trip,  I had the thought that if I were ever to have a major health problem
that I would try to get to Thailand for care.  Several health insurers now send patients to Bangkok
for surgery.  It saves the insurers a great deal of money and the care is on a par with our system.
Many uninsured individuals opt for Thailand as a more affordable alternative, as well.
Since we were getting our dental work done there, I thought I might take the time to get a thorough physical.  I researched my options and made an appointment online
at Bumrumgrad Hospital, a world class facility within walking distance of our guesthouse.

As fate would have it, in the weeks before our departure, I had an eye problem that required a trip
to the ER, an opthalmologist and a GP.   I experienced our US system up close for the first time
in many years.  To say I was dismayed would be kind.
Our system, still hailed as the best in the world, was expensive, inefficient and nerve-wracking.
Specialists had little time for questions or explanations. Information was hard to get and was,
at various times, contradictory, incomplete and confusing.
There were instances of delayed treatment, botched elements and cover-ups.
Doctors failed to return calls, do follow-up, or answer basic questions.
They vacillated between treating an emergency as if there were no concerns and treating
the slightest problem as life-threatening.
It was hard to believe that our system was really that bad.
I felt so sorry for patients who are at the mercy of our health care conglomerate.
The assembly line quality of 'care' where a doctor sees patients for 2 minutes while sprinting between multiple patients at one time was appalling.  They were clearly scattered in their thinking.
I had to remind them several times what I was there for.
Their staff was also deeply stressed from the chaos of cramming too many people into a workday.
There was no time to hear a patient, think creatively and treat well.
I could not imagine treating a patient like that, especially one in crisis.

I was reminded of my youthful decision to turn away from medical studies for just those reasons.
Churning patients for maximum profit left me very disillusioned, disheartened and suspicious
of our system of modern medicine...and that was 40 years ago.
Yet, today physicians and staff still claim to be the best in the state, the country and even the world,
depending on who you asked.
I felt as though I was being swindled, herded and treated as an ignorant person.
It was so upsetting, expensive and neglectful that I quickly booked additional appointments
with specialists at the hospital in Bangkok upon our arrival in hopes that I would find a saner
and more affordable alternative.
In exasperation and running out of time, I told the various US doctors that I would take copies
of my records and their orders for bloodwork, further testing and evaluation to a quality facility
in Thailand.  Two of them sternly advised me NOT to seek treatment in such a 3rd world country
and advised me to cancel my trip altogether.  By now, there was so much pressure and
fear-mongering that I began to doubt my own sense of my health (which is normally quite good).
to be continued...