A Recent Hospital Experience

After reading "Love and Insurance" by the Fuzzman (21/02/2007) and noting that the author paid 1,000,000 baht for a stay in a Thai hospital, it made me recall a question I put to myself recently, 'how much is much'? In Fuzzman's
case, he had a serious case of bacterial meningitis. It was pay or die, so any fee, 1, 2, 3 million baht was immaterial. In my case, I was diagnosed with a skin cancer on my nose. I was able to shop around before committing to any one hospital.

My first thought was to go to Bumrungrad, arguably Bangkok's premier hospital. I had used it in the past, and is perhaps the only hospital in the world with its own Starbucks! It is also very well located, walking distance to Sukhumvit
and soi 4. Researching through past readers' submissions, I came out with 2 other suggestions. One reader rated Ramkhamhaeng, (www.RamHospital.com) and Stick has suggested that the BNH hospital in Silom is also very good. (www.bnhhospital.com)

I ruled out Bumrungrad because 1) they were slow to give me an estimated price and 2) negative reviews on the website www.bumrungraddeath.com. Now that I have had more experience on this type of healthcare, I would say that the dangers presented
on this website are not only inherent at Bumrungrad. One would be well advised to heed the advice found on it, no matter which hospital is chosen.

I made an enquiry at Ramkhamhaeng and my email was immediately answered by an native English speaker. I assume that this gentleman has secured himself a job there as a go-between the hospital and the farang patient. This immediately put me
at ease, as well as getting a 12,000 baht quote. I booked the surgery immediately, a good 8 weeks in advance.

I was very precise that the surgery would have to conform to my timetable. I would arrive in Bangkok on a Saturday, have the operation on the Monday, allowing me enough time to recover and be back on the plane the following Sunday. All this
was agreed. The hospital was also very good at organizing someone to meet me at my hotel and take me back after the procedure.

I arrived on the agreed Saturday, sent an email stating the same, but early Monday morning I got a reply saying 'The doctor cannot not see you today, can you come in later in the week?'. This totally blew my timetable and therefore
cancelled the whole deal. I was out of sorts, in the Sukhumvit area, with a week to kill without a clue what to do. Luckily for me, there were numerous, 24 hour guides available to assist me, for really what was a modest fee…

Back in Farangland, I was determined to try again, and this time chose the BNH. They were fairly responsive with the emails so I made a booking with the same parameters.

My first consultation appointment was on the Monday, 17:00. Not knowing where the hospital was, I took a taxi, following the website's obscure directions as the main road in front of the hospital was closed at certain times of the day.
It was after this that I found that it is much easier to take the BTS to Sala Daeng station and walk the 3 – 4 minutes. I arrived in advance to perform a few administrational tasks. In the waiting room, I had 2 separate conversations with Americans,
both commenting on how the service here was so much better than the US, with great prices, and one with an Australian who organizes trips from Western Australia for dental treatment. I obviously wasn't the only one traveling to Thailand for
medical treatment.

A Thai doctor called me in at precisely 17:00 for my consultation. His English was very good and after discussing what needed to be done, he told me that he could do the procedure that evening and that I was to come back at 20:00. 2 hours
to kill in Patpong. What to do, what to do… I decided to play it safe, no need to stress myself unduly so read my book in the Starbucks down the road. The doctor was running late and didn't get me on the table until 21:30. Apparently he
had performed 2 operations before me. I asked him if he was still up for this, I mean, it's late and I am wondering what sort of day he has already put in before he cuts me open. He assured me that he was fine. The operation was done under
local anesthetic so I was conscious the whole time. Everything seemed to be fine, well, what did I know? I am not a health professional! I was on the table for 2 hours and all sorts of thoughts go through one's mind. One of them was "this
would make a good submission to Stickman! I need to get invited to those authors parties!" How sad is that! There was a point where another surgeon came in the room and started a conversation in Thai with the surgeon working on me. After
about 5 minutes, I could ascertain that the conversation had nothing to do with me. They were babbling on about … who knows .. their golf game or something! This was pissing me off and I wanted to say something like "would you shut up and
pay attention!!" I then scanned my brain for all of the readers' submissions concerning face. I didn't want my surgeon to lose face in front of his colleague and the attending nurses, especially since he was holding a scalpel 4
inches from my left eye! In the end, I said 'You are making me very nervous. I think you are talking about something else while you are working'. He said "Ah, we do this all of the time. We talk about life, the weather, food, and
women. If you were under general anesthetic you would know nothing". This was a good point but my objection had the effect of making the other surgeon leave the room. Hopefully my point was taken.

Finally the whole thing was over and he bandaged me up. I was not to touch the bandage and to come back to see him 5 days later. By the time I was back down in the lobby and taken to the cashier, it was 1am. It was then that I was presented
with a bill for 50,000 baht! I freaked! Well, as much as I could have after a 2 hour operation. My expectation was 12,000 baht and even if there was a cost over run, I was prepared to pay 20,000. This was well over that. I told them of the email
where I was told 12,000 baht but couldn't reproduce it. The administrators on the desk at that time all had blank stares. One of them ran off and found my file. One of the bits of paper in it said 'Estimation Sheet' but it had not
been filled in by my surgeon and had not been presented to me for signature. Administrative procedure had not been followed. I offered to pay 20,000 and as I was due to return, we could haggle the rest later, especially if I could find the email
with the estimated figure.

I looked for the email the following day but realized that the quote was for a different hospital! But so what? What if the hospital did quote me 50K. What if they said 100K? What could I do? How much is much? In my case I had to get this
fixed before it got any worse. In Fuzzman's case, it was life or death. This wasn't like new tires on car. I received an email from some administrator high up the tree who apologized that proper procedure wasn't followed and they
offered to reduce my bill by 10%. This I took as a gesture of goodwill, that they were willing to take responsibility for their own procedures not being followed. There are many criticisms of the USA but the one thing I can say, is that putting
things right is one of their specialties. It is very typical that American businesses will right a wrong, and then go one further to maintain good will. Trying getting a British bank to admit a mistake. They usually charge you 35 pounds just to
write you a letter! And France? … forgettaboutit.

I met with the doctor on the 5th day and he said everything looked fine. (to me, I looked like crap!) I settled my bill with the 10% reduction. What else could I have done? Apart from this mix up on the estimate, the service I received to
this point was very good indeed. The doctor did say that I would have to seek the services of a plastic surgeon back home to remove the stitches in 2 weeks time. A normal outpatient service was insufficient. As I don't have medical insurance
in the country where I reside, I had to go through the private sector. A single consultation visit is 6,000 baht. In the end, I needed 2. The surgeon back home asked me how much I paid for the operation. I told him and he said 'Wow, that's
cheap! If you had had it done here, it would have been 175,000 baht!" He had also complimented the Thai surgeon on the work done, as it was in his opinion, of a very high standard.

In summary, points to consider when opting for healthcare in Thailand.

1) What are you getting done?

If you are going for a procedure that is a known quantity, dental work or a tummy tuck, you can have a pretty good idea of what is going to happen to you. You don't need any nasty surprises while you are out there. In my case I wasn't
able to determine what they were going to do. In retrospect, perhaps I should have had a consultation with a local plastic surgeon to have it all explained to me first.

2) After care service

Is the procedure you are going to have be contained to Thailand and your visit there? Will you be able to follow up any work done? What if your tooth crown falls off? What if your surgery develops an infection? You're on your own. In
my case, I am not sure I would advise someone else to do as I have done, based on the uncertainty I went through and the after surgery care I needed. I say this despite the cost savings in going to Thailand.

3) Determine a price as best as you can

We all need to know how much anything is going to cost, whether it's an oil change or vasectomy.

It has been 8 weeks since my operation, the bandages are off and everything is fine. I still rate the BNH highly and think they perform a good service. Whether I would advise anyone to follow my example, is another story. Certainly I have
learned a few lessons and I hope this submission will help you with yours. If it is any indication, I am planning to have some dental work done the next time I am in Bangkok, at the BNH.

Stickman's thoughts:

What you say about the possibility of needing follow up care is a very important one and one I had never considered, but then it is largely irrelevant in my particular case as I live in Thailand. But for people travelling here, that is an issue that needs to be considered.

That issue with the first hospital postponing the surgery was a bit off, to say the least – but then there may have been a very good reason for it, I guess.