Readers' Submissions

Medical Diagnostics and Patient Privacy in LOS




I've been a Stick reader for about a year (thank you Mr. Stick for providing such a good forum) and I've finally decided to add my bit and contribute something. It concerns my first visit to a doctor in Thailand, at a medical centre in deepest, darkest Isaan.

Earlier this year I was visiting my new girlfriend's home town in Buriram province. Her son was visiting for the weekend from university and nursing what sounded to me like a bad cold or a mild dose of flu. My gf insisted on taking him to a medical centre where she had every test done she possibly could (at my expense I might add!). He was diagnosed as having tonsillitis and given some medicines. After a couple of days he improved and returned to university.

A week passed by. I didn't see too much of my gf – she is a teacher and mother and leads a busy life. But during this time I developed a really bad cold. I didn't catch it from her son I hasten to add as it was developing before I arrived there. I'm not the kind of person who runs to the doctor with the smallest thing and I was reasonably content to lay up for a week with a good book, eating local fruit and going out to eat with gf in the evening. By the weekend I felt I was on the mend but I was a little concerned because there were traces of blood in the thick sputum I was constantly bringing up. There was no cough, no sore throat but I felt I ought to have a chest X-ray to check for TB. My gf was very concerned and insisted on driving me to a medical centre 20 miles up the road in another town which she considered to be better than those nearby. No doubt the same one she took her son to the week before.

Our arrival at the centre didn't appear to cause any stir. We were met by blank looks from the many people in the waiting room and a rather bored and indifferent-looking receptionist. (These blank looks are what I encounter most of the time in Isaan and make me ponder why it is called the Land of Smiles.) My gf related the problem to the receptionist and it was suggested that maybe I would like a chest X-ray. Yes, that was exactly what I wanted and we were ushered out the back. 10 minutes later we were back in the waiting room, the X-ray done and over.

To digress a bit, I thought this experience made an interesting comparison with NHS treatment here in England where, to have a chest X-ray you have to visit your GP in the local health centre. He will then inform the local hospital after which you must ring for an appointment there, maybe 2 weeks away. You must then go to the hospital, in my case 15 miles away, and have the X-ray. A week later you must go and visit your GP again to hear the results. 3 weeks, 3 visits and 3 phone calls! No wonder the NHS costs so much money to run! They obviously do some things right in Thailand.

Anyway, to return to my story. We were soon ushered into the doctor's surgery where we were greeted by a rather gorgeous, young, Chinese-looking female who gave me a nice smile but spent most of the time staring at my X-ray which was up on the screen. On the other side of the room, I was surprised to see seated a row of several females all looking at me, including the bored-looking receptionist who now sported a big smile on her face. My confidence in the Land of Smiles was restored. It seemed that to all the female staff at that centre a farang's consultation with the doctor was an event not to be missed. Patient privacy in Thailand is not only non-existent but the lack of it is something to be relished! I chuckled to myself at the difference with my own country. I didn't mind, it was actually rather nice to know that this row of smiling females found me interesting. I wondered what it was that they found so fascinating. Were they hoping to catch a glimpse of my fifty-something year old lily-white body? My non-existent hairy chest? The beautiful curvature of my middle aged stomach? Maybe they thought I was going to drop my pants and reveal something to astonish and delight the average petite Thai woman! Or maybe they just wanted to stare at my aquiline nose and my almost bald head.

Alas they were to be disappointed as the doctor didn't ask me to expose myself in any way but continued to look at my X-ray and told me that everything looked normal and there was nothing wrong with my chest. She didn't examine me or ask me any questions but told me I had tonsillitis.

"That's interesting because I had my tonsils removed when I was 8." I said.

"Oh, you had surgery?"

" Yes."

"In that case" she said, pausing and still staring at my normal X-ray , "you are suffering from an allergic reaction to something in Thailand you don't have in your own country."

She turned and smiled at me with the confidence of her diagnosis and prescribed 4 medicines which were immediately given to me in little plastic bags which looked like they had all been stapled together before I even entered the surgery. They were antibiotics, anti-histamines, Paracetamol and I'm not sure about the 4th one. That should cover most things I thought.

While driving me back my gf looked perplexed and said "why did she say you had tonsillitis?", obviously casting her mind back to her son's diagnosis the week before. I could see her innocent little mind trying to compute the absurdity of the situation but I think it proved too much for a devoted mother with an unfailing trust in the medical profession, so she put it aside and insisted at great lengths that I make sure I take the medicines. I didn't take them. I don't believe in taking antibiotics unless it's absolutely necessary. I didn't take the Paracetamol because I wasn't in any pain. As far as the anti-histamines were concerned, I wondered what I was allergic to. Maybe it was the women but if that was the case I'd probably need something stronger than anti-histamines! In a few days I was back to normal.

Stickman's thoughts:

The good hospitals in Thailand are generally very good. The bad hospitals are….often very bad!