Stickman Readers' Submissions March 12th, 2020

The Quality Of Thai Doctors

I would like to relate some experiences with Thai hospitals, doctors and the health care system. Maybe something to think about concerning the CornonaVirus (some are trying to relabel the Wuhan virus, which others say is racist. Hmm?). Stickman just had some friends in Bangkok report on the virus, and one said “the Thai healthcare system is among the best in the world”. Well, I disagree.

First, what is the “healthcare system”? I think the parts are: cost, accessibility, the quality of hospitals, and the quality of doctors. On the old school A, B, C, D, F scale, I give those A, A+ A, and D-/ maybe F for the doctors.

He Clinic Bangkok

Second, disclaimer: I do not have a high opinion of Thais as a whole when it comes to intelligence, knowledge, work ethic, and ability to think outside the box. And the doctors are no different. Very ignorant (a lack of knowledge and awareness. uneducated) with a narrow array of skills. Got a broken arm? Sure, no problem. Tonsils? Yup, easy. Anything basic and easy I believe will probably get taken care of quickly and definitely at a low cost – although in my experience from having annual health checks done – the cost has been increasing significantly faster than the rate of inflation. I will also add that I am American and we have our own healthcare problems including among the highest cost in the world, but where collectively we have among the best hospitals in the world and probably the best doctors. (Wow, I think I’m gonna get crap for that. I’m not denying other countries have great hospitals and doctors. Many countries in Europe and English-speaking countries come to mind).

Here is the best example that I can give, and why I am definitely negative on Thai health care, which has seriously altered my thinking to retire there, especially since when older I will need more health care, not less.

I have one son. Sometime around age 3 he started developing a condition known as encopresis (basically chronic constipation) https://www.mayoclinic.orgdiseases-conditions/encopresis/symptoms-causes/syc-20354494. We moved to Thailand 6 months later in 2015. We thought that the issues were a phase, and it was all part of the toilet training process. By age 5, 2017 I realized it was becoming a problem. I brought him to both Phaya Thai and Samativej Hospitals. At each they generally offered no assistance, mostly advice on diet. After nearly a year of this, several doctors’ visits, a couple of enemas, a few doses of laxatives, lectures on diet, and still no change. I did dozens of hours of research. Finally, I got lucky as I had bought a kid’s book on pooping difficulties (there are dozens available for any type of difficulty in this area). The foreword described a condition known as Encopresis, which is basically a result of chronic constipation. The conditions and behavior of the fictitious boy in the book were exactly 100% the behavior of my son, and some internet research confirmed this was indeed the problem. There were periods of 6 – 10 days when nothing / little would come out.

CBD bangkok

I then told his doctor about this (We were now exclusively at <Name edited by Stick> Hospital). We had been moved from a pediatrician, to a gastrointestinal pediatrician, to a Professor of Pediatric Gastroenterology. I mentioned Encopresis and….nothing. blank look. It’s obvious now that she (The Professor HA!) had never heard of it. I can still see the expressionless stupid look on her face as she said “you should eat more fruit. Do you like strawberries?” despite me telling her a few times that his diet was good and not the issue (have to avoid foods like rice, pasta, potatoes, apples, bananas, carrots and eat plenty of fruit, especially papaya, pears, peaches, prunes, plums, as well as peas, broccoli beans). She wanted to give more enemas and laxatives (which as it turns out are both bad for kids. And another tried to stick her finger up his ass to “check it out”. You never saw a kid clench his ass tighter or scream louder than my boy). I will also mention that in my research I had suggested a couple of other possibilities which the doctors dismissed. Nope, diet was their only answer.

I will say that the only….not misinformation but not the best information that websites like WebMD and Mayo Clinic had, was that Encopresis is as much mental as physical. So we also went to a child play therapist.

Finally, at age 6½ early 2019 we moved back to the Boston area. Immediately went to see a Primary Care Pediatrician. Remember, only a specialist in kids – not the stomach. “Oh, I am very familiar with Encopresis. Very familiar….They used to think it was a mental condition. In reality we now know its nearly 100% physical and is easily treated. Here’s what we are going to do”. He immediately referred us to Boston Children’s Hospital, 5 years consecutive the #1 rated children’s hospital in the US, and if not the top, close to the best children’s hospital in the world. Patients come from all over the world for treatment.  Four days later we are in front of a specialist. “Well ,Encopresis is my specialty. I’m known as Dr. Poo n Spew cause I deal with poop and vomit”. Had my son in stitches for an hour, unlike the terror and tears from being with Thai doctors. “There is no reason to stick a finger in his butt.”. “I don’t give enemas. It’s traumatic for children”. “Only give laxatives as a last resort. The body becomes dependent on laxatives.” He made us watch a YouTube video. Yup, a video. Produced by Denver Children’s Hospital, it is a clear concise 5 ½ minute video that explains Encopresis perfectly.

And this is the saddest part. If anyone watches this video, as long as one has even a little sliver of intelligence, you will become instant almost-experts in Encopresis. The plumber in NZ. The truck driver in America. The accountant in Germany. The dentist in Sweden. All that have no reason to know about it. All will be more knowledgeable than a Professor of Pediatric Gastroenterology in Thailand will know a condition that he/she should know about. Note that statistics show that about 2% of infants aged 4 – 10 in the US have this condition on some level. So while it is not common, it is not rare.

wonderland clinic

The solution? Stool softener. Available over the counter, common, non-addictive. Apparently, they had never heard of it in Thailand. Due to so long with this problem and constipation, his colon went from a tight muscular functioning organ to a loose saggy sack. He literally cannot push anything out. Now we are in month 14 of an 12 – 24 month program of stool softener so poop drops out easily, and he has to train his body (think Pavlov) to sit on the toilet for a few minutes after every meal. Next, the Doc referred us to a nutritionist to make suggestions for a better diet, not necessarily while on stool softener (where he can eat pretty much anything in moderate doses) but for when he gets off stool softener when he needs an almost perfect diet. And the nutritionist knew a lot about Encopresis. A person who has never been to medical school. Knows more about a kid’s stomach issue that a Thai Professor of Pediatric Gastroenterology. Lets take score: In Thailand 2 hospitals, 5 doctors including 2 specialists and a professor. Knowledge of Encopresis = zero. In US a regular pediatrician, a stomach specialist and a nutritionist all high level of knowledge of Encopresis = 3. Cost – In Thailand, with admittedly inexpensive treatment, about 40,000 – 60,000 baht over a dozen visits. Visits in the USA, now 1 with pediatrician, 1 with nutritionist, and 5 with specialist (first visit and 4 follow up visits), $0.00 because of good, but yes expensive insurance (that cover my son and myself for anything)

My son is fine now, a normal life with a little treatment. Someday soon he will lead a normal life with no medicines. I wonder what would have happened had we stayed in Thailand. Possibly permanent colon damage, but he could have been 8, 10, 12 (18?) years old wearing a diaper / nappy and unable to push anything out. I urge anyone – if you have something serious, or something odd that can’t be diagnosed, run fast back to your home country and good doctors (and since I said USA has among the best doctors in the world, a shout out to Canada as my son’s specialist is from Montreal, of Indian heritage, and an alum of McGill U and medical school in Ireland and an amazing doctor). A friend in Bangkok recently was diagnosed with a small treatable cancerous tumor. He wisely flew home to New York for treatment and has now beaten it and is doing well. I would not have any faith in Thai doctors to take on a tumor. Back in 2003 in Thailand, not knowing any better I had a small procedure done in Bangkok. Later, 2 US Doctors said “I would not have done it that way. There are better and easier ways to do it.” I personally have no respect for Thai doctors and would not go to one for a broken finger. I would wait it out until I was back in the US. Just beware, you have been warned.

The author can be contacted at :

nana plaza