HermesHermes

At Thonburi Hospital now. Five minute cab ride from Starbucks General. Seems a little bit more normal, i.e. upper middle class? Staff more friendly than obsequious. Curiously, staff claims that they have a lung doctor working today. I am skeptical. Lost in translation? Offered a mask. Took my symptoms and history standing up at counter rather than sitting in a plush chair. The usual blood pressure, oxygen and weigh-in (technician fouled up and called me back asking what my weight and height are. "That's your job. Do it again!") Staff member at this step of taking vitals speaks English, though I suspect he does not understand well. Almost immediately taken to sit to see a doctor. Everything going quickly here. Doctor I saw is actually a pulmonogist. Very pleasant, enthusiastic and we communicated well in my minimal Thai. Fancy that, a real lung doctor working on the weekend. Not a kid either. Luck or a regular thing at Thonburi Hospital? Suggested an x-ray, although asked for my consent. Says it would be useful for diagnosis of any serious issues. Knows the price - "500-600" (she underestimated). Thinks I am likely just hypersensitive to severe P.P.M. dirty air in metro India. Asthmatic. Indeed I was as a child. Diagnosis to come. Might be prescribed puffer. Wouldn't be the first time. Basic bronchitis? These are all her pre-x-ray estimates. X-ray seemed rushed. Efficient and pleasant just as in fast-paced India where everybody seems hyperactive. Nothing chill about the pace like I am used to in Cambodia (BTW, I don't recommend living in that capital city of sorts if you have any chronic health issues that require frequent and/or well-qualified medical attention - it is a place to go to die. Many old men indeed do make it their last stop as an expat or sojourner in Southeast Asia). Conclusion: asked me if I prefer oral or puffer. I responded with it depends on what works best and price. She claimed that puffer is more efficient. Prescription: take oral antihistamine and a bronchitus puffer (of the usual ingredients? This one is Salmetrol & Fluticasone) for two weeks or until better. Could I buy the meds cheaper at a drugstore? Certainly. But what is my time worth? I have already spent 3.5 hours on this task. Damage... Medical: 1560 Pharmacy: 2407 Total: THB3967 = CAD148 Would I come back to this hospital?: Yes, though not as my first choice. Would I see this pulmonologist again?: definitely, Dr. Wanda Intharanongphai is the cat's meow. The physician impressed me more than the place. Would I buy drugs from this hospital again?: Probably not. Over half of my expenditure was on drugs from GSK, manufactured in USA. Ouch! Why the space age design delivery? Something wrong with a normal finger-operated metal cylinder? Am I an invalid and can't manage that athletic action? I had asked her if a generic would suffice and she said not really. Since hospitals in Thailand have a reputation of undercharging on professional fees and overcharging on drugs, I am skeptical. I suspect she is not permitted to say, 'you can buy Thai-made or Indonesian import equivalent for a third the price'. BTW, when a doctor from a private hospital in India ten years ago prescribed the same regimen the meds cost 20-30% of this. I should have seen a doctor in Mumbai where the patent is on process rather than formula, circumventing big pharma drug prices and in the process being the world's best value centre for pharmaceuticals. But it wasn't until that last taxi ride that my symptoms became so bad. Warning: It is not being a sissy to wear a mask in many places in China and India. Do these drugstore masks even help?

The new Siriraj bears zero similarity to the iconic and established Siriraj I am used to, with all its faults. I am here now. First impressions: lux hospital, similar to Bumrungrad. Air-con restaurants, live piano music. Pleeeeze, I just want a functional hospital. Registration: No Gulf state visitors or farang. Obvious by dress and grooming these are all wealthy Thais, not even middle-class. Bowing and scraping nurses in immaculate uniforms. Form to fill out. Instant card. Triage: asked symptoms and history. Suggested an intern for immediate consultation or go to chest clinic on third floor to see a specialist. She recomended Chest Clinic but did not say why. They do not know I will be here in Bangkok less than a week. This is the weekend. Specialist's work weekdays. Consultation: Chest clinic MD (pulmonologist?) not available until till Monday 2/21, four days from now. Soonest they could do when pressed was 16:15 on Tuesday, the day before I fly to Singapore (and no way will I seek non-emergency medical care there). I really should have come yesterday, Friday, and early. But I just bussed in from Pattaya in the afternoon and am not keen on any hospital there except BKK. Pattaya and their prices have gone through the roof IMHO. In 2013 they were premium but still affordable. Not now. Anyway, seeking medical care when travelling and zipping from country to country doesn't get you any follow up. Thirty-six hours before take off - would test results (x-ray, sputum, whatever) even be back back in time? But the clincher was this - staff at their computers at Chest Clinic can't (or won't) tell me the price for a consultation. Bad sign. All they will tell me is "+25%", i.e. non-resident surcharge. Too vague for me. Also, English fluency is horrible here after Mumbai and KL. Worst at the Chest Clinic counter. At least at Registration they have a couple of staff who are semi-fluent. Conclusion: I will take your advice and go to a mid-tier not for profit hospital. I don't care about the amenities like ice cream shops and gold-plated toilet seats or whatever elite features they offer here. Where do lower-middle class to middle class Thais get medical care if for some reason (e.g. if they are refugees or illegal overstayers) they don't get their doctor's visits paid by the public purse? Better yet if these symptoms worsen I will go to my local small town hospital in Malaysia when I get there Feb. 23ish. Is it good? No, but it is free and best of all since I will be there ten days it makes sense. I am tempted though to go back downstairs and see a non-specialist regular doctor though. Thing is, all he is likely to do is do a non-instant COVID test and prescribe antibiotics without tests. My guess only. Siriraj this is not. Same location only.

Thanks for link. I just checked the connected private hospital and while they do have several pulmonologists all appear to be working in the pediatric section. Just like at Siriraj public. Q: "Are you trying to be seen through the public channel or private wing?" A: Whatever is better value in Bangkok Noi. A private hospital attached to Mahidol University's Medical college did not exist five years, I believe. Symptoms & history: persistent phlegmatic cough since India (aggravated after taxi ride with window open for an hour in Mumbai). Roommate had COVID there. He recovered and I tested negative w/ATK. Previous lung problem: severe double pneumonia caught in remote Laos in Nov. 2021. Treated and recovered. Two current changes of medications on unrelated issues. Wheezing when lie down at night. Continuing for several weeks. Public vs. Private: I prefer public hospitals in Thailand due to much reduced costs (I believe also for foreigners). Plus it includes a ferry ride to get to Siriraj and a visit to some strange museums. In India and Malaysia I go to public hospitals (free, tax-supported). In Vietnam, likewise (cheap). Sure, you get more specialized care (certainly faster) at commercially viable hospitals everywhere. And I have done so in two countries mentioned above plus Malaysia and Thailand, even Bumrungrad. But paying 3-4 X more I am not convinced is better value. Often there are features like decor and coffee shops that have nothing to do with quality of medical care. Wouldn't surprise me if same doctors work at both. Also English fluency is a problem in Thailand and I do not speak Thai well. Last time I was at Siriraj I had the distinct impression that I was charged significantly more than I had been in the past. So, does this mean that we are now being discouraged from using the tax-funded system? Siriraj seemed rather bureaucratic and slow, even confusing. In general I find Malaysian expat medical care, at least in private hospitals, better value than Thailand. And I am travelling there in several days. Language is also less problematic. But I would rather get this respiratory problem looked at sooner rather than later.

I am illiterate in Thai. And the website seems to be semi-functional (or maybe it's me). I tried clicking on the English button but that takes me to the University. I clicked on the 'make an appointment' button but that eventually (like ten minutes later, and the third try) took me to a Thai webpage naturally. So I figured just look up on Google 'pulmonology consultations Siriraj' - nothing. Somehow I did find an Emglish-lamguage webpag but the listed hours are only for pediatric pulmonology. I read info such as out-patiemt dictors are available hour X to Y 'working days' (does this mean week days?) All I am trying to do is either make an appointment or find out what days the pulmonologists are taking walk-ins, say Wednesdays and Fridays between 08:00 and 12:00. Then I will show up on that morning and queue up. I actually have a membership card there, with photo and everything. Probably expired.

For my current and last six entries (and even exits) from Thailand over the last two years, things do not go as normally. The Immigration employees at the border are always polite. Eventually (i.e. after ten to twenty minutes) my passport is stamped and no comments are ever made to me. But I find it all very strange, as if my movements are being especially monitored. Usually the person at the other side of the counter just spends an unusual amount of time, buttons are pushed, supervisors are called in to take over. Originally I was taken aside for further keyboard punching. Once I was told that there must be someone with the same name or birthday. So? What gives? I am not enlightened as to what the non-problem problem is. I mean, if someone amd myself could be confused why doesn't the manual over-ride take care of the confusion once amd for all? The most I have ever been told is that is a 'technical problem' and would resolve itself with time. I am skeptical. I mean, if it is just that, why did the guy this time manually take a photo of my passport with his phone? I could understand being denied entry or being searched. But neither occur.