Gov. Hospital Exp/Rant

[Solinvictus]

Trying not to be another negative nate foriegner...I felt the need to share my thoughts and experience at a Thai government hospital. I'm still here now. I can speak Thai very well and understand it aswell. Been here 5 years.
 
I find the staff to lack professionalism and some lower nurses or assistants, not very skilled. I can't say they are lazy but dam near border line. The student doctors look like a group from a mainstream tv series and relying too much on textbook diagnosing. The bathrooms don't support me as I need a wheel chair to enter the stall. There is nothing to grab for support in it aswell. This is a hospital bathroom?  The wheelchair doesn't have extensions for my long legs. So my leg was dragged on the way there. Now I must go to level 1 each time I need to go take a load off. I'm on the 9th floor. The staff first did not want to help but did after my wife and I struggled to go ourselves. Also, one doctor told me I could walk and I can't....
 
And here it is..."falang falang falang." This is normal I know but the extent to which it seems to impact their ethics and priorities towards me I find utterly distasteful and of lowbrow character. I try to keep my smile and friendly with a nurse or 2 along with one very punctual and kind doctor who speaks English very well.  
 
If I'm being negative ehhh whatever. Just seems there are things and staff ethics or priorities not to mention facilities that are under my standards I grew up in. I guess get what I paid for too.
 
Thanks
 

 

[observer90210]

In which city would this be ? Bangkok ?

[Rc2702]

Well best wishes to you and all that and I hear you. I speak thai minimally and 9 months ago against mine and a pharmacist's judgement my Mrs opted to have our son in a gov hospital in NE Thailand, small city. Choice wise locally we had none and maybe she wanted her folks there so I supported her decision but I made that very clear. The delivery was nit too bad where it went wrong was the suite we paid extra for. Was a disgrace. 1 inch of dirt along the sills stuff like that. We had her mom sleeping in the room too and I was so buzzing with the birth I did not do any duedil.  9 hours in that room I started feeling quesy my Mrs had some infection and her moms health has never been great. I come back to the room after grabbing 2 hours sleep and even her moms saying "hong kee nok" so I kicked off and got us out in a much larger clean room but not before telling a nurse Mai Sanook when she would goggle at some basic requests. On the upside it taught my Mrs not to make decisions lightly and I do remind her about it when she rushes into things or tries to.

[Solinvictus]

7 hours ago, observer90210 said:

In which city would this be ? Bangkok ?

Yeah, Bangkok.

[Rally123]

I've no problems/complaints about government hospitals other than the cleaners are lazy and the nurses are allowed to watch TV whilst on duty. No discipline over the workforce.  

[colinneil]

Moaning about government hospitals seems to becoming a new pastime for some members.

Yes some have a few failings, but most staff do their best in sometimes difficult situations.

I have only praise for nurses/ doctors at government hospital in Khonkaen, they saved my life.

[worgeordie]

I am an outpatient at a local Government hospital,and very pleased with the service,

staff,and cost.before i attended a private hospital,where everything was about money,

wanting to do procedures,that i found not necessary, plus very high cost of drugs.

 

If you are not happy with what is happening to you at a Government hospital, check

into a private one, if you can afford it.

regards worgeordie

[Sheryl]

The physical infrastructure varies greatly by hospital. Some affiliated with universities benefit from more funding (grant monies, private endowments etc) than is available to others

 

It is a great mistake to equate the physical appearance and physical amenities with quality of medical care (though of course absence of wheelchair-appropriate facilities is a significant barrier for the disabled...Thais rely on family members to physically carry them in and out of restrooms  and even up and down stairs etc). 

 

The most egregious malpractice I have seen in Thailand has been in private hospitals, especially upcountry ones. With lovely modern-looking buildings and nice furnishings.

 

The biggest problems with government hospitals as I see it is (1) very limited time with doctors, everyone very rushed (2) most care given  by medical students/interns/residents in training, and while they are supervised the level of supervision is sometimes not adequate as senior doctors can be over-stretched (3) the crowds and waits, and inability to book in advance - these are especially hard for those who do nto live near the hospital.

 

One case of serious malpractice that I personally observed in a government hospital was the result of the supervising professor being stretched too thin plus a group of unusually inept students who not only made a mistake but then mis-informed the supervising Prof. as to the patient's resulting condition.  Aggravated by the patient being Cambodian and thus presumed too ignorant to listen to, her and her family's complaints were not being taken seriously. I was eventually able to reach the Prof directly and luckily it was not too late to intervene successfully, but I had to stage a virtual sit-in strike at the hospital to achieve this. This was at a teaching hospital but one affiliated with a decidedly second rate medical school.

 

On the other hand, the provincial hospital where I live (recently elevated to regional status) has done a superb job of diagnosing and treating people in my village including some very difficult diagnoses.  But yes, the wards are overflowing, patients are in cots in the hallways, relatives are sleeping under the beds (in the wards), most wards have no a/c, there is a complete lack of privacy in the ward, people die in full view of others (and yes, it can take some time to remove the body)  etc etc.   BTW all of these things are also true in the city hospitals of New York -- and they too deliver an exceptional quality of care  under adverse conditions.

 

Dilapadated buildings  often mean that the hospital is not putting appearances first in allocation of its insufficient budget, nor should they.  Overflowing wards is often a good sign -- people are not idiots and if they are flocking to a place and agreeing to be admitted there is a reason. And the overflowing aspect suggests that even when full to capacity the hospital does not turn people away.

 

But it should be noted that quality of care does vary greatly even among hospitals of the same level; there are a few provincial hospitals for example well known to be of poorer quality than most.

[Solinvictus]

Really good replies. Thanks.

Ranging from positive puffer to very thorough summaries with great examples. 555

 

Speaking and understanding Thai well allows for the possibility of more information to be taking into account aswell.

[hansnl]

On 15/11/2017 at 7:04 AM, colinneil said:

Moaning about government hospitals seems to becoming a new pastime for some members.

Yes some have a few failings, but most staff do their best in sometimes difficult situations.

I have only praise for nurses/ doctors at government hospital in Khonkaen, they saved my life.

The medical care is mostly on the same level as what you might get in private hospitals, if not better.

But yes, the rooms in the private hospitals might look better.

But cleaner?

I said look better.

Khon Kaen hospital is my choice also.

[wildewillie89]

Khon Kaen Hospital isn't too bad. The clinic doctors are obviously in training so not much better than the doctors in any hospital clinic, but the specialists are pretty good. Quite comfortable if you admit also with doctors on the wards who constantly keep you up to date on what is happening. The after hours clinic is useful also. Specialists there seem to go out of their way though, I had an infection specialist on his way home, come back just to book some tests for me as he knew I didn't live in Khon Kaen.

Also one test form wasn't completed so the people withdrawing my blood had to call the specialist, and they all remember you being a farang so could give permission over the phone to test for extra things (otherwise would have had to come back another day). Even many months later, the doctors remember you and ask how you are in passing. A couple of others seemed to show real care and took a good 20 minutes to discuss everything, rather than just treating you as another number. 

On the flip side my province government hospital isn't great (no university attached to it), and priorities are a big thing. For priorities to exist, morals have to be thrown out the window. So basically, if you know someone you will get a queue number between 1-10 and can arrive at 9, and be out by 9:30.

If you don't know anyone, you arrive early morning and will be waiting til 3pm with hundreds of other people until you get checked out by the doctor. By that time, the check will be all of 2 minutes and you may have to remind the doctor that they need to actually examine you, rather than just read what the nurse wrote down. Also disgusting toilets. So, of course, it can be hard to stay moral in such conditions. 

Our bigger private hospital is hit and miss. One great baby doctor who even helps us out contacting different specialists/discussing CT results with other hospitals on her days off (who is the family GP now, who also volunteers at the government hospital). Also another totally useless baby doctor works there. Similar with adult doctors, very hit and miss. 

[geriatrickid]

I note the observations and ask the OP, why so surprised? The hospitals reflect the general conditions and behavior one sees in Thailand. Perhaps a reality check is in order, and while it may seem cruel and even elitist, this is how it is in SE Asia. More specifically;

 

1. Status and social rank matters, A patient is often judged based upon appearance. Covered in tattoos, poor hygiene,  shoddy clothes and there is a quick judgement made, just as Thais do in shops, restaurants, offices, airports and elsewhere in Thailand. Adult foreign workers from poor countries  (e.g. the Burmese, Nepalese and Cambodian etc.) are treated poorly because they occupy a low social rank.  The treatment of a middle aged nicely attired  Danish gentleman will be significantly better than that of many other foreigners.

 

2. Biased Perception: Building on point 1, a foreigner using a  government hospital is seen as "poor" and "low class". It will surprise some to read that there are Thais who see foreigners using  government hospital services as a burden and taking away from Thais. It is the same sentiment as one experiences in  our homelands when we see the comments made about "foreigners" using government healthcare. 

 

3. How one conducts oneself matters. A smile, or joke in the midst of adversity works wonders. Calm vocal tones are important even when in excruciating pain. Thais do not react well when someone perceived as occupying a lower social rank gives an order or raises his voice to  someone higher on the pecking order. A doctor can belittle and insult a nurse or a student, but woe betide the student or nurse who talks back. The same applies with patients. Thai doctors often have a problem with their patients  asking questions or inquiring as to their treatment strategy.   If one thinks some of these doctors will tolerate a farang of dubious social status questioning them, you are in for a surprise. 

 

4. Cleanliness: The tropics are notorious for hospital sourced antibiotic resistant infections. The ambient humidity and  general state of filth is not conducive to hygiene. Singapore keeps its hospitals clean, but it is a struggle, even with enhanced  disinfection cycles and some of the most advanced strategies available. The cleaning cycles are  typically more thorough than what one sees in the west.Yet despite this, Singapore still has to deal with mold and mildew. Now, jump to Thailand where unlike Singapore there is no potable water on tap and consider just how difficult it is to prevent infection when every flush of the toilet that introduces dirty water. Air quality in Bangkok is bad. Unless one is in a positive pressure building such that the air pressure blows out, Bangkok's dirt and particulate is going to be coming  in through every crack and crevice.

 

5. Lack of  mobility impaired  facilities: Look around. Do  you see any effort to physically accommodate the disabled as there is in the developed world?  Thailand is the land of obstacles and impairments for those who are in a wheelchair, visually impaired or feeble. The inability to offer the most basic of facilities in a hospital, while deplorable and infuriating is in keeping with a culture that marginalizes  those who are impaired.

 

Complain all you want, but you picked a country that  is 50 years behind the times. It offered  benefits to you when you arrived. Now you must  accept the costs of those benefits if you wish to remain.

 

 

 

 

 

 

[JLCrab]

Thanks for all the info on the government hospitals. I have never been in one as in- or out-patient and the only time I walked though one it reminded me of MoChit bus station at Songkran.

 

By coincidence, should I ever have an emergency where I now live, there are 3 private hospitals closer than the nearest government hospital.