Why are Thai public hospitals so crowded?

[Brunolem]

I recently brought my son to the local (amphoe) hospital.

A small infection, nothing requiring the services of a brain surgeon.

Arriving around 9 am, he was given the number 95!

That's when I realized I had forgotten to bring along my camping gear...dammit!

The thing is that the locals do not hesitate to show up hours before the opening...as if they were going to put on sale the new iphone XXXL!

 

To be fair, things went pretty well.

Thanks to a triage system way beyond my comprehension, it was all said and done in a mere 2 hours.

First, a urine test, then a visit to a young doctor who knew what she was talking about (reassuring) and who spoke and understood some English (mindboggling), and finally the pharmacy to collect the antibiotics, plus the ubiquitous paracetamol, a medicine known for treating absolutely everything, including and especially amputation post trauma.

And the whole thing at a cost of...zero! Amazing Thailand indeed...

 

Having said that, everytime I have visited a public hospital over the years, for one reason or another, I have always found them overcrowded.

Now, in the same way that no American in his right mind would show up in an hospital without a team of lawyers, a Thai will generally bring with him a few of the most resilient members of his close family, along with a member of the clergy, if available (no one is ever too cautious...).

But then again, that in itself doesn't explain the permanent long lines.

It is as if those who had managed to escape the road Russian roulette, a.k.a. road carnage, would nevertheless end up in an hospital, for one reason or another.

Having not recently visited hospitals in other countries, I am left wondering whether the world is so sick, or if it is just Thailand, or what?

 

[Lamkyong]

whole thing at a cost of...zero!

[Thanyaburi Mac]

A few years back our young nephew needed the post-exposure rabies shots, this when the "baht 30 scheme" was pretty new.  The pleasant in the ER asked if I could pay for the shots as this would save their funding for a needed Thai.  I said OK, charged it to my Self & Family insurance plan.  This at the Thanyaburi District Hospital, when it was small, it's being very much upgraded now, new buildings, etc.

 

Mac

[MaeJoMTB]

It's cos the system doesn't use GPs.

Hospital is first port of call for everything.

 

Mind you, in the UK you usually need to wait a week for an appointment with your GP, walk in 2 hours is really quick.

Edited December 1, 2017 by MaeJoMTB

[surangw]

same as any business,  too many customers,  not enough staff

 

[Bob12345]

Why is it so busy?

- understaffing

- no charges

- no system with GPs doing a first assessment

- low education level of population so they go to the hospital for everything (hickups, common cold, sneezing)

[dotpoom]

And what about the Clinics....just look inside when passing ....packed to the rafters, with enough shoes outside to open 20 shops.

  PS....Back home (Western Europe) there is about a 4 or 5 year waiting list to get a bed in a hospital to have a procedure done?

.

[toolpush]

Is the poster really that naive? He wonders why there are long lines and then states that the service was free? Would he maybe be able to put together the fact that it is "free" and why there are long lines?

[hansnl]

18 minutes ago, Bob12345 said:

Why is it so busy?

- understaffing

- no charges

- no system with GPs doing a first assessment

- low education level of population so they go to the hospital for everything (hickups, common cold, sneezing)

The GP's, contrary to what you seemingly imply, are part of the system in the hospital.

The first doctor you will see, probably will be a GP.

However, in many places the GP is disappearing from the bigger hospitals and appearing in smaller clinics while patients are actively sent there.

If necessary the local GP will send you to specialist's care in the big hospital.

In Khon Kaen the number of waiting patients+ are getting less.

Me, for small things I will go to the local clinic.

 

[ksamuiguy]

I find the service greatly improved in the last year or so.

to many patients and not enough staff , but they get the job done!

[simoh1490]

26 minutes ago, Bob12345 said:

Why is it so busy?

- understaffing

- no charges

- no system with GPs doing a first assessment

- low education level of population so they go to the hospital for everything (hickups, common cold, sneezing)

To correct a couple of minor points:

 

There is no shortage of medical staff in Thailand, if anything there is an oversupply. There is, however, a structural problem in that more and more medical staff gravitate towards private hospitals where wages are much higher. That problem has in part been addressed by requiring new doctors to spend a percentage of their time working in government hospitals for the first five years of their career.

 

Co-pay is becoming quite common in many hospitals.

 

As said previously by another poster, hospitals do operate a system of triage hence the role of the GP is transferred to the triage system.

 

The pharmacist is the first port of call in Thailand for all things medical, not the hospital.

 

[kbb]

Have no problem with public hospitals here. 

Have seen them in action on Khon Khan, Bangkok, & Pattaya. 

This week was at Queen Sirikut (Naval) hospital in Sattahip for the 1st time. 

Was there with no appointment to get confirmation that a minor ache was in fact nothing serious. 

Trying to avoid the higher (much) fees at a place like Bangkok Hospital here in Pattaya. 

 

Every hospital seems to have a different routine for registration & such.

Details aren't important -- What you need to know is you should have a Thai with you. English is not  guaranteed. 

 

This hospital had an odd PAYGO method. At every step (Nurse, Dr, xRay, Pharmacy) you'd be directed to a payment window before proceeding on. Fine, once you get used to it. 

 

The building was a bit old, but it was very clean, and quite organized. The staff were nice and helpful. The computer system was actually top rate, and tasks like registration, ID cards, xRays, test results were handled very efficiently. 

 

As for crowding, the worst holdup was the pharmacy. But even that was no worse than a bad afternoon at Kasakorn Bank. 

 

 

[maxisrael]

18 hours ago, Lamkyong said:

whole thing at a cost of...zero!

WOW ! i was in Bangkok hospital due to the fact i need a differed doctor with was not available in my 'regular' hospital with is usual crowded as well, and now i know why Bangkok hospital is very expensise ! therefore hardly any ( Thai) i guess but only a few foreigners........

Rates are nearly triple form  my regular hospital Mc Cormick in Chiang Mai.

[simoh1490]

19 minutes ago, maxisrael said:

WOW ! i was in Bangkok hospital due to the fact i need a differed doctor with was not available in my 'regular' hospital with is usual crowded as well, and now i know why Bangkok hospital is very expensise ! therefore hardly any ( Thai) i guess but only a few foreigners........

Rates are nearly triple form  my regular hospital Mc Cormick in Chiang Mai.

Both of which are private hospitals, not government hospitals.

[Bangkok Barry]

It is a similar situation with many places that Thais need to go to. Everyone gets there very early so they don't have to wait, but then they have to wait anyway because the place isn't open yet/the doctor hasn't arrived etc. Thai logic in action. If you instead arrive 20 minutes before closing you usually don't have to wait at all as the crowds have gone. Try explaining that to a Thai though.

[jippytum]

I have been using government hospitals in Thailand for many years .I have always been presented with a bill including a  consultation fee  .  I am happy to pay the charges which are reasonable compared to private hospitals.  Never on any occasion was it free of charge. Government hospitals in Thailand are deeply in debt and for a foreigner to receive free treatment  and then wonder why so  Thai low income people are seeking treatment  at the same facility is absurd.

[Brunolem]

2 hours ago, Bob12345 said:

Why is it so busy?

- understaffing

- no charges

- no system with GPs doing a first assessment

- low education level of population so they go to the hospital for everything (hickups, common cold, sneezing)

It is not the staff, or lack of it, that explains the number of patients.

I agree with the zero cost, never a good idea, and the fact that people go there for anything...

[Brunolem]

12 minutes ago, jippytum said:

I have been using government hospitals in Thailand for many years .I have always been presented with a bill including a  consultation fee  .  I am happy to pay the charges which are reasonable compared to private hospitals.  Never on any occasion was it free of charge. Government hospitals in Thailand are deeply in debt and for a foreigner to receive free treatment  and then wonder why so  Thai low income people are seeking treatment  at the same facility is absurd.

I would suggest that you read again the first line of my post.

The visit to the hospital was for my son, who is Thai, and not for myself.

[Brunolem]

2 hours ago, dotpoom said:

And what about the Clinics....just look inside when passing ....packed to the rafters, with enough shoes outside to open 20 shops.

  PS....Back home (Western Europe) there is about a 4 or 5 year waiting list to get a bed in a hospital to have a procedure done?

.

Europe is a different case.

Hospitals, and almost everything else, are filled with elderlies who die a slow death, over years or even decades, at a huge cost for society.

They call it progress...

 

[Brunolem]

1 hour ago, toolpush said:

Is the poster really that naive? He wonders why there are long lines and then states that the service was free? Would he maybe be able to put together the fact that it is "free" and why there are long lines?

Free certainly is a factor, but would someone not feeling sick go to the hospital, wait for hours, just because it is free?

[BsBs]

So useless for Thai to go to hospital so often, and they actually mostly die because of the food that they eat !

[simoh1490]

3 minutes ago, BsBs said:

So useless for Thai to go to hospital so often, and they actually mostly die because of the food that they eat !

.....is the wrong answer, but thank you for playing!

[Tchooptip]

This very week my wife felt so bad all the night without understanding what was happening, so on the morning we decided to go to a hospital, we are in Maret, we knew it would have been cheaper in Nathon the public hospital in Samui, but she felt so bad and so weak, I said lets go to International Hospital in Bhoput it's nearer, she stays 24 hours for blood test and Xrays, they did not find anything...so the next day in the afternoon they sent her back home ... 22 000 ฿

In Nathon, the public hospital not sure it would have cost 10 000฿

[tinca tinca]

because they go and there is no reason to go....they go with a cold and a cough, and think "OH I MUST GO OSPITAL"....they would be no good living in the west, in the northern hemisphere.....

[Altalake]

We have found over 20 years or so the Thai medical services to be pretty good. Often more caring and meticulous than the West. Where it often seems to be a business.......

 

Yet some haughty folks still decry it!

 

Not us!

[Brunolem]

4 minutes ago, Tchooptip said:

This very week my wife felt so bad all the night without understanding what was happening, so on the morning we decided to go to a hospital, we are in Maret, we knew it would have been cheaper in Nathon the public hospital in Samui, but she felt so bad and so weak, I said lets go to International Hospital in Bhoput it's nearer, she stays 24 hours for blood test and Xrays, they did not find anything...so the next day in the afternoon they sent her back home ... 22 000 ฿

In Nathon, the public hospital not sure it would have cost 10 000฿

Many private hospitals, especially the Bangkok Hospital chain and the Bunrumgrad, are in the racket business!

Your story is sad, but small potatoes compared to the scams these hospitals pull up.

Even if you are well insured, you have to be very careful, because they do their best to push the bill up to your insurance limit, and then keep on invoicing while refusing to let you go as long as you don't pay!

Last year, a Swedish guy was caught up in the Bumrumgrad net.

They charged the 500,000 baht (five hundred thousand!) covered by his insurance in a few days, then kept on charging at a rate of 50,000 baht a day!

It became a Swedish national issue and the population had to come together and help paying for the ransom in order to free the poor guy...

[billmichael]

2 hours ago, dotpoom said:

And what about the Clinics....just look inside when passing ....packed to the rafters, with enough shoes outside to open 20 shops.

  PS....Back home (Western Europe) there is about a 4 or 5 year waiting list to get a bed in a hospital to have a procedure done?

.

In the USA, patients who clamor for "ObamaCare" would wet their pants if they knew how "socialized medicine" worked in real life.  The combination of available (for a price) insurance and greed keep the cost of care at nosebleed levels.  There is simply nothing to keep the price down, no competition, no regular market forces, nothing.

[Bob12345]

1 hour ago, Brunolem said:

It is not the staff, or lack of it, that explains the number of patients.

The staff, and lack of it, might not explain the number of patients but it does explain why it is so busy (which was the question).

A doctor can only help so many patients an hour. Get double the number of doctors and they can process patients quicker making it less busy.

[Spock]

1 hour ago, Bangkok Barry said:

It is a similar situation with many places that Thais need to go to. Everyone gets there very early so they don't have to wait, but then they have to wait anyway because the place isn't open yet/the doctor hasn't arrived etc. Thai logic in action. If you instead arrive 20 minutes before closing you usually don't have to wait at all as the crowds have gone. Try explaining that to a Thai though.

The same applies to prison visits. Lots of people arrive well before visiting time so you have to wait quite a while in the morning but in the afternoon visiting is relatively easy.

[yardrunner]

2 hours ago, simoh1490 said:

To correct a couple of minor points:

 

There is no shortage of medical staff in Thailand, if anything there is an oversupply. There is, however, a structural problem in that more and more medical staff gravitate towards private hospitals where wages are much higher. That problem has in part been addressed by requiring new doctors to spend a percentage of their time working in government hospitals for the first five years of their career.

 

Co-pay is becoming quite common in many hospitals.

 

As said previously by another poster, hospitals do operate a system of triage hence the role of the GP is transferred to the triage system.

 

The pharmacist is the first port of call in Thailand for all things medical, not the hospital.

 

if you want to risk your life make the pharmacist your first port of call i take a blood thinner (warfarin) and was taking it when i was still in the UK and the rule was always tell the doctor or pharmacist that i was on warfarin before they recommended any medicine, and the answer was always to try and avoid any medication but that if i really needed something this one should be OK but avoid these ones.  In Thailand i needed medicine for a cough so went to a pharmacist and was recommended a treatment that i was told would not react with warfarin so i took the medicine, Big mistake i ended up in hospital for three days as the medicine prescribed was not to be recommended for any patient on blood thinners. i was lucky but now if i want medication i go to the hospital and see a doctor i know and even then i check the medication on line before taking it,