Why are Thai public hospitals so crowded?

[Brunolem]

5 minutes ago, Bob12345 said:

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.

The question would then be: how many doctors and medical staff should there be?

What is a reasonable waiting time?

There are other factors that contribute to the crowding, such as the "free of charge" mentioned by another member above.

If patients had to pay, say, 100 baht per visit, the number of patients would probably fall rapidly.

The same goes for many issues.

One could argue that the number of road accidents would be reduced if there was a cop on duty every kilometer along the roads...or that the pupils' level would increase if there was one teacher for, say, only 10 children...

But all this staff, medical, police, teachers, comes at a cost that many are not willing to pay...

[Proboscis]

3 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)

If in the USA there were:

- free treatment, no questions asked for everyone, including foreigners

- doctors even speak a language other than the official national language

- you are in and out within 2 hours,

I guarantee you there would be queues around the block!

 

Even the NHS in the UK which is free will make you wait for everything. A non-emergency case would expect much longer wait than 2 hours.

[Tchooptip]

53 minutes ago, Brunolem said:

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...

No, my story is not "sad" 

I certainly would not have gone for sure to Bangkok hospital in Samui, I hesitated with Brandon hospital where I had already gone 2/3 times and the low bills had always amazed me.

On the other hand, 3 months ago I went to International hospital myself for redness under the arms, they told me you are lucky because today there is a dermatologist consulting, I saw a lady lets say ten minutes, she told me no problem you have a small fungus infection...you wait a little I will prepare my own cream and own body wash they more efficient, after a few minutes they gave me a little bottle of liquid soap and a tiny cream pot with maybe 20 grams of cream, no name or anything about ingredients  in  it...I went to pay....  4500฿

So yes that was a rip off for sure, for in any pharmacy a tube of antifungal cream cost  200฿,

 I did not learn my lesson from this hospital because my wife looked so bad and it was nearer. We are together for 6 years and she is certainly not oversensitive and never complain about anything!

[MaeJoMTB]

1 hour 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฿

Government hospital is free, my local does blood test in 2 hours. Sounds like they ripped you off, foreigner husband showing his face is always a mistake.

[janclaes47]

22 hours ago, Brunolem said:

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

 

So after all it took you maybe 30 minutes more, from start to finish, as it would have taken at Pattaya - Bangkok hospital, where you also would have paid through the nose.

[ToddinChonburi]

Your free socialized  health care,  hope you enjoy.

[Brunolem]

17 minutes ago, janclaes47 said:

 

So after all it took you maybe 30 minutes more, from start to finish, as it would have taken at Pattaya - Bangkok hospital, where you also would have paid through the nose.

That's exactly right!

[silent]

3 hours 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.

It's because punctuality is as cultural as the almost religious conviction of hurry up and wait syndrome. For many here the concept of space and time calculation is as foreign as map and clock reading or connecting dots.  "This is the dimension of imagination. It is an area which we call the twilight zone."

[blazes]

3 hours ago, Brunolem said:

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...

 

 

I assume you have quite a long time to go before you are one of the "elderlies"?

[natway09]

Next time your Son gets sick take him to an American Private  Hospital then.

Stop bashing

[Brunolem]

1 minute ago, blazes said:

 

I assume you have quite a long time to go before you are one of the "elderlies"?

Not so...already reached the 60s, yet not motivated by the artificial "immortality" promised by the wonders of medicine.

 

I always thought that the natural average age of passing away, around 75, was quite alright.

 

My family is full of people in their late 80s and 90s, most of them boring themselves to death, yet not dying, but talking and thinking a lot about it...

[blazes]

2 hours ago, billmichael said:

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.

 

I confess to being confused by this offering.  The second sentence describes with great accuracy the American system.  However, you seem to be condemning single-payer systems around the world where the cost to the individual is paid for in taxes, not in "nose-bleed" insurance premiums.

 

It's surely not accidental that all those polls done to discover the "best places to live"  come up with the Scandinavian countries and Canada and NZ and places like that, where taxes are high but medical treatment guaranteed, even if the wait for non-emergency treatment can be lengthy.

[Brunolem]

6 minutes ago, natway09 said:

Next time your Son gets sick take him to an American Private  Hospital then.

Stop bashing

What bashing?

Please read again carefully my original post, then quote the parts that you consider as being "bashing".

 

This thread is about the large number of patients visiting the public hospitals, it is NOT about the quality of these hospitals' services.

 

[Brunolem]

19 minutes ago, blazes said:

 

I confess to being confused by this offering.  The second sentence describes with great accuracy the American system.  However, you seem to be condemning single-payer systems around the world where the cost to the individual is paid for in taxes, not in "nose-bleed" insurance premiums.

 

It's surely not accidental that all those polls done to discover the "best places to live"  come up with the Scandinavian countries and Canada and NZ and places like that, where taxes are high but medical treatment guaranteed, even if the wait for non-emergency treatment can be lengthy.

If left to themselves, all the "socialist" healthcare systems would be bankrupt!

Nowadays, with the states being themselves bankrupt, it is money printing that keeps both (states + healthcare) alive...barely...

In the US, it is the patients who are going bankrupt, while the private healthcare corporations are doing fine, thank you very much.

Having balanced systems would be like squaring the circle...it could be done, but not without some serious effort and pain...

 

Edited December 2, 2017 by Brunolem
Spelling

[khunPer]

On 12/1/2017 at 7:57 AM, Brunolem said:

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?

You always have the option of a private hospital, or a clinic in some cases, where you will be treated as urgent VIP for a charge.

 

Two hours waiting time at a public hospital without prior arrangements seem fair to me, when I compare with my Western home country – once claimed to be among the best in the World with public health care (so our politicians convinced us) – where I've seen long queues of people waiting, and in news articles read about folks waiting several hours in pain at emergency waiting room. Today one cannot walk into a hospital, even emergency, without a prior telephone arrangement, where the operator will try to get you to first consulting your normally used doctor.

 

A close friend of mine complained about heavy abdominal pains, but could not get a hospital appointment as it was Easter-time, almost all doctors were on vacation and most non ICU-patient send home during the holiday. My friend was about to take for a planned trip to Thailand – very experienced Thailand visitor during some 25-years – but the pain got so bad that he cancelled his flight, and when finally coming to a hospital after Easter in severe pain, he not only suffered from appendicitis, but it had burst during the waiting (I think that is quite serious). My friend said that had the pain come just a few days later, then he would have been in Thailand, and then he would have been treated immediately, even at a public hospital, before the appendicitis had burst...

 

I'm happy that I live in Thailand, where I sometime has been driving friends from neighborhood to emergency at a public hospital, and they have always been taken care of immediately.

 

One time if my life I was myself in need of being send to an emergency room at a public hospital – unfortunately in my home country the year before I moved to Thailand – however there was no doctor available at late evening, so I was waiting all night in a gangway, and I was not the only one stored there, as there was no other place with free space. In the morning I was however feeling fine again, and said that I would prefer just to go home, because I could not see any reason for waiting longer. But I had to wait till 9 o'clock, because a doctor's visitation was mandatory, and when the kind doctor showed up, he said they needed an X-ray – I had been to Southeast Asia, so they were probably still scared about SARS or anything alike, at that time – I could have an appointment for an X-ray, and a blood test, the following day, and then come back for consultation the day after at 9 am; officially I was still hospitalized. When I showed up for the consultation, I meet another kind doctor, who said he didn't know where the X-rays were, and therefore he hadn't seen them, but since nobody (???) had mentioned anything, everything was probably Okay – the blood test was never mentioned – and I was free to leave... 

 

The second time in my life I've was in need of using a hospital, was luckily a Thai public hospital – due to dengue fever, not serious enough for emergency, as I had almost recovered myself – but within a couple of hours, and with no prior arrangement, I had seen doctor, had blood test, had lab-results, and seen the doctor again, who confirmed I had a dengue infection, and prescribed some medicine. All done between morning and before noon, and with an appointment for a re-check a week later – I dare not to think of, if that had been in Denmark...

[MyFriend You]

Subject:  Why are Thai public hospitals so crowded?

 

Answer:  And the whole thing at a cost of...zero!

 

You asked and answered your own question.  Thais will go to the doctor is they fart too much.

[MyFriend You]

3 hours 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฿

True story  -  my farang neighbor had a motorcycle accident, drove into a huge hole in the middle of the street at night - Ambulance came and took him to a Hospital in Chon Buri, his accident was in Jomtien - they kept him for 2 nights and 3 days - he felt fine, so asked when he could go home, they said five more days , he called his GF and told her to call the hospital and tell them his insurance had expired and he had no money - they released him that day .... his story not mine.  When she asked why they took him to the Chon Buri hospital, the company said "thats our hospital, we take all farang there" 

[WHYWHY]

A very loaded question 

Why is any hospital full Thailand does not hold a Monopoly oh hospitals being busy 

Go anywhere in the World you will find the same 

[BAYBOY]

i have used several Thai public hospitals over the last 10 years...apart from the waiting time(perhaps on 10% of my time) I have only praise how well they are run.

Remember Thais are "morning people" so they get to the hospital well before opening time. Try going mid afternoon and the place is empty of patients.

our Amphur has approx 20,000 adults and 1 public hospital. The only private clinics available are closed during the day as those doctors are working in the Public hospitals. Every Tuesday morning is the Diabetic clinic and the place is humming, again mid afternoon it is empty. 

Last week I had my medical for extending my work permit...blood test ,urine test, chest xray, and a brief talk with the doctor. Went at 3pm, in out 30 minutes cost 500 baht.....wonderful.

 

Cheers BAYBOY?

[Dumbastheycome]

Too often    what  appears  to  be an inundation of patients is  actually  the  presence  of  " family    support" individuals.

Those   can  include any  and  all  who  desire  a  day  trip  away  bringing   infants  and  grandparents   as  extremes  of  the   greater  family  spectrum who  happily  occupy patient  seating   and  if  available  select   entertainment  on  the  provided tv,  clog   access  to   or  utilize  wheelchair   facility, attempt  to    jump   the  queue  ( because   really  the   just   wanted   to  come  to  town  to  go   to   Bic Z,    Tusco   Let  us,  etc  so    hurry  up  ) and  do   not  really   give  one  dot  of   concern   for   who  ever  has  a  hangover   but  insists  on    seeing   a  neurosurgeon!

It    could  be  and  should  be  stopped    but  unlikely   because  the  downstairs 24  hour food  franchise  operations   pay  so damn  well  the   hospital  itself   provides  venues  for  entertainment   for  the  ridiculous  volumes   of Day  squatters   who  put themselves  at  risk of  cross  infections !

Ward    Managers lease a ll   VIP  rooms to   an enterprising individual   who  extorts  an  increased  cost.

Despite  the   30  Bht  scheme   Thai   public   hospitals   are so   open  to  extort  those  who  think a Hospital  Orderly is  some  sort  of  Doctor!

 

[BsBs]

15 hours ago, TunnelRat69 said:

True story  -  my farang neighbor had a motorcycle accident, drove into a huge hole in the middle of the street at night - Ambulance came and took him to a Hospital in Chon Buri, his accident was in Jomtien - they kept him for 2 nights and 3 days - he felt fine, so asked when he could go home, they said five more days , he called his GF and told her to call the hospital and tell them his insurance had expired and he had no money - they released him that day .... his story not mine.  When she asked why they took him to the Chon Buri hospital, the company said "thats our hospital, we take all farang there" 

 

When it's not a life emergency (or even...) ambulances bring you to the hospital that pay them the most, of course private. So anybody with a brain who is not in coma must tell that he wants to go to a public hospital.

 

 

 

 

[BsBs]

11 hours ago, BAYBOY said:

i have used several Thai public hospitals over the last 10 years...apart from the waiting time(perhaps on 10% of my time) I have only praise how well they are run.

Remember Thais are "morning people" so they get to the hospital well before opening time. Try going mid afternoon and the place is empty of patients.

our Amphur has approx 20,000 adults and 1 public hospital. The only private clinics available are closed during the day as those doctors are working in the Public hospitals. Every Tuesday morning is the Diabetic clinic and the place is humming, again mid afternoon it is empty. 

Last week I had my medical for extending my work permit...blood test ,urine test, chest xray, and a brief talk with the doctor. Went at 3pm, in out 30 minutes cost 500 baht.....wonderful.

 

Cheers BAYBOY?

 

It's far to be always true !

Sometimes the queue is so long that if you do not show in the morning they won't give you any queue ticket !

 

 

 

 

 

[Keesters]

22 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)

and a very sick nation due to poor diet and lack of exercise. Sugar in everything. Double and triple park rather than walk for 2 minutes.

 

[Rally123]

Next week I have to travel 340 km to a private hospital in BKK. Was told there's no appointments system. The doctor begins consultations at 9am and we need to arrive about 7am to submit my name to get a place in the queue. The doctor only works until 12 noon. If we get there too late I won't be seen. What is wrong with these people and having a working appointments system?

Edited December 3, 2017 by Rally123

[KMartinHandyman]

I haven’t experienced it personally in my one trip to the local government hospital to get a physical for the vehicle license certificate but my wife says the whole place shuts down for lunch and she comes home if still on the cue and goes back after one o’clock. It’s kind of quant and puts the place in perspective as this is normal for life in our little city.

[joecoolfrog]

23 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?

.

Nonsense !

[samsensam]

 

not a thai problem as such, same problems in the uk, failure to meet government targets; long waiting lists for operations, long waits at a&e. to be seen as a non-urgent patient in 2 hours is pretty good going. you want a better service go to a private hospital, you pay your money you make your choice.

[sandyf]

On 12/1/2017 at 6:20 PM, MaeJoMTB said:

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.

Last time I walked into a UK hospital I had wait about 4 hours.

 

The cancer hospital in Chonburi used to be walk in and it was chaos first thing but they have now changed to an appointment system. I went along on Tuesday(28th) and got an appointment for the 22nd December. They do a fairly good checkup for about 1600 baht.

[canuckamuck]

My criticism of the Thai public hospital system would not be that it is crowded. As has been mentioned, this is the way to the GP, so there are always going to be lots of people going to a GP everyday in any country. It is just that Thailand has an aversion to making appointments and prefers the rush seating approach. You show up early and get a better place in line. If you are an emergency case you will get some attention pretty quick though. Also as already been mentioned, people go to hospitals with whatever group feels like coming along. I recently took a woman to the hospital and I had 6 people in the back of my truck and one in the front. We all assumed she was dying though, so it was a special case. But three support people is quite common.

Being one of the few people in our remote town with a truck. I drive a lot of people to the hospital and the number one problem I have is that the doctors do not ask many questions so they often don't even know about other conditions and complications. And two, they don't tell people what is wrong with them. Most of the time when people get back and we ask what did they doctor say, they say, he just gave me this medicine. But I expect there is major problem in translating medical info to the masses, as well as the masses not being very technical in their own assessments.

Overall, the system, being a free system is very good, and many countries would love to have that type of system.

Just don't be the last person in line to see the doctor before lunch.

[sandyf]

17 hours ago, TunnelRat69 said:

True story  -  my farang neighbor had a motorcycle accident, drove into a huge hole in the middle of the street at night - Ambulance came and took him to a Hospital in Chon Buri, his accident was in Jomtien - they kept him for 2 nights and 3 days - he felt fine, so asked when he could go home, they said five more days , he called his GF and told her to call the hospital and tell them his insurance had expired and he had no money - they released him that day .... his story not mine.  When she asked why they took him to the Chon Buri hospital, the company said "thats our hospital, we take all farang there" 

Believe it or not, that or Bang Saen are probably the quickest decent government hospitals to get to. A couple of years ago a friend of mine's father in law(Thai) had a serious fall on Koh Larn and they took him to the government hospital in Naklua, they took one look and sent him to Chonburi. They did a scan and said he was brain dead and then put him in a ambulance to his home in Phitsanulok, he died on the way.