gastroenterologist for traditional diagnostics and treatments

[GeKoSc]

I am looking for an experienced gastroenterologist in Thailand who does not first try to sell an expensive diagnostic procedure but specializes in traditional diagnostics and treatments ... all letters are welcome....

 

[Sheryl]

No goox GI specialist "tries to sell" anything that is not medically necessary.

What exactly do you mean by "traditional diagnostics and treatment"?

And where in Thailand do you l8ve, and what type of GI problem is tbis?

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[GeKoSc]

Hi,

This is what most doctors in today's time do because they are paid for each endoscopy they sell to the patient (cost is roughly USD 1500 -2000 in accordance to the Pattaya hospitals). Some doctor not even touch their patients....Traditional medicine: The way the doctors diagnosed their patients before they could sell this profitable diagnostics...My problem: dysfunction of the intestine...I am living in Pattaya but for an excellent specialist I would accept traveling to other places .

[GeKoSc]

56 minutes ago, Sheryl said:

Did they do a colonoscopy?

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no....

[Sheryl]

Sorry the colonscopy question was meant for a different thread.

 

Most GI specialists do NOT unnecessarily push endoscopies. In fact in my several decades of experience with Thai medical servcies, the tendency is the opposite - if anything excessive reliance on empirical treatment first.

 

You make it sound like doctors are paid covertly by hospitals for "selling" endoscopoies, this too is incorrect. There is a direct fee for endoscopy (varying widely by hospital) and most of that is the doctor's fee. Quite straightfoward.

 

And they do nto cost 1500-2000 dollars, even in Pattaya. Most recent costs I have heard are around $1000 at most expensive hospitals.

 

Have you actually seen a doctor and been advised that you need an endoscopy, or are you just presuming this will happen?

 

I am not sure what you mean by "dysfunction of the intestine" but if you have intestinal symptoms,  depending on what they are, treatment might start with medication and/or diet, or a colonoscopy might  be advisable as it is by far the best means of excluding cancer of the colon and also  of diagnosing conditions like ulcerative colitis. No amount of "traditional" hands on examination can do this.

 

If you are 50 years old or more and have never had a colonscopy, it is recommended that everyone above that age does so at about 10 yearly intervals as a means of screening for colon cancer and catching it early while still curable.

 

For GI specialist in Pattaya I recommend Dr. Varocha Mahachai at BPH

https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=240&depid=11

She is only there on Sundays, rest of the week can be seen at Bangkok Hosp in Bangkok.

 

IF a colonoscopy is recommended and you have a problem with the cost at BPH you can get it done for under 10K at the government cancer hospital in Bangkok  http://www.chulabhornhospital.com/

but will likely have to first go in person to set it up.

 

If your problem is likely to be in the colon (I cannot tell from your vague response) then I highly recommend Prof. Chucheep Sahakitrungruang in Bangkok. He can be seen at Bumrungrad, Bangkok Christian Hospital and Chulongkorn Hospital. The last is a government hospital and will entail waits and red tape, even going through their after hours clinic. Bumrungrad is significantly more expensive than Bangkok Christian though his hours there are only once a week on Mondays https://www.bch.in.th/en/doctor-th-4/surgery/item/584-doc22.html

 

He is a Harvard trained specialist in colorectal problems but would only make sense to see him if your problem is colorectal.

 

I suggest you consult one of these 2 doctors and, IF they recommend endoscopy - which they may or may not, depneding on your hostor yand symptoms - allow them to explain to you why.

 

It is not reasonable to expect a doctor to treat you as they would have back before current diagnostic tools were available if it significantly limits their ability  to detect or rule out potentially life threatening conditions. In fact, it would be unethical and qualify as malpractice to fail to recommend endoscopy if indicated e.g. if the differential diagnosis includes cancer of the colon.

 

I first started to practice back in the days before endoscopies or even ultrasound and the like were available. It was not better, on the contrary a lot of  people died who would not today, and a lot of unnecessary surgery was done. Indeed, back then one of the most common surgical procedures was an "exploratory laparatomy"  i.e. cutting open the abdomen just to see what the problem was, and fix it if it proved to be surgical, otherwise not. Nowadays one almost never hears of this being done, thanks to better diagnostics.

 

 

 

 

 

[GeKoSc]

On 18/3/2018 at 3:17 PM, Sheryl said:

Sorry the colonscopy question was meant for a different thread.

 

Most GI specialists do NOT unnecessarily push endoscopies. In fact in my several decades of experience with Thai medical servcies, the tendency is the opposite - if anything excessive reliance on empirical treatment first.

 

You make it sound like doctors are paid covertly by hospitals for "selling" endoscopoies, this too is incorrect. There is a direct fee for endoscopy (varying widely by hospital) and most of that is the doctor's fee. Quite straightfoward.

 

And they do nto cost 1500-2000 dollars, even in Pattaya. Most recent costs I have heard are around $1000 at most expensive hospitals.

 

Have you actually seen a doctor and been advised that you need an endoscopy, or are you just presuming this will happen?

 

I am not sure what you mean by "dysfunction of the intestine" but if you have intestinal symptoms,  depending on what they are, treatment might start with medication and/or diet, or a colonoscopy might  be advisable as it is by far the best means of excluding cancer of the colon and also  of diagnosing conditions like ulcerative colitis. No amount of "traditional" hands on examination can do this.

 

If you are 50 years old or more and have never had a colonscopy, it is recommended that everyone above that age does so at about 10 yearly intervals as a means of screening for colon cancer and catching it early while still curable.

 

For GI specialist in Pattaya I recommend Dr. Varocha Mahachai at BPH

https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=240&depid=11

She is only there on Sundays, rest of the week can be seen at Bangkok Hosp in Bangkok.

 

IF a colonoscopy is recommended and you have a problem with the cost at BPH you can get it done for under 10K at the government cancer hospital in Bangkok  http://www.chulabhornhospital.com/

but will likely have to first go in person to set it up.

 

If your problem is likely to be in the colon (I cannot tell from your vague response) then I highly recommend Prof. Chucheep Sahakitrungruang in Bangkok. He can be seen at Bumrungrad, Bangkok Christian Hospital and Chulongkorn Hospital. The last is a government hospital and will entail waits and red tape, even going through their after hours clinic. Bumrungrad is significantly more expensive than Bangkok Christian though his hours there are only once a week on Mondays https://www.bch.in.th/en/doctor-th-4/surgery/item/584-doc22.html

 

He is a Harvard trained specialist in colorectal problems but would only make sense to see him if your problem is colorectal.

 

I suggest you consult one of these 2 doctors and, IF they recommend endoscopy - which they may or may not, depneding on your hostor yand symptoms - allow them to explain to you why.

 

It is not reasonable to expect a doctor to treat you as they would have back before current diagnostic tools were available if it significantly limits their ability  to detect or rule out potentially life threatening conditions. In fact, it would be unethical and qualify as malpractice to fail to recommend endoscopy if indicated e.g. if the differential diagnosis includes cancer of the colon.

 

I first started to practice back in the days before endoscopies or even ultrasound and the like were available. It was not better, on the contrary a lot of  people died who would not today, and a lot of unnecessary surgery was done. Indeed, back then one of the most common surgical procedures was an "exploratory laparatomy"  i.e. cutting open the abdomen just to see what the problem was, and fix it if it proved to be surgical, otherwise not. Nowadays one almost never hears of this being done, thanks to better diagnostics.

 

 

 

 

 

Although I understand that you protect your colleagues but do not share your view that I'm exaggerating what I have said ... I own the written estimate from the Bangkok Hospital: for Gastroscope and Colonoscope Baht 28,000 + polypectomy 15,000-20,000 baht. The International Hospital did not want to give me a written estimate, but said that it would cost around 50,000 baht. The recommendations for those expensive diagnostics are easy for the doctors, they are also mostly the ones who perform this treatment; they are paid for that ..

 

As you noticed by yourself, endoscopy is not useful in each case and the doctor should first diagnose and treat with simpler methods. But that was not offered to me in both cases. There would have to be extravagant arguments to open the abdomen, and in that case everybody would prefer endoscopy ... but until then, it can be a long way ...

Thank you very much for recommendations ..