Any recourse ($?) for bad medical diagnosis?

[Poopyface]

My friend just returned to the USA after a private hospital (name removed)  told him he needed cardiovascular care and possibly intervention (angiogram + stents).

After experiencing chest pain, they ran a stress-test which they claimed proved myocardial ischemia and CAD. As well as several blood panels. He was seen by a few cardiologists in CM who all referred to the stress test, he was put on several meds and encouraged to get an angiogram and probably stents.

 

Problem is, upon returning to the USA (which he jumped on the next plane at no small expense), he saw his GP who sent him in for an echo-stress test.

Results were normal.

 

So he showed the printout of the entire test done at (hospital name removed)  (some 50 pages) and his American cardiologist said

"well, now I am looking at 2 normal stress tests results. I don't know how any competent cardiologist could look at these results and say they were anything but normal. They got it wrong."

 

Diagnosis: digestive reflux and GERD. Taken off heart drugs prescribed in Thailand. Given antacids.

 

So my question is this:

Is it possible to approach the hospital in CM and request some compensation of the billing?

My friend incurred some sizable expenses due to this fiasco: upwards of 30,000 baht medical in Thailand and also an emergency flight home ect.

He is simply looking to cut his losses at this point.

 

Is there any recourse for a clearly faulty diagnosis in Thailand?

 

[Just Weird]

Who says the US doctor cannot be mistaken?

[Sheryl]

I have removed the hospital name to protect the Forum from defamation charges.

 

Since no lasting harm was done, he does not IMO stand a chance of getting any compensation.

 

I don't know what the 30k in medical expenses in Thailand was for, stress test, blood tests and meds are all that were mentioned and should not have come near that amount.

 

The decision to return to the US for second opinion/further treatment was his own. (Though maybe he did this in order to have the angio + stents done under Medicare?)  He could also have gone to another  cardiologist here in Thailand  -- even a US trained one -- for a second opinion.

 

Not trying to be unsympathetic, just practical. Compensation is probably not on the cards, though he can try and in any case should certainly do something to make sure the hospital administration are aware and, hopefully, put the docs concerned on notice.

 

My advice:

 

1. Send a  letter to the hospital administrator laying out the facts and asking for a face to face meeting to discuss.  While having a lawyer draft the letter and attend the meeting with him would add weight to it, it will also cost money and as I said chances of compensation are pretty low so take that into account - he may well end up out of pocket for any legal bills.

 

And/or

 

2. Make a written complaint to the Medical Council of Thailand. CC this to the hospital administrator and to Ms. Preeyanan Lorsermvattana, President, Thai Medical Error Network.  https://www.facebook.com/preeyanan.lorsermvattana.7

 

Important: before doing #1 or #2 get full copies of the hospital records. It is not at all unknown for them to redacted after the fact.  It will be important to be able to show that the stress test result was wrongly interpreted  as showing ischemic changes. If the misreading of the stress test was truly egregious then this may have been blatant fraud. Otherwise the doctors may just say "we only said it might be that and sent him for tests to find out" and to claim he misinterpreted what they said as a definitive diagnosis/recommendation when in fact they were only explaining the possibilities, and it was all a misocmmunictaion.  (And since you are basing all this on what your friend told you, maybe question him closely first as well to be sure this was not in fact the case.)

 

Also privately PM me the concerned doctors' names, and I will make sure not to refer anyone to them.

 

[Led Lolly Yellow Lolly]

I had a similar experience around 12 years ago, diagnosed with blocked coronary artery, immediately put on bags of meds and booked for further diagnostic procedures. I IMMEDIATELY went for a second opinion at a well known private hospital, the cardiologist scoffed at the diagnosis and the meds I'd been prescribed, stating it was absurd as I was in my mid-30s. Nevertheless I wanted checking out and fast, so I was in a CT scanner within a hour of walking into the place. Diagnosis, everything normal.

 

Blatantly fraudulent diagnoses are rampant in Thailand. If you find a doctor you trust, hang onto them. There are plenty of good ones too.

 

 

 

Edited February 13, 2019 by NilSS

[simon43]

Blatantly fraudulent diagnoses are rampant in Thailand.

 

I politely suggest that 'incompetent' might better replace 'fraudulent'.

[MiNombreEsFicticious]

Tell your friend to go on with his life knowing that he didn't waste it on trying to get a Thai to admit a mistake. I went to one of the top private hospitals and told the doctor I'm almost certain I've been infected with (rhymes with giffalous) gifted during a dodgy romantic encounter. I had read that in 99% of the cases penicillin is the treatment of choice. After the doctor confirmed the diagnosis of giffalous, I asked "so penicillin, yes?"  He said no. I said "are you sure?" He was sure, and sent me off with some pills. 3 weeks later and still oozing and itching, i booked an appointment with the dept. head. I showed her the pills her colleague prescribed. She said "that was stupid, you need penicillin." I was charged full price for the penicillin, all the fees for the two doctors, no consideration of any discount or compensation despite my raising the issue politely. And, yes, the penicillin worked. 

[Puchaiyank]

It's a scary thought...but I believe healthcare professionals...including dentists succumb to greed at the expense of the patient...I almost always seek a second opinion...do not really trust any of them...including hospital administrators and insurance companies...most would not pass close scrutiny...

[Christophers200]

10 minutes ago, Puchaiyank said:

It's a scary thought...but I believe healthcare professionals...including dentists succumb to greed at the expense of the patient...I almost always seek a second opinion...do not really trust any of them...including hospital administrators and insurance companies...most would not pass close scrutiny...

As a retired healthcare professional, I resent your implication. Which "opinion" do you trust? The first, the second or do you then seek a third opinion? 

[Poopyface]

5 hours ago, Just Weird said:

Who says the US doctor cannot be mistaken?

Always a possibility, he was seen by a highly rated 'interventional cardiologist' who came highly recommended. The doctor has his own practice in addition to working at one of the best hospitals in the county.

An interventional cardiologist is one who specializes in angioplasty, and this specialist said "the angiogram is the gold standard, but in your case I simply see no signs to recommend it. We can do it if you insist, but if it were me, I wouldn't at this time. These are 2 normal stress tests"

So my friend trusts him.

 

3 hours ago, Sheryl said:

I don't know what the 30k in medical expenses in Thailand was for, stress test, blood tests and meds are all that were mentioned and should not have come near that amount.

 

The decision to return to the US for second opinion/further treatment was his own. (Though maybe he did this in order to have the angio + stents done under Medicare?)  He could also have gone to another  cardiologist here in Thailand  -- even a US trained one -- for a second opinion.

 

Important: before doing #1 or #2 get full copies of the hospital records. It is not at all unknown for them to redacted after the fact.  It will be important to be able to show that the stress test result was wrongly interpreted  as showing ischemic changes. If the misreading of the stress test was truly egregious then this may have been blatant fraud. Otherwise the doctors may just say "we only said it might be that and sent him for tests to find out" and to claim he misinterpreted what they said as a definitive diagnosis/recommendation when in fact they were only explaining the possibilities, and it was all a misocmmunictaion.  (And since you are basing all this on what your friend told you, maybe question him closely first as well to be sure this was not in fact the case.)

Wow, great advice! 

Yes he's on Medicare.

I just called him and he said he saw 4 different cardiologists before leaving Thailand, but they all took the diagnosis of the first who administered the stress test as gospel, they didn't review the test itself, just the diagnosis. 

In hindsight he should have insisted they review the test.

He did get the records that state in writing ischemic changes but the US doctor looked closely at all of it and disagrees with the interpretation.

 

He hung up before telling me how the 30,000 baht was spent, as I forgot the time change and woke him up in the middle of the night ????

Oops.

 

Thanks everyone for your perspective!

[BritManToo]

23 minutes ago, Christophers200 said:

Which "opinion" do you trust? The first, the second or do you then seek a third opinion? 

I trust the doctor, backed up by 'Google', and my own intelligence.

My 5yo was complaining of stomach pains, we took him to a local Chiang Mai Hospital, they diagnosed appendicitis and wanted to operate (free as he's Thai). I thought the pain and the area he described didn't seem right for that diagnosis and took him to NakornPing Hospital a bit further away. They diagnosed severe constipation, a syringe of gunk in the bum, and 30 minutes later he was cured (no charge).

Edited February 13, 2019 by BritManToo

[Sheryl]

19 minutes ago, Poopyface said:

.....I just called him and he said he saw 4 different cardiologists before leaving Thailand, but they all took the diagnosis of the first who administered the stress test as gospel, they didn't review the test itself, just the diagnosis. 

In hindsight he should have insisted they review the test.

He did get the records that state in writing ischemic changes but the US doctor looked closely at all of it and disagrees with the interpretation.

Do PM me the name of the first doctor.

 

I can rather understand the next 3 taking it as a given that the 1st one's interpretation of the stress test results was correct, and with a history of pain in the chest region (as gastritis can also cause) and (supposedly) ischemic changes on the stress test, the recommendation for an angiogram is standard. So really it all goes back to the interpretation of the 1st stress test, which any cardiologist should be well able to do correctly.

 

He might be including his costs in the US into that 30,000 baht (Medicare deductible/Part B copay)?

 

While as I mentioned compensation is highly unlikely he should take some effort to at least make sure the hospital administrator is aware he has a cardiologist practicing in his hospital who is either incompetent or unethical.

[Poopyface]

1 hour ago, Christophers200 said:

As a retired healthcare professional, I resent your implication. Which "opinion" do you trust? The first, the second or do you then seek a third opinion? 

My impression of health care professionals (in the US anyways) is that the vast majority mean well, but are not as informed as I would like regarding things like naturopathic approaches and Eastern medicine.

 

But I tend to "trust" the opinion of the one who tells me I have the best chance at recovery!

I seek optimistic opinions.

[Led Lolly Yellow Lolly]

4 hours ago, simon43 said:

 

 

 

I politely suggest that 'incompetent' might better replace 'fraudulent'.

No I meant fraudulent. Medical incompetence a plenty can be found in the 'beloved' NHS and in Thailand, but there is no doubt in my mind fraudulent diagnoses are rampant in Thailand, from the most serious diagnoses, to the mundane i.e. leaving with a bag of unnecessary pills for a cold.

[puukao]

i went to a doctor about 3 times for a cough and then i asked him, can you do more than stop the cough for a week or so?  he said, "oh, ah, i could give you something that would help in the long run (paraphrasing)".  it worked.   i just shook my head.

 

sure, sue the doctor and hospital, court case in thailand, get 1000 experts from around the globe, maybe it will last 5 years.... you might get 10 baht.

 

i have a feeling the OP knows the answer, just upset.  i totally understand. 

 

[dotpoom]

The opposite sinario....

 A friend of mine died recently. He was told by the medical professionals here that there was nothing wrong with him (had been feeling poorly). Felt so bad he flew home ..was dead a few weeks later ...cancer....RIP.

Edited February 14, 2019 by dotpoom

[Jeffrey346]

Four years ago I had a heart attack. Fortunately, I live only 5 minutes to one of the largest hospitals in KK.

I want it known that the Cardiologist did save my life as I was revived twice.. BUT there are some disturbing facts.

To make a long story short, there was a blockage and a stent was necessary.

The disturbing part is the Cardiologist never came to seem me after the procedure. He sent a medical student. The student told me an artery was partially blocked, and was told a stent was not necessary.

After 7 days, I was released and given an appointment 2 weeks later to see the Cardiologist. 

I returned in 2 weeks, not feeling very well only to be told the Dr was not in the hospital and my appointment needs to be rescheduled. I told them I wasn't feeling well and wanted to be seen by a Cardiologist.

2 hours later a doctor listened to my chest, said it sounds fine and sent me home.

Still not feeling well [dizzy and no energy] I returned to the hospital. No tests were done but I was prescribed Dramamine and sent home.

At this point I did some research and found who was considered one of the best Cardiologists in NE Thailand.

My wife called and explained to him what was going on. He asked I come to the hospital ASAP.

He did an ECHO only to find a good size blood clot in my heart. Which BTW if moved could have killed me.

He treated the clot with meds and I'm feeling fine. I do see him every three months. 

I have found many Dr's here do not like to be questioned or challenged. My advise, do it and if you are not happy with the answers find another Dr.

[PerkinsCuthbert]

16 hours ago, MiNombreEsFicticious said:

Tell your friend to go on with his life knowing that he didn't waste it on trying to get a Thai to admit a mistake. I went to one of the top private hospitals and told the doctor I'm almost certain I've been infected with (rhymes with giffalous) gifted during a dodgy romantic encounter. I had read that in 99% of the cases penicillin is the treatment of choice. After the doctor confirmed the diagnosis of giffalous, I asked "so penicillin, yes?"  He said no. I said "are you sure?" He was sure, and sent me off with some pills. 3 weeks later and still oozing and itching, i booked an appointment with the dept. head. I showed her the pills her colleague prescribed. She said "that was stupid, you need penicillin." I was charged full price for the penicillin, all the fees for the two doctors, no consideration of any discount or compensation despite my raising the issue politely. And, yes, the penicillin worked. 

Jumping Mohammad, what's this "rhymes with giffalous", why not just be a brave fornicator, face the music and say syphilis?

[BritManToo]

16 hours ago, MiNombreEsFicticious said:

Tell your friend to go on with his life knowing that he didn't waste it on trying to get a Thai to admit a mistake. I went to one of the top private hospitals and told the doctor I'm almost certain I've been infected with (rhymes with giffalous) gifted during a dodgy romantic encounter. I had read that in 99% of the cases penicillin is the treatment of choice. After the doctor confirmed the diagnosis of giffalous, I asked "so penicillin, yes?"  He said no. I said "are you sure?" He was sure, and sent me off with some pills. 3 weeks later and still oozing and itching, i booked an appointment with the dept. head. I showed her the pills her colleague prescribed. She said "that was stupid, you need penicillin." I was charged full price for the penicillin, all the fees for the two doctors, no consideration of any discount or compensation despite my raising the issue politely. And, yes, the penicillin worked. 

Amoxicillin 500mg, 30bht for 5 days worth from Makro Pharmacy.

Why would you go to a doctor for something so easy to cure?

[ujayujay]

Nope!

[Bang Bang]

Bumrungrud a year ago:

I went in to see an ENT doc with a problem in my right ear - it felt clogged and I wasn't hearing well that side. It was a walk-in and they assigned me to whoever was on the roster then. I didn't care as it clearly wasn't anything serious, an irrigation at best I figured.

 

As I am waiting to see the doc a nurse appears and says we need to do a hearing test before you see the doc. I protest - the doc needs to see me first I tell her. She looks mildly offended and goes off. Finally I get called to the doc who looks at me sternly and asks why I didn't take the test - "you have to take the test or how will I know?" I am already a bit annoyed and explain to him, look doc the hearing test is going to show a problem because I have a problem which is why I am here. Why don't you look in my ear and maybe clean it out a bit and then if there's still a problem we can test for stuff.

 

The doc isn't happy but he does his thing, cleans out my ear and I feel fine (oh, the equipment is fancy - I watch a fascinating real-time video of the inside of my ear on a wall monitor). Then I go up to pay the bill and it's a pretty large amount. I check the details. Yep, they had added on the test they never did. Again, I protest and a couple of phone calls between the cash counter and the ENT section gets the matter resolved.

 

Pain in the ass experience. I bet the doctors are pretty well incentivized to rack up a bill.

Edited February 14, 2019 by Bang Bang

[emptypockets]

20 hours ago, Christophers200 said:

As a retired healthcare professional, I resent your implication. Which "opinion" do you trust? The first, the second or do you then seek a third opinion? 

An old mate of mine had his own mechanical workshop servicing cars and trucks in the local town.

Nobody is perfect.

He recalled an upset doctor complaining about some minor fault with his car. Doctor raved on about lack of professionalism etc etc. Said mate let him go for a while then said " the difference between your job and mine is my mistakes come back to me....you bury yours'.

[emptypockets]

5 hours ago, BritManToo said:

Amoxicillin 500mg, 30bht for 5 days worth from Makro Pharmacy.

Why would you go to a doctor for something so easy to cure?

Perhaps it needed to be diagnosed first and not simply thinking it was Beethovens ear?

[Pdavies99]

Health diagnosis is I found very very hit and miss in Thailand, I was diagnosed with Dengue Fever, yet when immediately returning to UK was told the Thailand blood results showed no dengue fever and the UK blood trests showed noindication now or in the past, I actually had pneumonia!

 

When I was in Thailand I was diagnosed with Stomach Cancer, UK blood tests and a gastroscopy showed nothing, but I had a slipped disc.

 

What you do get in Thailand, is a differing diagnosis in every hospital, a bag full of unneccesary medicines and a large bill with requests to come back in 2 weeks. 

 

I'm sure some Doctors in Thailand get it right, it can't be harder than driving a car!!

[Pilotman]

2 minutes ago, Pdavies99 said:

Health diagnosis is I found very very hit and miss in Thailand, I was diagnosed with Dengue Fever, yet when immediately returning to UK was told the Thailand blood results showed no dengue fever and the UK blood trests showed noindication now or in the past, I actually had pneumonia!

 

When I was in Thailand I was diagnosed with Stomach Cancer, UK blood tests and a gastroscopy showed nothing, but I had a slipped disc.

 

What you do get in Thailand, is a differing diagnosis in every hospital, a bag full of unneccesary medicines and a large bill with requests to come back in 2 weeks. 

 

I'm sure some Doctors in Thailand get it right, it can't be harder than driving a car!!

I had the opposite experience some years back.  Arrived in the UK with flu like symptoms and heavy joint pain.  My Thai family kept telling me it was probably  'broken bone disease' (Dengue ) but the doctor wouldn't have it.  I had a private blood test done and it was confirmed as Dengue Fever.  What doctors don't know would fill a building full of volumes.   

[VocalNeal]

After X years in Thailand me and most of my friends understand that the Thai system is great for emergencies like broken bones and accidental damage. They are not known for diagnosis of undefined illness. 

There are of course exceptions like the guy at Bangkok Christian who correctly, as far as I was concerned, and immediately diagnosed me and started in-patient care. With just a verbal assurance from me that I could pay for it.

Dr Tanin, Neurologist. If anyone wishes to go and see him.

[MiNombreEsFicticious]

6 hours ago, BritManToo said:

Why would you go to a doctor for something so easy to cure?

I was stupid and had some money. And syphilis. 

[Letseng]

22 hours ago, NilSS said:

I had a similar experience around 12 years ago, diagnosed with blocked coronary artery, immediately put on bags of meds and booked for further diagnostic procedures. I IMMEDIATELY went for a second opinion at a well known private hospital, the cardiologist scoffed at the diagnosis and the meds I'd been prescribed, stating it was absurd as I was in my mid-30s. Nevertheless I wanted checking out and fast, so I was in a CT scanner within a hour of walking into the place. Diagnosis, everything normal.

 

Blatantly fraudulent diagnoses are rampant in Thailand. If you find a doctor you trust, hang onto them. There are plenty of good ones too.

 

 

 

If the diagnosis I was given at a hospital nr Silom/Sathorn Rd. had been correct, I would not have left the check up centre alive. My GP back home just commented: this is Thailand.

However, in the less fancy hospitals in Bkk I've had very competent treatment over the years. 

Twice now I got a 2nd opinion in Singapore on a Bkk medical recommendation. Twice the recommended op wasn't necessary. Once about my knee, recently about a blocked tear duct. 

[RotBenz8888]

30 minutes ago, Pdavies99 said:

When I was in Thailand I was diagnosed with Stomach Cancer, UK blood tests and a gastroscopy showed nothing, but I had a slipped disc.

Did they diagnose stomach cancer without any gastroscopy? ???? 

[Sydebolle]

Forget it - you might be right but you'll never get to the cashier to get compensated.

A much more important lesson in the whole story is ALWAYS GET A SECOND AND THIRD OPINION.

A visual blur was diagnosed in a leading private Pattaya hospital and I was told "cataract", two multi-focal lenses (although just one eye was affected) and everything would be perfect. A second opinion in a leading private hospital in Sriracha diagnosed slight cataract, mono-focal lens for the UNAFFECTED eye (as per my insurance company). 

I then had it, decided to see the experts at the leading eye hospital in Bangkok; they found out that I had a developing age-related macula degeneration. Three years treatment and now I am OK; without NOT trusting the first and second medic I would have new lens(es) but suffer from irreversible tunnel-blindness. 

My six months old son (30+ years ago) was diagnosed with malaria due to high fever, little blisters on his skin - turned out he was teething two teeth which gave him the fever. 

My other sone, as an infant (also 30+ years ago) was diagnosed with food poisoning and pumping out his little stomach; all he had was a running stomach due to a milk bottle which was not properly sterilized. 

I could go on and on - lesson is ALWAYS RECHECK WHAT THEY SAY. Never heard a medic saying "I dont know, I have to pass you on to somebody else" and this, combined with the semi-divine status of Khun Acharn, kills queries and questions in most cases. Be warned and good luck to the OP for ......... getting a second opinion (which you hopefully had rechecked as well). 

[55Jay]

My first Thai Doc flaked on me, thankfully it wasn't a very serious matter.  I had accidentally kicked the bottom rung of a heavy, solid wood deck chair on the patio one night.  Now, I'd banged my foot before, we all have at some point, but this was next level painful, thought sure there was some damage done.

 

Xrays done, Doc, who looked to be in his mid 60s, went over it all with wife and I, alternating between English and Thai, explaining where the source of the pain was.  He was great, and I was pleased with my first visit to a Thai hospital so far.   So I asked him the big question I had - was anything broken/cracked/fractured, and he said no.  He suggested some physio 3x/week, meds to take the edge off, and I followed the plan.  By the top of Week 2, no improvement.  The pain was just as acute as it was on Day 1.

 

Went back to see him, he reviewed the Xrays and his notes and I sensed his demeanor change a bit.  So I asked him what was up.  He waffled then said something might have been broken or fractured.  Oh!  I kinda chuckled and said, yeah, I thought that might have been the case before and it sure still feels that way now, which is why I came back.  

 

So I asked him what's next?  He said it was probably too late now, it should have been addressed a couple weeks before.   The way he said it, it was as if he'd just met us for the first time and I had waited too long to seek care.  Or, as if I had gone to a different hospital, and he was pointing out another Dr.'s oversight.   It was surreal the way he was acting and talking.  He shut down, it went nowhere, so we left.  I did a few more physio sessions there but decided to chew on Motrin and suck it up.  Eventually the pain subsided and went away.  Never been back to that hospital.

Edited February 14, 2019 by 55Jay