Any recourse ($?) for bad medical diagnosis?

[TallGuyJohninBKK]

On 2/13/2019 at 1:16 PM, Just Weird said:

Who says the US doctor cannot be mistaken?

 

I see you're never disappointing, and always finding a way to defend anything and everything the Thais do here, regardless of whether they were right or wrong... Bravo!!!

[TallGuyJohninBKK]

On 2/13/2019 at 2:37 PM, Sheryl said:

2. Make a written complaint to the Medical Council of Thailand.

 

Good, informative post, Sheryl...  On the Council you mention above, do you know if they can accept and deal with EN language submissions?

 

[TallGuyJohninBKK]

23 hours ago, simon43 said:

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

 

Or potentially both...depending on the individual case... It doesn't have to be one or the other.

 

[TallGuyJohninBKK]

8 hours ago, Jeffrey346 said:

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.

 

The problem the patient here often has is, having a hard time knowing what to believe.

 

If the Dr. tells you you're fine, can you rely on that, or still have to worry they missed something?

 

If the Dr. here tells you you're stick, can you trust that, or have to worry they're lining you up for an unnecesary treatment and procedure.

 

I did a heart exercise stress test for the first time ever this week at a private hospital in BKK... The results according to the cardiologist and my GP said everything was fine.  So, can I trust that, or still need to worry? It's a dilemma.

 

[Sheryl]

19 hours ago, NilSS said:

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.

Overmedication is not a "fraudulent diagnosis". It is indeed prevalent here and not always  economically motivated as you may assume, even the government hospitals do it, and it actually costs them money to do so. It is a cultural thing, patients expect and want a number of different medications and equate that with "good" care, and will even get angry and insulting it given "only one" let alone none. 

 

Genuinely fraudulent practices   exist here but are far from "rampant",  Over the years I've run into cases of it here and there.

 

 

[indepth]

22 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? 

Never get a second opinion. Healthcare professionals would never lie. Ignore the OP,,who has proved different. 

[Led Lolly Yellow Lolly]

38 minutes ago, Sheryl said:

Overmedication is not a "fraudulent diagnosis". It is indeed prevalent here and not always  economically motivated as you may assume, even the government hospitals do it, and it actually costs them money to do so. It is a cultural thing, patients expect and want a number of different medications and equate that with "good" care, and will even get angry and insulting it given "only one" let alone none. 

 

Genuinely fraudulent practices   exist here but are far from "rampant",  Over the years I've run into cases of it here and there.

 

 

I've heard the culture excuse used for this before but I just don't buy it. Culture is used often as a BS excuse for the misfires in Thai society. People in my home country go to the doctor with a cold and expect to be given something for it too, but our doctors have the professional wherewithal not to over medicate. If you want to use the word 'culture', use it for the culture of indifference within the medical community towards malpractice.

 

 

 

 

 

Edited February 14, 2019 by NilSS

[Christophers200]

26 minutes ago, NilSS said:

I've heard the culture excuse used for this before but I just don't buy it. Culture is used often as a BS excuse for the misfires in Thai society. People in my home country go to the doctor with a cold and expect to be given something for it too, but our doctors have the professional wherewithal not to over medicate. If you want to use the word 'culture', use it for the culture of indifference within the medical community towards malpractice.

 

 

 

 

 

I have no idea where you come from but "professional wherewithal" in the USA results in some 250,000 iatrogenic deaths/year.

[Sheryl]

2 hours ago, TallGuyJohninBKK said:

 

Good, informative post, Sheryl...  On the Council you mention above, do you know if they can accept and deal with EN language submissions?

 

Yes.

 

But keep it clear and factual and please, no frivolous complaints.

 

And don't expect miracles or a detailed investigation, there will nto be one.  But it will help to have it as a cc on letter of complaint to a hospital or doctor.

[atyclb]

On 2/13/2019 at 12:44 PM, Poopyface said:

After experiencing chest pain, they ran a stress-test which they claimed proved myocardial ischemia and CAD

 

 

did the written report actually state this?

[Poopyface]

20 minutes ago, atyclb said:

 

 

did the written report actually state this?

Yes.

[atyclb]

2 hours ago, TallGuyJohninBKK said:

11 hours ago, Jeffrey346 said:

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.

 

The problem the patient here often has is, having a hard time knowing what to believe.

 

If the Dr. tells you you're fine, can you rely on that, or still have to worry they missed something?

 

If the Dr. here tells you you're stick, can you trust that, or have to worry they're lining you up for an unnecesary treatment and procedure.

 

I did a heart exercise stress test for the first time ever this week at a private hospital in BKK... The results according to the cardiologist and my GP said everything was fine.  So, can I trust that, or still need to worry? It's a dilemma.

 

if uncertain, get a copy of complete test and email to a doctor you trust wherever, home country, etc.

[atyclb]

26 minutes ago, Poopyface said:

47 minutes ago, atyclb said:

 

 

did the written report actually state this?

Yes.

 

 

wow, amazing.

 

there was an infamous usa cardiologist doing unnecessary procedures, stents, etc just for reimbursement. i think he is in prison currently. can have bad apples anywhere but likely more in a society that lacks checks and balances and accountability

 

https://www.theguardian.com/us-news/2015/dec/23/convicted-doctor-harry-persaud-medicare-fraud-obamacare

 

heres a cardiologist that plotted to kill a competing cardiologist

https://newyork.cbslocal.com/2017/01/31/long-island-doctor-murder-for-hire-sentence/

https://www.newsday.com/long-island/dr-anthony-moschetto-james-chmela-james-kalamaras-in-murder-for-hire-plot-da-says-1.10267210

Edited February 14, 2019 by atyclb

[TallGuyJohninBKK]

17 minutes ago, atyclb said:

 

if uncertain, get a copy of complete test and email to a doctor you trust wherever, home country, etc.

 

That's a good suggestion... But as an extension of that...

 

Remember, perhaps, there are these periodic reports on TV and the news in the big wide world outside Thailand about how nifty tele-medicine is going to be for the future. The idea being you can consult with and talk with a doctor/expert from anywhere in the world, unconstrained by country/location. And even technology that allows remote diagnostics and testing.

 

Well, I see and hear about it on TV, but I've yet to encounter it in the real world of doctors and medicine, even from the U.S.  Perhaps it's out there, and I just haven't become aware of it stuck in an intellectual black hole here in Thailand. Last time I wanted to see a particular specialist doctor in the U.S. last year, their office told me they had a 6 month waiting list for office appointments!  And that wasn't at Stanford or Johns Hopkins.

 

Edited February 14, 2019 by TallGuyJohninBKK

[Sheryl]

A lot of what people are reporting here is the result of not carefully researching and pre-selecting their doctor.

 

It amazes me that people who would probably not take their car to a mechanic without at least asking around to try to ascertain which ones are good, will just walk into a hoispital and let the clerks at the desk select a doctor for them. (Or call and do likewise).

 

Taking potluck like that is the worst thing you can possibly do. You actually stand a greater chance of ending up with a bad doctor than if you just pulled a name out of a hat, since you hospital staff will automatically send you to the least busy doctor of the type you request.  Being less busy is usually NOT a good sign. For sure you will nto be shunted to the best doctors as they are almost always jam packed with appointment requests.

 

There are good, ethical, dedicated  doctors in Thailand, including many with extensive training in a western country. These last are socialized to western expectations and will have no problem being questioned by a patient, and their English will be fluent.

 

There are also an arguably larger number of mediocre doctors. And there are some truly incompetent ones and some truly unethical ones. Not many in this last group, but they exist, and there is every chance of ending up in their clutches if you don't take some caring in selecting a doctor. They will be found almost exclusively in private hospitals, one of the down side to the fact that doctors in private hospitals have complete latitude in how they practice. In government hospitals they are required to follow approved treatment algorithms.  So if you absolutely refuse to research and select doctors, then stick to only government hospitals. You may still end up with an incompetent doctor, and very good chance you'll have one who does not tolerate much questioning, but it is highly impropable you'll encounter any deliberate fraud.

 

I actually would not take "pot luck" on a doctor in my home country either. But here in Thailand it is even more important to do your homework.

[watcharacters]

On 2/13/2019 at 6:40 PM, 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? 

 

 

I knew a fellow who at a minimum wanted four opinions.    I told him he was daft if he didn't get at least 7 and then flip a coin.    Some people??

[Lacessit]

My experience with Thai doctors has been less than stellar. Not very effective diagnosticians, and the first thing they do is sling a fistful of pills at you. They don't seem to have any interest in my previous medical history. On two occasions, I have rejected taking something they prescribed, because when I looked at the interactions on line, they were high risk to someone of my age. It's quite odd, because the dental people I deal with here are highly professional.

IMHO the possibility of recourse is quite limited, and there is also the matter of face. Complaining here is the same as insulting a person.

If it is within my power to do so, I will be on a plane back to Australia for any treatment level more complex than simple ailments.

 

[TallGuyJohninBKK]

4 minutes ago, Lacessit said:

My experience with Thai doctors has been less than stellar. Not very effective diagnosticians, and the first thing they do is sling a fistful of pills at you. They don't seem to have any interest in my previous medical history. On two occasions, I have rejected taking something they prescribed, because when I looked at the interactions on line, they were high risk to someone of my age. It's quite odd, because the dental people I deal with here are highly professional.

IMHO the possibility of recourse is quite limited, and there is also the matter of face. Complaining here is the same as insulting a person.

If it is within my power to do so, I will be on a plane back to Australia for any treatment level more complex than simple ailments.

 

 

It is kind of perplexing how Thailand seems to have developed this tourist-oriented reputation for high quality medical care in SE Asia... But as a lot of the posts here indicate, a lot of folks who live here on an ongoing basis have had a variety of substandard and worse experiences with private hospital doctors here.

 

Perhaps it's relative based. Compared to typical medical care in say Cambodia or Vietnam or Laos, then yes, perhaps Thailand deserves a reputation for better quality medical care. But in my experience in a variety of private hospitals and doctors here, that by no mean means you're necessarily going to get a doctor who knows what they're doing or can properly diagnose and treat your specific ailment. It often seems to be a bit of a cr** shoot, even when starting out with doctors who have some western training.

 

On the other hand, is the typical private hospital medical care here better or worse than one's home country doctors?  I know for certain, the Thai version is certainly less expensive on average in the private hospital setting than the same in the U.S. But are the typical doctors here on a comparable scale in terms of skill and capability, that, I'm not sure about.

 

 

 

[kane666]

Here is an example of recourse for a bad medical treatment in Thailand. How would you feel about getting 240,000 baht for this? Apologies if I ruin anyones dinner/breakfast.

 

 

[TallGuyJohninBKK]

53 minutes ago, Lacessit said:

My experience with Thai doctors has been less than stellar. Not very effective diagnosticians, and the first thing they do is sling a fistful of pills at you. They don't seem to have any interest in my previous medical history. On two occasions, I have rejected taking something they prescribed, because when I looked at the interactions on line, they were high risk to someone of my age. It's quite odd, because the dental people I deal with here are highly professional.

 

 

I've had very similar experiences here in BKK private hospital / outpatient settings over the years:

--poor or wrong diagnosis where the doctor makes up their mind about a cause, and even when the symptoms and other details don't fit with their diagnosis, they stick to it -- even when their treatment doesn't work after all is said and done.

--little or no interest in pertinent past medical history, unless you go out of your way to inform them.

--over prescribing of medicines, as in, virtually any malady can best be treated by taking some pills.

--I've been prescribed (but didn't take) medicine here that had been banned as flatly unsafe in 1st world countries, and when I challenged the hospital pharmacist about it, they knew nothing about it.

[Pdavies99]

6 hours ago, RotBenz8888 said:

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

Yes...they said from blood tests!

[Sheryl]

37 minutes ago, Pdavies99 said:

Yes...they said from blood tests!

There is no way to diagnose stomach cancer from a blood test. It requires an endoscopy and then biopsy.

 

there are certain "cancer markers" that can be tested and, if elevated, it increases the possibility that you have cancer but they are not diagnostic.

 

Are you certain that they told you 100% you definitely had stomach cancer? And not that you might have it?

 

Something wrong with this story, even an uncompetent doctor would nto do this, and even a deliberately fraudulent one would go through the motions of endoscopy.

[Pdavies99]

6 hours ago, Sheryl said:

There is no way to diagnose stomach cancer from a blood test. It requires an endoscopy and then biopsy.

 

there are certain "cancer markers" that can be tested and, if elevated, it increases the possibility that you have cancer but they are not diagnostic.

 

Are you certain that they told you 100% you definitely had stomach cancer? And not that you might have it?

 

Something wrong with this story, even an uncompetent doctor would nto do this, and even a deliberately fraudulent one would go through the motions of endoscopy.

Well I can assure you that's what I was told, they diagnosed Heli Bacter pylori and cancer, now as to how certain they were I don't know, thay just told me how much and I need keyhole surgery. I shied away from this and jumped on a plane to the UK! Are you in the medical industry? I wonder? We all know how diagnosises are done in Thailand!! I'm not saying all Doctors are of a certain type but you can see here from other comments that is a trait seen in Thailand and I can offer what happened to me.

 

Edited February 14, 2019 by Pdavies99

[RotBenz8888]

9 hours ago, Pdavies99 said:

Well I can assure you that's what I was told, they diagnosed Heli Bacter pylori and cancer, now as to how certain they were I don't know, thay just told me how much and I need keyhole surgery. I shied away from this and jumped on a plane to the UK! Are you in the medical industry? I wonder? We all know how diagnosises are done in Thailand!! I'm not saying all Doctors are of a certain type but you can see here from other comments that is a trait seen in Thailand and I can offer what happened to me.

 

You could always ask for a copy of your medical records to find out.

[Pdavies99]

3 minutes ago, RotBenz8888 said:

You could always ask for a copy of your medical records to find out.

Yes you right and I do not want to go further into my records in public.... this is a forum for people to offer comments, I just felt that some, not you, just want to argue of course!

[BKKBike09]

My two cents on this would be much as some others have said: there are some very competent specialists and GPs in the Thai medical system, but there are also some useless ones, just as in any country. 

 

My sense is that over-prescription, whether drugs or tests or both, is exacerbated if you have insurance. The logic seems to be: "if you are not paying for this, what difference does it make?" Of course this is a deeply flawed approach, but sadly I think it is quite prevalent. Recently, at one of Bangkok's best known private hospitals, one of my kids was treated for what turned out to be an MRSA infection on a limb. The treatment (specialised antibiotics aside) required the wound to be cleaned and dressed every day. After 3 days of this, costing around THB 2,000 a time, I queried the cost of the swabs, saline and dressings. The doctor told me that, because it was all covered by insurance, they used "the best", the implication being that if it wasn't covered by insurance, they'd use cheaper supplies. I bought exactly the same supplies at a local pharmacy for literally 30% of what the hospital charged and dressed the wound at home (for the next month, but with weekly visits to the hospital to check that all was healing properly).

 

Of course it is also because of rampant over-prescription of antibiotics that MRSA infections are much more prevalent (and, worryingly, they are now becoming resistant to classes of antibiotics that used to be effective). 

[edgarfriendly]

id say their dentistry and doctoral skills are on a par with their driving and logic skills.

 

sub-par at best!

 

#flame on