Doctors And Their Diagnoses

[chevykanteve]

First, check out this article:

Doctors want law to protect them from patients

The Medical Council is pushing for a new law that will make it impossible for patients to file a criminal lawsuit against doctors - except for intentional mistakes or "gross negligence".

The reason behind the move was a jump in criminal lawsuits filed against doctors, which had shaken the medical profession's morale, said Dr Somsak Lolekha, president of the council.

The council had already drafted a bill entitled "Liability and Legal Procedure for Health Professionals" and hopes it may become law within the tenure of the interim government, said Dr Amnat Kusalanunt, secretary-general of the council.

"It shouldn't be that anytime a patient dies, a doctor faces a criminal lawsuit," he said. "As their work is to save people's lives, doctors should not be left to live in fear."

The Nation

Now for my comment. Perhaps these doctors are spot on and the criminal lawsuits filed against them are unfair to the extent of necessitating a new law. Yes, perhaps. Now, having said that, I'll tell you a true story. About 4 years ago I went to a government hospital in Northeast Thailand. My symptoms were fever, headache, general bodyache and sore throat. The doctor, a young central Thai woman who just graduated from medical school, told me to open my mouth as she peered into the depths of my throat with a little flashlight. She then told me I was ill because of my "tonsin" (=tonsils) which, she said, were inflamed. When I told her that my tonsils were removed in 1957 she looked somewhat shocked, smiled, then said "you have influenza" (ki wut yai). I could only smile back at her, not out of agreement, but because she was so incredibly cute!

[farangene]

..... When I told her that my tonsils were removed in 1957 she looked somewhat shocked, smiled, then said "you have influenza" (ki wut yai). I could only smile back at her, not out of agreement, but because she was so incredibly cute!

tonsils can grow back again or so I was told by a western doctor.

[PeaceBlondie]

In my limited experience here, I found Thai doctors to be poor at diagnoses of illnesses such as infections, far worse then Western doctors, even a few who were trained in the West. Medical diagnosis is incredibly difficult, but it's easy to just say "You have a virus." Or, when you have intensive internal infection at a surgical site, to say "You have contact dermatitis."

[soundman]

I have found the doctors, (one is a close family member & does exactly what I am describing here) in thailand to be extremely generous with their prescription methods.

My wife might go to see a doctor, (nothing less than a BKK hospital (vichayuit) doctor mind you which is about a two hour drive), for a common cold. We then walk out with about fifteen different pain relievers, antibiotics & vitamin suppliments.

All for a 48hr cold. I go ape about it, & the wife looks at me like I'm sending her to the gallows.

Go figure!!!

Soundman.

[sinom]

during recent annual company medical, following the ECG, the machine automatically printed out that I had suffered a recent stroke and the old ticker was a bit out of kilter. Then they checked my blood pressure which was orbiting pluto! I felt sure that had I had a myocardial infarcation I would have felt it!

Doc. referred me to the cardiologist who basically cursed the day they bought in these auto-ECG diagnostic machines!!

At least the "human error" is more fun (Cute??)

I'm fine by the way, just got to ease off on the cholesterol bits!!

[bkkmadness]

intentional mistakes

Can someone explain to me how you can make an intentional mistake?

[GuestHouse]

I've got a string of Thai doctor tales, but the most common experience I have had is to be told, after an initial and cursory examination, that I, or who ever it is in my family who has is visiting the doctor, have some dreaded disease. TB, recent Heart Attack, Cancer etc - Load of <deleted>!

I've had a Thai doctor at a major international hospital try to get me to have an X-Ray on my kneck, after I went to have ear ache treated. Why would I want an X-Ray, well you seem to be holding your kneck stiff - Well so would you if you had a bl00dy ear ache!

I've seen a Thai doctor (and I would go on oath in a court of law on this) fit a saline drip to a woman who had drowned - A Ducth medic who was at the scene had already said she had been dead for at least an hour!

And without a doubt, all Thai doctors over prescribe medicines - They dish them out like smarties.

[soundman]

intentional mistakes

Can someone explain to me how you can make an intentional mistake?

Yeahh - the nutty professor

soundman.

[chevykanteve]

..... When I told her that my tonsils were removed in 1957 she looked somewhat shocked, smiled, then said "you have influenza" (ki wut yai). I could only smile back at her, not out of agreement, but because she was so incredibly cute!

tonsils can grow back again or so I was told by a western doctor.

Mine haven't.

[soundman]

intentional mistakes

Can someone explain to me how you can make an intentional mistake?

Yeahh - the nutty professor

soundman.

intentional mistake - oops the country is fuc!ed...

Soundman.

[andook]

I've had a Thai doctor at a major international hospital try to get me to have an X-Ray on my kneck, after I went to have ear ache treated. Why would I want an X-Ray, well you seem to be holding your kneck stiff - Well so would you if you had a bl00dy ear ache!

How is your "kneck" now?.... Ok? Sorry, spelling bee here.

Agreed though. You don't feel like you've actually been to the Docs here unless you are walking out from surgery with less than three shopping bags full of smarties / placebos.

The stuff you get over the counter here is stronger than most illegal "buzzes" back home. That is probably the whole point.....?

[chevykanteve]

GUESTHOUSE: RE your comment And without a doubt, all Thai doctors over prescribe medicines - They dish them out like smarties:

You mean, for example, amoxicillin? It seems to be the "cure all" here for any illness.

[penguin]

Thai private hospitals love to prescribe a vast array of medicine for even the simplest complaint because they have a bigger mark up than your local pharmacy. Of course your local pharmacy may not be selling genuine products but l've compared prices with my local pharmacy where l'm satisfied they sell the real thing and there can be some big price differences at times. One problem with some local pharmacies is that they will sell anyone stronger medicine than in the west, often without asking enough questions about your medical history like a good doctor would. I always google any medicine l'm prescribed now and a few times when reading the manufacturers website found that l probably shouldn't be taking the medicine.

Private clinics all over the world always want to perform extra tests. Maybe they genuinely want to make sure all the bases are covered but as a patient it's hard to know sometimes if all these tests are warranted or if it's mainly a money making exercise to help pay off some expensive testing equipment.

[benjeleuk]

Went to the Bangkok Christian Hospital 15 years ago for a cold. The doctor asked me how long have you had this cold, I replied 3 weeks. He said, oh well, I think you have AIDS, let me just confirm it by having you take a blood test. Negative was the result!

Went to a private Clinic 13 years ago in the Minburi area, again for a cold. The woman doctor got the shock of her life. A farang... she moved almost two meters away from me and without touching me she very quickly held the flash light near my throat and prescribed some antibiotics. I was out of the clinic in minutes!

Went to Ramkamheang hospital 8 years ago for stomach cramps. Was told that my apendix needed to be removed immediately. Got suspicious, and checked out and went the next day to a government hospital. There I was told I had stomach cramps!

Went to the same hospital, Ramkamheang Hospital. Weird as this may sound, a different doctor was able to correctly diagnose an ailment I have had vor over 25 years!

Some Thai doctors are very good and some aren't. My experiences with Thai doctors have been mostly positive. I think one should make their own judgment and always seek a second opinion from a different doctor......

[alaina]

Are they trying to say that medical tourists are "not the class" the TOT want? Who would come here for surgery with even less assurance that it will be done right?

[Pepe']

A small sampling of Thai magazine covers:

Ping Pimp-A-Porn?

classic

:D

I have found the doctors, (one is a close family member & does exactly what I am describing here) in thailand to be extremely generous with their prescription methods.

My wife might go to see a doctor, (nothing less than a BKK hospital (vichayuit) doctor mind you which is about a two hour drive), for a common cold. We then walk out with about fifteen different pain relievers, antibiotics & vitamin suppliments.

All for a 48hr cold. I go ape about it, & the wife looks at me like I'm sending her to the gallows.

Go figure!!!

Soundman.

-------------------

I have found most Thais like to take medicines...

[qwertz]

intentional mistakes

Can someone explain to me how you can make an intentional mistake?

Plan B after mistaken intentions fail.

[tc101]

This is a great discussion.

I live in the USA and one of the reasons I have considered retiring to Thailand is to get better medical care at a more reasonable price. I am 57 and will have to pay my own health insurance until I am 65. It gets more expensive every year. In addition to the high price, the doctors in the USA are very arrogant and it is hard to deal with them.

From what I am reading here there are problems with health care in Thailand also. Are the doctors arrogant?

[qwertz]

An English specialist advised me 30 years ago, after I suffered a cerebral haemorrhage, not to make any long term plans. He died shortly after of a cerebral haemorrhage. Ain't life strange?

[November Rain]

-------------------

I have found most Thais like to take medicines...

Think it's instilled in them from birth. My son is nearly 6 and has been living with me since he was 2. BF (his father) used to cart him off to the doctor for the slightest sniffle. Even now, son believes that a spoonful of medicine is the cure all for everything. We stayed in BKK for a week, once, while my mother underwent breast cancer surgery. Little boy was eating lots of different foods, going to bed late, visiting his grandma in hospital etc. When we came back he had an upset stomach, so BF took him to the doctor. No questions about has his food/lifestyle been different, or had he been anywhere he could have caught something (& of course, BF, being Thai didn't volunteer this information). No, doc decided in his wisdom, that he was allergic to cows milk. Gave him medicine (why?) & said we should change to soya milk. Little boy still drinks cows milk now, 3 years on, with no ill effects.

Personally, I've given up going to doctors here. I used to be a general nurse in UK & I've yet to come across a doctor here (doing general practice, I've met some very good specialists) that knows what he's talking about. Scary.

[t.s]

I have found the doctors, (one is a close family member & does exactly what I am describing here) in thailand to be extremely generous with their prescription methods.

My wife might go to see a doctor, (nothing less than a BKK hospital (vichayuit) doctor mind you which is about a two hour drive), for a common cold. We then walk out with about fifteen different pain relievers, antibiotics & vitamin suppliments.

All for a 48hr cold. I go ape about it, & the wife looks at me like I'm sending her to the gallows.

Go figure!!!

Soundman.

that always amazes me too.

the second you tell someone you have a cold the ask "have you been to the doctor?"

they never comprehend when i try to explain that as there is no cure for the cold, there is no point in seeking medical help. also that medicine beyond a little tiffy is pointles.

Another thing that i find myself doing is having them explain what each medication prescribed is for and then refusing the antihistamines and other extraneous stuff at the time i pay the bill. there is no point in getting into a discussion with the doctor over it

i can find tylenol anywhere on my own if necessary.

that said i have had a parent die in Canada of gross neglignce (told her it was all in her head -- two days later she had a massive aneurism -- so in a way he was right), and i have received excellent treatment here for a shattered leg and more recently a massive asthma attack when my medicine ceased to be effective.

My asthma is now completely controlled, something a western doctor never managed.

the point being is doctors everywhere are hit and miss. one of the largest causes of patient death in the US is prescription errors.

i would say something similar to Nov Rain: Doctors here tend to be much better on procedure than they are on diagnostics

Edited March 27, 2007 by t.s

[onzestan]

Unfortunately I can write books about hospitals in and around Pattaya.

So one very small example here.

I have a heart condition that requires me to take blood-expanders daily, so I always tell the doctors, nurses, dentists etc. before any intervention that could provoke blood flow.

I needed a wart removed from my scalp, and went to Bangkok Pattaya hospital. but googled first

i.o to be informed. Anyway I decided that I would go with the flow and see what they came up with.

To make a long story short, they advised me to take a very expensive laser treatment that needed

3 upto 4 repetitions. Total cost abt 30.000 baht.

I went to Queen Sirikit Naval Hospital in Sattahip, were they removed the wart, root and all, with scalpel, and then burned the small wound to stop bleeding. Total cost 350 Baht.

Cheers

Onzestan

[Prakanong]

"the second you tell someone you have a cold the ask "have you been to the doctor?"

Not just Thailand though - I had exactly the same question from a researcher in Clinical trials here in Singapore only two weeks ago!

Maybe its Asians in general like to see their Dr and take pills as Dr's surgery's in Singapore seem to be very busy.

Then again a free at the point of contact healthcare system in the UK probably has people going when they do not really need to.

[Prakanong]

Unfortunately I can write books about hospitals in and around Pattaya.

So one very small example here.

I have a heart condition that requires me to take blood-expanders daily, so I always tell the doctors, nurses, dentists etc. before any intervention that could provoke blood flow.

I needed a wart removed from my scalp, and went to Bangkok Pattaya hospital. but googled first

i.o to be informed. Anyway I decided that I would go with the flow and see what they came up with.

To make a long story short, they advised me to take a very expensive laser treatment that needed

3 upto 4 repetitions. Total cost abt 30.000 baht.

I went to Queen Sirikit Naval Hospital in Sattahip, were they removed the wart, root and all, with scalpel, and then burned the small wound to stop bleeding. Total cost 350 Baht.

Cheers

Onzestan

There was a feature on Fox News (I know I know but I find it amusing when getting ready for work) this morning about overcharging in USa hospitals with Medical Bill advocates saying they have never seen a correct bil yet.

ne guy had his bill reduced for a partially severed arme from 39k USD to around 6K - it seems a lot of bills there are not itemeised or when they are the item lists, "Hospital Extra's"

When I have had private tratment here in Singapore or the UK every item is listed down to pieces of gauze.

[percy2]

Then again a free at the point of contact healthcare system in the UK probably has people going when they do not really need to.

People don't have time to go in the UK if they don't really need to.

A vist to your local GP is normally available only after a 2 week wait.

Cheers

[bobbytwoshoes]

I have found the doctors, (one is a close family member & does exactly what I am describing here) in thailand to be extremely generous with their prescription methods.

My wife might go to see a doctor, (nothing less than a BKK hospital (vichayuit) doctor mind you which is about a two hour drive), for a common cold. We then walk out with about fifteen different pain relievers, antibiotics & vitamin suppliments.

All for a 48hr cold. I go ape about it, & the wife looks at me like I'm sending her to the gallows.

Go figure!!!

Soundman.

that always amazes me too.

the second you tell someone you have a cold the ask "have you been to the doctor?"

they never comprehend when i try to explain that as there is no cure for the cold, there is no point in seeking medical help. also that medicine beyond a little tiffy is pointles.

Another thing that i find myself doing is having them explain what each medication prescribed is for and then refusing the antihistamines and other extraneous stuff at the time i pay the bill. there is no point in getting into a discussion with the doctor over it

i can find tylenol anywhere on my own if necessary.

that said i have had a parent die in Canada of gross neglignce (told her it was all in her head -- two days later she had a massive aneurism -- so in a way he was right), and i have received excellent treatment here for a shattered leg and more recently a massive asthma attack when my medicine ceased to be effective.

My asthma is now completely controlled, something a western doctor never managed.

the point being is doctors everywhere are hit and miss. one of the largest causes of patient death in the US is prescription errors.

i would say something similar to Nov Rain: Doctors here tend to be much better on procedure than they are on diagnostics

I was told by a U.K Doctor milaria has the same symptom's as the common cold, maybe that's why everyone goes to the Doctor's over here.

[Scott]

I've had a lot of medical treatment here in Thailand. I've had 4 surgeries as well as some significant illnesses. In general, the surgeries are some of the best I've had. I've had no problems.

Diagnosis of illnesses, however, is a whole different ball game. I know a little about this stuff, and they really don't do it very well. But if you know what you have, it's a great place to get treatment.

Oh, yes, and as for all the pills they like to prescribe. Well, I tell them I have asprin at home, but I need some Valium. Oh, and I have vitamins, but I am plumb out of Vicodin, etc. etc. etc. I find after about the 3rd prescription for Class A narcotics, they don't insist on giving me anything else.

At least here the misdiagnosis results in a HIGH Ol' time!

[GuestHouse]

My asthma is now completely controlled, something a western doctor never managed.

As an asthmatic myself my experience, and that of two other expat asthmatics I know is that our asthma is very much easier to control in Thailand's warm humid climate. We all of us report the same thing, retuning to colder drier climates brings back our asthma. So perhaps more to do with the climate and less to do with the doctors.

Here's two not so encouraging Thai medical experiences:

#1

Back in the late 90s I was taken ill with food poisoning, it was clearly not going to get better so my wife carted me off to the PIC (They were covered by our company health plan and had the quickest time to see a doctor of any of the hospitals in the area.. so s0d the price!)

The doctor decides to wack some anti convulcents into me, so gives me a jab - I went into allergic shock.

I left hostpital two days later, with a huge bill and in compliance with my company medical procedures a copy of my medical report was sent to our doctors in the UK - Surprise surprise, no mention of anti convulcents, no mention of allergic shock.

#2

My wife and I arrived at my wife's family home to find the whole house full of family, sitting around my wife's mother who was trembling - I took her pulse and it was all over the place, like a missfiring two stroke.

So we carted her off to hospital, I told my wife to bring the bag of smarties her mother had been subscribed.

The discussion was had that I was not going to be allowed to go into the examination room with MiL, so I remained outside and took the oportunity to take the smarties over to the pharmacy counter and ask if any of these are listed as not to be taken together. She immediatly spotted that two of the drugs should not be taken together. MiL's prescription was changed and it looks now as though she'll outlive me.

These two experiences illustrate to me what is wrong with medical treatment in Thailand - Carelessness and a disregard for the patient.

Talk to Thais who use wester medical care, mainly expectent mothers and mothers with small children, and they are full of praise for the western medical care.

Yes, Thai medical care is cheap, but in almost every case you are getting what you pay for.

[Prakanong]

Then again a free at the point of contact healthcare system in the UK probably has people going when they do not really need to.

People don't have time to go in the UK if they don't really need to.

A vist to your local GP is normally available only after a 2 week wait.

Cheers

I have only seen a GP once in the UK since 98 and that was in 2000 so have no clue about the situation nowadays but I got in pretty quick then even iof only for the check up to sign on with a Dr.

Here in Singapore I turn up any night I feel like it and have never had to wait more than 20 minutes. I do pay at point of contact though and claim the money back from my employer.

[Jet Gorgon]

I only went to Thai docs for checkups. A few times for infected mosquito bites and a bladder infection. I hate antibiotics so never took them and I survived.

But, a Thai doc at a teaching hospital cured an English friend with Parkinson's disease (OK, totally diminished her symptoms). He gave her a new medication and she has been fine for several years.

They are as savvy as Western docs IMO.

I think it all depends on the hospital and situation. But, that's the same anywhere.