Surgery In Bumrungrad Hospital.

[griffer]

This is just intended as general information for anyone considering surgery in Thailand. I had heard of various levels of success and just thought I'd share my experience.

I will try and give plenty of detail and costs--apologies if it bores those who already know.

I had been suffering back pain for several years. It had progressively become worse. I visted a doctor in Bumrungrad Hospital Bangkok for the first time in September 2002. For those who don't know, Bumrungrad is one of the best hospitals in Thailand. Although relatively expensive for Thais, it is comparatively cheap for westerners. I arrived at the hospital without an appointment--I saw a doctor within about 45minutes.He sent me for Xrays --a nurse escorts you to the Xray department---I waited maybe 25 minutes--had the Xrays -- and then returned to the Doctor.He reviewed these and said they were indicative of a disc problem but to make certain it would be better to have an MRI scan. This was booked for the following evening.They took me down to the MRI machine to see it in operation.Apparently many patients get claustrophobic inside and they want to see what you think...you can ask to be sedated.

I arrived the next evening...half an hour before the appointment.You get changed and wait. You are taken into the MRI room and laid onto a sliding bed.Earphones with music playing are put on you and you are given a panic button. The bed slides into the machine. It is very claustrophobic.If you press the button they pull you out.You are in the machine for 30--45 minutes.

I came the next day to see the doctor. The results of an MRI are amazing.Its like a series of photos down through your body and understandable by even the untrained. He showed me where my disc had herniated and was pushing out against a nerve.

He suggested I try physiotherapy and certain exercises..and see how it goes. The alternative is surgery and it seemed premature for that.

The cost for the above set of Xrays/doctors consultaion/ MRI was about 14,000baht(an MRI scan is 10080 baht)You can also keep the MRI scans if you would like to take them to someone for a second opinion.

OK..so my back does not improve..I am back in March 2004...by now the pain is nearly constant..waking me at night..I am limping..the only relief is to lay down.

Back to see the doctor..Xrays..another MRI..we then try 2 weeks of physiotherapy.They manage to stop the pain for a few minutes at a time.They inject Novacaine into my buttock and back of my leg and that switches the nerve off for about 30 minutes and its bliss.

So..we are at the point where they are advocating surgery. I speak to a doctor friend in the UK and he seems to confirm their diagnosis. I try to get some prices out of BUPA UK...they seem to say the operation alone will be around 8000pds+ tests+aftercare.

So I take the plunge and sign up to go into Bumrungrad.I have to wait 1 week to get a bed and the necessary surgeon available. I go in on a Friday afternoon. I choose a private room(+private bathroom+TV+kitchen).

The surgeon and the original doctor visit me on Thursday afternoon and explain what they will be doing.The surgeon has spent 2 years working in a hospital in Chicago (USA), speaks english very well and seems very competant.

I have the operation at 6am on Friday morning.It takes about 1 hour 40 minutes.I come round about 9.30/10am. I felt rough. I had a morphine drip in my arm and a dispenser in my other hand...I could push the button and it injects more morphine into me..up to a certain level.

They took me back to my room and eased me back into my bed. The surgeon visited me about 2pm and said he felt the operation was a success. He gave me a small bottle with the part of the disc they had removed inside.Lovely...

He came the next day and asked me to allow him to lift my leg. I was dubious. Before the operation I could only lift my left leg about 9 inches off the bed.He lifted it about 2 feet and there was no pain.

By Sunday I was walking around, and I was discharged on Wednesday.

The cost..each physiotherapy session combined with a doctor consultation cost around 2000 baht. I had about 8 of these. The MRI cost 10080 baht. The Xray and consultation cost 4400 baht.The pre-op tests(cardiac/blood tests) 2800 baht.The actual operation ,room fees, nursing costs, medicine 155,353 baht.

So I make that around 188633 baht.

So far its been a complete success...I can only recommend the hospital and the doctors. If anyone out there is suffering like I was, I hope you are as fortunate as I have been.

[griffer]

hmmm--I went in on a Thursday afternoon( not a Friday)..otherwise it seems like it took a week for anyone to come and see me..

[ProThaiExpat]

Will you share the name of your operating surgeon and his specialty?

[griffer]

Sure...so I went to the Orthopedic centre and initially saw Dr. Panya Wongpatimachi...he assisted in the the operation. Unfortunately I don't have the the name of the other orthopedic surgeon ( the one who had been to The States) with me at the moment--I have his card in bkk-- when I return I will post it..

I am sure that Dr. Panya could give you his name if you contacted Bumrungrad.

Contact me privately if it would help.

[Suzy]

I made an appointment at this hospital and was kept waiting more than three hours before being seen by the doctor.

Backache attributed to the syptoms described is extremely common and occurs in around 90% of any nation, caused by the fact that we are still developing as bipeds. As humans, we do not not sit, walk, lie or pick up heavy objects correctly. All causes of a worn disc pinching on a nerve causing pain in differing areas of the lower body.

Any operation for this condition is extreme and everyday aches and pains can be controlled quite adequately by analgaesic medication - extremely efficient and cheap. Physio does not always help but aggravates the situation as it further inflames the already swollen nerves. Anyone in this condition should avoid soft seating and bedding, learn to walk, sit and lift correctly and life can continue with very little discomfort, pain and unnecessary expense.

[Felt 35]

Great to hear Griffer.

Have to get surgery at Bumrungrad myself later this year so this was positive+ to hear.

[griffer]

Suzy.. I agree with what you are saying...I wasn't advocating that everyone with a twinge in their back hobbles along to Bumrungrad and slaps themselves down onto an operating table. I seem to remember Dr. Panya saying that something less than 3(or was it 5?) % of the cases he sees require surgery. I had reached the point where sitting was terribly uncomfortable...on a flight from Papua New Guinea to Singapore (6.5 hours) I needed 3 seats so I could lay down.....even after taking pain-killers.

I had been taking Ibruprofen and Celebrex (anti -inflammatories I believe)( not simultaneously) for extended periods with limited success.

(As an aside...especially for Felt 35...note that they take you into the operating theatre without any pre-med....so you are wide awake while they prepare the operating table...which consisted of a pyramid pile of cushions for me to be bent over on top of the table...and then they get all the lovely sharp instruments and long needles out on a stainless steel tray next to you...it took about 15 minutes for them to get ready and then they put you to sleep....you really feel like leaping up and saying "oh its not that bad really,.... think I'll trot off home now"...)

[sbk]

Extended use of NSAIDS (non steroidal anti-inflammatories) can lead to ulcers and stomach bleeding. Not all patients respond the same way to proscribed treatments. Not every treatment is recommended for every person.

Personally, I feel that anyone with extreme back pain would probably be better off seeing a qualified orthopedic doctor.

[dr_Pat_Pong]

a highly qualified orthopedic surgeon at the hospital did the operation.

[lopburi3]

From information provided would guess this is the doctor?

Dr. Nanthadej Hiranyasthiti

[griffer]

Lopburib 3 is correct--that was the surgeon..

As I said before, he speaks excellent English...so that is a great help.

I think he told me that he had performed 4 other discectomies that week..although not all L5/S1 as mine was.

I can only speak from experience...and after years of pain, its marvellous.

[Felt 35]

a highly qualified orthopedic surgeon at the hospital did the operation

highly qulified orthopedic, hm, that means maybe my legs should be an easy task for him!

Interesting and Thanks for the info.

[sbk]

a highly qualified orthopedic surgeon at the hospital did the operation.

Actually, Dr PP, I wasn't referring to the original post.

I, too, have been to Bumrungrad, I saw a doctor within an hour of walking in without an appointment. I was registered as a patient, and given an appointment with a dr within the hour. I found their service to be good, their attitude friendly and professional and their prices, when compared to a similar service back in the US, more than reasonable.

[DogNo1]

Just to add my two cents: I visit Bumrungrad every year when I vacation In Bangkok and have been pleased with their service except for one time when the physiotherapist forgot to come and remove the heatpack applied to my back. Actually no big deal.

I had a condition similar to the one mentioned. The doctor, I think it was Panya, diagnosed my problem as sciatica - a pinched nerve in the back. It was very painful to even sit and I suffered on the airplane on the way over. Medication and physiotherapy helped somewhat, but the condition didn't really get better until I got home and started an exercise program with a personal trainer. After about two months of exercises designed to buld up the muscles in the back and buttocks my problem went away. If I stop exercising, it may come back, but it's gone for now. I had a similar problem with a neck whiplash injury in California. All kinds of medication didn't really help and I only got better when I found a good physical therapist and exercised to strengthen the neck and shoulder muscles. Of course I realize that some people's conditions don't respond to exercise, but it's worked great for me.

[drbones666]

So far its been a complete success...I can only recommend the hospital and the doctors. If anyone out there is suffering like I was, I hope you are as fortunate as I have been.

Just so everyone knows, I'm an evil Chiropractor.

Back surgeries fail 50% of the time within the first year. Look down the time-line and around the 5-7 year mark the failure rate is so close to 100% that it isn't worth talking about. Now, I'm not saying that if you went to a Chiro you would no longer have back pain, I'm just saying enjoy it while it lasts.

I hope you are one of the lucky, lucky ones. If not, write back to me and I'll give you some general guidelines on healing discs that you won't get in very many places. I don't practice in BKK so I won't be making any money off you. Just always happy to help a fellow traveler.... and be a spoil-sport.

[ProThaiExpat]

Not surprised a Chiropractor has your attitude, but your facts are wrong and the "failure rate", whatever that means, is far from what your represent them to be.

Chiropractors do a lot of good, and have helped me immensely, but when they talk like you do, they discredit themselves and their profession.

Since your throwing around the facts, break down "failure rate" into the types of back surgeries perormed, the part of the spine operated on and are you including fusions in your statistics?

[Dradam]

Bumrungrad is certainly the premier hospital in Thailand. Be careful about assuming that they are the best in every field of medicine and every surgery. Some of the best surgeons are at other hospitals or operate out of private clinics where they can charge appropriately for their skill. Inquire sufficiently into any surgical procedure so that you can find the top doctor in the field that you require.

In some cases, a large hospital can overwhelm specialties and drags them into mediocrity. Cost-cutting practices at large hospitals can also be harmful so beware.

I have heard from numerous sources within the medical profession here in Thailand that Payathai, Bangkok, Samitivej, as well as other hospitals have their own specialties which are higher quality than Bumrungrad.

[griffer]

Dr.adam...yep, it would be naive to believe the best doctors for evry speciality works out of Bumrungrad..

as you say, through the medical profession you have heard of many higher quality specialists working out of other hospitals. The point here is that you have heard this "through the medical profession".How does joe public find this out?...well, he can't. He can ask around,hmmm..and it still comes down to someones subjective view...

I think the ordinary punter is probably going to have to take his chance on one of the big hospitals and see how the doctors shape up. As I said, I tried to get as much info as possible before the op and cross-checked it with someone in the UK.

It seemed to stack up. But any operation has some level of risk..whether I had it in Thailand or the UK.

As for the doctors in private practises being able to charge appropriate to their skill....there is something like that happening in Bumrungrad..I haven't got details..but as I understood the set-up, the doctors charge independently of Bumrungrad, though still under their billing system, and Bumrungrad takes a percentage back out of what they charge.

dr.bone... crikey so I've got a 50% chance of getting through the first year..better get some parachuting in quick....

they are amazingly high failure rates that you quote...and within 7 years I'm back to square one? is there anywhere on the web where this is documented? seems bizarre...

i guess anyone who is back to square one by implication had the op done 8 years ago...my understanding is that these ops have improved markedly over the recent times....so I hope your figures were calculated by using statistics from the early roman empire..

another link for those interested is this

http://www.alphaklinik.com/Slipped-Disc-with-Stenosis.html

its a klinik(?) in germany specialising in this type of surgery..if you follow the links it will actually show you what happens in the op. It was another of the places I considered going. They are willing to do the op with you still conscious..crikey..."pass me the scalpel, will you please, patient"...

[drbones666]

Yes, we Chiropractors tend to be very knowledgeable. Since this is my field and I've been at it for over 11 years now I've seen quite a bit. One thing I keep seeing over and over is failed surgeries. I also see very few of my patients end up under the knife. For those who need it I've got a very nice mutual referral network with several surgeons at a local "Expat-Quality" hospital here in K.L.

A quick perusal of my hard drive (and that's all you get because you're just being a twit) yields a few of hundreds of citations:

Many people who have had spinal surgery claim that within one year after surgery their symptoms are no different than before they had the surgery.

Dommisse, G.E & Grahe, R.P The failure of surgery for lumbar disc disorders. Disorder of the lumbar spine. Lippincott, 1978.

Salenius, P. & Laurent, L.E. Results of operative treatment of lumbar disc herniation. Octa-Orthop Scand, 1977, iS, pp. 630-634.

Sadly, however the number of spinal surgeries is increasing much faster than the population.

Davis, H. Increasing rates of cervical and lumbar spine surgery in the United States, 1979-1990. Spine, 1994, 1,9(10), pp. 1117-1124.

One observer explained this increase in purely monetary terms: "Surgery rates are influenced by the ratio of surgeons to population."

Wennberg, J. & Gittelsohn, A. Variations in medical care among small areas. Scientific American, 1982, 246(4), pp. 120-134.

Back surgery for herniation should only be attempted as a last resort. That is because back surgery is a dangerous procedure with a high failure rate. The failure of back surgery is so common that those suffering from it have Failed Back Surgery Syndrome. About 600,000 back surgeries are performed per year with an average failure rate of 53%.

[griffer]

Dr.bone..

Unfortunately you have taken my good humoured approach to me being a twit…..I was only asking for a few more details to underline your claims of rate of failure and perhaps some links.

Anyway…I note the referral documents and their dates..1978,1977,1994, and 1982. So they range from 27 years ago to 10 years ago. Would you not agree that success rates in surgical operations have improved dramatically in the last 25 years?

As to the failed back surgery syndrome..

I found this link :

http://www.spine-health.com/topics/surg/fa...led_back01.html

“Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a misnomer, as it is not actually a syndrome - it is a very generalized term that is often used to describe the condition of patients who have not had a successful result with back surgery or spine surgery”

“There are many reasons that a surgery may or may not work, and even with the best surgeon and for the best indications, spine surgery is no more than 95% predictive of a successful result.”

“After spine surgery, careful follow-up and rehabilitation is very important. If there is continued pain after back surgery, despite adequate time to heal and rehabilitation, then further workup may be warranted to find if there is a new lesion or a different type of problem that could contribute to the patient’s pain.

Failed back surgery syndrome is really not a syndrome, and there are no typical scenarios. Every patient is different, and a patient’s continued treatment and workup need to be individualized to his or her particular problem and situation.

By: Peter F. Ullrich, Jr., MD”

…. ”misnomer,,,not really a syndrome”…some of the operations are not successful..I would have thought that was the case with almost any surgical procedure…

as to you saying that the failure rate of these operations is 53 %..are these figures also calculated from statistics from 10—25 years ago?

I used to go to a chiropractor in the UK..nice and regular..hand over my 35 pds for 30 minutes…hopefully I will not have to do that anymore..If this surgery can be improved to the level where even chiropractors have to admit it can prove successful, it could leave a few more empty seats in the waiting room……….

[ProThaiExpat]

griffer: Pay attention to the post from the guy who just had a successful back surgery at Brumregard and try to get the same operating surgeon.

While I am an advocate of Chiropractic care for physical therapy type treatment, heat, massage, stretching, traction and in some cases adjustment, especially SOT, Chiropractors are way over their undergraduate degrees and homeopathic approach when it comes to herniated discs that produce unrelenting pain, nerve root impingement, sphinter loss, reflex changes and atrophy.

Believe me, good orthopedic surgeons and neuro-surgions full explore the palliative avenue of treatment including all modalities of physical therapy in hopes of remedying disc problems prior to recommending surgery. (They certainly offer everything a chirporactor does in this regard, and if osteopathically trained, adjustment as well).

Comparing the level of education alone, without comparing the clinical training, chiropractors come off a very, very poor second to well credentialed surgeons specializing in this field. Your finding defects in the sources quoted as authority speaks volumes regarding the source of the medical advice being provided by this chiropractor.

I have had numerous occasions to cross-examine Chiropractors in court in lititgation over "disc" surgery cases, both pre-op and post-op, and they are easily shown up for their lack of education, clinical training and pure lack of good medical knowledge, especially anatomy. There are exceptions, of course, but those have tended to specialize and label themselves as Chiropractic Orthopedists.

Such practitioners, are quick to refer patients to qualified surgeons when it is clear from diagnostic proceedures that the underlying problem is an extruded disc with nerve root impingement, a medical condition for which "disc jockeying" is contra-indicated, and is in fact harmful.

Would you believe there was a Chiropractic Hospital in Colorado that treated cancer patients. There is much Chiropratic Literature, usually available in brochures available in Chiropractor's offices, that say Chiropractores can treat systemic disease processes, including diabetis, and internal organ disfuction.

It is unfortunate that Chiropractors reach so desperately to practice medicine that they exceed their grasp so often, as they have a very legitimate nich in medical treatment and many have been very successful professionally and financially without trying to compete with physicians.

I woke up doubled over in pain one day, and after visiting a physician and receiving muscle relaxers and physical thereapy without relief, a friend said I had nothing to lose to go to a "disc jockey".

The Chiropractor I consulted, did not adjust my spine, but merely put a wedge under one hip and iced my spine. After 17 minutes I walked out of his office, compelety ok. The problem returned, but not nearly so severe and I continued the three treatment regime, every other day. Each time the wedge and ice treatment was reduced in time length. I was completely healed after a week and have had rare relapses in the past 30 years. This is the type of injury for which there is no substitute for Chiropractic care. Spinal alignment, muscle pulls, ligementous injuries, dislocations and sub-luxations are all well withingChiropratic expertise, but true herniated discs are not, as anyone who has one and gone to Chiropractor for treatment will attest.

[Martin]

I had to have my left coronary artery reamed out. Having had the right one done in Singapore in 1993, I knew what was involved. A long guidewire inserted in the big artery in your groin and poked up to the heart, manipulated till it is through the constriction, and then a tube carrying a minute inflatable balloon fed along the guidewire and the balloon inflated etc etc etc. Look up 'angioplasty', if you wanr the details, but it is basically "the Dynorods of the blood-pipes plumbers".

However letting people poke around inside my heart is not something I will do without I have assured myself of their competence.

I looked at Bumrungrad's website and it said the right things, so it was a candidate for deeper evaluation. But when I went for exercise ECG, echo sounding etc at Srinakarind Hospital at Khon Kaen, I had a look at their Catheter Lab and talked with their two cardiologists who do this procedure all the time. They passed muster, and their charges were way, way less than Bumrungrad's. So I went to Srinakarind. Obviously, since I am typing this!, it was a success.

Below is a posting that I put on the NE Expats Forum:

"I think newcomers would like to know what to do if they get ill.

Six years ago, I was carrying a paraumbilical hernia (caused by interminable coughing in the dry, dusty air in the Himalayas). It started giving trouble whilst I was in Isan. My mother, who had been a hospital nurse, used to say "Anywhere in the World, for medical treatment, your best chance is the Teaching Hospital". So I went to Srinakarind, which is the very big hospital associated with Khon Kaen University. It is on the left as you go up the hill, leaving Khon Kaen on Highway2 towards Udon Thani.

I was looked after well in a General Surgical Ward, and the Operating Theatre conditions and staffing seemed first class. I remember that the Surgery Fee was 5000 baht, and all the rest (five nights in hospital, and medicines) was about another 4000 bahts.

This year I went back there with angina pains. I had had angioplasty to open up a partly-blocked Right Coronary Artery in Singapore in 1993 and this time it was the turn of the left one. I thought that they might say that I had to go to Bankok, but not so. They had all the diagnostic equipment (ECG, echo-sounder etec) and a modern Catheter Laboratory and were inflating miniature balloons and placing stents inside hearts every week. Again their surgery and hospitalisation charges were very low, compared to the West; but they have to charge for the catheters about 20,000 to 30,000 bahts each, as those are imported from Western medical equipment companies, such as Johnson&Johnson.

So I am fully-confident in Srinakarind (in fact I wouldn't let anyone in whom I was not fully confident go poking around inside my heart!!).

The only drawback is that it is a very busy place in the Outpatients Departments, so there is quite a lot of waiting around to do when you go back for your follow-up consultations, and each takes a full morning (hint: take a good book).

I have also been to Aek Udon Hospital as an Outpatient with minor complaints. They see to you very quickly and their charges (100 bahts for a consultation), and prices for medication, are very reasonable. But I found that the standard of English was better at Srinakarind.

Incidentally, if you take routine medication, you may well find that it pays you to register at your local (Amphur) hospital as an Outpatient, tell the doctor what you are on, and get it at their dispensary. The common drugs seem to be only a quarter to a tenth of the prices quoted on the Internet. My ten pills a day are only costing me 11 bahts."

[thaigene2]

The fact you had a good operation with a good doctor doesn't really stand as valid recommendation for Bumrungrad Hospital.

I think BH is a bit like the McDonalds on the 2nd floor. They run you in then run you around to as many tests as they can squeeze in then write you an Rx and walk you to the cashier. Before you know it you're on your way with that little brown designer bag with the prescription and a return appointment. But was it all necessary? (In your case apparently so). It is a hypochondriac's paradise, I'll admit.

I have had doctors there offer my kids anti-biotics for what was clearly a cold. Another doctor nicked a woman's bladder during a C section (think that was Samitvej actually), and I have had a doctor remove hyper-plastic polyps from my stomach, telling me this was absolutely necessary, when the British Medical Journal and Harvard's online info said normally they are benign and should be left alone.

And there's something more than mildly upsetting to realize the doctors at BH seem to be 'freelancers', occupying an exam room only for a couple of hours before taking their name plate off the door for the next quack's turn.

Yes, I like the modernity of the place, and yes I go there too. But I'm always worried in the back of mind about whether this doctor knows what s/he's doing. To me what's more important than the blitzkrieg-style of service is the doctor's competency. For your back problem it worked out. Glad for you. But that doesn't stand as a recommendation for BH in general..although I'll make a note of your doctor's name just in case. What I'd like to see is a ranking of good doctors, so we know which ones are good and which ones are not. Wonder if BH will let ANY 'qualified' doctor work there? How do they get in? Do they pay their way in? Is there an entry fee for doctors like joining a club? BH is a money spinning business and must be viewed sith a healthy amount of skepticism. Lots of unanswered questions.

[Orion76]

I think BH is a bit like the McDonalds on the 2nd floor. They run you in then run you around to as many tests as they can squeeze in then write you an Rx and walk you to the cashier. Before you know it you're on your way with that little brown designer bag with the prescription and a return appointment. But was it all necessary? (In your case apparently so). It is a hypochondriac's paradise, I'll admit.

In my home country you first see your family GP, he then acknowledges something is wrong and he refers you to a hospital.

Your appointment is 2 weeks later and the specialist agrees with your doctor that something is wrong and he makes an appointment to do some tests.

2 weeks later you come in for your tests and are then asked to come back 2 weeks later for the results.

I'll take the Bumrungrad Blitz Care approach any day

Thaigene, over medicating is not a Bumrungrad thing, it's a Thai thing. Patients here expect to be given medicine and if they don't they'll go to a different hospital that does give them lots of pills.

[lopburi3]

And there's something more than mildly upsetting to realize the doctors at BH seem to be 'freelancers', occupying an exam room only for a couple of hours before taking their name plate off the door for the next quack's turn.

What you see are doctors that are top staff at other hospitals working at Bumrungrad on their day off for the most part. Some other will divide their time between several hospitals. This is especially true of those from the public sector but also valid at other private hospitals (my dermatologist works at Ladphao General full time but at Bumrungrad on day off).

They are not quacks. I have issues with this hospital but it is without a doubt one of the top medical facilities in Thailand and the region in general. Those that work there, or the other top hospitals, are normally the very best doctors in their fields.

[Orion76]

Also some are university professors who work in the hospital on their off days.

[griffer]

Just as an aside...Bumrungrad probably makes more sense when you realise that the CEO is an american (Curtis Schroeder)..

a friend of mine who is a freelance journalist, interviewed him a year or so back. Unfortunately, or maybe fortunately for those of us who use the place, he couldn't find anyone interested enough to publish the piece back in USA. The idea was to compare standard of treatment and pricing. Apparently dental treatment was already very popular with 'medical tourists', to coin a phrase.

One can see by the way that Bumrungrad caters for foreign visitors--translators available for instance---we must already contribute a large percentage of the revenue.

[lopburi3]

One can see by the way that Bumrungrad caters for foreign visitors--translators available for instance---we must already contribute a large percentage of the revenue.

300,000 patients last year (1/3 of total) according to this recent Singapore Straits Times article.

My Webpagehttp://www.cancerstory.com/servlets/bumrungrad.jsp

[griffer]

Slipped disc surgery for Mubarak..

http://news.bbc.co.uk/2/hi/middle_east/3822571.stm

crikey..you never know who might be reading this forum....

[camerata]

In my home country you first see your family GP, he then acknowledges something is wrong and he refers you to a hospital.

Your appointment is 2 weeks later and the specialist agrees with your doctor that something is wrong and he makes an appointment to do some tests.

2 weeks later you come in for your tests and are then asked to come back 2 weeks later for the results.

Actually, I think it's often a disadvantage that we DON'T see a GP at these big hospitals. They seem to be full of specialists who don't really look at the Big Picture as far as your health is concerned. And I don't recall ever being referred from one specialist to another.

A case in point is when I sprained my ankle one night. I told reception at BH I thought it was broken and got to see an osteopath (who turned out to be an expert in sports medicine). I ended up with the wrong size bandage ("It's the largest we have"), no cast, some pills and a recommendation to stretch my foot in one direction. 7 weeks later I reinjured it while walking. 6 months later I am still having trouble. There was never any referral to a physical therapist - I had to arrange that myself. Now I'm getting ultrasound, therapy and a whole bunch of range-of-motion, flexibility and strengthening exercises.

But the one GP I saw at BH was useless. She failed to diagnose the classic symptoms of trigeminal neuralgia (often called "the most painful condition known to medical science"), and sent me away with no medicine, no advice and no referral. When I arranged an appointment with a neurologist a week later, he knew exactly what the problem was, but even he didn't give me any useful advice. I had to get that from the Internet.

On the whole I like BH but I'd prefer having a good GP decide which specialists I should see instead of having to figure it out for myself. I can honestly say I've never been overmedicated (quite the opposite) or given unnecesary tests. And my dentist at BH is very conservative - not always wanting to crown teeth or pull them out.