I Am So Angry With Samitivej Hospital

[Sakeopete]

I am at work in the UK and my wife takes our 20 month old son to the doctor because he has a bit of a fever and they tell my wife he needs a chest x-ray. OFC my Thai wife doesn’t question the doctor and as expected nothing was wrong he only has a cold. The doctors only think about money and are happy to expose a baby to radiation to make it. It wasn't our regular paediatrician as he was unavailable. I went for a check up a couple years ago and they tried to talk me into a chest x-ray and MRI. I said no then went a few months later to my doctor in Canada for a real check up. He said it is common these private hospitals prescribing unnecessary procedures to make money. He thinks it's an unethical practice.

Anyways sorry for venting on this forum but I want to warn parents. When I get back I’m going to have words with my regular paediatrician and see what he says if he backs the decision as I guess he will I will try a different hospital.

Edited August 10, 2007 by Maestro
Changed reference to a name of a fashion brand to "doctors"

[dee123]

I remember a similar story on british TV,...same kinda thing but in greece,.....the more time in hospital the more the insurance co. have to pay......first you think "my god their thorough here!".....but then when the premiums go up....!!

[londonthai]

always worth to have a second opinion - and it will be too late to have this opinion in 2 months time when talking to your regular paediatrician.

I am not sure why your wife couldn't get an appointment in the governmental hospital on a 30baht/year health card - it wasn't emergency and it wasn't anything that complicated that any doctor can deal anytime. Maybe you should talk as well to your wife not to panic in the future in a similar situation. It's all too common in thailand to go to the hospital with only a small problem, like ordinary flu.

[Dakhar]

I for one am not used to affordable medical assistance.

What 10$ for an ex-ray for my son... can I have one too?

I am more used to filling out credit information before the doctor will see me... and selecting on of the following:

30 second visit 200$ (visit with physician assistant)

2 minute visit 350 (visit with Nurse pratcitioner)

Platnume member service 5 minutes (with weight & temp taken) 750 $ (Visit with MD)

[jingjingna]

I personally believe that all the private hospitals here are operating one massive scam!

Through work I have Bupa..yet each time I go I am produced with two bills...one for the insurance company covering the full 1,000 Baht OPD visit and another for me to pay the excess..sometimes 1,000 baht plus!

However, once I tried not to use Bupa and guess what? My bill was less than 1,000! Go figure.

It's always for the same kind of treatment, flu, cold or allergy...something needs to be done to expose these guys!

[PeaceBlondie]

The opening post isn't very clear. Did the attending physician listen to the child's chest carefully? Could there have been lung congestion or rumblings that justified an xray? What ever happened to 'better safe than sorry'? Tuberculosis is not uncommon in Thailand. I see my cardio doctor every month of two, and he always listens to my chest, front and rear. I have no doubt he'd send me for an xray if he heard something in my chest. Haven't modern xray machines been reengineered to give smaller doses? Are we to imagine that Samitivej gives the same patient several unneeded xrays every year? Doubtful. I used to kid my Thai dentists that if all else failed, they'd finally give me a mouth xray.

I have my own doubts about Samitivej's best doctors, but we're not talking about a little chest rumble. And they may be the best in the world, simply unable to cure a massive deep infection, and unwilling to cut me open and take out the infection. The govt. hospital in Chiang Mai quickly saw the infection wasn't being cured, and opened me up.

But again, I walked into an American specialist in infectious diseases, and her opening remark was "I've read your charts, and I can't help you." Medical science sometimes is just a desperate guessing game of semi-ignorant, over-educated, over-charging doctors.

[Sakeopete]

I guess I should clear things up a bit. As for the costs I’m not concerned as my company’s insurance plan covers 100% of my family’s medical costs. My son was born at the hospital and I like the facilities they have modern equipment and the hospital seems clean. Our son just had his vaccination a few months back with his regular paediatrician who is a doctor at the hospital who speaks excellent English and I am happy with. However from my own experience with Samitivej I feel they are pushing patients into expensive diagnostic treatments purely to make money. They tried it with me when I went for a check up and I believe they did it to my son. My concern is the unnecessary exposure to radiation from the x-ray. You may argue with me as you may about the dangers of x-rays but with all the crap our bodies are being bombarded with daily extra radiation doesn’t help.

[lopburi3]

The amount of radiation from a chest x-ray is minimal.

A chest x-ray from modern equipment should not be more than 0.1mSv (or what you would naturally receive in about 10 days from normal background exposure) according to this site http://www.radiologyinfo.org/en/safety/ind...xray&bhcp=1

[Maestro]

Sakeopete, what if your child had had pneumonia, the doctor did not order an x-ray, and your son suffered serious consequences. What would you have posted then?

The sad fact is that many doctors are no longer trained properly in the art of auscultation or if they are trained they don’t trust themselves to use it correctly. Instead, doctors learn about what equipment to use for what diagnostic procedure in the presence of what symptoms.

The alternative is for you to find a trustworthy general practitioner of the old school as your family doctor but, alas, this type of doctor is a dying breed.

--

Maestro

[Sakeopete]

The amount of radiation from a chest x-ray is minimal.

A chest x-ray from modern equipment should not be more than 0.1mSv (or what you would naturally receive in about 10 days from normal background exposure) according to this site http://www.radiologyinfo.org/en/safety/ind...xray&bhcp=1

Thanks for the info Lopburi3 maybe I'm a paranoid parent but after living in Thailand for almost 6 years and seeing the short cuts Thais take when it comes to repairings thing can you blame me. Does the technician know what he is doing or did he get the job from a friend? If he doesn't know for sure will he ask a senior co-worker and lose face? or will the usual Mai Pen Rai justification be chosen.

Maestro, my son only had a slight temperature even my wife was suprised the doctor asked for a chest X-ray but her Thai up bringing did'nt allow her to question the doctor. I have instructed her to always take the boys to the doctor if they develop a fever because a couple of years ago our oldest had malaria but the symptoms were no diffrent than the flu. I prefer to be safe than sorry with the kids but from what my wife tells me I can't see how an x-ray was justified.

[Sheryl]

It is perfectly possible that the doctor was unable to rule out pneumonia with just a physical exam. Especially when there is a lot of upper airway congestion, it can be difficult for even a very skilled practiticioner to be sure the lungs are clear. In that case, an x-ray is the safest bet.

I don't think one can conclude a profit motive from the information available. More likely the doctor was concerned about his/her own liability if he missed an early pneumonia. Unless you have other reason to believe that this particular doctor is unscrupulous in that regard, give the benefit of the doubt.

I would put more emphasis on the doctor than the hospital. Bumrungrad in my experience is the money grabber extraordinaire of them all, but I have encountered some very honest and compassionate doctors there who went out on a limb to bend the rules to help a patient save money. You have to use your own judgement in sizing up a doctor as to how honest and committed they are.

And, of course, one has to make sure the doctor knows your concerns. When tests are recommended, say up front :"I'm concerned about cost, is this absolutely necessary to do now?". They aren't mind readers and will not know that finances are a factor unless you say so. Or, say up front "I don't want my child exposed to unnecessary radiation, is it really necessary to do an X-ray at this point?". As other posters have noted the X-ray exposure radiation is minimal but a good doctor will respect your concern even if he/she doesn't share it. Chances are that if the OP's wife had said either of these things the doctor would have replied, "Well, I can't be sure he doesn't have pneumonia without one, but he doesn't seem to be in acute distress and we could defer it provided you watch him closely and bring him straight back if he develops (describe signs of trouble breathing".

As for doctors who won't be that responsive or at least explain and justify their recommendations -- dump them and find one who will.

[Sakeopete]

It is perfectly possible that the doctor was unable to rule out pneumonia with just a physical exam. Especially when there is a lot of upper airway congestion, it can be difficult for even a very skilled practiticioner to be sure the lungs are clear.

I appreciate your comments however as I mentioned in my posts there was no upper airway congestion. He woke up with a mild temperature and my wife took him to the doctor. He was playing and breathing just fine.

My suspicion lies in the fact that when I went for a check up they tried to talk me into a chest x-ray, when I questioned the doctor and asked him what basis he recommended a chest x-ray he seemed upset that I questioned him and gave no answer. I told him I don't want unnecessary exposure to radiation then he tried talking me into an MRI.

[steffi]

chest xrays are a high dose of radiation but I've had one this trip as I had some respitory infections due to the pollution.

I've had similar experience in so far as they prescribe too little medicine and you're expected to return again later.

But that said. a chest xray really tells them a lot they cannot see and compared to western pricing they are dirt cheap here. MRI is certainly not necessary but again they are trivial in price compared to western prices. I had one a few years back on my shoulder and it cost $200 but I got it all back from my wifes insurance.

I am at work in the UK and my wife takes our 20 month old son to the doctor because he has a bit of a fever and they tell my wife he needs a chest x-ray. OFC my Thai wife doesn’t question the doctor and as expected nothing was wrong he only has a cold. The doctors only think about money and are happy to expose a baby to radiation to make it. It wasn't our regular paediatrician as he was unavailable. I went for a check up a couple years ago and they tried to talk me into a chest x-ray and MRI. I said no then went a few months later to my doctor in Canada for a real check up. He said it is common these private hospitals prescribing unnecessary procedures to make money. He thinks it's an unethical practice.

Anyways sorry for venting on this forum but I want to warn parents. When I get back I’m going to have words with my regular paediatrician and see what he says if he backs the decision as I guess he will I will try a different hospital.

[lopburi3]

Read my post 8 please. Chest x-rays are not a high dose of radiation.

[Queenie]

Why don't your wife ask the doctor for the reason to get your son chest x-ray? so you would know better before you get angry. I have to admit that some doctor is just doing it to protect themself, if anything worse happen. Like someone has said earlier, what if doctor suspect any symptom from hearing and he couldn't see...

The Thai doctors seem to give less explaination, sometime we need to questions them.