Hospital Nightmares

[bsided69]

I would serioiusly reconsider having any unnesacery medical treatment in Thailand. Having been here for 6 years on and off I know of very few postive experiences. There are some great Doctors, but many of the younger junior doctors and nurses are a joke, and these are the people that will be looking after you once youve had your Op.

A friend of mine fell off her bike on Thursday ( pished as a fart). Along came the ambulance and off to the hospital. not sure of the name, but its on Chang Klan . I went to see her in the A an E department. She had some minor grazes no bigger than a 10 baht coin on her elbow and head. She had quite obviously hit her head tho, and was complaining of a pain in her shoulder. The clown, oops sorry Doctor put some Iodine on her grazes and sent me to the pharmacy to pay the bill and pick up some meds. So quess what they give her? ?????? Yes you got it, antibiotics and paracetamol. Ok pain killers, but why antibiotics????? Well this isnt the meat of the tale. When I got back to her she was being helped up and into a wheel chair. She winced with pain and again said her shoulder hurt. She pulled back the top of her T-shirt revealing another minor graze that hadnt been spotted. I had not been there for the first hour that she had arrived, but assumed ( ha, assumed in Thailand) they had removed her top at some point to examine her propaly. I should of questioned this but I forgot how to speak Thai.( im an idiot who speaks very little Thai) So we Take her home are told to keep an eye on her and watch out for any fainting spells and vomiting.

In the morning she wakes up with a thumping head and severe pain in her shoulder. Back to the hospital she goes. (I was not there) The Doctor this time had obviously attended doctors school, as he sent her for X-rays. Well would you Adam and Eve it? Broken Collar bone. Now how the Bloody hel_l does the doctor on the night shift miss this one????? Because I suggest, he is a Muppet with little or no Knowledge of medical treatment. These are the people that will be giving you aftercare. The people that will not question a senior Doctors methods even if they can see that there is quite obviously something not right.

I have many more storys like this, but will save them for another time.

ps I love Thailand and want to spend the rest of my life here and die of natural causes.

[onethailand]

First of all, what does this have to do with Bangkok?

Secondly, antibiotics are normal for grazes to fight possible infection?

Thirdly, if she did not mention to the doctor that she had shoulder pain, how would you expect a doctor to react? That's like going to the doctor and saying "I hurt" the doctor asks "Where" and you respond "You're the doctor, you're supposed to tell me".

If you have a complaint about that hospital, don't suddenly make it a diatribe on all medical services in Thailand.

[mr_hippo]

Let's start with the antibiotics and painkillers, should we? You cannot give anything stronger than paracetamol within the first 24 hours of a suspected head injury. You were given the best advice there as well - ' told to keep an eye on her and watch out for any fainting spells and vomiting. ' You also say that she had 'road rash', so the wounds could become infected. Now which would you prefer? Antibiotics as a precaution against possible infection or wait until she has a raging infection and then treat her?

Now for the fractured collar bone. How many hospitals do you know who keep an X-ray department staffed 24 hours a day? There will be an X-ray tech. on call for major incidents. Could the fracture be missed in Europe or the US? Yes, it could! I do not know the specifics in this case. You say 'broken collar bone' - was it a complete break with its attendant deformity and excruciating pain?

[JeffCA]

I have personally had several instances to go to the Doctor/Hospital in Bangkok. I have always gone to Bumrungrad and had service that compared to the best hospitals in the U.S. (which I have had to be in a couple of those as well). The great health care I receive here was the reason this pushed to the top of overseas low cost retirement destinations for me. For those reading this post, the OP just had a bad experience from his viewpoint.

[Macx]

ps I love Thailand and want to spend the rest of my life here and die of natural causes.

Hmm, I think that the longer you live here, the lower your chances of dying of natural causes.

I too have had several bad experiences with doctors here, some of them from the "best international hospitals" in this country and also at the hands of their farang directors. But, well, that's for another thread.

Edited February 17, 2008 by Macx

[geriatrickid]

I think the answer lies with the "pished as a fart" condition. It really is quite difficult to communicate and diagnose properly with someone in that condition. If there are not indications otherwise, the SOP is to allow the patient to sober up and to not prescribe any sedatives or strong analgesics for obvious reasons. Now they could have kept her in the hospital until then but then one would have heard complaints about an unnecessary stay and the expense. Best place for her was at home in comfort under observation.

As for the broken collarbone. What was the nature of the break? Hairline fracture? Hard to diagnose and treatment often involves nothing more than immobilization or a brace depending upon the nature of the injury. Of course a proper examination includes the verification of all body parts but often women are hesitant to allow the attending to examine them. It becomes particularly difficult when the patient is in a "pished" state". A n attending that isn't determined or gifted with interpersonal skills just gives up. As well, physicians like everyone else don't want to deal with "pished" adults. I think the problem you described is common to all hospitals and not specific to BKK hospitals.

[Furbie]

Let's start with the antibiotics and painkillers, should we? You cannot give anything stronger than paracetamol within the first 24 hours of a suspected head injury. You were given the best advice there as well - ' told to keep an eye on her and watch out for any fainting spells and vomiting. ' You also say that she had 'road rash', so the wounds could become infected. Now which would you prefer? Antibiotics as a precaution against possible infection or wait until she has a raging infection and then treat her?

Now for the fractured collar bone. How many hospitals do you know who keep an X-ray department staffed 24 hours a day? There will be an X-ray tech. on call for major incidents. Could the fracture be missed in Europe or the US? Yes, it could! I do not know the specifics in this case. You say 'broken collar bone' - was it a complete break with its attendant deformity and excruciating pain?

Please, after an accident, anyone complaining of localized pain should be x-rayed. If the hospital does not have the capability, the patient should be sent somewhere that does. Given the fact that even small clinics in Bangkok have X-ray machines in them for the 250 baht work permit physical, etc, I am sure the cost of keeping an X-ray tech in a hospital on a 24 hour basis is very low. By the way, if the fracture was missed in the US, there would be a nice lawsuit; which I'm sure would have resulted in someone taking an X-ray as an initial step.

As to the head trauma, what if the patient's headache was related to severe trauma? Take her home and keep an eye on her could result in death. Keeping a head trauma overnight for observation seems far more prudent.

[backflip]

If the intoxicated woman was X-rayed, and nothing was found, her boyfriend would complain that the X-ray was unnecessary, and that it was conspiracy because they were farangs, it was the mafia, and they were double-charged from the get-go.

[mr_hippo]

Please, after an accident, anyone complaining of localized pain should be x-rayed. If the hospital does not have the capability, the patient should be sent somewhere that does. Given the fact that even small clinics in Bangkok have X-ray machines in them for the 250 baht work permit physical, etc, I am sure the cost of keeping an X-ray tech in a hospital on a 24 hour basis is very low. By the way, if the fracture was missed in the US, there would be a nice lawsuit; which I'm sure would have resulted in someone taking an X-ray as an initial step.

As to the head trauma, what if the patient's headache was related to severe trauma? Take her home and keep an eye on her could result in death. Keeping a head trauma overnight for observation seems far more prudent.

First of all you were not there and neither was I! I speak from 30 years experience, how experienced are you?

You say that 'anyone complaining of localized pain should be x-rayed', now how do you reach that conclusion? If you stubbed your toe and the doctor said 'I think it's broken.' Would you demand an X-ray? If you did, all you would be doing is wasting time and money but, hey, it's your money! Treatment:- tape two toes together, you cannot put a Plaster of Paris splint on toes!

Broken collar bone, as I have said there is excruciating pain and visible deformity and there may be some degree of crepitus.

Did the patient have any of the following:-

Sagging shoulder (down and forward)

Inability to lift the arm because of pain

A grinding sensation if an attempt is made to raise the arm

A deformity or "bump" over the fracture site

So if these were absent, would you suspect a fractured collar bone? OK she has pain in her shoulder, does not have full range of movement and can lift her arm. Is an X-ray necessary? It can be done in the morning, does not warrant calling in the X-ray tech.

Now, the head injury. All we know is that she 'hit her head'. Was she conscious? Were her pupils equal and reacting to light? Could she answer simple questions? If 'yes' to those questions, why keep her in for observation? I can only speak for UK hospitals but all will give a head injury card which give the patient or the patient's relatives of what to look for and what to do See example - http://www.chw.edu.au/parents/factsheets/pdf/head_injury.pdf

[mr_hippo]

Sorry - typo in my last line. It should read:-

but all will give a head injury card which tell the patient or the patient's relatives what to look for and what to do See example -

[kingwilly]

I have personally had several instances to go to the Doctor/Hospital in Bangkok. I have always gone to Bumrungrad and had service that compared to the best hospitals in the U.S. (which I have had to be in a couple of those as well). The great health care I receive here was the reason this pushed to the top of overseas low cost retirement destinations for me. For those reading this post, the OP just had a bad experience from his viewpoint.

exactly go to a cheap hospital and whaddya expect !

[bsided69]

If the intoxicated woman was X-rayed, and nothing was found, her boyfriend would complain that the X-ray was unnecessary, and that it was conspiracy because they were farangs, it was the mafia, and they were double-charged from the get-go.

An X-ray cost peanuts and any man who would complain about the expense of an X-ray should receive a quick kick in the Gonads. She is a wealthy girl anyway.

[bsided69]

Please, after an accident, anyone complaining of localized pain should be x-rayed. If the hospital does not have the capability, the patient should be sent somewhere that does. Given the fact that even small clinics in Bangkok have X-ray machines in them for the 250 baht work permit physical, etc, I am sure the cost of keeping an X-ray tech in a hospital on a 24 hour basis is very low. By the way, if the fracture was missed in the US, there would be a nice lawsuit; which I'm sure would have resulted in someone taking an X-ray as an initial step.

As to the head trauma, what if the patient's headache was related to severe trauma? Take her home and keep an eye on her could result in death. Keeping a head trauma overnight for observation seems far more prudent.

First of all you were not there and neither was I! I speak from 30 years experience, how experienced are you?

You say that 'anyone complaining of localized pain should be x-rayed', now how do you reach that conclusion? If you stubbed your toe and the doctor said 'I think it's broken.' Would you demand an X-ray? If you did, all you would be doing is wasting time and money but, hey, it's your money! Treatment:- tape two toes together, you cannot put a Plaster of Paris splint on toes!

Broken collar bone, as I have said there is excruciating pain and visible deformity and there may be some degree of crepitus.

Did the patient have any of the following:-

Sagging shoulder (down and forward)

Inability to lift the arm because of pain

A grinding sensation if an attempt is made to raise the arm

A deformity or "bump" over the fracture site

So if these were absent, would you suspect a fractured collar bone? OK she has pain in her shoulder, does not have full range of movement and can lift her arm. Is an X-ray necessary? It can be done in the morning, does not warrant calling in the X-ray tech.

Now, the head injury. All we know is that she 'hit her head'. Was she conscious? Were her pupils equal and reacting to light? Could she answer simple questions? If 'yes' to those questions, why keep her in for observation? I can only speak for UK hospitals but all will give a head injury card which give the patient or the patient's relatives of what to look for and what to do See example - http://www.chw.edu.au/parents/factsheets/pdf/head_injury.pdf

The point you seem to be missing is this was a an A an E dept that was being run by a clown. He did not even remove her top to examine her shoulder. She isnt shy and would not object. She mentioned many times that her shoulder hurt. What would of happened if it was more serious? I was there and have enough experience to recognise someone who has done a few months in medical college being left in charge of an Aan E department.

[bsided69]

First of all, what does this have to do with Bangkok?

Secondly, antibiotics are normal for grazes to fight possible infection?

Thirdly, if she did not mention to the doctor that she had shoulder pain, how would you expect a doctor to react? That's like going to the doctor and saying "I hurt" the doctor asks "Where" and you respond "You're the doctor, you're supposed to tell me".

If you have a complaint about that hospital, don't suddenly make it a diatribe on all medical services in Thailand.

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

She said to the clown many times that her shoulder hurt. He did not even remove her top to examine her. She is not shy and would not object. Basically all he did was put iodine on her grazes. Money was not a problem as she is wealthy and I was the Farang ATM so I feel a x-ray should of been taken as a matter of precaution.

It just scares me to think of anybody that would be sent here with any serious injuries. Maybe the real doctor was having a Kip? Wouldnt want to find out tho.

I placed this winge to get reactions. To here similar storys good or bad. If you experience bad service from hospitals in a country many times it is only natural to be worried and negative in your attitude towards hospitals.

[bsided69]

Let's start with the antibiotics and painkillers, should we? You cannot give anything stronger than paracetamol within the first 24 hours of a suspected head injury. You were given the best advice there as well - ' told to keep an eye on her and watch out for any fainting spells and vomiting. ' You also say that she had 'road rash', so the wounds could become infected. Now which would you prefer? Antibiotics as a precaution against possible infection or wait until she has a raging infection and then treat her?

Now for the fractured collar bone. How many hospitals do you know who keep an X-ray department staffed 24 hours a day? There will be an X-ray tech. on call for major incidents. Could the fracture be missed in Europe or the US? Yes, it could! I do not know the specifics in this case. You say 'broken collar bone' - was it a complete break with its attendant deformity and excruciating pain?

She had minor grazes no worse than carpet burns. Iodine would do the job. Antibiotics are given far to often and will soon have no affect on the serious infections that they are needed for.

The doctor clown did not even remove her top to examine her shoulder. She is not shy and money was not a problem. She is a wealthy girl and I was obviously the farang ATM. They should of sent her to a hospital with an X-ray machine if they did not have one. This would of resulteds in a loss of face tho. Cant have that can we?

This is one of many bad experiences that I have had in CM. I felt compelled to write about it. Feel free to tell of your good experiences.

[mr_hippo]

Sorry to be the bearer of bad news but the only 'clown' in this episode appears to be you! OK she came off her bike and 'it hurt', what did she expect - exquisite pleasure? In case English is not your native language, can you read the following again?

Did she have any of the following:-

Sagging shoulder (down and forward)

Inability to lift the arm because of pain

A grinding sensation if an attempt is made to raise the arm - and sometimes can be heard!

A deformity or "bump" over the fracture site

Any of these can be seen without removing clothing.

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

They are also given too frequently in the US as well and for sore throats then you are right but in this case - WRONG! Did you understand what I wrote "You also say that she had 'road rash', so the wounds could become infected. Now which would you prefer? Antibiotics as a precaution against possible infection or wait until she has a raging infection and then treat her?" It was given as a precaution. How clean are Thai streets?

I was there and have enough experience to recognise someone who has done a few months in medical college being left in charge of an Aan E department.

I will assume that the girl spoke a bit of English so why didn't you say anything through her either about the treatment or the doctor's competency?

It just scares me to think of anybody that would be sent here with any serious injuries. Maybe the real doctor was having a Kip? Wouldnt want to find out tho.

It was not a serious incident but very minor. "Maybe he 'real' doctor was having a Kip[sic]. There is a British expression 'spending a penny' which means 'going to the toilet'. Is having a (Laos) Kip the Thai version of it?

As for staffing the X-ray department 24/7, I won't go into the costing problems but the personnel problems. To have just one tech. available for full cover, how many more techs will you need? If someone is at home but on-call, they have a different mindset to one who is in an empty department for the whole shift and therefore he will not be as ready for 'duty' as an 'on-call' would.

She is a wealthy girl and I was obviously the farang ATM.

That one sentence speaks volumes!

[mrtoad]

Have to say from the story, that there was not much wrong with the care received.

I have used several hospitals in Thailand for myself, partner and daughter, and apart from the sometimes irresponsible prescribing of antibiotics (I will normally refuse them, if not needed) then care is normally of a good standard.

I think Mr Hippo has pretty much summed it up.

[sbk]

OP, one of your threads has been deleted and this one is being moved to the Health forum. In the future, do not post the same thing in multiple forums. thank you

///MOVED///

[Sheryl]

Thanks, SBK (not!)

(Just kidding!)

She may or may not have been treated properly; as a health professional I can't make that determination from the information available.

What I can say from many, many years personal experience here is that the full spectrum of medical care is available, from the best to the worst. If someone has had a bad experience it is because of the individual providers or possibly facility, not because it was in Thailand. Bad medical care is unfortunately available in every country, even the most advanced.

[gunnyd]

It's just lucky for Thai doctors that they are not subjected to the idiotic lawsuits that are filed on a daily basis in my homeland. Yes in a U.S. hospital they would have done blood tests for everything under the sun, X-Rays, Ultrasound, CT scans, MRIs and much much more. Even working as an R.N. I had to always worry about the constant threat of being sued. It's no wonder that treatment in top hospitals in SEA are at a fraction of the cost.

As for the treatment received one word TRIAGE. The more serious the case the higher the priority it is given in an Emergency Room. Sounds like the OP was expecting the full insured US hospital patient treatment. I have been in many Thai and Filipino hospitals and have been well cared for. It makes me sad about the current conditions in the United States health care system (if it could be called that).

I assume that no harm came to your friend because of the treatment that was delivered. Be happy.

GunnyD

[onethailand]

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

Carpet burn and a graze from a road accident are entirely different things - you obviously haven't a clue. I'd like to know someone who caught tetanus from carpet burn... and you seem to know a whole lot about "far too frequently" for someone who has been here 6 years and can't even remember the name of the hospital (probably McCormick).

You should have insisted on an x-ray if you were present and heard her complain many times in front of the doctor. X-ray does not need a Thai translation.

Maybe you should consider purchasing medical insurance that includes evacuation to a first world country if you are so afraid of medical care here in Thailand.

[Furbie]

Please, after an accident, anyone complaining of localized pain should be x-rayed. If the hospital does not have the capability, the patient should be sent somewhere that does. Given the fact that even small clinics in Bangkok have X-ray machines in them for the 250 baht work permit physical, etc, I am sure the cost of keeping an X-ray tech in a hospital on a 24 hour basis is very low. By the way, if the fracture was missed in the US, there would be a nice lawsuit; which I'm sure would have resulted in someone taking an X-ray as an initial step.

As to the head trauma, what if the patient's headache was related to severe trauma? Take her home and keep an eye on her could result in death. Keeping a head trauma overnight for observation seems far more prudent.

First of all you were not there and neither was I! I speak from 30 years experience, how experienced are you?

You say that 'anyone complaining of localized pain should be x-rayed', now how do you reach that conclusion? If you stubbed your toe and the doctor said 'I think it's broken.' Would you demand an X-ray? If you did, all you would be doing is wasting time and money but, hey, it's your money! Treatment:- tape two toes together, you cannot put a Plaster of Paris splint on toes!

Broken collar bone, as I have said there is excruciating pain and visible deformity and there may be some degree of crepitus.

Did the patient have any of the following:-

Sagging shoulder (down and forward)

Inability to lift the arm because of pain

A grinding sensation if an attempt is made to raise the arm

A deformity or "bump" over the fracture site

So if these were absent, would you suspect a fractured collar bone? OK she has pain in her shoulder, does not have full range of movement and can lift her arm. Is an X-ray necessary? It can be done in the morning, does not warrant calling in the X-ray tech.

Now, the head injury. All we know is that she 'hit her head'. Was she conscious? Were her pupils equal and reacting to light? Could she answer simple questions? If 'yes' to those questions, why keep her in for observation? I can only speak for UK hospitals but all will give a head injury card which give the patient or the patient's relatives of what to look for and what to do See example - http://www.chw.edu.au/parents/factsheets/pdf/head_injury.pdf

First, not sure where you live as you have not provided the information, but I must say I agree with the poster – the quality of healthcare in Thailand is not all that great. Sure, if you want McDonald's and Starbucks or an alternative on an expensive procedure that you can't afford, Thailand is a viable option. It's like everything else here, looks great on the surface, but problems underneath. What can you say about a system that schedules c-sections as a matter of routine practice? However, for those with decent insurance, I would stick with the West. Especially in the States, with good insurance you will get far superior healthcare than what is available in general in Thailand. The standard remedy for almost anything in Thailand is to load you up on pills (especially Tylenol and antibiotics and maybe a blood thinner) even when you have a cold, and send you on your way. Additionally, in Thailand you MUST be a very savvy consumer of medicine – why, too many under skilled doctors who do nothing but bounce from hospital to hospital practicing assembly line medicine trying to see as many patients as possible in an hour: I have had several friends misdiagnosed here. As I have stated on previous posts, I have never had a doctor (and I am speaking of the Thai international hospitals here) take a decent medical history (though there was a form filled out once at Bumrungrad 5 years ago) or ask anything related to lifestyle, such as do I drink, smoke, exercise whatever. Why, it would slow them down. How many doctors here ask what pills you are currently on before they load you up? The only question I ever get asked, and it is asked by the Pharm Tech, is if I have a medical allergy.

As to me; no, I am not a medical professional, however, when it comes to injuries, I have had 11 sports injuries and three car accidents all requiring a trip to the hospital with each and every one requiring an X-ray, and only one, fortunately showing a hairline fracture. Though it was good of you to point to a stubbed toe as a reason not to do an X-ray, someone in a crash or accident should be judged by a different criteria. I would also point out that when I accompanied my friend to the hospital for a suspected broken toe, they still took an X-ray. Maybe where you come from procedures are different, which makes it hard to compare. I can only judge by my first hand experiences. In an accident, suffering from localized pain, take an X-ray. Let's see, the person in question in this story DID have a hairline fracture. What are your thoughts on the missing X-ray - wait till morning and come back to the hospital. Again, X-ray techs are cheap in Thailand, even the clinics have them - they cost around $10 at an international hospital. There is no reason to delay.

As to the head trauma, the person was on a bicycle (I assume not motorcycle accident, which would likely be worse) and knocked their head. Would not an ounce of precaution be warranted here? How many people die or seriously injure themselves ever year with head injuries from riding? It's ridiculously cheap to stay overnight in a government hospital in Thailand, and still pretty cheap for a public room in a private hospital. She should have been kept for observation – especially as the person who took her in was a friend, not a husband or brother who would stay with her all night to look after her as you suggested.

The doctor dropped the ball, as happens frequently in Thailand. Why; what are the ramifications for the doctor, for the hospital? Even if the patient dies, four years later you may win 200,000 baht in a wrongful death suit if you are lucky. However, doctor got his cut from the visit and the commission on each and every pill he prescribed - another reason to watch what they give you.

So yes, always take an X-ray if you think something is broken – it's cheap. If you crack your head in an accident and are in pain, stay overnight or for a few hours in the hospital – again, cheap.

[mr_hippo]

^ I am British but have worked for American companies. From the OP, I think that he is also British and Furbie is American.

Now for the third time:-

Did the patient have any of the following:-

Sagging shoulder (down and forward)

Inability to lift the arm because of pain

A grinding sensation if an attempt is made to raise the arm

A deformity or "bump" over the fracture site

Let's see, the person in question in this story DID have a hairline fracture. What are your thoughts on the missing X-ray - wait till morning and come back to the hospital. Again, X-ray techs are cheap in Thailand, even the clinics have them - they cost around $10 at an international hospital. There is no reason to delay.

OK, we will assume that the girl did have a hairline crack - what would you suggest? Let's not rely on my experience, we will go to the Mayo Clinic site - http://www.mayoclinic.com/health/broken-collarbone/AN00854

Sign & symptoms are roughly the same as mine:-

Immediate pain and swelling in the area of the fracture

A crackly or grinding sound in the affected area when you move your shoulder

The shoulder sagging forward and downward

A snapping sound that occurs at the time of the fracture

It goes on say:-

Seek immediate medical evaluation if you have shortness of breath, arm pain and progressive swelling. A doctor may diagnose a broken collarbone by:

A physical examination

X-rays

Note the words in bold - 'may diagnose' - it does not say that they have to have an X-ray. I will leave you to look up the treatment on the Mayo site.

I have had 11 sports injuries and three car accidents all requiring a trip to the hospital with each and every one requiring an X-ray, and only one, fortunately showing a hairline fracture.

Where the injuries here in Thailand or elsewhere? What time of day did they happen? How severe were they? If the happened between the normal times of operation of the X-ray department then OK have an X-ray but if the X-ray department was closed, were your injuries severe enough to warrant a 'call-out'?

Especially in the States, with good insurance you will get far superior healthcare than what is available in general in Thailand. The standard remedy for almost anything in Thailand is to load you up on pills (especially Tylenol and antibiotics and maybe a blood thinner) even when you have a cold, and send you on your way.

Let's keep the accident details the same but move it to the same town in the USA and change the sex. John W. Doe III, living in the better part of Podunk, Ky with full insurance and Billy Jim Bob living in Uncle Buck's Trailer Park and no insurance. Would they both receive the same service? John W. Doe III would have the 'bells & whistles treatment' - X-ray, full blood work, private, possible follow-up physio but what about Billy Jim Bob? No insurance - quick exam, couple of generic painkillers if he is lucky and 'head injury card'

[Dakhar]

Let's keep the accident details the same but move it to the same town in the USA and change the sex. John W. Doe III, living in the better part of Podunk, Ky with full insurance and Billy Jim Bob living in Uncle Buck's Trailer Park and no insurance. Would they both receive the same service? John W. Doe III would have the 'bells & whistles treatment' - X-ray, full blood work, private, possible follow-up physio but what about Billy Jim Bob? No insurance - quick exam, couple of generic painkillers if he is lucky and 'head injury card'

Yep, medicine in the US in screwed to the hilt.

I have found a mixed bag in Thailand, and the same with the US. In this particular incident, I would be more worried about a slow bleed due to the head injury.

What anoys me about the doctors in Thailand is they do not seem to take charge. What I mean is, you sit down, give them the symptoms.... and then they ask, "What would you like done?"

As if health care here is on a menu, and you, the patient, pick what you want done. As if you the patient should know in advance what shoud be done! So the reality is, if this drunk patient had the capacity to ask for an x-ray, it would have been done, along with an MRI for the head trauma.... but she did not ask, so take some pills and get over it.

Fortunatley we have the internet to arm us, and going to the hospital now if more like renting diagnostic equipment more than anything..... sad.

[kash]

Now for the fractured collar bone. How many hospitals do you know who keep an X-ray department staffed 24 hours a day?

huh? let's reverse it, how many hospitals do I know that does not keep an x-ray dep open 24 hours?

none!

[bsided69]

Sorry to be the bearer of bad news but the only 'clown' in this episode appears to be you! OK she came off her bike and 'it hurt', what did she expect - exquisite pleasure? In case English is not your native language, can you read the following again?

Did she have any of the following:-

Sagging shoulder (down and forward)

Inability to lift the arm because of pain

A grinding sensation if an attempt is made to raise the arm - and sometimes can be heard!

A deformity or "bump" over the fracture site

Any of these can be seen without removing clothing.

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

They are also given too frequently in the US as well and for sore throats then you are right but in this case - WRONG! Did you understand what I wrote "You also say that she had 'road rash', so the wounds could become infected. Now which would you prefer? Antibiotics as a precaution against possible infection or wait until she has a raging infection and then treat her?" It was given as a precaution. How clean are Thai streets?

I was there and have enough experience to recognise someone who has done a few months in medical college being left in charge of an Aan E department.

I will assume that the girl spoke a bit of English so why didn't you say anything through her either about the treatment or the doctor's competency?

It just scares me to think of anybody that would be sent here with any serious injuries. Maybe the real doctor was having a Kip? Wouldnt want to find out tho.

It was not a serious incident but very minor. "Maybe he 'real' doctor was having a Kip[sic]. There is a British expression 'spending a penny' which means 'going to the toilet'. Is having a (Laos) Kip the Thai version of it?

As for staffing the X-ray department 24/7, I won't go into the costing problems but the personnel problems. To have just one tech. available for full cover, how many more techs will you need? If someone is at home but on-call, they have a different mindset to one who is in an empty department for the whole shift and therefore he will not be as ready for 'duty' as an 'on-call' would.

She is a wealthy girl and I was obviously the farang ATM.

That one sentence speaks volumes!

Yes that would seem to suggest I am her fella and she is wealthy from me. Not the case though. Its her money and I am a farang and we are often seen as ATMs in situations like this. Not a complaint before anyone starts foaming at the mouth. The bill was only 700baht, but I would of been happy if it was 2000baht and the real doctor took a look at her.

As for the girl questioning a Doctor? That does not really happen. You should know that? A doctor tells a Thai person they are OK and the Thai respects there opinion (right or wrong? You will decide).

You seem to be very well informed on most things, things but I will 100% disagree with Antibiotics for Grazes. Just remove any gravel or dirt and use Iodine to keep it clean. If your talking about the " Chaing Mai tattoo" (skin craft stuff) then yes.

Oh, and I have had some carpet burns that bloomin well hurt and left my knees and elbows looking like i might of taken a fall from my bike. Nylon Sheets can leave your kness in one hel_l of a mess. Iodine and cotton sheets is the answer.

[bsided69]

OP, one of your threads has been deleted and this one is being moved to the Health forum. In the future, do not post the same thing in multiple forums. thank you

///MOVED///

Very new to forums and posted it in the Bangkok forum by mistake. This was pointed out by someone very promptly. Now I wait for all the Pish takers to read this and make me feel good.

Apologies for the inconvenience.

[mrtoad]

Now for the fractured collar bone. How many hospitals do you know who keep an X-ray department staffed 24 hours a day?

huh? let's reverse it, how many hospitals do I know that does not keep an x-ray dep open 24 hours?

none!

Uhm, I could list plenty. Many of the X-ray departments are not staffed out of hours, although there may be an on call Radiologist on location. As Hippo has pointed out, on call workers are only called out if it is truly necessary. In this case the Doctor obviously didn't feel that it was required.

Certainly, in the UK it is common that if an X-ray is required that the patient will be transfered to another hospital, where the department ay be open. Certainly this is the case with MIU's.

As Sheryl has quite rightly pointed out, standards of care in what ever countryy vary from very good to bloody awful. I have used Thai hospitals on a number of occassions, and have found the level of care to be very good in general. I now tend use the same place, as It has so far, always met our needs. BTW, I work in the profession, so I am pretty picky about Hospitals and standards of care.

In the end put it down to a bad experience, and go and find a hospital that meets your expectations. I'm pretty sure you will find one in Thailand.

Edited February 20, 2008 by mrtoad

[mr_hippo]

X-ray departments - where I lived in the UK there were 6 fairly large hospitals, one was psychiatric so we will discount that one. Of the other 5, I worked in four of them. One, Halton Hospital, had a catchment area of about 350,000 people. It had a Minors Injuries Clinic (Note not an A&E) but only operated from 0800 to 2300 and no X-ray after 1700. Whiston, large hospital with Regional Burns Centre, full A&E department but X-ray from 0900 to 1700, Broad Green, Regional Cardio Thoracic centre, no A & E and X-ray from 0900 to 1900, Warrington General, Regional Trauma Centre (M6 motorway was not too far away) - full A&E department but again X-ray from 0900 to 1700. I never worked at St Helens Hospital but it had a 9-5 'walking wounded' A&E department.

Having re-read your original post, bsided69, it appears that you had three choices:-

1) Explain to the doctor that you were not happy

2) Go immediately to a different hospital for 'better' treatment or

3) Do nothing but whinge about it here

Why didn't you do 1) or 2)?

PS By the way, I am not merely 'very well informed' as you put it but very experienced - there's a world of difference there!

Edited February 20, 2008 by mr_hippo

[bsided69]

Obviously you work in a hospital. Antibiotics for minor grazes no worse than a carpet burn is dangerous. They are given far to frequently in this country and very soon will start to become inafective against the serious infections that they are suppose to fight.

Carpet burn and a graze from a road accident are entirely different things - you obviously haven't a clue. I'd like to know someone who caught tetanus from carpet burn... and you seem to know a whole lot about "far too frequently" for someone who has been here 6 years and can't even remember the name of the hospital (probably McCormick).

You should have insisted on an x-ray if you were present and heard her complain many times in front of the doctor. X-ray does not need a Thai translation.

Maybe you should consider purchasing medical insurance that includes evacuation to a first world country if you are so afraid of medical care here in Thailand.

Did nt want to name the hospital for obvious reasons!! Well done!