Negligent Hospital.

[onethailand]

We are talking about the use of an MRI machine, not a microwave oven. It is not like an MRI is on 24/7 and you have a coveyor belt line up for the use of such a machine. So one would think the back of the line, would not be toooooo far back even if one was going use the 30 baht plan. But yes, I do see your point.

I think the problem is the availability of staff, not the availability of the machine The way I see it, doctors have appointments - only if an appointment is not kept by someone do they take on a walk-in patient, and then they would take a normal walk-in if there was one... and only if there wasn't would they take someone from the 30-baht line. And I doubt they would take an appointment from someone using the universal health scheme.

In the OP's case - they were trying to get paperwork for an MRI, not the MRI itself. I can't begin to tell you how overworked the administrative staff are... but I still do not agree with the "come back tomorrow" attitude that was exhibited. The least they could've done is to place the request in the queue, for the OP's wife to come back and pick it up tomorrow... somehow I doubt that admin would be busy 24/7.

Private hospitals are surprisingly busy here - not on the level of government hospitals, but still it's unusual to be able to walk in and get to see the doctor quickly. I use Samitivej - arguably the most expensive along with Bumrungrad - and when I walk in I am still made to wait for an opening.

[JetsetBkk]

I do believe that the OP's wife only recorded sound. Pictures are not, therefore, available. Are you suggesting that actors be employed to provide a possible "visual" effect?

You really shouldn't "speed read" these threads. Makes it look like you don't understand what has been written before:

I would put it on Youtube - the story, the recorded conversation (with sub-titles), pictures of the hospital, map of the hospital's location...

...now you could add some more pictures that are the translations of the conversation and get them in sync with the sound...

[elkangorito]

I do believe that the OP's wife only recorded sound. Pictures are not, therefore, available. Are you suggesting that actors be employed to provide a possible "visual" effect?

You really shouldn't "speed read" these threads. Makes it look like you don't understand what has been written before:

Please explain. Did the OP take pictures too or are you suggesting that the OP go back to the hospital & take pictures?

[Dakhar]

We are talking about the use of an MRI machine, not a microwave oven. It is not like an MRI is on 24/7 and you have a coveyor belt line up for the use of such a machine. So one would think the back of the line, would not be toooooo far back even if one was going use the 30 baht plan. But yes, I do see your point.

I think the problem is the availability of staff, not the availability of the machine The way I see it, doctors have appointments - only if an appointment is not kept by someone do they take on a walk-in patient, and then they would take a normal walk-in if there was one... and only if there wasn't would they take someone from the 30-baht line. And I doubt they would take an appointment from someone using the universal health scheme.

In the OP's case - they were trying to get paperwork for an MRI, not the MRI itself. I can't begin to tell you how overworked the administrative staff are... but I still do not agree with the "come back tomorrow" attitude that was exhibited. The least they could've done is to place the request in the queue, for the OP's wife to come back and pick it up tomorrow... somehow I doubt that admin would be busy 24/7.

Private hospitals are surprisingly busy here - not on the level of government hospitals, but still it's unusual to be able to walk in and get to see the doctor quickly. I use Samitivej - arguably the most expensive along with Bumrungrad - and when I walk in I am still made to wait for an opening.

I have had too much time latley, so I have been giving this situation some thought. I use diagnostic equipment fairly often, and sometimes they can get pretty complicated, and expensive to operate. Now the equipment I use can range from 7k to 250K USD. Nothing near the costs of MRI machines. It would take an expert in MRI machines to comment on this....

But I was wondering if MRI machines have a set limit of uses before there is a mandatory maintainence on the machine? If so, it would be more economically prudent to get the best bang for the buck, each time the machine is used, before costly maintainence is performed. Just a thought, and I could be wrong. Some diagnostic equipment are hooked up to the net and a diagnostic run of the equipment is ran daily via a remote system. This type of equipment is extremely expensive, but is not rare to find in hospitals.

[onethailand]

I have had too much time latley, so I have been giving this situation some thought. I use diagnostic equipment fairly often, and sometimes they can get pretty complicated, and expensive to operate. Now the equipment I use can range from 7k to 250K USD. Nothing near the costs of MRI machines. It would take an expert in MRI machines to comment on this....

But I was wondering if MRI machines have a set limit of uses before there is a mandatory maintainence on the machine? If so, it would be more economically prudent to get the best bang for the buck, each time the machine is used, before costly maintainence is performed. Just a thought, and I could be wrong. Some diagnostic equipment are hooked up to the net and a diagnostic run of the equipment is ran daily via a remote system. This type of equipment is extremely expensive, but is not rare to find in hospitals.

Good morning...

The OP's wife was wanting paperwork for an MRI... not the MRI itself.

[Travel2003]

Unfortunately, in order to sometimes get some reaction here, we need to use the threat of making someone losing face.

One easy way, that not always work though, might be to send a letter/mail to the Hospital first.

But,

Make sure that several particular (high ranking) names are mentioned in the mail, and still the language used is polite.

Then politely inform that the letter will soon also be sent to various departments and news papers, etc.

This way, those names will be spread in the system. Something nobody likes.

Even innocent people do not like to have their names spread, especially when they are connected to something negative.

As mentioned, this does not always work, but it is very easy to do. Always worth a try.

I have done this a few times in my life, if feel I cant get through, and it actually works surprisingly often.

[Moonrakers]

I have had too much time latley, so I have been giving this situation some thought. I use diagnostic equipment fairly often, and sometimes they can get pretty complicated, and expensive to operate. Now the equipment I use can range from 7k to 250K USD. Nothing near the costs of MRI machines. It would take an expert in MRI machines to comment on this....

But I was wondering if MRI machines have a set limit of uses before there is a mandatory maintainence on the machine? If so, it would be more economically prudent to get the best bang for the buck, each time the machine is used, before costly maintainence is performed. Just a thought, and I could be wrong. Some diagnostic equipment are hooked up to the net and a diagnostic run of the equipment is ran daily via a remote system. This type of equipment is extremely expensive, but is not rare to find in hospitals.

Good morning...

The OP's wife was wanting paperwork for an MRI... not the MRI itself.

Absolutely.

I should have mentioned before that Kluaynamthai does not even have an MRI machine, we had to go to them purely for administration and so I fail to see just how it makes any difference to them.

[Dakhar]

I have had too much time latley, so I have been giving this situation some thought. I use diagnostic equipment fairly often, and sometimes they can get pretty complicated, and expensive to operate. Now the equipment I use can range from 7k to 250K USD. Nothing near the costs of MRI machines. It would take an expert in MRI machines to comment on this....

But I was wondering if MRI machines have a set limit of uses before there is a mandatory maintainence on the machine? If so, it would be more economically prudent to get the best bang for the buck, each time the machine is used, before costly maintainence is performed. Just a thought, and I could be wrong. Some diagnostic equipment are hooked up to the net and a diagnostic run of the equipment is ran daily via a remote system. This type of equipment is extremely expensive, but is not rare to find in hospitals.

Good morning...

The OP's wife was wanting paperwork for an MRI... not the MRI itself.

Absolutely.

I should have mentioned before that Kluaynamthai does not even have an MRI machine, we had to go to them purely for administration and so I fail to see just how it makes any difference to them.

It could be a "gentlemen's" agreement.... "You don't 30 baht patients on me, I will not dump 30 baht patients on you," type of thing. Or it could be that they have standing instructions not to promote any other health care facility at all costs. Trust me I have seen this many many times.

I worked for a physicians that would refer people out to a physician located about 600 miles away. But the reality is, a competitor could perform the needed procedure and his office was 2 blocks away. He did this just to protect his bottom line....

I still work remotely in the health care industry in Thailand, and I have seen the same grotesque practices, if not worse than in the states here.

On a side rant. I was disapointed that the documentary SICKO did not focus on physicians as much as they did on insurance companies. I think they are birds of the same feather, myself.

Edited September 25, 2008 by Dakhar

[Moonrakers]

I have had too much time latley, so I have been giving this situation some thought. I use diagnostic equipment fairly often, and sometimes they can get pretty complicated, and expensive to operate. Now the equipment I use can range from 7k to 250K USD. Nothing near the costs of MRI machines. It would take an expert in MRI machines to comment on this....

But I was wondering if MRI machines have a set limit of uses before there is a mandatory maintainence on the machine? If so, it would be more economically prudent to get the best bang for the buck, each time the machine is used, before costly maintainence is performed. Just a thought, and I could be wrong. Some diagnostic equipment are hooked up to the net and a diagnostic run of the equipment is ran daily via a remote system. This type of equipment is extremely expensive, but is not rare to find in hospitals.

Good morning...

The OP's wife was wanting paperwork for an MRI... not the MRI itself.

Absolutely.

I should have mentioned before that Kluaynamthai does not even have an MRI machine, we had to go to them purely for administration and so I fail to see just how it makes any difference to them.

It could be a "gentlemen's" agreement.... "You don't 30 baht patients on me, I will not dump 30 baht patients on you," type of thing. Or it could be that they have standing instructions not to promote any other health care facility at all costs. Trust me I have seen this many many times.

I worked for a physicians that would refer people out to a physician located about 600 miles away. But the reality is, a competitor could perform the needed procedure and his office was 2 blocks away. He did this just to protect his bottom line....

I still work remotely in the health care industry in Thailand, and I have seen the same grotesque practices, if not worse than in the states here.

On a side rant. I was disapointed that the documentary SICKO did not focus on physicians as much as they did on insurance companies. I think they are birds of the same feather, myself.

The "gentleman's agreement" argument does not add up because the hospital that will be giving my daughter the MRI scan is the Prasat neurological institute, which is a government institution, not a private venture. This is not a dig at yourself, after all how were you to know that my daughter was not being referred to another private hospital, as I did not state this until now.

The more I think about it wonder if maybe this is down to a few individuals rather than the hospital as a whole, it is no secret that some segments of Thai society consider the poor unworthy of the sh*t on the sole of their shoe, and so maybe this is just a bitter bunch in a particular office that are responsible. Although if I am right it by no means excuses higher management/owners of their actions. I shall step up my efforts tomorrow to let those at the very top of their hospital to know what has happened and still is happening, after all I do have some very damning evidence.

I have watched 'SICKO' myself and I thought that the whole point of it was to criticise the medical system in the US, and not the physicians. Although maybe the actions of the physicians should be enough for another documentary. But to be honest i am a Brit and so cannot really comment on what happens in the US as I just don't know.

Edited September 25, 2008 by globalj

[Moonrakers]

*UPDATE*

My wife had to return to this hospital today and noted a considerable improvement.

Between the last post of this thread and now, another incident occurred in that after all of the above the hospital STILL did not give the correct documentation, seemingly deliberately. This lead to another phone call to the government helpline and they where not at all happy with what was happening.

I thought that I would leave this thread alone at the time because we eventually got things sorted but now I have some good news.

As I said previously my wife noted a marked improvement and even commented that the staff where both friendly and helpful, and significantly the main culprit had been "re-located".

It think it probable that our actions (And probably those of others) have led to this hospital being told to get their act together, it is nice to think that our actions may have helped those in need in the future at this particular hospital.

We have lost the number of the direct contact that we had but the government helpline for things such as this is 1330, perhaps a mod could add this to the useful numbers list (If there is one/isn't there already). I don't know if they speak English.

And so a happy ending, clearly the government/some people out there DO give a sh*t.

[sassienie]

Last month my 81 year old mother in law went to a well known eye hospital here in Chiang Mai for the removal of a cataract.

The doctor that operated on her made a horrific mess of the operation. After 5 days my mother in laws eye was just a ball of red jelly with some puss hanging off of it.

I thought that I had seem everything in my lifetime and that nothing could ever shock me, but when I saw the eye, it was beyond belief.

The Doctor had charged my mother in law 25000 baht for the main op and than additional fees for trying to stop the infection that totalled 31000 baht. Instead of sending her to another hospital that had better facilities to try and correct the mess this eye hospital had made of the job, the Doctor was prepared to let my mother in law die from infection rather than spoil his reputation.

I visited the eye hospital, cleared his surgery and gave the Doctor a balling out. He refunded the 31000 baht immediately and now we are in the process of suing him, as my brother in law is a lawyer.

On the same day we took my mother in law to another hospital in Chiang Mai. After examination the Doctor told us that my Mother in law has a most severe eye infection and if not operated on within the next 2 days, she will go blind and plus the infection will probably spread with fatal consequences.

I asked about the 30 baht scheme, as the hospital was a participant in the scheme. The Doctor said that if we choose that option there is no guarantee that my mother in law can be seen for a least a month. So I asked OK, HOW MUCH. About 80000 baht replied the Doctor. Thought about it for a couple of seconds and said, yes, go ahead. It’s only money; my mother in laws welfare is what counts.

So the operation was performed the following day and now after 2 weeks of intensive care, the life of my mother in law was spared, although she has lost most of the sight of her eye.

This is as in the UK, everyone knows that for those going private will receive priority over National Health, and the same applies in Thailand. Money talks, it’s a fact of life.

Not worth all the hassle and concern about the loss of prestige when someone’s health is at stake.

Edited October 28, 2008 by sassienie

[fridgemagnet]

Last month my 81 year old mother in law went to a well known eye hospital here in Chiang Mai for the removal of a cataract.

The doctor that operated on her made a horrific mess of the operation. After 5 days my mother in laws eye was just a ball of red jelly with some puss hanging off of it.

I thought that I had seem everything in my lifetime and that nothing could ever shock me, but when I saw the eye, it was beyond belief.

The Doctor had charged my mother in law 25000 baht for the main op and than additional fees for trying to stop the infection that totalled 31000 baht. Instead of sending her to another hospital that had better facilities to try and correct the mess this eye hospital had made of the job, the Doctor was prepared to let my mother in law die from infection rather than spoil his reputation.

I visited the eye hospital, cleared his surgery and gave the Doctor a balling out. He refunded the 31000 baht immediately and now we are in the process of suing him, as my brother in law is a lawyer.

On the same day we took my mother in law to another hospital in Chiang Mai. After examination the Doctor told us that my Mother in law has a most severe eye infection and if not operated on within the next 2 days, she will go blind and plus the infection will probably spread with fatal consequences.

I asked about the 30 baht scheme, as the hospital was a participant in the scheme. The Doctor said that if we choose that option there is no guarantee that my mother in law can be seen for a least a month. So I asked OK, HOW MUCH. About 80000 baht replied the Doctor. Thought about it for a couple of seconds and said, yes, go ahead. It’s only money; my mother in laws welfare is what counts.

So the operation was performed the following day and now after 2 weeks of intensive care, the life of my mother in law was spared, although she has lost most of the sight of her eye.

This is as in the UK, everyone knows that for those going private will receive priority over National Health, and the same applies in Thailand. Money talks, it’s a fact of life.

Not worth all the hassle and concern about the loss of prestige when someone’s health is at stake.

I paid for an operation at Maharaj hospital, and the surgeon made a mess of it. The consequences for me are severe.

Is there any point in trying to get compensation?

[photojourn]

OneThailand posted an email address for the owners of the hospital in question on the first page of this thread.

Yesterday morning I sent a very blunt email to Sranyoo Chanate with a linkback to this thread along with a number of very direct questions as well as my own comments about loss of face and bad karma.

This morning (1.53am) the following response was received from Khun Sranyoo:

"Thank you very much for this article. I am now investigating this incident and will put it up on the web to clarify the matter.

Yours,

Sranyoo Chanate"

I guess we all wait and see what happens.

To the OP, please advise me by PM if there are any further problems.

[t.s]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

I think that you are mis-understanding the 30 baht scheme, and completely missing the point mate.

congratulations on the result.

while i do sympathize with you and the plight of your daughter, i am astonished that you would consider the 30 baht scheme anything more than a populist gimmic. i know of very few thais who expect results from this system. the treatment your family received is just further proof that it is a sham. condemn the hospital surely, but under this scheme there comes a point where the hospital itself is providing services for which it will not be compensated.

I too am eligible for care under the 30 baht scheme, but would not use it because i would be diverting healthcare funding from those who really cant afford it. i would rather pay for helath insurance and know i will receive service when and where i require it.

Edited October 30, 2008 by t.s

[citizen33]

I think that you are mis-understanding the 30 baht scheme, and completely missing the point mate.

There is a lot of confusion about the UC health scheme on this thread, and I am not sure we ever got to the bottom of just what happened here and the role of the private hospital in providing paper work as mentioned by the OP. My guess, which may be wrong given the paucity of information, would be along these lines.

The story starts with the daughter of the OP obtained her UC gold card from the private hospital mentioned, and thus being a registered member with the contracted unit for primary care (CUP) based there. This means that the hospital’s involvement is as a CUP needing to approve a referral. To explain further, this hospital has previously applied to become a CUP under the UC scheme, and as part of its remit must then co-ordinate a local primary care network, offer certain secondary care services and arrange referrals for other hospital care it cannot provide. In return for doing this it receives a capitation payment of 2100 baht per registered member per annum from the National Health Security Office (NHSO). This sum multiplied by the number of members (and with some top-slicing for administration at higher levels, etc) is paid regardless of whether members require treatment in the year. The CUP’s total budget allocation for all its UC members will thus be quite significant. Additionally the hospital in which the CUP is based can also obtain UC scheme income from other CUPs that refer patients to it, based on the DRG cost of the procedures provided. Conversely where outward referrals to other hospitals are made, the CUP will lose a proportion of the ‘inpatient’ component of its capitation-based UC budget which goes to pay for those treatments.

In this case, the paper work mentioned by the OP was probably the referral authorisation required to ensure that the cost of the MRI scan at the second hospital was covered by the UC scheme. The first private hospital had already received funding as a contracted unit (i.e. the funding based on 2100 baht per annum per member) and was obligated to make referrals when they were clinically necessary. There is a perverse incentive for hospitals to hold on to patients and not make tertiary referrals that will result in them losing some of their pot of money, but the NHSO has been taking steps to tighten up on this. From the NHSO’s standpoint the hospital had contracted to provide a service for a local population for the year and should not be opting in or out of this agreement on a case-by-case basis. One would expect that when this episode came to the notice of the NHSO they were not very happy and instructed the hospital to meet its obligations under its contract.

Here is a recent update on how the UC scheme is getting on:

http://www.who.int/social_determinants/res...and_2007_en.pdf

[Moonrakers]

You clearly know more about it than I do.

Going by the process(es) that we went through, the private hospital did indeed have the responsibility of referring us to another hospital with the appropriate facilities, in fact the said hospital supplied no medical treatment whatsoever including fulfilling the medication pescription (SP).

It made no real sense to us as to why they would not simply give us the documentation that we needed considering that the treatment was to be undertaken at another hospital, we suspected very much that we where simply dealing with a "Hi-so" character who did not deem the 30 baht 'peasants' as worthy of their time/help.

It would make sense that the hospital would not want to refer to another so that they do not lose money, however this hospital simply did not have an MRI machine itself and there have been many cases of neglect against this hospital involving in-patients.

It certainly seems also that the NHSO where not happy with what happened because my wife's latest visit to said hospital this week was in complete contrast to previous visits. The staff where friendly and helpful and the main culprit had been "re-located", clearly somebody with authority has "Had a word"

And photojourn:

Good work with the E-mail mate, it would be interesting to what response (If any) you get asides from the original reply. If he reads this thread then he will likely listen to the audio link on you-tube of one event that was recorded. I don't expect any more problems because they seem to have got their act together and hopefully that go's for all 30 baht patients at that hospital.

[photojourn]

>> And photojourn:

Good work with the E-mail mate, it would be interesting to what response (If any) you get asides from the original reply. If he reads this thread then he will likely listen to the audio link on you-tube of one event that was recorded. I don't expect any more problems because they seem to have got their act together and hopefully that go's for all 30 baht patients at that hospital.<<

Thanks globalj,

Always happy to help in these type of situations. The thanks though should go to OneThailand who posted the email details.

Certainly Khun Sranyoo knows of this thread and I gather from the reply has read it. Likewise I presume the YouTube link has been viewed as well. We now wait to see what happens next and yes, hopefully it helps all the other Bt30 patients as well.

I doubt if Khun Sranyoo will be the one who wants to loose face over this incident - but that will be the case if someone else isn't made accountable for the treatment you received.

Time will tell.

Glad all is now well.