Bumrungrad

[The Mask]

I recently went to Bumrungrad to have a swelling on my right leg examined by their muscle/bone orthopaedic specialist but found the whole experience very strange.

The doctor sent me for an x-ray not only of my leg but of my lungs to (no idea why).

He then told me he dosent know if its cancerous or benign unless he opens me up. He then wanted me to have a Bone Scan, CT scan of my lungs (??) and MRI.

I spoke to a GP in the UK and he said normally the first stage would be a biopsy to determine if it is in fact cancerous.

It just seemed throughout the whole process that they were inventing as many tests as possible to extract money from me.

I am not surprised at this experience given 'TIT' but I was wondering what experiences other people have had at Bumrunggrad.

Does anyone have any doctor recommendations for soft/tissue lumps etc?.

Thanks

[Mobi]

I have been using Bumrungrad for years, and in comparison some other hospitals (especially Bangkok - Pattaya) I have found that the specialists have a reasonable degree of integrity, and generally don't go over the top in terms of milking us for as many treatments and tests they can get away with.

The only exception to that, which cost me a bloody fortune in tests, was probably my chronic diarrhoea which eventually turned out to be nothing more than IBS - ironically, eventually diagnosed correctly by a specialist at Bangkok Hospital. (Bangkok - not Pattaya).

I never trust any hospital in Thailand very much, and one always has to be one one's guard and armed with medical information.

Every hospital has good and bad doctors, and I have even heard very positive stories of some doctors at my least favourite hospital.

Farangs are very "vulnerable" at Thai hospitals because:

• Farangs have 'loadsa money', and many hospitals encourage their doctors to extract as much of it as they can. (I am sure many of them are on commission)
  

• Farangs have a hard time complaining, because most of them speak little Thai, and in any case this is not their country.
  

• Most farangs are transient, so the doctors feel little responsibility for their treatment. They know that a majority of them will never return, even if they reside in Thailand.
  

So I don't doubt your experience, but that doesn't mean that all doctors at Bumrungrad will do the same thing.

Caveat Emptor, I GUESS.

[The Mask]

I have been using Bumrungrad for years, and in comparison some other hospitals (especially Bangkok - Pattaya) I have found that the specialists have a reasonable degree of integrity, and generally don't go over the top in terms of milking us for as many treatments and tests they can get away with.

The only exception to that, which cost me a bloody fortune in tests, was probably my chronic diarrhoea which eventually turned out to be nothing more than IBS - ironically, eventually diagnosed correctly by a specialist at Bangkok Hospital. (Bangkok - not Pattaya).

I never trust any hospital in Thailand very much, and one always has to be one one's guard and armed with medical information.

Every hospital has good and bad doctors, and I have even heard very positive stories of some doctors at my least favourite hospital.

Farangs are very "vulnerable" at Thai hospitals because:

• Farangs have 'loadsa money', and many hospitals encourage their doctors to extract as much of it as they can. (I am sure many of them are on commission)
  

• Farangs have a hard time complaining, because most of them speak little Thai, and in any case this is not their country.
  

• Most farangs are transient, so the doctors feel little responsibility for their treatment. They know that a majority of them will never return, even if they reside in Thailand.
  

So I don't doubt your experience, but that doesn't mean that all doctors at Bumrungrad will do the same thing.

Caveat Emptor, I GUESS.

Thanks for your input, I think what concerns me the most about Thailand is that a doctor friend of mine who worked at BNH and Piyavete told me some horror stories of many doctors buying their degrees and even performing some procedures with the aid of a textbook! lol

[Mobi]

Thanks for your input, I think what concerns me the most about Thailand is that a doctor friend of mine who worked at BNH and Piyavete told me some horror stories of many doctors buying their degrees and even performing some procedures with the aid of a textbook! lol

I don't doubt that has happened, as anything is possible in this country.

that is one of the reasons I always go to the best Bangkok hospitals, as they have the best, most qualified doctors, and many have overseas experience.

You can check out every specialist on the web - experience, qualifications etc. I always do, and choose which one I want to see.

[Sheryl]

I recently went to Bumrungrad to have a swelling on my right leg examined by their muscle/bone orthopaedic specialist but found the whole experience very strange.

The doctor sent me for an x-ray not only of my leg but of my lungs to (no idea why).

He then told me he dosent know if its cancerous or benign unless he opens me up. He then wanted me to have a Bone Scan, CT scan of my lungs (??) and MRI.

I spoke to a GP in the UK and he said normally the first stage would be a biopsy to determine if it is in fact cancerous.

It just seemed throughout the whole process that they were inventing as many tests as possible to extract money from me.

I am not surprised at this experience given 'TIT' but I was wondering what experiences other people have had at Bumrunggrad.

Does anyone have any doctor recommendations for soft/tissue lumps etc?.

Thanks

It sounds like the doctor strongly suspects a malignancy and that the surgery that would be required would be extensive enough that it might not be worth doing if there is metastasis which is what the lung film various scans would tell.

I really can't comment on this not having seen your leg or having any idea of where the lump is e.g. is it soft tissue or is it bone? And what did the X-ray show?

If it is truly just a soft tissue mass with no bone abnormalities seen on Xray then yes, a smple biopsy (or possibly removal + biopsy depending on its size and location) would be the noraml course of taction and could be done by a general surgeon. But if the Xray results suggested possible bone malignancy that complicates matters considerably.

If you get your records from Bumrungrad (they have to provide them on demand, but you'll have to go in person with your passportor other ID) and then tell us what the doctor's notes and Xray report say I may be able to advise further. Would also help to know who you saw at bumrungrad as they have many ortho specialists.

[camerata]

In over a decade I haven't seen any surplus tests given to me at Bumrungrad. After my shoulder was injured, it was only several weeks later after no progress with physio that they gave me an MRI. The day after, they called me and said they had "seen something" and wanted to do another MRI with contrast dye injection. There was no charge for the second MRI, just for the injection. What they had seen was some kind of lesion on the upper arm, but when a surgeon looked at the film he said it was nothing serious and no need to operate.

[Curt1591]

From my experience, over many years, I have found that if I want a problem to be solved, head to Bumrungrad. I have had varying degrees of success using both local and "international" hospitals in Bangkok. But, whenever I've taken my problem to Bumrungrad, I have come away with the cure.

They may seem to run excessive tests, and over prescribe, but being from the States, I am used to this. Besides, if the problem is cured, what the heck!

My latest episode:

I came down with my occasional bout with diarrhoea. After the Gastrol Bismol failed, I took a 5 day dose of Cipro. Everything seemed fine, but then the diarrhoea returned.

I went to a very famous, non-international hospital for diagnosis. The doctor said it was possibly this, that or the other thing. I asked if he wanted a sample. He replied that he has found that patients can't take a decent sample, then prescibed a weaker antibiotic and told me not to eat fruit, veggies, spicy food, milk ,... etc".

This yielded marginal results. But, when I returned to the doctor for a follow up, he pronounced me "cured"!

I did a follow up at Bumrungrad. The doctor discussed the possibilities and trusted me with the awsome task of taking a sample. At that point he said to continue what had already been prescribe and we will wait on the tests.

Well, I guess I was good enough to wrangle up two different "foreign" bacteria. But, what impress me was that, after finding the little bugs, they cultured them and tested their reaction to different antibiotics. The doctor made his prescription based on this.

But there's more.

After a couple days of taking the pills, I came down with some really heavy diarrhoea. We called the pharmacy, they contacted the doctor, he stopped one of the meds and the problem cleared.

Now we were stuck with had become expensive, useless meds.

NOT!

The pharmacy, following the doctors report, refunded the price of the unused medication, minus 10% because they have to destroy it. Try to find this in the States!

I've always been pleased with Bumrungrad. But, as stated before, doctors are individuals, and your mileage may vary!

Edited June 15, 2009 by Curt1591

[hhgz]

"The doctor sent me for an x-ray not only of my leg but of my lungs to (no idea why)."

Why didn't you ask?

[Goinghomesoon]

A few weeks ago I had minor surgery at Bumrungrad to remove a benign uterine growth. I have mostly used BNH and been very happy but my doctor left and I was assigned a new one. Upon meeting me she announced that she planned to do serious abdominal surgery to remove the lump and I would need "a few weeks" off work to recover. She based her decision on 12-month old scans and didn't even intend to re-do them to see if the growth had changed in size! Queue one stressed farang woman scampering away from BNH as fast as I could

I felt very reassured at Bumrungrad when the doctor took things step-by-step. He did a variety of scans and blood tests and determined the best (and least intrusive way) to operate. I had an overnight stay and was back to normal activity two days later.

Thank goodness I am a scaredy-cat about being cut open and insisted on a second opinion. Otherwise I might have just stuck with the first doctor!

[Mobi]

It just goes to confirm my point that wherever you go, and however good the hospital is, at the end of the day you have to rely on the competence and integrity of individual doctors. Hence I have had mainly good , but also some bad experiences at Bumrungrad with different doctors.

In Thailand, I believe it is more important than in your home country, to question your doctor's diagnosis, and in particular, if the treatment recommended is very expensive and/or involves surgery, then a second opinion should be obtained.

[Sheryl]

Absolutely, Mobi.

On this board over the years I have seen innumerable good and bad reports. There is not a single hospitakl for which there has not been a (justifiable) complaint, and in my experience as a clinician there is no such thing as a hospital without any "bad" (i.e. sub-standard) doctors.

Simply walking ionto a hospital -- any hospital -- and letting the staff there direct you to a doctor is a very, very bad idea. Odds are you will end up with whomever is least busy, and that doctor is apt to be not busy for a reason.

Pick the doctor, not the hospital, and do your homework. Most of the "international" hospitals list qualifications for each doctor on staff. Check them out. Or, post on TV and ask for recommendations.

Which is not to say that the OP didn't chose carefully; he may have done. From his post it is not possible to tell if his suspicions are justified or not; it may be that the treatment, receommended tests etc were justified but uinadequately explained to him. Without more details to work with, who knows.

[The Mask]

Absolutely, Mobi.

On this board over the years I have seen innumerable good and bad reports. There is not a single hospitakl for which there has not been a (justifiable) complaint, and in my experience as a clinician there is no such thing as a hospital without any "bad" (i.e. sub-standard) doctors.

Simply walking ionto a hospital -- any hospital -- and letting the staff there direct you to a doctor is a very, very bad idea. Odds are you will end up with whomever is least busy, and that doctor is apt to be not busy for a reason.

Pick the doctor, not the hospital, and do your homework. Most of the "international" hospitals list qualifications for each doctor on staff. Check them out. Or, post on TV and ask for recommendations.

Which is not to say that the OP didn't chose carefully; he may have done. From his post it is not possible to tell if his suspicions are justified or not; it may be that the treatment, receommended tests etc were justified but uinadequately explained to him. Without more details to work with, who knows.

I have searched the websites of most of the top hospitals I can think of in Bangkok (Samitivej, BNH etc) and I cannot find any doctor in this field (ortho tumors etc) which has experience working overseas (Europe, USA) etc.

Subsequently, it is very difficult to put my faith in their ability. If anyone knows of a competent Doctor in this field please let me know.

Thanks

[Sheryl]

I have searched the websites of most of the top hospitals I can think of in Bangkok (Samitivej, BNH etc) and I cannot find any doctor in this field (ortho tumors etc) which has experience working overseas (Europe, USA) etc.

Subsequently, it is very difficult to put my faith in their ability. If anyone knows of a competent Doctor in this field please let me know.

Thanks

Try one of these:

Samitivej Hospital

Rapin Phimolsarnti , M.D.

Specialty : ORTHOPAEDIC SURGERY

Sub Specialty : ศัลยกรรมกระดูกและข้อ - เนื้องอกกระดูก และเนื้อเยื่ออ่อน (ORTHOPAEDIC SURGERY - MUSCULOSHELETAL ONCOLOGY)

ศัลยกรรมกระดูกและข้อ (ORTHOPAEDIC SURGERY)

Expertise : Musculosheletal Oncology and Adult Reconstruction

Orthopaedic

Language : ENGLISHTHAI

Education : แพทยศาสตร์บัณฑิต คณะแพทยศาสตร์ มหาวิทยาลัยมหิดล

Diplomate Thai Board of Orthopaedic Surgery

Fellowship in Musculosheletal Oncology, Mayo Clinic, USA

Fellowship in Musculosheletal Oncology and Adult Reconstruction, University of Toronto, Canada

Date Time Office

TUE 18:00-20:00 Samitivej Sukhumvit Hospital

OPD Orthopedic

Bumrungrad

Dr. Apichat Asavamongkolkul

Speciality: Orthopaedics (Bone), Musculoskeletal Oncology, Orthopaedic Surgery

Language: Spoken: English,Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand, 1987

Board Certifications:

- Diploma of The Thai Board of Orthopaedic Surgery, 1993

Fellowships:

- Musculoskeletal Oncology, Thailand, 1994

- Orthopaedic Surgery, UCLA School of Medicine, USA, 1998

Special Clinical Interests:

- Bone & Soft-Tissue Tumor, Metabolic Bone Disease

Day Time Location

Mon 18:30 - 20:00 NS 12A (Orthop/Physical Med)

Thu 18:30 - 20:00 NS 12A (Orthop/Physical Med)

Sat 12:00 - 15:00 NS 12A (Orthop/Physical Med)

Bangkok Hospital

Dr. Piya Kiatisevi

Specialty : Orthopaedic Surgery (Bone, Joint)

Sub Specialty : Bone and Soft-tissue Tumor / Cancer

Interest :

Language : English, Thai

Education : 2007 Fellowship in Lower Limb Reconstruction Joint Replacement and Oncology University of British Columbia, Vancouver, Canada

2006 Fellowship in Orthopedics Surgery UCLA School of Medicine, Los Angeles, USA

2002 Residencies of Orthopedics Surgery Faculty of Medicine Siriraj Hospital

1996 Medical Doctor, Faculty of Medicine Chiang Mai University

Schedule : Saturday 17:30 - 20:00

[ThaiPauly]

I have always been pretty satisfeied with the service and quality of care I have received at Bumrungrad, even though it is expensive.

Last year I could not walk more than a few hundred metres without having to sit down.

Sheryl kindly reffered me to a specialist at the hospital, he did an MRI (22,000) but could find nothing.

He then reffered me to a "Pain Specialist" who managed to block nerves that were apparantly the cause of my problems (33,000)

Result: I was cured.

I have been there for many other problems as well, never been dissapointed with the Doctors......I just faint when I get to see the cashier

[offset]

Never be afraid of getting a second or third opinion the doctors do not seem to mind it may get a bit expensive but it is worth it for the piece of mind it brings I saw 3 doctors at the Bumrungrad, all said that I needed surgery 2 checked through the reports that I had from a different hospital and gave me a physical examination the third went by my notes only I must admit he sold a good operation but he was not the one I have picked I will go with the one that I feel most comfortable with and back my own judgement

[The Mask]

Try one of these:

Samitivej Hospital

Rapin Phimolsarnti , M.D.

Specialty : ORTHOPAEDIC SURGERY

Sub Specialty : ศัลยกรรมกระดูกและข้อ - เนื้องอกกระดูก และเนื้อเยื่ออ่อน (ORTHOPAEDIC SURGERY - MUSCULOSHELETAL ONCOLOGY)

ศัลยกรรมกระดูกและข้อ (ORTHOPAEDIC SURGERY)

Expertise : Musculosheletal Oncology and Adult Reconstruction

Orthopaedic

Language : ENGLISHTHAI

Education : แพทยศาสตร์บัณฑิต คณะแพทยศาสตร์ มหาวิทยาลัยมหิดล

Diplomate Thai Board of Orthopaedic Surgery

Fellowship in Musculosheletal Oncology, Mayo Clinic, USA

Fellowship in Musculosheletal Oncology and Adult Reconstruction, University of Toronto, Canada

Date Time Office

TUE 18:00-20:00 Samitivej Sukhumvit Hospital

OPD Orthopedic

Bumrungrad

Dr. Apichat Asavamongkolkul

Speciality: Orthopaedics (Bone), Musculoskeletal Oncology, Orthopaedic Surgery

Language: Spoken: English,Thai

Qualifications: Medical School:

- M.D., Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand, 1987

Board Certifications:

- Diploma of The Thai Board of Orthopaedic Surgery, 1993

Fellowships:

- Musculoskeletal Oncology, Thailand, 1994

- Orthopaedic Surgery, UCLA School of Medicine, USA, 1998

Special Clinical Interests:

- Bone & Soft-Tissue Tumor, Metabolic Bone Disease

Day Time Location

Mon 18:30 - 20:00 NS 12A (Orthop/Physical Med)

Thu 18:30 - 20:00 NS 12A (Orthop/Physical Med)

Sat 12:00 - 15:00 NS 12A (Orthop/Physical Med)

Bangkok Hospital

Dr. Piya Kiatisevi

Specialty : Orthopaedic Surgery (Bone, Joint)

Sub Specialty : Bone and Soft-tissue Tumor / Cancer

Interest :

Language : English, Thai

Education : 2007 Fellowship in Lower Limb Reconstruction Joint Replacement and Oncology University of British Columbia, Vancouver, Canada

2006 Fellowship in Orthopedics Surgery UCLA School of Medicine, Los Angeles, USA

2002 Residencies of Orthopedics Surgery Faculty of Medicine Siriraj Hospital

1996 Medical Doctor, Faculty of Medicine Chiang Mai University

Schedule : Saturday 17:30 - 20:00

Hi, I actually researched these doctors already, and noticed that they completed 'fellowships'. It is my understanding that fellowships are more of a study programme rather than actual hands on experience.

Any input would be appreciated.

[Sheryl]

No, a surgical fellowship is thoroughly hands on clinical prasctice in a specialty area. It is a step above residency.

I do not have any first hand knowledge of these doctors but all seem good n terms of qualifications, and they specialize in bone and soft tissue tumors.