My Experience At Siriraj Hospital

[dottie]

Hi all, I'm a regular reader but infrequent contributor to the Ladies' Forum. Anyway, I thought I might share my recent experience of the Thai government health system after I found very little information on the web in the run-up to my operation. Hope it might be of interest or of help. Sorry if it's a bit wordy.

A couple of months ago, I mentioned to my regular OB/GYN at Bumrungrad that I had had very painful periods for the past few years. On hearing that, I immediately had an ultrasound booked for me which showed that there were "chocolate" cysts on my ovaries. The doctor told me that she should remove these in a laparoscopic procedure. When I heard the price, I nearly fell on my nose ... 140,000-160,000 baht (and presumably that's not including anything like board and lodging).

Well, I knew that my insurance wouldn't cover that and I don't have those kinds of savings - my Thai b/f said that he would pay for me but it just seemed an awful lot of money.

Fortunately, one of my Thai friends is a doctor who had just finished specialising in OB/GYN at the Siriraj. By some bad timing, she had just started a new job elsewhere in the country but she contacted the doctor who'd trained her who advised me to come to see him at his STI clinic! My friend told me to get to the Siriraj at 8am because it would take a good hour to register and get a hospital card.

Since it was a Tuesday, I went along on my own to the Siriraj, feeling like a bit of a fraud with my Bumrungrad scan file under my arm (trying to hide it!). Well, it was a circus in the main area on the ground, with all signs in Thai only, and masses of people sitting on wooden benches eating their street food and obviously having been there for quite some time. It was hot hot in there too.

Thanks to my passable Thai, I found someone to explain that I had an appointment with a doctor and that I needed to register first. Someone produced some registration documents (I believe they were in English as well as Thai), which I filled out and then I had my photo taken. A while later, I got given a very nice hospital card and was told to report to a room upstairs where my documents would be sent up later.

The room upstairs proved to be a large room with more wooden benches, each taken up with a heavily pregnant woman. Smaller rooms led off the main one, with what seemed to be ante-natal classes going on in some. I was directed to the room at the end. I still hadn't seen another foreigner in the hospital and goodness knows what they thought when I asked for the STI clinic! Anyway, in room 309 (air-conditioned!), the nurses explained to me that the doctor was delayed and that I'd have to wait a while. I was ushered to a space on one of the benches outside and proceeded to wait ... it was hot and I still hadn't had anything to eat or drink (in case I had to give any samples). After about an hour and a half, in a fairly faint state of mind I asked if there was time for me to get some water. Thankfully, a branch of 7-Eleven was just outside in the stairwell lobby so, thus fortified, I returned to my place on the bench, only to be told that the doctor was on his way and that I could go into the inner room.

There, I joined half a dozen Thai women sitting on little stools. In the middle of the room, there was a school desk and 2 stools, and to one side there was a curtained off area. In fact, the whole room reminded me of my biology classroom in my 1980s British government school (a bit shabby but with fittings from the 1950s that were built to last!) - but it was blissfully cool at least. The doctor hurried in, with sleeves rolled up, tie tucked in his shirt, and I was first up.

I took my place on one of the stools at the school desk and, in front of the whole room of people (most of whom couldn't understand a word anyway because the doctor fortunately spoke good English), I explained my problem. Generously, he took about a whole hour to question me at length. He wasn't particularly interested in the Bumrungrad scan but said that a pelvic exam would tell him more. I was ushered behind the curtained off area where he promptly reduced me to a state of such pain that I emerged back into the main room in a somewhat tearful state. Bearing in mind that this was the STI clinic, who knows what the other patients imagined he'd just done to me!

Anyway, the verdict was that the cysts weren't the main problem but rather something called Deeply Invasive Endometriosis (scarily they kept writing it as DIE on the documentation!) and that I needed a laparoscopic operation to remove it. The doctor asked if I would be willing to have him operate and, when I suggested that I should have him do it at one of the private hospitals that he also works at, he said that he prefers to treat patients who first see him at the government hospital on the public health system ... good, that meant that I would save a load of money.

Once that was agreed, it was suddenly all systems go. First I paid for the doctor's consultation (Baht 40!!) and then was sent to different areas for blood tests (Baht 800) and a chest x-ray (Baht 200). Although the surroundings weren't glitzy and the staff (except for the senior nurses and the doctors) didn't speak English, it was like a production line for sick people ... unceremonious but fast and efficient. It reminded me of a UK National Health Service hospital from the 1980s but with the right equipment and procedures where it matters.

That done, I emerged after lunch, with orders to report back for the results the following day.

I returned as instructed and waited in a quite modern air-conditioned room where a junior doctor explained the results to me in English, while sat at one of many school desks arranged round the room. Privacy is not one of the things to expect in a government hospital, it would seem. A set of admissions papers were produced, all written in Thai, by the esteemable Nurse Wanaa, the Admissions Nurse, who could speak fairly good English and offered to help me complete them. However, in a moment of nervousness when I wanted to be completely sure about what I was agreeing to, I asked if I could take them home so I could send them to b/f (working overseas, hence his absence from these proceedings) to translate.

On the 3rd day, I returned again and this time Nurse Wanaa and I worked out a suitable date when the doctor was free, my b/f would be back in Thailand, and when I would be mid-cycle. That was for the 20th July, a record time apparently since my doctor friend told me that normally there is a 6-month waiting list for this operation.

My Thai colleagues, some of whom are very wealthy, all told me that I would not have to worry about the Siriraj and that this is their hospital of choice; however, that the long waiting lists mean that, like most Thais who can afford it, they end up going to private hospitals. My main worry at this point would be that I'd end up in a big ward where b/f wouldn't be able to stay with me for moral support and translation services!

So, last Sunday I reported to the ward at 8am and was shown this very nice private room with a lovely river view and complete with kitchenette and sofa. Everything seemed well-maintained and clean, and the bed was very high-tech. I checked in and was told that it was a liquid diet for me that day ... but I was permitted to go downstairs with b/f for a Doi Tung coffee and a read of the newspapers! The rest of the morning was taken up with blood tests and interviews with the anaesthetist.

Then, in the afternoon, chaos! My b/f had gone home to get some towels which for some reason the hospital doesn't provide and he'd left his reading glasses there. He returned to find that we had to attend a class given in Thai by the nurses to the half dozen Thai women and me. It was actually a great presentation on what would happen to us and about after-care of the wound, exercises we could do, etc. All very professional. However, we were then given a test paper (in Thai) to make sure we'd understood what we'd just been taught. Well, I NEVER expected an exam of that kind in hospital! In the absence of b/f's reading glasses, a nurse came to my room and read out the questions for b/f to translate so I could provide my answer. When we got to the bit about fallopian tubes, he did lose it slightly ... obviously never learned THAT in his upcountry village school's English classes ! Thank goodness I'd paid attention in my school human biology lessons because, on hearing the key word "wings", I as able to use my imagination and draw a quick diagram of a woman's reproductive system to show the nurse. And so I answered the question and PASSED the test, yay!

The doctor came by to discuss the operation - although it was his day off and on his way to a meeting of the society of laparoscopic surgeons, he was in a cheery mood and spent over an hour telling me about his experiences while training in Germany and UK. He still spoke quite good German too. Anyway, it was all quite jolly and he no doubt was quite late for his meeting.

Later I was given 3 jugs of some bowel preparation and told I'd have to drink that all before 6pm. It was at that moment that one of my colleagues came in, having trekked from north of BKK on her day off, bearing a huge fruit basket. I could have cried. It was so lovely of her and unfortunately I couldn't eat any of it, yet! She didn't stay long which was probably a good thing because the bowel prep was having its effect by then and by the end of the day I felt as flat as a pancake. I sent b/f home for a good nights' sleep so he'd be fresh for the big day and chugged down the sleeping pill they'd given me. Well, after staggering around the room like a drugged elephant for one last trip to the bathroom, all effects of the pill then completely wore off and I was left to spend the night watching TV (just one English language channel, thankfully a movie channel) and reading.

At 5.30am a cheery nurse entered the room brandishing the fleet enema and 10 minutes later it had the intended effect. I wondered back to my bed, having showered and dressed in my surgical gown only to find my phone was missing from my bedside table. At first, I couldn't believe it. Who would steal from a sick person in a hospital? Well, in my hungry and unslept state of mind, I was quite upset, especially as I envisaged not having my mum's number in UK to let her know I was OK. The nurses called my b/f who came back with my spare phone and UK SIM card which fortunately had quite a lot of my numbers stored in it. Then, since I was going to be the last of the doctor's 3 patients for operations that day, they wanted to put me on a drip. Honestly, that was the most painful thing of the whole experience. On the 5th try, they managed it and I started to feel a bit steadier in my mind!

At 11am, a veritable army of people entered my room ... the doctor's ready for you now! I was hauled off pronto, down to the prep room on the 5th floor, swallowing a pill of something along the way. The doctor appeared and told me he would just go and get some noodles (I love Thailand!) but wouldn't be long. By the time he came back, I was already dozing off but, no rest for the wicked, it was time to go into theatre (as we say in UK) where I was tucked in like a mummy ... so no chance of escaping anywhere now.

The procedure involves injecting the abdomen with CO2 gas through the belly-button and then cutting 2-3 holes (each about an inch long) to insert the camera and implements with which the doctor does his cutting and burning off of the endometriosis and cysts.

Over 3 hours later (the doctor said it was a very long operation for this kind of procedure), I came to in the recovery room ... and the first thing that I uttered, in Thai, was that I wanted to eat "rad-naa" ... the perfect "getting well" food. Hmm, things must have gone OK then.

I was wheeled back to my room, to find that b/f by that time was quite beside himself since I'd been away for 5 hours. Then came a long night of being woken up for my temperature and blood pressure to be taken and constantly to be asked if I'd peed yet. Apparently that's a pretty vital sign that things haven't gone wrong in the operation. Well, it doesn't make for a peaceful night. For the record, I did pee (twice) and the first trip to the bathroom proved quite an adventure, first escaping from my bed which had the barriers firmly up, with drip in tow. I had an almighty funny turn on the way back to bed and ended up getting ammonia to sniff from one of the nurses.

In the morning, the doctor arrived for a debrief. "What, you're still in bed? My other patient is already showered and wanting to go home!". Hmm, no-one gives me a challenge like that. Normally people are telling me to take it easy! I did point out that I was: a) trapped in my bed and; I didn't think I could shower with the IV tap still in my arm. Ha!

Well, the upshot of all of this was that I have had to have a temporary menopause induced for 6 months, to kill off the roots of the endometriosis. The injection of hormones for this cost a whopping 20,000 baht (even with the government hospital's negotiated discount) and I've got to have another one in 3 months' time. The only real cure is to have a baby though and with b/f and my advancing age and his working away, it might be easier said than done! However, I feel OK now, despite being quite tired. The scars are amazing - no stitches or dressings (the stitches are inside and the wounds are sealed with a special glue which flakes off after about 10 days). The worst pain has been the CO2 gas which travels around body looking for a way out. Agonizing but it wears off after several days.

The cost of the operation, board & lodging and nursing care, and the hormone shot was 60,000 baht. If the hormone injection was 20,000 baht and the room etc was 2,500 a night (I was in for 2 nights), I calculate that the operation itself must have cost 35,000 baht. A steal, compared to the Bumrungrad which would have topped 200,000 baht in total, I reckon.

So, in summary, my experience at the Siriraj was very positive (except for the phone theft which apparently is common both in Thai private hospitals and UK public ones - according to my friends). The care from the nurses was extremely professional and the doctor was the kind of man I like, willing to roll up his sleeves and get his hands "dirty" (something I find very lacking in the more plush private hospitals here). His knowledge was obviously excellent and, as far as I remember it, the equipment and facilities were all fine if not in the most shiny environment. I got a DVD of my operation too, which makes for fascinating watching! I was obviously lucky in that I had the right contacts in my Thai doctor friend. I'm not sure if that helped in my getting treated more quickly. Actually, when I compare my experience with that of my friend who had an operation at Bumrungrad 4-5 years ago, I think the care was much better in the Siriraj.

The advice I would give to any foreigner thinking about getting treatment in a government hospital is to take a Thai friend along. I found that, even though I speak quite good Thai, my knowledge of medical vocabulary obviously needs working on and also when I am tired or stressed all my foreign language ability seems to disappear. In such stressful situations, you don't want to feel alone, and the general staff in the Siriraj would struggle (although some spoke enough English for normal stuff, when pushed to speak in English!).

In short, I would definitely go back to the Siriraj and felt comfortable with the staff there - they really put themselves out for me, even though many of them are seriously overworked.

I attached some photos of my room and, when I was researching the Siriraj, I found a good account posted by someone called Robert Walker who had an operation there several years ago. I found it informative and amusing: http://www.robert-walker.net/writings_full...erationInAB.php

Sorry this has proved to be quite long. Well, hopefully it will be of interest to someone!

Edited July 28, 2009 by dottie

[mmushr00m]

Sirirajdoes have a rather good following. The BIG man himself goes there.

The missus prefers it over Bumrungrad as well.

[dottie]

And apparently the Queen prefers Chula. In my photo of the river view, you can see a tall building on the left. That's where HM stays when he's there.

[prodriver]

That tall building was where I stayed when I was in Siririaj. I was there for 17 days (15 days after the op for rectal cancer). It was a fantastic room. 16th floor if I remember and just along the corridor were a pair of very fancy ornate white and gold doors which I never saw opened but was told that was where members of the Royal Family went when they stayed at the hospital.

I agree that the hospital is extremely crowded and without my Thai wife helping me when I first registered etc. I don't know how I would have managed. I've only ever seen one other farang there in all the visits I have made there. My surgeon had done some of his training at Hammersmith hosp. London and my radiologist had trained at the Royal Marsden, London so I felt in good hands and at a fraction of what it would have cost at any of the private hospitals in Bangkok. I actually started treatment at a private hospital (Thonburi Hospital) but was advised by my radiologist to have the radiation treatment done at Siriraj because they had better equipment.....and would be cheaper, she said with a wink! So one thing led to another and I ended up having the operation done there as well. That was three and a half years ago. I still go there for check-ups and I'm pleased to report that I'm still in the clear.

[dottie]

That tall building was where I stayed when I was in Siririaj. I was there for 17 days (15 days after the op for rectal cancer). It was a fantastic room. 16th floor if I remember and just along the corridor were a pair of very fancy ornate white and gold doors which I never saw opened but was told that was where members of the Royal Family went when they stayed at the hospital.

I agree that the hospital is extremely crowded and without my Thai wife helping me when I first registered etc. I don't know how I would have managed. I've only ever seen one other farang there in all the visits I have made there. My surgeon had done some of his training at Hammersmith hosp. London and my radiologist had trained at the Royal Marsden, London so I felt in good hands and at a fraction of what it would have cost at any of the private hospitals in Bangkok. I actually started treatment at a private hospital (Thonburi Hospital) but was advised by my radiologist to have the radiation treatment done at Siriraj because they had better equipment.....and would be cheaper, she said with a wink! So one thing led to another and I ended up having the operation done there as well. That was three and a half years ago. I still go there for check-ups and I'm pleased to report that I'm still in the clear.

Wow, your room must have been a special one for you to be on the same floor as the Royal Family's area. Good to hear your tale and that you are still in the clear Tell me, do you normally have to wait a long time when you go for your check-ups?

I was wondering what it'd be like to go there for GP consultations. Presumably, you'd be joining the masses on the ground floor and signing up for a very long and hot wait. Pity because I'd rather do all my med stuff there ... suppose that means I'll have to keep going to a private hospital for regular stuff, since my company won't understand my having to take a whole day off for a doctor's appointment I kind of resent paying private hospitals' "service charge" each time just to have my weight, blood and temp taken!

[prodriver]

That tall building was where I stayed when I was in Siririaj. I was there for 17 days (15 days after the op for rectal cancer). It was a fantastic room. 16th floor if I remember and just along the corridor were a pair of very fancy ornate white and gold doors which I never saw opened but was told that was where members of the Royal Family went when they stayed at the hospital.

I agree that the hospital is extremely crowded and without my Thai wife helping me when I first registered etc. I don't know how I would have managed. I've only ever seen one other farang there in all the visits I have made there. My surgeon had done some of his training at Hammersmith hosp. London and my radiologist had trained at the Royal Marsden, London so I felt in good hands and at a fraction of what it would have cost at any of the private hospitals in Bangkok. I actually started treatment at a private hospital (Thonburi Hospital) but was advised by my radiologist to have the radiation treatment done at Siriraj because they had better equipment.....and would be cheaper, she said with a wink! So one thing led to another and I ended up having the operation done there as well. That was three and a half years ago. I still go there for check-ups and I'm pleased to report that I'm still in the clear.

Wow, your room must have been a special one for you to be on the same floor as the Royal Family's area. Good to hear your tale and that you are still in the clear Tell me, do you normally have to wait a long time when you go for your check-ups?

I was wondering what it'd be like to go there for GP consultations. Presumably, you'd be joining the masses on the ground floor and signing up for a very long and hot wait. Pity because I'd rather do all my med stuff there ... suppose that means I'll have to keep going to a private hospital for regular stuff, since my company won't understand my having to take a whole day off for a doctor's appointment I kind of resent paying private hospitals' "service charge" each time just to have my weight, blood and temp taken!

For the first two years after my operation I was going there every 3 months. Now I only have to go every 6 months ( up till 5 years aniversary from op). If I see my surgeon I have to go to the OPD on the third floor of the main building. Armed with an appointment it isn't too long a wait. My surgeon and my radiologist both wish to see me for the check-ups but as their clinics are on different days it means two visits so I tend not to bother to visit my surgeon any longer. I just see my radiologist who has an oncology clinic in a separate building. I could get my blood tests, xrays and ultra sound scans done at Siriraj but to cut the time down I get all the tests done at a local hospital to where I live and just go to Siriraj armed with all the results. That way with an appointment I've normally no more than an hour to wait to see the doctor.

So to answer your question, I would just use Siriraj for the important stuff and use another hospital for the routine things (unless you like being amongst a seething mass of people! )

By the way, sorry to be posting on this forum as I know it's for the ladies. It was just that the name Siriraj caught my attention.

[Boo]

Prodriver, the ladies forum is for lady specific issues & but men are always more than welcome to post here anytime

[dottie]

That tall building was where I stayed when I was in Siririaj. I was there for 17 days (15 days after the op for rectal cancer). It was a fantastic room. 16th floor if I remember and just along the corridor were a pair of very fancy ornate white and gold doors which I never saw opened but was told that was where members of the Royal Family went when they stayed at the hospital.

I agree that the hospital is extremely crowded and without my Thai wife helping me when I first registered etc. I don't know how I would have managed. I've only ever seen one other farang there in all the visits I have made there. My surgeon had done some of his training at Hammersmith hosp. London and my radiologist had trained at the Royal Marsden, London so I felt in good hands and at a fraction of what it would have cost at any of the private hospitals in Bangkok. I actually started treatment at a private hospital (Thonburi Hospital) but was advised by my radiologist to have the radiation treatment done at Siriraj because they had better equipment.....and would be cheaper, she said with a wink! So one thing led to another and I ended up having the operation done there as well. That was three and a half years ago. I still go there for check-ups and I'm pleased to report that I'm still in the clear.

Wow, your room must have been a special one for you to be on the same floor as the Royal Family's area. Good to hear your tale and that you are still in the clear Tell me, do you normally have to wait a long time when you go for your check-ups?

I was wondering what it'd be like to go there for GP consultations. Presumably, you'd be joining the masses on the ground floor and signing up for a very long and hot wait. Pity because I'd rather do all my med stuff there ... suppose that means I'll have to keep going to a private hospital for regular stuff, since my company won't understand my having to take a whole day off for a doctor's appointment I kind of resent paying private hospitals' "service charge" each time just to have my weight, blood and temp taken!

For the first two years after my operation I was going there every 3 months. Now I only have to go every 6 months ( up till 5 years aniversary from op). If I see my surgeon I have to go to the OPD on the third floor of the main building. Armed with an appointment it isn't too long a wait. My surgeon and my radiologist both wish to see me for the check-ups but as their clinics are on different days it means two visits so I tend not to bother to visit my surgeon any longer. I just see my radiologist who has an oncology clinic in a separate building. I could get my blood tests, xrays and ultra sound scans done at Siriraj but to cut the time down I get all the tests done at a local hospital to where I live and just go to Siriraj armed with all the results. That way with an appointment I've normally no more than an hour to wait to see the doctor.

So to answer your question, I would just use Siriraj for the important stuff and use another hospital for the routine things (unless you like being amongst a seething mass of people! )

By the way, sorry to be posting on this forum as I know it's for the ladies. It was just that the name Siriraj caught my attention.

Thanks for that. Good to hear about your experience. Difficult to find info about government hospitals - they aren't as into using their websites for marketing as the private ones.

Oh and I only posted this in Ladies' forum because it was a womens' issue healthwise (suppose it could have gone into Health Forum) ... decisions decisions!

[alantheembalmer]

Dottie

Thank you for your very informative post. Siriraj is the closest hospital to where I live, and I always meant to find out if I could be accepted as a patient there. After your experience, I e-mailed them, and they replied very quickly with a factual and detailed reply. The next step is to register myself there, and to have a medical examination. Fortunately, I am in good health at the moment, so I can do this in my own time.

Many thanks again, and I hope that others on this forum read your post, as it is excellant.

Alan

[dottie]

Dottie

Thank you for your very informative post. Siriraj is the closest hospital to where I live, and I always meant to find out if I could be accepted as a patient there. After your experience, I e-mailed them, and they replied very quickly with a factual and detailed reply. The next step is to register myself there, and to have a medical examination. Fortunately, I am in good health at the moment, so I can do this in my own time.

Many thanks again, and I hope that others on this forum read your post, as it is excellant.

Alan

THANK YOU alantheembalmer!

I have been very impressed with this place compared to my experiences at 3 private hospitals in BKK and, while I am aware that the Siriraj has somewhat of a "special" status with support from the highest and best places, I could not fault the professionalism and skills of the staff.

My doctor wanted his staff to practice speaking English with me because he would like more "medical tourists" (his words, not mine) and he's quite senior so I am sure that the hospital management is thinking about how to encourage more foreigners to go there ... to raise its profile and also generate income from private patients..

I don't know how you are with speaking and reading Thai but I would advise going there with an open mind (consultations in private rooms seem to be a rarity but no-one will understand what you are discussing with the doc if you are speaking English!), a smile and patience, and I'm quite sure that the staff will do all they can to help you!

I wish you well for when you do go to the Siriraj.

[khun_j]

dottie, thanks for this post. very interesting. i´ve used bum & sam srinakarin and can´t say that i am always really satisfied with their medical skills.

wish you good luck with the ultimate cure - the baby

[sibeymai]

I recently had a bad experience at Siriraj Hospital when my wife and I took her mother there for a diagnosis of kidney stones. The doctor would not accept any medical information from other hospitals such as x-rays, urine and blood tests. When I asked him about various methods of treatments (such as sound wave treatment as opposed to surgery) he wouldn't answer any of my questions and walked out of the room. His manner was completely non-communicative and unprofessional. His attitude was clearly "I'm the doctor and you have no right to question me". We went to our regular private hospital (Vibharam) and had all of our questions answered patiently and in full by the doctor and at no charge.

I think the problem with Siriraj is that there are lots of patients and the doctors appear to have very little time to diagnose. Based on the short consultation time (the doctor was spending less than 10 minutes per patient) plenty of revenue is being generated but I wonder about the accuracy of the diagnosis in such a short time. It looks like a money making scheme for the doctors, especially when they insist on duplicate servicing. Since when is exposing patients to unnecessary x-rays in the health interests of a patient ?

I would not send my dog to Siriraj based on my experience and what I saw there.

[dottie]

I recently had a bad experience at Siriraj Hospital when my wife and I took her mother there for a diagnosis of kidney stones. The doctor would not accept any medical information from other hospitals such as x-rays, urine and blood tests. When I asked him about various methods of treatments (such as sound wave treatment as opposed to surgery) he wouldn't answer any of my questions and walked out of the room. His manner was completely non-communicative and unprofessional. His attitude was clearly "I'm the doctor and you have no right to question me". We went to our regular private hospital (Vibharam) and had all of our questions answered patiently and in full by the doctor and at no charge.

I think the problem with Siriraj is that there are lots of patients and the doctors appear to have very little time to diagnose. Based on the short consultation time (the doctor was spending less than 10 minutes per patient) plenty of revenue is being generated but I wonder about the accuracy of the diagnosis in such a short time. It looks like a money making scheme for the doctors, especially when they insist on duplicate servicing. Since when is exposing patients to unnecessary x-rays in the health interests of a patient ?

I would not send my dog to Siriraj based on my experience and what I saw there.

Wow, sorry you had such a bad experience.

While I agree with you that the staff are very overworked, I found that they all were very generous with their time. My first visit was more than an hour with the doctor and my latest one this week I was with him for nearly an hour as he patiently answered all my niggling post-op questions. There was no question of him being annoyed with my "question the doctor" approach; rather, he seemed found me quite intriguing especially when I told him I'd watched the entire DVD of my operation, which prompted him to ask me if I'd seen my liver etc etc!

And he did look at my Bumrungrad scan but only briefly, since he said a physical exam would tell him more, as it did - endometriosis, Funnily enough, the Bumrungrad doctor had completely omitted to detect or inform me about this and, when I went back to Bumrungrad to do the originally scheduled 2nd scan and to tell her I wouldn't be able to do the op there, she looked rather uncomfortable when I asked her if endometriosis and not the cysts were the problem. Suddenly there was then a noticeable amount of backtracking on her part (and she's one of the most senior doctors in that field in Bumrungrad!

Over the past 5 years here, I've been to several private hospitals and also asked lots of friends and acquaintences (Thai and farang) for their recommendations regarding doctors. The overwhelming opinion was that no one hospital was all good, and that you probably will end up going to one hospital for one doctor and to another for a different specialist, in order to get the best service. Opinions on the Bumrungrad, BNH and Samitivej all varied wildly, and I found that most people had something negative to report about one or the other of them. Many of my Thai friends recommended finding a good private doctor and then asking them if they work at a government hospital, where they could get the same service much cheaper.

In my pre-op research, I also noted that it's critical to choose a surgeon who has sufficient regular experience of actually doing a laparoscopic operation. That's because many don't do that many of these quite complex operations. In UK at least, private hospitals certainly tend not to have as good a reputation as the government NHS hospitals because they don't get as much regular practice in doing the different procedures. I doubt very much that the private hospitals here do laparoscopic operations as frequently as the Siriraj. The doctor who operated on me does this procedure at least every couple of weeks (and several in one day, on the day that he's in the operating theatre).

I suppose the bottom line is that private hospitals are run as businesses and should always be viewed as such. At least in a government hospital, there is less of the money-making "let's send her for all the tests we can do" aspect. And on that note, on my recent return visits to the Siriraj, the staff in that department recognized me and took the time to have a personal chat and ask how I was doing. I don't recall having that experience in the much less busy private hospitals.

[dottie]

dottie, thanks for this post. very interesting. i´ve used bum & sam srinakarin and can´t say that i am always really satisfied with their medical skills.

wish you good luck with the ultimate cure - the baby

Thanks! Will keep you posted

[jasreeve17]

I think you were very lucky to get into Siriraj via your friend.

I've tried to get in there because it's close to my house, but I'm not allowed to on my government insurance (full, I'm told, even though I pay 8,000 baht per year on my insurance..). I'm at mission hospital which is okay (ish), but I'd rather pay and go to Bumrumgrad then have the free treatment at mission. I use the term free loosely because 1) It's not free; I pay monthly premiums, 2) Far from everything is covered. - The government health insurance is awful value, but you don't get the choice; it's automatically deducted.

Siriraj has the reputation as one of the best hospitals in the part of the world - probably true and reinforced by your experiences. Now you are in their system with your hospital card should bode well for future treament.

[dille]

I have expierence with Siriraj just once.I have strong headaches, a little damaged spine and problem with neck due my profession.After spending 5 h in registration,getting x-ray done and waiting for doctor,he just said with cute smile..according to your age(!) everything looks very good! And suggest me to move back to home with nothing.My age? I am 40, not overweight,non smoker and overall very healthy.Severe pains,dizziness,weekly migrains are normal? I will never return back there.

[anon25424354]

I'd like to share my story as well.

I am planning to take my Mom to Siriraj Hospital to get a mammogram and also have her eye sight checked out. My mom is 78 years old and seems to be in ok shape for someone her age (as she's told). However, I'm concerned about how they will diagnose and treat her. We have been to Rama hospital three years ago where she had her cataract eye surgery. Everything went ok. Cataract is more of a common procedure nowadays. But still I was worried that something would go wrong as you hear stories from other Thai people. But thankfully things went great.

But towards the end of last year mom was complaining about breast pains. My sister took my Mom to Thammasat Hospital, Klong Luang district Pathum Thani (because it's close to where we live, at the time). Turns out, my sister called me at work and told me that my mom had breast cancer. I was shocked and scared. Furthermore, my sister told me that the nurses informed her that there is a waiting list of up to 6 months and we needed to make a decision right then and there. Now I'm not the kinda of person to jump on the band wagon and follow others. I'm very analytical and microscopic. I needed to make sure that my mom was going to get the best treatment & care and be in good hands. While still on the phone with my sister, I asked her to put the doctor on the line. At that point, my sister was already back in the waiting room. So she told me that she would have to call back because she will need to 1) find the doctor 2) ask him if he'd talk to me.

Sure enough my sister called me back in 10 minutes and then put the doctor on the phone. Turns he told me the same exact thing that my sister told me. Hence, the Doctor was not friendly after I asked a couple of simple questions like what stage is the cancer? and what are the operation procedures? He then gave me this rudeness "I'm the doctor and who are you to question me" attitude. Turns out I ended up having an argument with the doctor and he hung up on me. Totally unprofessional!

I did some research and asked around and my aunt referred me to Phyathai hospital. It happens to be that my Aunts doctor is a cancer specialist.

Doctor Chuanpit Boonyaratawaet, one of the doctors specializing in cancer at Phyathai Hospital also serves at the National Cancer Institute.

Dr. Chuanpit answered all my questions and assured me that my mom would be fine. She explained the whole procedure and pre and post operation.

I also learned that the routine procedure at Thammasat or any other government hospital would be to remove the cause of the problem at the roots meaning that they would remove the whole entire breast regardless of how big or small, or how much or little the cancer has spread. This could also be the best solution for Thais who are not able to afford chemo or follow up treatments. However, this may not be the choice for foreigners or Thais who can afford advanced medical treatment.

At private hospitals like Phyathai, they will remove the cancer itself with some of the bad tissue surrounding it; leaving some femininity so that the patient doesn't lose self esteem.

But of course they would have to do a thorough study to make sure that the cancer has not spread elsewhere. This of course is per the patients approval as well.

Hence, there will be follow ups and medication, or chemotherapy thereafter.

Anyway, I just want to make the long story short that my moms surgery went great at Phyathai and I would definitely recommend this hospital to anyone who still prefers a private hospital but does not wish to pay too much money. My total expense at Phyathai was 70,000 all inclusive. Two nights, anesthesia, operation, medication, nursing service, food etc.

I have to admit that Bumrungrad Hospital is really over rated and too expensive even for some foreigners.

However, I am still willing to give a government hospital such as Siriraj a try, after my bad experience with Thammasat. Like they say, "Never judge a book by it's cover" or let "one rotten apple spoil the barrel".

I also want to mention that as a luk krueng (half Thai half American) I sense that foreigners 90% of the time will have better treatment compared to Thais because,

foreigners can afford the medical treatment (where some Thais cannot), In addition, amongst the Thai doctors... those that speak English and can treat foreign patients are more acknowledged and respected etc. It's a shame but true in some cases. Oh! furthermore, if you don't have a Thai friend who's a doctor or simply put "No Connection" things might turn out to be different as well.

So, I'm about to make my mom's appointment at Siriraj Hospital with no connections. And being that I'm half luk krueng and my mom is Thai... let's see how we're going to be treated.

Oh! and I can't read or right Thai at all and my mom's too old to fill out the forms. Let see if we'll get any help...

Stay tuned.....

[sbk]

While I agree with you that foreigners will often receive better treatment, I suspect this is because not only do many Thai doctors have the attitude of "I am the doctor and I know all" but most Thai people do as well. While this attitude has gone by the wayside in most Western countries, it is still very pervasive in Thailand. Especially among the elderly.

I know my father-in-law gets better treatment now because I make sure my (Thai) husband asks questions and pushes to make sure that things get taken care of properly.

[scorecard]

My comment is to support using government hospitals.

I used to use the so called 5 star hospitals both in Bkk and in Pattaya, for my family, and I can share numerous examples of poor service and serious mistakes at these places.

About 18 months ago a retired US doctor of medicine, living in Thailand for more than 2 decades, suggested I try the government hospital at Sri Racha. My doctor friend is highly impressed with hospital.

It has now become our main hospital.

Sri Racha is impressive in terms of the quality of medical services, state of the art equipment and the knowledge of how to use it for diagnosis and for treatment, their friendly, professional and thorough manner. And their doctors (especially their specialists) speak advanced English.

Costs are just a tiny fraction of the 5 start fees.

I would encourage people living close to Sri Racha (including Pattay residents) to try this hospital, I think you'll be pleasantly surprised.

[Sheryl]

The problem of being unreceptive to questions is common among Thai doctors who have not trained or practiced in the West. The top specialists at govt hospitals will have, and thus will usually be much better in this regard, but the average internist will not and may take offense.

Another factor is that there is an inverse relationship between how expert and knwoledgeable a dcotor is and how open s/he is to being asked questions. Thai nurses I know have told me that this, more than the cultural status buit, accounst for a lot of it...that a doctor who pulls rank and objects to being asked questions is usually concerned with saving face because they may not in fact be all that knwoledgable.

Certainly I have found the really top specialists in this country -- and in other countries -- to be quite open to questions and frank exchanges. They can afford to be, they have nothing to prove or protect.

Aside from the red tape factor, one of my biggest hesitations with government hospitals is that you usually cannot choose your doctor, and thus cannot be assured of getting someone with western training/experience (which generally equals bioth very good and also open to questions, and of course obviously will equal good English). Most of the top docs in govt hosps have private practice somewhere and I will often use that avenue to meet them directly with the idea of having any surgery or other major treatment done by them later at the govt hospital if cost is a concern.

[WhiteShrek]

Dottie. Very useful post. Thank you. The main thing is you're happy with you're treatment and condition, and are happy with your doctor and service.

Seems similar to NHS experiences. Some have very good experiences and some not so. Often it is not necessary to pay privately, though sometimes people wish they had/could. I do wonder to what extent you got a little preferential tratment, either because of your referral or as being a foreigner.

The parts that would put me off the hospital would be waiting around, lots of people, lack of privacy, and sometimes the uncertainties around what is happening. Those for me would be the comfort factors worth paying for. But useful to know of people's good experiences, so thank you again.