Phuket Eyes Huge Medical Tourism Boom

[webfact]

Phuket eyes ‘huge’ medical tourism boom

Dr Wirat Seetamanotch said Phuket stands to win big on medical tourism.

PHUKET: -- Medical and healthcare providers on the island can expect to get a large slice of the 402.9 billion baht that the Ministry of Health (MoH) expects Thailand’s medical tourism industry to rake in over the next five years.

Phuket Public Health Office Deputy Director Dr Wiwat Seetamanotch said, “Over the past five years, Phuket has enjoyed great success in health services provided to tourists and earned a huge amount of money as Phuket is a world tourist destination that not only is beautiful in nature, but also complete in accommodations, food and transportation.

“In addition, health services here are cheaper than in neighboring countries,” he said.

The MoH, according to its current five-year plan for 2010 to 2014, expects to generate the 400-billion-baht windfall whilst spending only 3.13 million baht in developing the services that are to garner the revenues.

The preceding plan, for 2004-2008, concentrated on providing medical services to patients from abroad. Under that plan, the MoH aimed to make Thailand a “Center of Excellent Health Care of Asia”, through treatment businesses, health supplement businesses, health products and Thai herbs.

The current plan targets developing the same businesses and products, but adds more services in the realms of Thai traditional medicine and alternative medicine.

The move follows Thailand’s enjoyment of huge growth in its medical tourism over the past decade.

According to MoH statistics, 550,161 foreign patients received treatment or healthcare in Thailand in 2001, but in 2007 that number had swelled to 1,373,807. Most were Japanese, followed by Americans and Europeans.

More than 70% of the foreign patients during that period were medical tourists, with 25% being expatriates and less than 5% being tourists who came to Thailand but not expressly for medical or health care.

The most popular health services during that year were health checks, heart operations, knee replacements, cardiovascular surgery, plastic surgery, gender reassignment surgery, dental care and Lasik corrective eye surgery.

Dr Wiwat expects the number of medical tourists to Phuket to increase dramatically in the coming years.

“In the next 20 years, the number of elderly people in the world will rise by 18% to 20% – or one in five of the world’s population. That is an enormous market,” he said.

“In addition to three government hospitals in Phuket, there are also three private ones that are recognized as international standard.

“Some countries have problems with long queues for operations and it sometimes takes two to three years for people to receive treatment. So many tourists choose Phuket because of the international-standard services available here, and it’s cheaper with shorter queues – they are our prominent points,” he added.

-- Phuket Gazette 2010-07-31

[chainarong]

This stuff is big, Straight Times(Singapore) estimated last year over 400,000 used this medical service, mostly into Thai, people mainly from Northern Hemisphere, Singapore is now also promoting this, there's actually special tour operators out of US, ( some info), there's six special hospitals in Thailand that have been into this for some years.Doctors , specialists are from all around the world.

[geriatrickid]

Here we go again. More pie in the sky wishful thinking. Do these people read medical journals or track the patients that enter Thailand?

Here's some discussion points;

- China and India also are promoting themselves as centers of medical tourism. They draw some of the most profitable procedures and you know what those are don't you? Does anyone want to join me in a chorus of where or where have all the organs gone?

- What exactly are Thailand's "International Standards"? Just who enforces those standards? When is the last time any hospital or health professional faced sanctions for a botched procedure? Oh, that's right, there are no cock ups in Thailand's health system. Thailand isn't like other countries...... Sure there was the eye surgery fiasco last year, and what pray tell was the outcome?

- US citizens can find more cost efffective medical centers in Mexico, Panama and even Canada. Yes. that's right. Canada has a very lucrative eye care business that charges a fraction of the US costs for cataract and other corrective surgery and the procedures are less costly than in Thailand. Factor in the travel costs and Canadians can find more affordable cosmetic procedures in the USA, Cuba and even India. Surprised?

- If you were a wealthy asian, and you were unable to obtain care, why would you pick Thailand, when Singapore and Malaysia have excellent facilities? But then, if you had the money, you surely wouldn't be going to Thailand. You'd get it done in your homeland. So you know what that means, don't you, Thailand has to offer the procedures at a lower cost to attract these patients. The most significant input in healthcare that can be shoved down is labour costs, and I regret to say, that top quality surgeons that perform standardized procedures in Thailand do not charge fees that are as small as people think. Check out the fees that surgeons are paid under the the UK NHS, or Canada's provincial health care plans. They are often close to the rates Thai surgeons charge. Surprised? How about this. If you are an American and have a decent health plan, the rate paid by the insurer is going to be significantly less than the "rack" rate at a hospital. Surprised again? Think of the hotel industry. There are volume discounts and there are rack rates. There are are other ways to cut costs. Want to hear about the surgical scalpel blades sourced from India? 1/2 the cost of the German blades. Trouble is that the the blades kept breaking off in the patients. The North American hospitals that made the mistake of purchasing those blades went after the suppliers. Guess what happened? The Indian supplier went to vapors. The North American hospital systems scrapped the blades and ate the costs. What do you think a Thai hospital would do?

Aren't the majority of procedures performed in Thailand on foreigners are elective cosmetic activities?. Often surgeons have declined to perform the surgery in the patient's homeland. Do Thai surgeons explain procedures to their patients? Do the chop shop folks ever talk a patient out of an elective surgery? The much promoted gender reassignment surgeries undertaken have been criticized by some observers because the patients were not suitable for the surgery. In order to have a sex reassignment in the EU, Canada, Australia etc., the patient must complete the pre counseling and be thoroughly screened. Patients can avoid this by running off to Thailand. These are the ones that usually return to their countries and have serious psychological problems.

Oh sure, some will say, I can't wait for the heart bypass surgery in Canada because there is a 2-4 month waiting period. Know what? If the patient's condition was critical the patient would go to the head of the line and more importantly, that patient would most likely die if he or she attempted a 12 hour plane ride. So, I reckon, the case isn't that critical if the patient makes it to Thailand. Selling health care services is now like selling life insurance. Quick, you better have this stent in before you drop dead. Quick, go to XYZ hospital and do it now, before it is too late.

I am not slamming Thailand's medical system because it's private care facilities can and do provide excellent care on a daily basis and they treat enough foreigners in times of emergencies to warrant respect. However, there is a big difference between those that practice medicine as a profession and those that work in chop shops. Don't believe me? If you have a relationship with your health care provider, ask him or her for their opinion.

Medical tourism is a sham. It doesn't matter what country provides it. The procedures where low labour costs are a factor such as in palliative care, or rehabilitation therapy would be ideal for Thailand. However, these are not as profitable as putting in some new boobs or sucking out some blubber. What people forget is that there are complications from liposuction and you just can't get on a plane an fly home a week later without the serious risk of something going pop. Even basic facelifts carry inherent risks. Air travel, jet lag and a change in suroundings have an impact upon the healing process. In plain language, the patients that do best are those that benefit from having a support network and sufficient time to recuperate. Most procedures that medical tourism wants to attract require a healing and recovery window of time, that the typical foreign patient does not have. What about a follow up? What does the patient do if 3 months down the road there are complications?

Why doesn't the MoH track and publish Adverse Events?

(I leave dental procedures out of the discussion, because those are an entirely different matter.)

Boy, do articles like this tick me off. They reduce an honourable profession to that of mutton vendors at a market.

[RedNIvar]

Here we go again. More pie in the sky wishful thinking. Do these people read medical journals or track the patients that enter Thailand?

Here's some discussion points;

- China and India also are promoting themselves as centers of medical tourism. They draw some of the most profitable procedures and you know what those are don't you? Does anyone want to join me in a chorus of where or where have all the organs gone?

- What exactly are Thailand's "International Standards"? Just who enforces those standards? When is the last time any hospital or health professional faced sanctions for a botched procedure? Oh, that's right, there are no cock ups in Thailand's health system. Thailand isn't like other countries...... Sure there was the eye surgery fiasco last year, and what pray tell was the outcome?

- US citizens can find more cost efffective medical centers in Mexico, Panama and even Canada. Yes. that's right. Canada has a very lucrative eye care business that charges a fraction of the US costs for cataract and other corrective surgery and the procedures are less costly than in Thailand. Factor in the travel costs and Canadians can find more affordable cosmetic procedures in the USA, Cuba and even India. Surprised?

- If you were a wealthy asian, and you were unable to obtain care, why would you pick Thailand, when Singapore and Malaysia have excellent facilities? But then, if you had the money, you surely wouldn't be going to Thailand. You'd get it done in your homeland. So you know what that means, don't you, Thailand has to offer the procedures at a lower cost to attract these patients. The most significant input in healthcare that can be shoved down is labour costs, and I regret to say, that top quality surgeons that perform standardized procedures in Thailand do not charge fees that are as small as people think. Check out the fees that surgeons are paid under the the UK NHS, or Canada's provincial health care plans. They are often close to the rates Thai surgeons charge. Surprised? How about this. If you are an American and have a decent health plan, the rate paid by the insurer is going to be significantly less than the "rack" rate at a hospital. Surprised again? Think of the hotel industry. There are volume discounts and there are rack rates. There are are other ways to cut costs. Want to hear about the surgical scalpel blades sourced from India? 1/2 the cost of the German blades. Trouble is that the the blades kept breaking off in the patients. The North American hospitals that made the mistake of purchasing those blades went after the suppliers. Guess what happened? The Indian supplier went to vapors. The North American hospital systems scrapped the blades and ate the costs. What do you think a Thai hospital would do?

Aren't the majority of procedures performed in Thailand on foreigners are elective cosmetic activities?. Often surgeons have declined to perform the surgery in the patient's homeland. Do Thai surgeons explain procedures to their patients? Do the chop shop folks ever talk a patient out of an elective surgery? The much promoted gender reassignment surgeries undertaken have been criticized by some observers because the patients were not suitable for the surgery. In order to have a sex reassignment in the EU, Canada, Australia etc., the patient must complete the pre counseling and be thoroughly screened. Patients can avoid this by running off to Thailand. These are the ones that usually return to their countries and have serious psychological problems.

Oh sure, some will say, I can't wait for the heart bypass surgery in Canada because there is a 2-4 month waiting period. Know what? If the patient's condition was critical the patient would go to the head of the line and more importantly, that patient would most likely die if he or she attempted a 12 hour plane ride. So, I reckon, the case isn't that critical if the patient makes it to Thailand. Selling health care services is now like selling life insurance. Quick, you better have this stent in before you drop dead. Quick, go to XYZ hospital and do it now, before it is too late.

I am not slamming Thailand's medical system because it's private care facilities can and do provide excellent care on a daily basis and they treat enough foreigners in times of emergencies to warrant respect. However, there is a big difference between those that practice medicine as a profession and those that work in chop shops. Don't believe me? If you have a relationship with your health care provider, ask him or her for their opinion.

Medical tourism is a sham. It doesn't matter what country provides it. The procedures where low labour costs are a factor such as in palliative care, or rehabilitation therapy would be ideal for Thailand. However, these are not as profitable as putting in some new boobs or sucking out some blubber. What people forget is that there are complications from liposuction and you just can't get on a plane an fly home a week later without the serious risk of something going pop. Even basic facelifts carry inherent risks. Air travel, jet lag and a change in suroundings have an impact upon the healing process. In plain language, the patients that do best are those that benefit from having a support network and sufficient time to recuperate. Most procedures that medical tourism wants to attract require a healing and recovery window of time, that the typical foreign patient does not have. What about a follow up? What does the patient do if 3 months down the road there are complications?

Why doesn't the MoH track and publish Adverse Events?

(I leave dental procedures out of the discussion, because those are an entirely different matter.)

Boy, do articles like this tick me off. They reduce an honourable profession to that of mutton vendors at a market.

I get all my Dental work done in Malaysia, it's half the price of Thailand.

It is all in the marketing. What Thailand does well is package the deal.You interested in a Medical checkup and/or Holiday. Check in to the Thai Hospital/Hotel, where you have a list of times when certain test are done (along with dietary requirements before the test). You can go ahead with your holiday the rest of the time. End of the day, you get a holiday which is cheaper when compared to paying for a hotel and a full medical workup upon checkout. The beautiful and pleasant looking nurses and attendants is also a plus.

[Dakhar]

I work on the side skirts of the medical field here in Thailand, and I see what goes on behind the closed doors... and to be honest, I don't think folks would even begin to believe half of what I have to tell.

That said, as GK mentioned, prices for "Quality work" in Thialand really is not all that cheap. A boob job can run 80K baht, and u can get that kind of a price back in the states. Lasik surgery done at Thailand's top facility, will run u about the same cost in the states.

Then folks, the bad news.... ENGLISH ENGLISH ENGLISH

Folks, it is not only about the physicians level of English that matters, it is the support staff, the diagnostic teams etc etc. I do not mean, "Hi how are u" English, I am talking about the ability to participate in training sessions, programs etc held in English. The diagnostic machines manuals, instruction materials etc will be written in English or German and if the diagnostic team has poor English.... forget about the accuracy of the diagnostic tests.

Then you have the "Qualifications" required to be doing that type of diagnostic work. In my country, to do my work, one is required a Doctorate degree. In Singapore, nothing.... in Thailand a BS degree... in China.... well they are not sure yet.

So folks, physicians are important, but the diagnosticians lay the foundation that diagnoses are formed and treatment plans are based on. If the team under the physicain has NO CLUE on what they are doing.... well.... then you get "Garbage in Garbage out."

Good luck Thailand.... & good luck to us all

[jayjay0]

Here we go again. More pie in the sky wishful thinking. Do these people read medical journals or track the patients that enter Thailand?

Here's some discussion points;

- China and India also are promoting themselves as centers of medical tourism. They draw some of the most profitable procedures and you know what those are don't you? Does anyone want to join me in a chorus of where or where have all the organs gone?

- What exactly are Thailand's "International Standards"? Just who enforces those standards? When is the last time any hospital or health professional faced sanctions for a botched procedure? Oh, that's right, there are no cock ups in Thailand's health system. Thailand isn't like other countries...... Sure there was the eye surgery fiasco last year, and what pray tell was the outcome?

- US citizens can find more cost efffective medical centers in Mexico, Panama and even Canada. Yes. that's right. Canada has a very lucrative eye care business that charges a fraction of the US costs for cataract and other corrective surgery and the procedures are less costly than in Thailand. Factor in the travel costs and Canadians can find more affordable cosmetic procedures in the USA, Cuba and even India. Surprised?

- If you were a wealthy asian, and you were unable to obtain care, why would you pick Thailand, when Singapore and Malaysia have excellent facilities? But then, if you had the money, you surely wouldn't be going to Thailand. You'd get it done in your homeland. So you know what that means, don't you, Thailand has to offer the procedures at a lower cost to attract these patients. The most significant input in healthcare that can be shoved down is labour costs, and I regret to say, that top quality surgeons that perform standardized procedures in Thailand do not charge fees that are as small as people think. Check out the fees that surgeons are paid under the the UK NHS, or Canada's provincial health care plans. They are often close to the rates Thai surgeons charge. Surprised? How about this. If you are an American and have a decent health plan, the rate paid by the insurer is going to be significantly less than the "rack" rate at a hospital. Surprised again? Think of the hotel industry. There are volume discounts and there are rack rates. There are are other ways to cut costs. Want to hear about the surgical scalpel blades sourced from India? 1/2 the cost of the German blades. Trouble is that the the blades kept breaking off in the patients. The North American hospitals that made the mistake of purchasing those blades went after the suppliers. Guess what happened? The Indian supplier went to vapors. The North American hospital systems scrapped the blades and ate the costs. What do you think a Thai hospital would do?

Aren't the majority of procedures performed in Thailand on foreigners are elective cosmetic activities?. Often surgeons have declined to perform the surgery in the patient's homeland. Do Thai surgeons explain procedures to their patients? Do the chop shop folks ever talk a patient out of an elective surgery? The much promoted gender reassignment surgeries undertaken have been criticized by some observers because the patients were not suitable for the surgery. In order to have a sex reassignment in the EU, Canada, Australia etc., the patient must complete the pre counseling and be thoroughly screened. Patients can avoid this by running off to Thailand. These are the ones that usually return to their countries and have serious psychological problems.

Oh sure, some will say, I can't wait for the heart bypass surgery in Canada because there is a 2-4 month waiting period. Know what? If the patient's condition was critical the patient would go to the head of the line and more importantly, that patient would most likely die if he or she attempted a 12 hour plane ride. So, I reckon, the case isn't that critical if the patient makes it to Thailand. Selling health care services is now like selling life insurance. Quick, you better have this stent in before you drop dead. Quick, go to XYZ hospital and do it now, before it is too late.

I am not slamming Thailand's medical system because it's private care facilities can and do provide excellent care on a daily basis and they treat enough foreigners in times of emergencies to warrant respect. However, there is a big difference between those that practice medicine as a profession and those that work in chop shops. Don't believe me? If you have a relationship with your health care provider, ask him or her for their opinion.

Medical tourism is a sham. It doesn't matter what country provides it. The procedures where low labour costs are a factor such as in palliative care, or rehabilitation therapy would be ideal for Thailand. However, these are not as profitable as putting in some new boobs or sucking out some blubber. What people forget is that there are complications from liposuction and you just can't get on a plane an fly home a week later without the serious risk of something going pop. Even basic facelifts carry inherent risks. Air travel, jet lag and a change in suroundings have an impact upon the healing process. In plain language, the patients that do best are those that benefit from having a support network and sufficient time to recuperate. Most procedures that medical tourism wants to attract require a healing and recovery window of time, that the typical foreign patient does not have. What about a follow up? What does the patient do if 3 months down the road there are complications?

Why doesn't the MoH track and publish Adverse Events?

(I leave dental procedures out of the discussion, because those are an entirely different matter.)

Boy, do articles like this tick me off. They reduce an honourable profession to that of mutton vendors at a market.

You have a lot of good points here. I recently had a x ray of my foot. the main bone is broken I forget the name. It is the one the leg bones and the heel bone hook to. It will not mend so the doctors in Canada put a screw in it. Two of the specialists told me that the only other thing they could do for me was to fuse the bone. They both recommended against the process as long as I could stand the pain. Eight years on. The doctor here in Thailand took one look at the x ray and said we have to operate. That was two years ago at the best hospital here in Chiang Mai. I still have not had the operatin or do I plan on it.

The reason they recommend against it is that 15% of the time it does not work and you are left with the pain and no mobility in the area. My ex's mother had it in the states it worked fine for two years then the pain came back.

I am from Canada maybe some parts of Canada have a two to four month waiting list for heart by pass but in B C it is over a year. Now I am in no way a doctor but to need a heart by pass surgery seems to me you are all ready in a critical situation. At what point would it be so critical that you had to have the surgery right now. Possibly you might not live through that point. I have a friend who had to sell his business as he could not carry on for over a year on the list for heart bypass.

You are quite correct a botched job here in Thailand is just ignored you really have no means of redress. For a high standard of medical procedures you are left to the hospital's own standards. The government doe not really set standards that would lead one to pick this or that hospital to be equal in quality of care.

Leaving all that aside one must admit that Thailand does have many fine doctors and some world class hospitals. And the services are far cheaper than in Canada and the U. S. unless you have insurance. Can't say for the European health care system all though I have heard that England is get on a long list service.

By the way I have heard that Cuba does indeed have great medical expertise. How ever the service is not that great they have hardly any drugs for follow up. I think that was one of the things Obama was going to loosen up on.

Edited July 31, 2010 by jayjay0

[ovaltina]

.......

Aren't the majority of procedures performed in Thailand on foreigners are elective cosmetic activities?. Often surgeons have declined to perform the surgery in the patient's homeland. Do Thai surgeons explain procedures to their patients? Do the chop shop folks ever talk a patient out of an elective surgery? The much promoted gender reassignment surgeries undertaken have been criticized by some observers because the patients were not suitable for the surgery. In order to have a sex reassignment in the EU, Canada, Australia etc., the patient must complete the pre counseling and be thoroughly screened. Patients can avoid this by running off to Thailand. These are the ones that usually return to their countries and have serious psychological problems.

....

100% disagree with the GRS claim you make in a very broad brush way. They *arrive* in Thailand with very "serious psychological problem" called 'gender dysphoria'. Some of them will go back and still have problems. Many return to happy new lives of fulfillment, in every sense cured of GD.

Post op trans have a very high morbidity mortality rate, regardless of where the surgery was performed and how much / little counselling was administered before surgery. The media is currently touting this very simple crayola picture of Eastern chopshops where kids go and don't get psych test and then go home to regret it. Infact, that is absurd, and as many people who have the 1 year of RL tests and psych meetings before surgery will regret it in the West.

A much greater reason for post-op problems is the synthetic hormones themselves which push human physiology so far that the mind suffers & causes the post op to depression and occasionally suicide. Post ops do have a high rate of suicide, but also heart attacks & organ failure & mental disorders from taking HRT.

It is wrong to simply say people go to Asia and have non-psych GRS and go home all messed up. There's just as many people go the Western route and are messed up. Many who go both routes and are happy in later life. There is plenty of empirical evidence on Tgirl sites to suggest that those who had GRS in Asia had surgical procedures of equal excellance to those of the Western surgeons.

Also you ignore the fact that many people with GD are actually suffering terribly and don't / cannot drag it out another year through psych evals & RL tests. They are decided and want to end their own suffering quickly. Who are you to say that instant holiday-Grs is not right?

I've had double hip surgery & spinal surgery in Bangkok, I am treated here in Bkk monthly, for hyperconvulsive epilepsy and Multiple sclerosis.

I grew up in England and can not afford BUPA there where they charge £190 for a one hour consultation chat session. I was on the NHS hel_l-wards for 30 years with epilepsy and MS, which left me so sick on mis-prescribed drugs & ill-informed doctors & beaurocratic stratified mismanagement of priorities, hospital infections, etc. that by the time I moved to Bangkok & finally recieved competent & affordable Health Care, I was near critical because of Western doctors.

I have talked to an Arab oil billionaire on the same ward as me in Bangkok so I don't think Thailand is less popular than other lands in the area eg Malaysia.

I think anything that brings money to Thailand is good. Its a shame that there is corruption and the slightly tarnished image from recent political turbulence. But Bangkok is still a truly great choice for surgery, diagnosis, medicine, and well-trained friendly staff, modern equipment, clean wards, & affordable quality care .

Edited July 31, 2010 by ovaltina

[BB1950]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

[chainarong]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

Good to see someone is tuned in to the right channel, met a nice elderly lady from the US one morning, she was going there for a hip replace ment op.

[slapout]

One of the problems for medical service in Thailand is the accountability of the profession for the botched procedures.That seems to be under review at this time. Granted there are good and not so, facilities as well as medical professionals in every country. Thailand with the present accountability, both socially and monetary, will need to make some changes to stay in contention. The payment schedule seems to follow the general tourist industry thinking, less costumers, increase prices.

[animatic]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

I've had surgery, and EENT work at Bumrungrad.

No complaints at all, good english skills and everything was explained in detail.

Only one bad experience and that was a walk in and not my regular EENT guy.

Attitude issue and not technique. Regular guy is great.

[Dakhar]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

I've had surgery, and EENT work at Bumrungrad.

No complaints at all, good english skills and everything was explained in detail.

Only one bad experience and that was a walk in and not my regular EENT guy.

Attitude issue and not technique. Regular guy is great.

Ahhh yes, EENT

Eyes, Ears, Noes and Throat.... 2 years after a BS degree, only to become an expert in 4 areas of the body. So broken down that is 24 months devided by 4 = 6 months per subject, (area of the body)

I think I mastered the use of chopsticks in 6 months, but that is about all the bragging power I have, I must not be quick on the "up-take"

[cardinalblue]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

I am going to cal you on the carpet on this one. Not saying you are wrong but you make some serious staements which I guess can be verified or not...Firts, I know that the CEO is an american who was the CEO of USC medical center prior but the top management/decision-making is comprised of american doctors, other american managers and american investors? Would really like to more if this is true as in a country like Thailand, hard to beleive they would allow that to happen considering their paranoia and being cut out from profit streams...

All the doctors down to technicians are all educated and trained in America. I flat out don't believe it. first of all, One need a college degree to go to medical school in the US. here students go from high school (yes, high schoo). I will seach Their website but doubt if any actual Thai person has a US medical degree. Okay, maybe a couple but it would be rare. As to short-term training courses, it's a money maker for US medical schools and hospitals so not same ball-game as a medical degree nor completing residency programs. I truly wonder how many really have residencies meaning completion of three, four, five year programs? Could be a few but doubt it is commonplace as you have lead in your post to believe.

Again, if you can back up your statements with statistics ( 65% of Thai cardiologists completed their residencies in america) and that does not mean "oh, my cardioloists did his residency at Harvard Medical School". I will be very surprised if you have not over-inflated what you deem to know about the Thai medical staff at BHI..

Thanks for your research in advance and please throw in where as your post alluded to the best American hospitals and research institutions.

CB

[chainarong]

One of the problems for medical service in Thailand is the accountability of the profession for the botched procedures.That seems to be under review at this time. Granted there are good and not so, facilities as well as medical professionals in every country. Thailand with the present accountability, both socially and monetary, will need to make some changes to stay in contention. The payment schedule seems to follow the general tourist industry thinking, less costumers, increase prices.

The hospitals that myself and BB1950 , mention, are audited every Quarter and must meet the US health , medical standards , audits are conducted by international medical auditors ,not from Thailand.

Edited July 31, 2010 by chainarong

[jayjay0]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

It is like a 5 star hotel because that is what the designer normally does. I also heard that the nurses where all RNs as opposed to LPNs. 60 minutes did a segment of there show on it in the States. Just so no one misunderstands it was a complementary report.

[cardinalblue]

One of the problems for medical service in Thailand is the accountability of the profession for the botched procedures.That seems to be under review at this time. Granted there are good and not so, facilities as well as medical professionals in every country. Thailand with the present accountability, both socially and monetary, will need to make some changes to stay in contention. The payment schedule seems to follow the general tourist industry thinking, less costumers, increase prices.

The hospitals that myself and BB1950 , mention, are audited every Quarter and must meet the US health , medical standards , audits are conducted by international medical auditors ,not from Thailand.

Again, another person speaking in gereralities. every quarter? US health or medical? Which one? Do you actualyl know speciifcs or just talking what you hear? I do kjow they were the first international JCAHO hospital is Asia. Don't know the frequency, but it is every three years in the US and you actually pay a huge amount of money to be accreditied. I believe 80% to 90% of US hospitial meet JCAHO standards. What does that really tell you? In theory, an accredited hospital should be a better facility than a non-accredited one? Does that mean better medical care and less errors? I hope so...

From my experience of passing five US JCAHO inspections and my limited experience working in Thai hospitals, they are not even closely comparable at this stage. To say they are held to US medical standards, I flat out don't believe it....Remember, the survey is money first so a little bit fox in the hen house don't you think...

It's a win for the hospital, a win for the private org conducting the suvey but a win for the patient? Probably could be debated...

Side note, do you really think junior docs here honestly criticize senior physicans in the peer review process? Think about how Thai culture works before you answer that question...

CB

[cardinalblue]

Here we go again. More pie in the sky wishful thinking. Do these people read medical journals or track the patients that enter Thailand?

Here's some discussion points;

- China and India also are promoting themselves as centers of medical tourism. They draw some of the most profitable procedures and you know what those are don't you? Does anyone want to join me in a chorus of where or where have all the organs gone?

- What exactly are Thailand's "International Standards"? Just who enforces those standards? When is the last time any hospital or health professional faced sanctions for a botched procedure? Oh, that's right, there are no cock ups in Thailand's health system. Thailand isn't like other countries...... Sure there was the eye surgery fiasco last year, and what pray tell was the outcome?

- US citizens can find more cost efffective medical centers in Mexico, Panama and even Canada. Yes. that's right. Canada has a very lucrative eye care business that charges a fraction of the US costs for cataract and other corrective surgery and the procedures are less costly than in Thailand. Factor in the travel costs and Canadians can find more affordable cosmetic procedures in the USA, Cuba and even India. Surprised?

- If you were a wealthy asian, and you were unable to obtain care, why would you pick Thailand, when Singapore and Malaysia have excellent facilities? But then, if you had the money, you surely wouldn't be going to Thailand. You'd get it done in your homeland. So you know what that means, don't you, Thailand has to offer the procedures at a lower cost to attract these patients. The most significant input in healthcare that can be shoved down is labour costs, and I regret to say, that top quality surgeons that perform standardized procedures in Thailand do not charge fees that are as small as people think. Check out the fees that surgeons are paid under the the UK NHS, or Canada's provincial health care plans. They are often close to the rates Thai surgeons charge. Surprised? How about this. If you are an American and have a decent health plan, the rate paid by the insurer is going to be significantly less than the "rack" rate at a hospital. Surprised again? Think of the hotel industry. There are volume discounts and there are rack rates. There are are other ways to cut costs. Want to hear about the surgical scalpel blades sourced from India? 1/2 the cost of the German blades. Trouble is that the the blades kept breaking off in the patients. The North American hospitals that made the mistake of purchasing those blades went after the suppliers. Guess what happened? The Indian supplier went to vapors. The North American hospital systems scrapped the blades and ate the costs. What do you think a Thai hospital would do?

Aren't the majority of procedures performed in Thailand on foreigners are elective cosmetic activities?. Often surgeons have declined to perform the surgery in the patient's homeland. Do Thai surgeons explain procedures to their patients? Do the chop shop folks ever talk a patient out of an elective surgery? The much promoted gender reassignment surgeries undertaken have been criticized by some observers because the patients were not suitable for the surgery. In order to have a sex reassignment in the EU, Canada, Australia etc., the patient must complete the pre counseling and be thoroughly screened. Patients can avoid this by running off to Thailand. These are the ones that usually return to their countries and have serious psychological problems.

Oh sure, some will say, I can't wait for the heart bypass surgery in Canada because there is a 2-4 month waiting period. Know what? If the patient's condition was critical the patient would go to the head of the line and more importantly, that patient would most likely die if he or she attempted a 12 hour plane ride. So, I reckon, the case isn't that critical if the patient makes it to Thailand. Selling health care services is now like selling life insurance. Quick, you better have this stent in before you drop dead. Quick, go to XYZ hospital and do it now, before it is too late.

I am not slamming Thailand's medical system because it's private care facilities can and do provide excellent care on a daily basis and they treat enough foreigners in times of emergencies to warrant respect. However, there is a big difference between those that practice medicine as a profession and those that work in chop shops. Don't believe me? If you have a relationship with your health care provider, ask him or her for their opinion.

Medical tourism is a sham. It doesn't matter what country provides it. The procedures where low labour costs are a factor such as in palliative care, or rehabilitation therapy would be ideal for Thailand. However, these are not as profitable as putting in some new boobs or sucking out some blubber. What people forget is that there are complications from liposuction and you just can't get on a plane an fly home a week later without the serious risk of something going pop. Even basic facelifts carry inherent risks. Air travel, jet lag and a change in suroundings have an impact upon the healing process. In plain language, the patients that do best are those that benefit from having a support network and sufficient time to recuperate. Most procedures that medical tourism wants to attract require a healing and recovery window of time, that the typical foreign patient does not have. What about a follow up? What does the patient do if 3 months down the road there are complications?

Why doesn't the MoH track and publish Adverse Events?

(I leave dental procedures out of the discussion, because those are an entirely different matter.)

Boy, do articles like this tick me off. They reduce an honourable profession to that of mutton vendors at a market.

I get all my Dental work done in Malaysia, it's half the price of Thailand.

It is all in the marketing. What Thailand does well is package the deal.You interested in a Medical checkup and/or Holiday. Check in to the Thai Hospital/Hotel, where you have a list of times when certain test are done (along with dietary requirements before the test). You can go ahead with your holiday the rest of the time. End of the day, you get a holiday which is cheaper when compared to paying for a hotel and a full medical workup upon checkout. The beautiful and pleasant looking nurses and attendants is also a plus.

Now getting back o the main point of the thread, medical tourism, and the critique of BI, I think you make a lot of good remarks. It has become big business. I don't know if it is a scam as we market the same back home. And yes, it is all about marketing. probably the most critical point in all this is how can the industry be regullated and monitored across the globe. I don't think it can at this time..

I really think it becomes a hit and miss picture for the patient. One really needs to do their homework. it would be interesting to see a top ten list of procedures under medical tourism and I don't mean herbal spa treatments and mediatation retreats. Simple things like health checks, lazer surgery, dental work would be okay. Complicated and chronic illnesses should best be followed by one's own internists at home. I think there probably should be an universal regulating body but that would be hard to pull off since historically medicine is practiced at the cultural and geographically-specific level within countires...

My biggest fears are the lack of competent peer/QA review, lack pf proper follow-up, lack of accountability and lack of a gov reg body. Right now, this industry is booming b/c of low labor and insurance/liability costs overseas.

I would recommend that one of health foundations like Kaiser or Ford does a massive study of medical tousim over time both from the cost and quality of care perspecytives . We would then really find out whether truly cost effectve and/or quality outcomes. It would tell us whether it was a scam or a good health-care decision. In the mean-time, everyone qualitfies as a canary...enter at YOUR OWN risk...

CB

[geriatrickid]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

No, it is not negativity and rubbish. What exactly are the major procedures done under the banner of medical tourism in Thailand? My understanding of the situation is that they are for the most part elective cosmetic procedures. Of course one cannot discuss this properly because the participants will not release the information. I wonder why?

There is a big difference between the provision of critical care under the "normal" operations of a hospital and catering to medical tourists. The big ticket procedures on behalf of westerners are few and far between. It is in large part driven by costs. Once one factors in the ancilliary and associated charges of flying to Thailand for most procedures, the savings, if any does not justify the hassle of travel or the added risks.

I fully acknowledge that Bummie is able to deliver quality care. However, the issue is one of elective procedures which is what the core basis of medical tourism is. People do not fly to Thailand from the UK, Australia, USA etc. for chemo or cardiac care. Why would they when they can get the care for less cost in their home countires? Yes, even in the USA. If one is on medicare or medicaid in the USA, the treatments are available. Those that fall outside that program or do not have private health care are not going to be able to afford the options in Thailand. Western critical care cardiac patients cannot just fly in to Thailand and stick around for 1-3 months. They would die in flight if they did because people with advanced coronary disease just don't do well under such conditions.

No one would doubt or argue that some hospitals can and do provide excellent care in Thailand. However, one is confusing that situation with elective critical care procedures. Add in all the costs associated with the hospital stay and recuperation and the costs exceeed that of what one pays outside of Thailand for the big procedures. Here's an example;

Cataract surgery at Bummie (just the surgery) costs between C$2,200 and $3,600. If one chooses to go the private route in Canada, and avoid the 6 month waiting period, the cost is approx. C$2,500. How about hip replacement surgery? Let's take Louie from Omaha. He can have it done at the local state hospital for free or $10,000. at worst case. If he goes truly private, he has to pay $30,000. If he is old enough, he probably has medicaid or medicare, or he may have private health care coverage. Let's assume Louie is part of the working poor without coverage, so he needs to pay $30,000. Well, he can consider Costa Rica or Mexico where the list prices are between $7,000 and $15,000. Or he can go to exotic India for the flight and treatment special of $10,000. Curry is inclusive. Now compare to Bumrungrad at $15,000. for the procedure, exclusive of travel costs. Where exactly are the savings?

The issue that you miss is that of medical ethics. It is an entire thread in and of itself. Asian hospitals do not have the same code of ethics as do western based hospitals. If I want to harvest some organs for transplant in the EU I better be able to identify the donor and circumstances of the harvest. Do you think that happens in China or India? If I want to run a clinical trial in Canada, I better be able to explain myself to the Ethics Review Board. What's the process of review in Thailand?

Do you know what the JCI does? It is still trying to get some hospitals to follow basic procedures that are a way of life in Australia, the EU etc. Look at it's last initiative, all intended to address major problems in developing world hospitals;

1. Look-alike, sound-alike medication names

2. Patient identification

3. Communication during patient hand-overs

4. Performance of correct procedure at correct body site

5. Control of concentrated electrolyte solutions

6. Assuring medication accuracy at transitions in care

7. Avoiding catheter and tubing misconnections

8. Single use of injection devices

9. Improved hand hygiene to prevent health care-associated infection

When the starting point is impressing upon hospital staff that they cannot reuse disposables, there's plenty of room for improvement.(BTW that was one of the issues highlighted in the elective eye surgery fiasco last year.)

I said it before and I will say it again, medical tourism has a massive ethics issue because it attracts patients shopping for procedures that medical practioners often refuse to do in their home countries because the patients are not good candidates. If a patient has serious medical problem and would benefit from a visit to a foreign location, that patient is most likely unable to travel in the first place.

Many Thai hospitals, even those not certified by JCI are able to provide excellent critical care treatment. That is not the issue. The question that has not been dealt with is whether or not some of the procedures are appropriate. It is not restricted to Thailand. Gastric bypass surgery is a big fad in North America. There is a reason why many of the practioners also operate in places like Mexico. The Mexican clinics cater to the higher risk candidates declined by the US and Canadian surgeons. The likelihood of being held accountable in Mexico is less likely when a high risk procedure goes wrong. Several of the surgeons that do the procedures in Canada and the USA also fly down to Mexico to perform the surgeries where they can double their incomes.

Where Thailand could have an advantage are for those procedures that require extended recovery or rehabilitation. The cost driver is labour. Unfortunately, even with a markup of 100% of the provision of labour, the profit margins are not there so a Thai healthcare system is not going to be interested. As well, there is a shortage of qualified physiotherapists and rehabilitation nurses (like everywhere else). Not a lucrative part of the health service field I guess.

Edited July 31, 2010 by geriatrickid

[moe666]

Some of the problems you mentioned above are also rampant in US hospitals. Post surgical infection has become so bad that medicare and medicaid will no longer pay for treatment associated with this problem. In New Mexico they have institued a program of cutting infections and other problems with poor patient care some of the solutions: wash hands and change gloves before examining a different patient, better shift change info exchange, and change dressings more often. One would think these things would be common place no they had to conduct a study to find out they were not routine.

Bad health care isn't confined to other parts of the world it is alive and well in the US and for all of the same reasons you will find in asia lack of training, lazy, lack of resources(Dr, nurses, and supplies).

The people in health care world wide are just human beings some good, some bad, most average good luck finding a good one.

[mrtoad]

One of the problems for medical service in Thailand is the accountability of the profession for the botched procedures.That seems to be under review at this time. Granted there are good and not so, facilities as well as medical professionals in every country. Thailand with the present accountability, both socially and monetary, will need to make some changes to stay in contention. The payment schedule seems to follow the general tourist industry thinking, less costumers, increase prices.

The hospitals that myself and BB1950 , mention, are audited every Quarter and must meet the US health , medical standards , audits are conducted by international medical auditors ,not from Thailand.

Hmm, very dubious are the auditing standards of JCI etc. Auditing should not be carried out by paid for bodies such as JCI / ISO - although they have some creditability - actual Health Care Standards should be in legislation - and purely non profit, independent or non political organisations, through a proper Care Standards Act and regular unannounced inspections. Sorry, ISO / JCI don't mean squat to me - they are paid for accreditation, whatever they pertain to be. My feeling is that JCI /ISO these days are seen more as marketing tools than any actual commitment.

[ovaltina]

The issue that you miss is that of medical ethics. It is an entire thread in and of itself. Asian hospitals do not have the same code of ethics as do western based hospitals. If I want to harvest some organs for transplant in the EU I better be able to identify the donor and circumstances of the harvest. Do you think that happens in China or India? If I want to run a clinical trial in Canada, I better be able to explain myself to the Ethics Review Board. What's the process of review in Thailand?

From JAMA.

"Medical malpractice is a form of negligence where an injury results from a medical professional's or medical facility's failure to exercise adequate care, skill or diligence in performing a duty.

According to the Journal of the American Medical Association (JAMA), more than 225,000 people die each year in the United States due to medical malpractice. This is the third-leading cause of death behind heart disease and cancer.

Also according to JAMA, eight out of 11 dental cases were decided against the dentist over a period of nine years and 6 to 10 percent of psychiatrists were found to have had sexual contact with their patients"

The picture is the same in the U.K. Deaths due to medical negligence are horrifying and well-documented facts of medical lore. What is not usually so easily quantified is the "clubbing together" of Doctors who have committed medical negligence / malpractice. Papers/ computer files going missing, other doctors testifying to what a great guy he is. They're all in the same golf club. They stick together, when you try to go to court against their medical malpractice, they are the most expensive and prolonged legal caes imaginable and they really do join forces against the victim whereever possible. So much for Western accountability.

In terms of long flights when you are sick, I fly backwards and forwards with MS & epilepsy, metal hips & spine studs on 12 hour flights. I'd sooner make the extra flight & get medical care in Bangkok than in UK.

[chainarong]

One of the problems for medical service in Thailand is the accountability of the profession for the botched procedures.That seems to be under review at this time. Granted there are good and not so, facilities as well as medical professionals in every country. Thailand with the present accountability, both socially and monetary, will need to make some changes to stay in contention. The payment schedule seems to follow the general tourist industry thinking, less costumers, increase prices.

The hospitals that myself and BB1950 , mention, are audited every Quarter and must meet the US health , medical standards , audits are conducted by international medical auditors ,not from Thailand.

Again, another person speaking in gereralities. every quarter? US health or medical? Which one? Do you actualyl know speciifcs or just talking what you hear? I do kjow they were the first international JCAHO hospital is Asia. Don't know the frequency, but it is every three years in the US and you actually pay a huge amount of money to be accreditied. I believe 80% to 90% of US hospitial meet JCAHO standards. What does that really tell you? In theory, an accredited hospital should be a better facility than a non-accredited one? Does that mean better medical care and less errors? I hope so...

From my experience of passing five US JCAHO inspections and my limited experience working in Thai hospitals, they are not even closely comparable at this stage. To say they are held to US medical standards, I flat out don't believe it....Remember, the survey is money first so a little bit fox in the hen house don't you think...

It's a win for the hospital, a win for the private org conducting the suvey but a win for the patient? Probably could be debated...

Side note, do you really think junior docs here honestly criticize senior physicans in the peer review process? Think about how Thai culture works before you answer that question...

CB

Not generalities my friend , even Singapore is in the mix , its been around a decade or more, as for your jnr doc's, same go's on a flight deck on most asian carriers, think about that.

[cardinalblue]

One of the problems for medical service in Thailand is the accountability of the profession for the botched procedures.That seems to be under review at this time. Granted there are good and not so, facilities as well as medical professionals in every country. Thailand with the present accountability, both socially and monetary, will need to make some changes to stay in contention. The payment schedule seems to follow the general tourist industry thinking, less costumers, increase prices.

The hospitals that myself and BB1950 , mention, are audited every Quarter and must meet the US health , medical standards , audits are conducted by international medical auditors ,not from Thailand.

Again, another person speaking in gereralities. every quarter? US health or medical? Which one? Do you actualyl know speciifcs or just talking what you hear? I do kjow they were the first international JCAHO hospital is Asia. Don't know the frequency, but it is every three years in the US and you actually pay a huge amount of money to be accreditied. I believe 80% to 90% of US hospitial meet JCAHO standards. What does that really tell you? In theory, an accredited hospital should be a better facility than a non-accredited one? Does that mean better medical care and less errors? I hope so...

From my experience of passing five US JCAHO inspections and my limited experience working in Thai hospitals, they are not even closely comparable at this stage. To say they are held to US medical standards, I flat out don't believe it....Remember, the survey is money first so a little bit fox in the hen house don't you think...

It's a win for the hospital, a win for the private org conducting the suvey but a win for the patient? Probably could be debated...

Side note, do you really think junior docs here honestly criticize senior physicans in the peer review process? Think about how Thai culture works before you answer that question...

CB

Not generalities my friend , even Singapore is in the mix , its been around a decade or more, as for your jnr doc's, same go's on a flight deck on most asian carriers, think about that.

Which US health standards must be met quarterly or what happens? Not generalities? Give me specifics! Singapore in the mix for what? And what does that have to do with Thailand health care? I am talking Thailand medical care not a first world country! What's been round for a decade? Not a general comment? Back up your statements with specific examples. So what does your example of flying an airplane have to do with understandfing the purpose of peer review process and the critique of QA cases in Thailand?

Can you demonstrate any medical knowledge, related experience or health care background in either the US or Thailand but preferably both? I am just saying how you wrote your post does not exhibit that other than making broad sweeping statements which doesn't give me the sense you have any personal or professional experience in the unfounded statements you make. Just be more specific or concrete. Can you even cite one US standard (i.e. CCR or CFR?) that you allude to? I would think Thailand have enough issues just trying to comply with their own regulations than trying to meet a foreign one in which Thai gov body is directing them for compliance? Your statement makes absolutely no sense to one who understands how regulatory compliance works...

So yeah, that is why I find your remarks generalizations, unfounded and unwarranted..

CB

[cardinalblue]

Such negativity and rubbish!

I guess you have never heard of Bumrungrad in Bangkok. Probably one of the finest hospitals in the world. Rated as one of the best in Asia. Definitely the best that I have ever seen! Like staying in a 5 star hotel. The environment alone has been proven to improve the recovery period dramatically. It's managed by an American group of doctors, managers, and investors. The specialists, surgeons, physicians, and technicians are all trained and educated at the most renown hospitals in the US. They are also rotated back to the US, for more training every 3 months or so, to keep up on the latest procedures.

By the way, they specialize in cancer and cardiology. Not cosmetology.

India, Singapore and Malaysia are not the only countries in Asia dealing in medical tourism. Medical tourism is big business in Thailand and has been for many years. It's nothing new. There are other 'medical tourist' hospitals in Bangkok, Chang Mai, Pattaya, and Rayong, so why not Phuket?

No, it is not negativity and rubbish. What exactly are the major procedures done under the banner of medical tourism in Thailand? My understanding of the situation is that they are for the most part elective cosmetic procedures. Of course one cannot discuss this properly because the participants will not release the information. I wonder why?

There is a big difference between the provision of critical care under the "normal" operations of a hospital and catering to medical tourists. The big ticket procedures on behalf of westerners are few and far between. It is in large part driven by costs. Once one factors in the ancilliary and associated charges of flying to Thailand for most procedures, the savings, if any does not justify the hassle of travel or the added risks.

I fully acknowledge that Bummie is able to deliver quality care. However, the issue is one of elective procedures which is what the core basis of medical tourism is. People do not fly to Thailand from the UK, Australia, USA etc. for chemo or cardiac care. Why would they when they can get the care for less cost in their home countires? Yes, even in the USA. If one is on medicare or medicaid in the USA, the treatments are available. Those that fall outside that program or do not have private health care are not going to be able to afford the options in Thailand. Western critical care cardiac patients cannot just fly in to Thailand and stick around for 1-3 months. They would die in flight if they did because people with advanced coronary disease just don't do well under such conditions.

No one would doubt or argue that some hospitals can and do provide excellent care in Thailand. However, one is confusing that situation with elective critical care procedures. Add in all the costs associated with the hospital stay and recuperation and the costs exceeed that of what one pays outside of Thailand for the big procedures. Here's an example;

Cataract surgery at Bummie (just the surgery) costs between C$2,200 and $3,600. If one chooses to go the private route in Canada, and avoid the 6 month waiting period, the cost is approx. C$2,500. How about hip replacement surgery? Let's take Louie from Omaha. He can have it done at the local state hospital for free or $10,000. at worst case. If he goes truly private, he has to pay $30,000. If he is old enough, he probably has medicaid or medicare, or he may have private health care coverage. Let's assume Louie is part of the working poor without coverage, so he needs to pay $30,000. Well, he can consider Costa Rica or Mexico where the list prices are between $7,000 and $15,000. Or he can go to exotic India for the flight and treatment special of $10,000. Curry is inclusive. Now compare to Bumrungrad at $15,000. for the procedure, exclusive of travel costs. Where exactly are the savings?

The issue that you miss is that of medical ethics. It is an entire thread in and of itself. Asian hospitals do not have the same code of ethics as do western based hospitals. If I want to harvest some organs for transplant in the EU I better be able to identify the donor and circumstances of the harvest. Do you think that happens in China or India? If I want to run a clinical trial in Canada, I better be able to explain myself to the Ethics Review Board. What's the process of review in Thailand?

Do you know what the JCI does? It is still trying to get some hospitals to follow basic procedures that are a way of life in Australia, the EU etc. Look at it's last initiative, all intended to address major problems in developing world hospitals;

1. Look-alike, sound-alike medication names

2. Patient identification

3. Communication during patient hand-overs

4. Performance of correct procedure at correct body site

5. Control of concentrated electrolyte solutions

6. Assuring medication accuracy at transitions in care

7. Avoiding catheter and tubing misconnections

8. Single use of injection devices

9. Improved hand hygiene to prevent health care-associated infection

When the starting point is impressing upon hospital staff that they cannot reuse disposables, there's plenty of room for improvement.(BTW that was one of the issues highlighted in the elective eye surgery fiasco last year.)

I said it before and I will say it again, medical tourism has a massive ethics issue because it attracts patients shopping for procedures that medical practioners often refuse to do in their home countries because the patients are not good candidates. If a patient has serious medical problem and would benefit from a visit to a foreign location, that patient is most likely unable to travel in the first place.

Many Thai hospitals, even those not certified by JCI are able to provide excellent critical care treatment. That is not the issue. The question that has not been dealt with is whether or not some of the procedures are appropriate. It is not restricted to Thailand. Gastric bypass surgery is a big fad in North America. There is a reason why many of the practioners also operate in places like Mexico. The Mexican clinics cater to the higher risk candidates declined by the US and Canadian surgeons. The likelihood of being held accountable in Mexico is less likely when a high risk procedure goes wrong. Several of the surgeons that do the procedures in Canada and the USA also fly down to Mexico to perform the surgeries where they can double their incomes.

Where Thailand could have an advantage are for those procedures that require extended recovery or rehabilitation. The cost driver is labour. Unfortunately, even with a markup of 100% of the provision of labour, the profit margins are not there so a Thai healthcare system is not going to be interested. As well, there is a shortage of qualified physiotherapists and rehabilitation nurses (like everywhere else). Not a lucrative part of the health service field I guess.

I enjoyed reading your post - well-informed, knowledgeable and raised some interesting points. Do you know if the JCI standards, in particular, the EOC section can be assessed anywhere (in English) as I am intersted in seeing what Thai hospitals seeking accreditation are expected to comply with or if these are customized further for individual countries like Thailand? Best bet to get a copy of these standards?

Thanks,

CB

[geriatrickid]

I enjoyed reading your post - well-informed, knowledgeable and raised some interesting points. Do you know if the JCI standards, in particular, the EOC section can be assessed anywhere (in English) as I am intersted in seeing what Thai hospitals seeking accreditation are expected to comply with or if these are customized further for individual countries like Thailand? Best bet to get a copy of these standards?

Thanks,

CB

Some of the information is available in the annual report (in English). (Downlaod from their website) There is nothing wrong with the JCI, and the goals are admirable. However, they charge for their services so their programs and rating criteria are not public. They also list all of their verified hospitals.