Thai Physicians Threaten To Strike Over New Patient Protection Bill

[webfact]

Physicians Threaten to Strike Over New Patient Protection Bill

The Federation of Medical and Public Health Operators of Thailand threatens to strike if the government continues to push forward the new patient protection bill.

The Federation of Medical and Public Health Operators of Thailand Deputy Director Tapanawong Tang-uraiwan sent a letter to the Public Health Minister expressing opposition to the new patient protection bill.

He explained that the letter contains the signatures of 10,000 people in Roi Et province who oppose having such a law, which, he claims, is not fair to doctors.

Tapanawong went on to say there are 1.3 million residents in Roi Et, while only 167 doctors work there, when at least 872 doctors are needed to effectively provide services in the province.

As such, the bill on the protection for those who are affected by public health service will put an enormous amount of pressure on already work-ridden doctors, who are already trying their best to avoid mistakes.

Tapanawong threatens to lead doctors and nurses across the country to strike, but that only workers in the out-patient department would take part in the strike, to avoid risking the lives of in-patients who need constant care.

The secretary-general for the Association for Consumers, Saree Ongsomwang, said doctors must fully take into account the impact a strike would have on patients.

Meanwhile, she added that a conference about the bill in question will be held at Thammasat University to discuss the issue.

-- Tan Network 2010-09-23

[SamritT]

Here we go again.

[sevenhills]

Here we go again.

What side of the fence do you sit on this one?

[Thaihog]

What a load of <deleted>...... if the doctors are competent then they have nothing to worry about.

They just have to get malfeasance insurance to protect themselves. Standard practice for any competent professional in the western world.....

[TheLaughingMan]

What a load of <deleted>...... if the doctors are competent then they have nothing to worry about.

They just have to get malfeasance insurance to protect themselves. Standard practice for any competent professional in the western world.....

Arent you forgetting that there are not enough doctors? Looks like they are working at 25% strength and expected to not make mistakes? This is the governments fault, as usual. They need to take education and health care seriously instead of underpaying and over working what they've got. This all boils down to the usual problem, some rich politician is pocketing the majority of the money supposed to go into health care and education.

[way2muchcoffee]

Arent you forgetting that there are not enough doctors? Looks like they are working at 25% strength and expected to not make mistakes? This is the governments fault, as usual. They need to take education and health care seriously instead of underpaying and over working what they've got. This all boils down to the usual problem, some rich politician is pocketing the majority of the money supposed to go into health care and education.

Precisely which rich politician is pocketing the money? How much has he pocketed? What mechanism was used to embezzle the funds? Do you know? Hot air and baseless accusations?

[TheLaughingMan]

Wow ok.. seriously? I mean.. seriously? This IS Thailand right? The entire country is ridden with corruption and thievery from the top down. I thought everyone knew this... really? Wow.

[geriatrickid]

Tapanawong went on to say there are 1.3 million residents in Roi Et, while only 167 doctors work there, when at least 872 doctors are needed to effectively provide services in the province.

Of these 167, how many are primary care, or ER physicians? In a situation like this, the health system is reduced to providing cursory care. What's an ER physician expected to do when confronted with a waiting room of 25-50 serious emergencies on any given day, when each case requires several hours of basic care just to keep the patient alive? This is the same situation that confronts ERs in many western nations. Just as a physician in the west doesn't want to go work in East Armpitville, so too is the situation in Thailand.

The bulk of serious cases is most likely handled by approx. 30 overworked and very tired physicians with limited experience and training. It is to be expected that the typical GP physician when confronted at the same time with a head trauma, a complicated pregnancy, a severed limb, a child poisoning, a car crash victim, a heart attack, a respiratory crisis and a host of other emergencies is going to make errors. This subject was dealt with in detail last year when it was shown that the remuneration and working conditions discouraged physicians from hanging their shingles in some regions. Many of the complications and deaths are directly due to the inability to access medical care in the regions.

[IAMSOBAD]

Thailand is a laugh a minute.

Maybe it would be better with TS back as PM.

He could kill all troublemakers and power hungry corrupt people and keep all the money he wants.

Just stop the Thai childish nonsense so we can have One day without biitching!

[way2muchcoffee]

Wow ok.. seriously? I mean.. seriously? This IS Thailand right? The entire country is ridden with corruption and thievery from the top down. I thought everyone knew this... really? Wow.

So if it is common knowledge you will be able to name at least one and more likely dozens of individuals, and the specific cases just off the top of your head. I am not saying there is no corruption. I am simply pointing out that you are making statements based on hearsay and without facts. Your main argument begins with 'Everyone knows....' Sorry, but that just doesn't cut it.

Do you know what percentage of the health and education budgets disappear through graft? I don't. But then again I don't make wild assertions without any evidence either (unless I am drinking of course).

My main objection is your sentence right here:

This all boils down to the usual problem, some rich politician is pocketing the majority of the money supposed to go into health care and education.

You state that the majority of the education and health care budgets are going into a rich politician's pocket through corruption. The word majority means over half. I think that is a ridiculous comment and I simply do not buy it. If I were to hazard a guess I'd say that perhaps a few percent is siphoned off collectively by hundreds of corrupt officials. Of course that is merely a guess. It could be more. It could be less.

[Pib]

Tapanawong went on to say there are 1.3 million residents in Roi Et, while only 167 doctors work there, when at least 872 doctors are needed to effectively provide services in the province.

Of these 167, how many are primary care, or ER physicians? In a situation like this, the health system is reduced to providing cursory care. What's an ER physician expected to do when confronted with a waiting room of 25-50 serious emergencies on any given day, when each case requires several hours of basic care just to keep the patient alive? This is the same situation that confronts ERs in many western nations. Just as a physician in the west doesn't want to go work in East Armpitville, so too is the situation in Thailand.

The bulk of serious cases is most likely handled by approx. 30 overworked and very tired physicians with limited experience and training. It is to be expected that the typical GP physician when confronted at the same time with a head trauma, a complicated pregnancy, a severed limb, a child poisoning, a car crash victim, a heart attack, a respiratory crisis and a host of other emergencies is going to make errors. This subject was dealt with in detail last year when it was shown that the remuneration and working conditions discouraged physicians from hanging their shingles in some regions. Many of the complications and deaths are directly due to the inability to access medical care in the regions.

From spending a lot of time in Thai public hospitals/clinics (three different public/govt hospitals and four different clinics) over the last 6-8 months in regards to the mother-in-law (had a back operation) and an uncle-in-law (cancer, old age) above comment about the health system providing cursory care is on target. During my many hours in the hospitals/clinics waiting, walking around, and observing, it's easy to see the hospital/clinic staff is usually overwhelmed with the number of patients, especially under the government's 30 baht medical program. And the common wards are full with patient beds litterally placed side by side with only 1 meter of spacing. The staff almost has to herd large number of patients into the doctor's office for only a few minutes consultation/examination (more discussion than examination), which many times results in the issue of numerous pills and the recommendation to come back in two weeks if you don't get better. End result: a misdiagnosis can easily occur which leads to more serious health problems or even death.

Now, in a private hospital you can usually get a more thorough examination, good time with the doctors, and the hospital has better equipment--that's because you are paying. And if it's one of the medical tourism/hotel-like hositals you can get very good treatment, be treated like a rock star---but at a big price...still low cost when comparing to western hospitals but still a fairly pricey amount. For many, many Thai's going to a private hospital is just not an option due to the cost.

Now, if a person has only visited/been treated at high end Thai private hospitals/clinic and not visited/been treated in Thai public hospitals/clinics, he/she may not have a good understanding of the big difference in medical capability and available time per patient, even when some of the doctors work at both public and private hospitals during the week.

I can somewhat understand the fear that many doctors have regarding the proposed patient protection bill due to the available time they can allot to each patient, the capability of their hospital/clinic, knowing they can only charge X-amount since many Thai's are poor, wanting to treat as many patients as possible, and malpractice insurance low availability/high cost.

This proposed patient protection bill shouldn't be just a one way conversation when considering the entire country's medical system and trying to strike a balance which is best for everyone.

While the doctors, nurses, and staff are definitely dedicated and hard working I think they know their hospital/clinic doesn't have the medical capabilty (i.e., equipment, medications, etc) to

[tomyummer]

Wow ok.. seriously? I mean.. seriously? This IS Thailand right? The entire country is ridden with corruption and thievery from the top down. I thought everyone knew this... really? Wow.

So if it is common knowledge you will be able to name at least one and more likely dozens of individuals, and the specific cases just off the top of your head. I am not saying there is no corruption. I am simply pointing out that you are making statements based on hearsay and without facts. Your main argument begins with 'Everyone knows....' Sorry, but that just doesn't cut it.

Do you know what percentage of the health and education budgets disappear through graft? I don't. But then again I don't make wild assertions without any evidence either (unless I am drinking of course).

My main objection is your sentence right here:

This all boils down to the usual problem, some rich politician is pocketing the majority of the money supposed to go into health care and education.

You state that the majority of the education and health care budgets are going into a rich politician's pocket through corruption. The word majority means over half. I think that is a ridiculous comment and I simply do not buy it. If I were to hazard a guess I'd say that perhaps a few percent is siphoned off collectively by hundreds of corrupt officials. Of course that is merely a guess. It could be more. It could be less.

Way2muchcoffee is right. It's not quite over half. The going rate these days is about 30%. And do the names "Sudarat Keyuraphan" and "Chalerm Ubumrung" ring any bells? They were both former Ministers of Health. Use your own imagination on that one and draw your own conclusions. How anyone can amass over 500 million baht in luxury cars as a cop is beyond me. And yes, I've been to his house and have seen the cars. Makes me want to become a cop.

[jan1van1hooten]

this sounds like the same sort of campaign waged by insurance companies in the USA.

the insurance companies just want to have to pay out less for malpractice claims,

so they try to scare the public, and complain about unreasonable "settlements" to patients.

but I have met two permanently disabled people, one confined to a wheelchair for life, because of a medical mistake.

those doctors are certainly eager to keep making the payments on their mercedes sedans.

[asiawatcher]

Irrespective of the load the doctors bear, they chose their profession and knew the situation. It has never varied in centuries. And like the litigious West, it has just caught up here. CEO's can get indemnity insurance and now so can doctors, but that will bite us all in the ass and the cost of medical cover and services will rise and there ain't nothing anyone can do about is whilst the insurance companies grow larger!

As to the doctors not wanting the problem, too late boys, the West paved the way to malpractice.

[Thai at Heart]

Irrespective of the load the doctors bear, they chose their profession and knew the situation. It has never varied in centuries. And like the litigious West, it has just caught up here. CEO's can get indemnity insurance and now so can doctors, but that will bite us all in the ass and the cost of medical cover and services will rise and there ain't nothing anyone can do about is whilst the insurance companies grow larger!

As to the doctors not wanting the problem, too late boys, the West paved the way to malpractice.

In fairness, they should have indemnity insurance, problem is to what value? If I understand, in the US the claims are not capped so it has run out of control.

[kuffki]

Let them strike!

As it stands right now, they are not liable for anything and really could not care less.

i have had times when those sweet doctors gave me medicine despite me telling them 10 times i have allergy and high blood pressure and when i get home and google it, it says in big warning writing

~If known to have allergy-do not take!

-If suffering from high blood pressure-do not take~

Some given medication to my GF without eve asking if she had allergy, same night she almost died due to allergic reaction.

They misdiagnose and get away with it, in some instances like the one in Bangkok Pattaya, they pronounced one woman dead while she was alive and by miracle passing by doctor noticed that.

If anything this bill will make them use their brain and not prescribe paracetamol for every single sickness or medication for which pharmaceutical company gives them a kick back.

I do not trust any doctor, especially in Thailand and always check all the meds and symptoms, but most Thai's will just follow the "doctor's orders" and suffer the consequences.

Best i ever heard was 1 doctor in Korat prescribing some "magic" cream for woman who had stomach cancer.He should not have medical license -full stop

[phetaroi]

Here we go again.

What side of the fence do you sit on this one?

I think I agree with Sevenhills. Samrit, your one line post has no meaning, and that is often the way in which you post. I assume you are Thai, so I am glad you are here, but it would be great if more of your posts actually took a position.

[animatic]

I was in the Gov. Hospital yesterday AM. More than 300 people in the waiting area,

and something like a 2 hour wait to register...I turned around and left, no reason to expect my

2nd opinion was going to happen before I could read a novella. And someone in more dire need

would use my space more productively.

It would appear that these doctors threatening a strike, regardless of work load,

are more worried about, their bottom lines and protecting fuzzy butts than about

the people they are expected to cure or at least help. It also no doubt has to do

with them fearing loss of face for being more easily accused of mistakes,

no Thai tolerates getting beeped at for traffic mistakes, being accused professional

of incompetence must make them completely nutzo.

What a sad state of affairs.

"Physician heal thy self."

and

"Above all first do no harm."

And get this straight.

Your face means nothing compared to a patient's health.

[animatic]

Let them strike!

As it stands right now, they are not liable for anything and really could not care less.

i have had times when those sweet doctors gave me medicine despite me telling them 10 times i have allergy and high blood pressure and when i get home and google it, it says in big warning writing

~If known to have allergy-do not take!

-If suffering from high blood pressure-do not take~

Some given medication to my GF without eve asking if she had allergy, same night she almost died due to allergic reaction.

They misdiagnose and get away with it, in some instances like the one in Bangkok Pattaya, they pronounced one woman dead while she was alive and by miracle passing by doctor noticed that.

If anything this bill will make them use their brain and not prescribe paracetamol for every single sickness or medication for which pharmaceutical company gives them a kick back.

I do not trust any doctor, especially in Thailand and always check all the meds and symptoms, but most Thai's will just follow the "doctor's orders" and suffer the consequences.

Best i ever heard was 1 doctor in Korat prescribing some "magic" cream for woman who had stomach cancer.He should not have medical license -full stop

I had Dengue last year. I typed out all my symptoms and the time line down to an hour before showing up.

He/They didn't get it.

"I can't tell what you have, maybe cold."

I said, "Well. what about Dengue, I listed all the symptoms right here."

Oh, yes, maybe Dengue, I'll have you tested.

1 hour later; "You have Dengue."

"I said I likely had Dengue when I entered your office.

Why did you not look for that first when I brought it up."

"It was not obvious."

[Robby nz]

It is correct about a huge number of patients per Dr even in BKK public hospitals.

However I do believe, on my experiences with the system over the last couple of years, that the Dr's do their best to avoid mistakes.

For instance: I have to go in to a public hospital in BKK for a small procedure soon and the week before I go for blood tests, an ECG and X rays to check I am fit for the OP.

They look to have the best in up to date gear like CT, MIR, radiation etc.

Probably much different in the far out provinces but I guess thats the same in most countries.

Suspect what the Dr's are scared of is what the see in places like the USA where there are huge claims for sometimes trivial reasons.

[hoaker]

It's becoming a norm in Thailand to organize a strike when the minority of the country doesn't like a bill passed for the greater good. Eventually down this road, there is going to be a civil war that will take thailand back to the dark ages. Guess the upside would be more business opportunities as everything will be destroyed!!

Amazing Thailand!!

[dumball]

Put this into a different light , you take your vehicle to the car 'Doctor' with a problem , he can touch it/smell it/tasteit/and drive it , but he cannot ASK it anything , if your vehicle is not perfect after the repair in your point of view , you hurry back and compain . You do not care if he was up to his gonads in other work , your vehicle should have been repaired in a competent manner , you would have prefered he spent all the time it took after the other vehicles ahead of you were repaired , who wants to land up wrapped around a tree because the brakes failed simply because in his rush he failed to tighten a onion bolt to the correct specs .

Excuses are only accepted if you make it back to the garage ALIVE .

[golferchin76]

In Thailand, public health care outside of BKK and surrounding provinces has an extreme low standard. A Thai can use the 30 baht per visit or social insurance from the job to effectively combat common cold or simple allergies but that's probably it.

Example 1. one of my trucker's mother was complaining about headaches for months. The son brought her to nearest provincial public hospital many times but all she could get was medication to ease the pain. One day she just fainted and fell to the ground. She was sent to the nearest hospital at Hua Hin by her relatives but declared dead past mid night. I asked my trucker what was the diagnosis from the doc, what was the cause of such tragic event. He said that the doc told him, "the water that feeds the brain cannot reach the brain, so she passed away."

water that feeds the brain cannot reach the brain= nam-liang-sermong-bai-mai-terng-sermong

What on earth was that!?!? A sudden faint fell to the ground with prior complaints of headache would suggest it is 'probably' a stroke. She very likely suffered from brain damage as blood engulfed her brain, suffocating cells and created internal pressure. And it was quite evident because when the sons arrived there was blood from her nose.

Example 2. another trucker's 2nd or 3rd wife (a worker in the rubber plantation) I am not so sure was complaining about daily tiredness and weakness and pain from the stomach area. Every time the trucker brought her to public hospital, or if she went by herself, it was same prescription; medication to ease pain. Few months later I said, hey man if you care about her enough you should bring her to a larger hospital and get a proper diagnosis, because it doesn't make sense such pain doesn't go away for a long time. So they went and made an appointment and "weeks later" finally it was their queue for x-ray (with several delays too). The diagnosis was that she's got a tumor her womb, and she has arrange to take it out quickly. So appointments were made and delayed (repeat that like 3 times, each time a few weeks) and finally nothing was done up until now.

Example 3. recently the old filling in one of my tooth chipped away. I went to Samitivej at Thonglor and got myself a female dentist and she told me this is going to be a big job. Need to cut out part of my gum, let it heal, then shave the bony base and strengthen it, cut that tooth in half, sand & grind it so it becomes smaller, then fit an artificial crown on top. I asked her if I can use a gold tooth (ok this is joking). The whole process should take a few weeks and no less than 4 visits. In addition to that, she pointed out to me that I have several decaying teeth so while I was there she grinded and filled 2 of them. It was grinding, sanding, filling, and I don't know what the <deleted> was going on but she made it hurt bad, and she wasn't gentle to force my mouth wide open. After an hour and 2 teeth filled, she said next appointment she would do more. I asked, "but I have another few you told me, why not do it today?" Well, it's passed her clinic hour so she wants to go home, later I saw her rushed out to the elevator with regular clothing and a hand bag and realized. The next time I went to a clinic on Petkasaem where my wife always visit. I went for the same old doc my wife recommends. The same tooth that previously declared unusable is still unusable but the procedure would be a bit simpler and he explained in much more detail, in understandable human language, and the price he quoted was much cheaper. (And he said a gold tooth would be doable if I want to, seriously). Then he fixed 2 more of my rotten teeth and this time magically it felt like a light turbulence in Air Asia only. And he also use temporary filling in my nearly half-chipped tooth and formed it to look like a real tooth and it is still right now in my mouth because he did such a good job I can chew with it and I am no in hurry to do the big surgery.

I've come from various jobs before, machining, jewelry manufacturing, car tuning, and trucking. In each industry and various fields of work, I've met with professionals who tried and were successful in perfecting their skills. Imagine a silversmith who has only a few years of education but can turn small chunks of silver into a fine piece of jewelry after hours of melting, hammering, annealing, soldering, drilling, filing, stone setting, polishing. And a young designer with college degree trained on CAD and keeps improving and one day his CAD file can be printed out directly from a prototype machine in a 3 dimensional wax form to be used as a mold or for presentation, conference purpose. An engine workshop takes a 2.0 liter Honda engine and after days of modification turn a stock 150bhp engine into a fire-breathing high revving 275bhp monster race engine (without force induction). A trucker, can drive a tractor/semi 3-4 days from Nakhonsrithamarat to Chiang Rai, cross the Mekong river into Laos, drive another 250km of treacherous snake-like 2 lane mountain road, at a speed competitive to snail to the border of China (Laos is LHD) which takes about 10 hours for that route alone, deliver the payload (fruit), and uses another same amount of time to transport vegetables from Yun-Nan of China back to fresh produce distribution center in Rangsit before head back to south, and he is clean from Ya Ba according to urine test. (The whole trip is roughly 4000km, and they do that 3.5 times a month)

All these people, when I converse with them about the work, they make sense (not all of them, but the good ones do), and when I give them tasks, they try to complete or discuss ways to complete them. These are real professionals, and they are Thais. Now, back to the doctors. I've always told my wife that, doctors are human beings just like us. They weren't born as doctors or they don't possess special magical skill because theirs were learnt skills just like everyone else too. Sure some can save lives, but it is why they are doctors and they didn't do it for free (can be very expensive) so don't look at them like they are God. And because they are humans, there will be good, average, bad doctors. A good surgical doctor can operate a non invasive balloon surgery in less than an hour and leaves only a nearly invisible scar. A bad one, can cut open your artery during a bypass surgery because his hand are not steady. And a bad plastic surgeon will do you a pair of really fake looking boobs.

A lot of Thai doctors take the job as a nine to five job. Not all of them, but a lot of them, and that's enough to feel scared. Only a small portion are genuinely good and caring and smart. But where are they? They work in private hospitals where only 10% of the population can afford their fees.

The rest of them are just not smart enough, well educated enough, and too ill equipped to combat anything more than common colds. And eventually some of them don't care no more because they realized they can't save the world they dreamed to save, because they do not have enough of the government's support.

[golferchin76]

Wow ok.. seriously? I mean.. seriously? This IS Thailand right? The entire country is ridden with corruption and thievery from the top down. I thought everyone knew this... really? Wow.

So if it is common knowledge you will be able to name at least one and more likely dozens of individuals, and the specific cases just off the top of your head. I am not saying there is no corruption. I am simply pointing out that you are making statements based on hearsay and without facts. Your main argument begins with 'Everyone knows....' Sorry, but that just doesn't cut it.

Do you know what percentage of the health and education budgets disappear through graft? I don't. But then again I don't make wild assertions without any evidence either (unless I am drinking of course).

My main objection is your sentence right here:

This all boils down to the usual problem, some rich politician is pocketing the majority of the money supposed to go into health care and education.

You state that the majority of the education and health care budgets are going into a rich politician's pocket through corruption. The word majority means over half. I think that is a ridiculous comment and I simply do not buy it. If I were to hazard a guess I'd say that perhaps a few percent is siphoned off collectively by hundreds of corrupt officials. Of course that is merely a guess. It could be more. It could be less.

I can't show you proof, but I swear over my neighbor's daily barking dog's life that a quarter to a third of public health budget was siphoned off in the process, and another was simply wasted. Just as the case in my country (Taiwan) where the cost of a complete set of LED traffic light cost only 33% of the budget set to buy it, and a doctor will get a 15%-20% cut if he installs an artificial hip in a patient so he will try to sell to his patients about, "your tendon needs replacement, your knee joint is no longer workable, etc, etc." And at surgery time he needs the salesman's instruction to assemble the dam_n parts in the operating room the first time he use it on the patient. Do you not feel strange how he talked to the patient into surgery the first place? The patient is lying on the surgery bed, unconscious, anesthetized, while the medical equipment salesman instructs the doc and the doc assembles the dam_n piece of joint into the patient's body.

And all these for? Mercedes Benz, mistress, new cellphones, watches.

I am not lying because the LEDs were from my cousin, and the medical equipment salesman is my college friend. And my mom shattered a part of a vertebrae from a golf kart accident and got operated and the bill was 1.2 million Baht at Param 9 Bangkok hospital !! Does the expense make sense to you? It doesn't for me, but that's my mother so we had to.

Sometimes it is a really ugly world.

[golferchin76]

It is correct about a huge number of patients per Dr even in BKK public hospitals.

However I do believe, on my experiences with the system over the last couple of years, that the Dr's do their best to avoid mistakes.

For instance: I have to go in to a public hospital in BKK for a small procedure soon and the week before I go for blood tests, an ECG and X rays to check I am fit for the OP.

They look to have the best in up to date gear like CT, MIR, radiation etc.

Probably much different in the far out provinces but I guess thats the same in most countries.

Suspect what the Dr's are scared of is what the see in places like the USA where there are huge claims for sometimes trivial reasons.

Is that a private or public hospital you are talking about? CT, MIR in public hospital?

[Sheryl]

In my years moderating the Health forum I've come across quite a few instances of gross malpractice. most of it occurred in private hospitals, where the working conditions issues mentioned by some do not apply.

The doctors have some legitimate issues with the bill as drafted but their proposed changes would let doctors and hospitals totally off the hook for malpractice and result in their being no incentive for either to clean up their act.

Between a system which penalizes doctors for things beyond their control and one that gives them and the institutions they work in a free pass to be negligent there is a middle ground.

Let's hope the final legislation finds it.

BTW the bill will only apply to health care provided under the national health scheme/social security. So will not be applicable for many farang.

[golferchin76]

Wow ok.. seriously? I mean.. seriously? This IS Thailand right? The entire country is ridden with corruption and thievery from the top down. I thought everyone knew this... really? Wow.

So if it is common knowledge you will be able to name at least one and more likely dozens of individuals, and the specific cases just off the top of your head. I am not saying there is no corruption. I am simply pointing out that you are making statements based on hearsay and without facts. Your main argument begins with 'Everyone knows....' Sorry, but that just doesn't cut it.

Do you know what percentage of the health and education budgets disappear through graft? I don't. But then again I don't make wild assertions without any evidence either (unless I am drinking of course).

My main objection is your sentence right here:

This all boils down to the usual problem, some rich politician is pocketing the majority of the money supposed to go into health care and education.

You state that the majority of the education and health care budgets are going into a rich politician's pocket through corruption. The word majority means over half. I think that is a ridiculous comment and I simply do not buy it. If I were to hazard a guess I'd say that perhaps a few percent is siphoned off collectively by hundreds of corrupt officials. Of course that is merely a guess. It could be more. It could be less.

Way2muchcoffee is right. It's not quite over half. The going rate these days is about 30%. And do the names "Sudarat Keyuraphan" and "Chalerm Ubumrung" ring any bells? They were both former Ministers of Health. Use your own imagination on that one and draw your own conclusions. How anyone can amass over 500 million baht in luxury cars as a cop is beyond me. And yes, I've been to his house and have seen the cars. Makes me want to become a cop.

Non-sense!

A rich cop doesn't mean he make it his own.

First of all, he has to have a well connected soldier or cop father or relatives who already amassed an amazing amount and built up the relationship connection tree. Then the son just take it and prosper it.

You can be a cop, but you won't go very far on your own, especially when you have blue eyes and not dark hair. 555

[siampolee]

Do the doctors here in Thailand take the Hippocratic oath or is it the hypocrite oath I ask ?

[Bagwan]

 The farang doctor who attends my  HIV positive wife is very thorough and checks her out for anything that statistically could ail her. Her previous doctor, a resident at a hospital of international renown (and charges accordingly),  who apparently has a good reputation for his diagnostic expertise and ability to prescribe suitable treatment, is by comparison slapdash. It seems that he thought a pap smear every six months was overkill, as did the gynaecologist at Pattaya' s most expensive hospital who didn't think to check the DNA of the HPV's detected. Nor did the  gynaecologist investigate some mild inflammation at the neck of her cervix.. Our farang doctor, after ascertaining that the HPV 's were of the harmless types, suggested that an ultrasound scan would be a good idea to see what could be causing the inflammation. T he results of that set alarm bells ringing since not all was well with my wife's right ovary. A blood test was ordered and to our relief no cancer antibodies  were found to be present. He opined that she probably had a small cyst or more likely there was scar tissue from a previous cyst.  As this problem was outside of his medical specialty he suggested that we get a second opinion and directed us to a lady gynaecologist in private practice.  She confirmed his opinion that it was only scar tissue.

Conversations with both the farang doctor and the lady gynaecologist were illuminating. The farang suggested that we not take the original gynaecologist to task since little would be done.  He stated that all doctors from this part of the world were not trained to be inquisitive and pursue anything that might be amiss. Since in my experience no Thai can see a corner without wanting to cut across it, I got the point. I suggested that a parallel might be that a policeman hearing gunshots would do nothing until he tripped over a dead body. He chuckled and agreed.

The lady gynaecologist after listening to the story of how we had arrived at her surgery said that she was worried for her grandchildren. She said that when she and her husband died there would not be a doctor in the family that the grandchildren could consult. She added that all today's young doctors were concerned about was money rather than developing into competent professionals. She added that some hospitals when confronted with a breech birth, transfer the patient to another hospital either through lack of available knowledge/expertise or not wanting their reputation besmirched if things went wrong. If the mother to be died on the way, so what? It had not happened on their patch. Let the receiving hospital clear up the mess.

I am on very good terms with a very highly qualified lady doctor working out of a BKK hospital. We discuss many things other than medical matters. I once asked her that given Thailand's corrupt professional examination system it seemed that who you know was as important as what you know. Would she say that some doctors were a positive danger to their patients, I asked. After some thought to couch a suitable reply she told me that as I was an intelligent and well read man, she thought that I already knew the answer to that. She added that she thought that only lawyers in cross examination asked questions when they already knew the answers. 

Should there be a compensation scheme? Yes, yes, yes and it should be funded but not administered by the doctors themselves.  But wouldn't that mean an independent inquiry panel and where in Thailand are you going to get one of those? Does anybody really think that a doctor would be censured, their licences to practice suspended or if necessary struck off the register? This is the land of mai pen rai and 'honest mistakes'. It is not at all easy to bring a wayward or careless doctor to book in the UK so what are the chances here? Remember the doctor who killed his wife, also a doctor, cut her up into pieces and flushed them down the loo? He was given two years probation since he would be of more use to the country following his profession than rotting in jail?  Thankfully a public outcry changed that miscarriage. What are the chances of changing a system where a doctor will tell a patient to go away, presumably to quietly die elsewhere, if they cannot afford to pay the bills? 

Doctors reside in the hi-so camp so the needs of the plebs are not nor will be a priority until the entire fabric of Thai society changes,. and I expect to make the acquaintance of a famous Norwegian Blue before that comes about.