Severe Shortage Of Medical Specialists In Thailand

[webfact]

Severe shortage of medical specialists

By The Nation

With just 1,000 medical specialists graduating every year, Thailand is suffering a severe shortage of experts while general physicians are overwhelming the market.

Dr Somsak Lolekha, president of the Medical Council, said yesterday that in the next six years some 10,000 graduates would have to compete for 1,700 positions for general physician at state hospitals.

In comparison, Thailand currently has 20,000 specialists, and there are 2,000 vacancies every year. However, the council is only able to produce about 1,000 specialists annually. Therefore, he said, students should choose to specialise.

His comments came at a press conference held to announce the Thailand Medical Expo 2010, which will be held from November 2628 at the Queen Sirikit National Convention Centre. He also said that on average, there were 600,000 patients per day in the country, 10 per cent of whom needed intensive care.

-- The Nation 2010-11-12

[BillR]

that would explain the aspiran I was prescribed for my lung cancer

[kuffki]

To be a specialist requires to really study and devote some part of the life to it, while to be GP does not require much at all(the extensive knoweledge), and wages are almost the same.

From memory in BKK hospital, fee to see GP is the same as to see specialist or may be 100 baht more.

Compared to say Oz where GP is around $50 and specialist from $120-$300

[Felt 35]

Isn’t Thailand the medical "hub" of Asia

[moetownblues]

Isn't Thailand the medical "hub" of Asia

The medical hub project, initiated in 2003 by the Thaksin Shinawatra government, included three medical service facets: sickness prevention, spa services and Thai massage. It also promoted Thai herbal medicine products. (Taken from another topic)

I don't think there is any shortage of spas or Thai women qualified to give massages.

[waza]

WOW! 60,000 patients per day require intensive care. Thats a lot of people on life support, is that because of the lack of specialists or causing it?

[moetownblues]

Personally I think the medical services in Thailand are far better than anything you will get in Australia. In OZ if you need to see a Dr you have to make an appointment 2 weeks in advance. If you need an operation you are placed on a waiting list for anything up to 2 years or more. You have people laying on trollies for days in emergency departments waiting to see a doctor. In Thailand you can virtually walk in of the street and get a heart transplant.

[waza]

Personally I think the medical services in Thailand are far better than anything you will get in Australia. In OZ if you need to see a Dr you have to make an appointment 2 weeks in advance. If you need an operation you are placed on a waiting list for anything up to 2 years or more. You have people laying on trollies for days in emergency departments waiting to see a doctor. In Thailand you can virtually walk in of the street and get a heart transplant.

Hmmm, I am an Aussie and I work in health care.

1. I have never had to wait 2 weeks to see a GP, I usually get in to see one the same day I call for a appiontment.

2. Yes there is a waiting list for elective surgery, but emergency surgery is conducted as soon as the staff can be assembled.

3. Yes, you may have to wait for long periods in an emergency department for non essential medical care. Thats why its called an emergency Department.

4. If you are prepared to pay for health care, like farrangs in Thailand, then you will get prompt care from a private hospital.

5. Unless a hospital has a stock of spare hearts sitting on a shelf, there is no way you can get a heart transplant in a month let alone a day.

Australian health care is some of the best in the world and medicare makes it fair and equitable for all Aussie.

Edited November 12, 2010 by waza

[Caliguy]

Most of them are overseas working and get paid ALOT more. I've seen whole hospitals where the doctors are Thai and Indian and the nurses are Filipino. In the US anyway.

[kaeri]

Most of them are overseas working and get paid ALOT more. I've seen whole hospitals where the doctors are Thai and Indian and the nurses are Filipino. In the US anyway.

Where is this??? I sure would like to know.

[Boss]

Those, who can pay / having a good insurance will always get the best treatment immediately in Thailand or elsewhere, that's no big news.

My friend is an ENT surgeon with western standard and but not allowed to work here. Protectionism it's called. But maybe the Thais will have to lift the ban soon - hope so.

[moetownblues]

Those, who can pay / having a good insurance will always get the best treatment immediately in Thailand or elsewhere, that's no big news.

My friend is an ENT surgeon with western standard and but not allowed to work here. Protectionism it's called. But maybe the Thais will have to lift the ban soon - hope so.

Maybe his standards are not as high as thai standards. All medical staff have to re sit exams if they want to work in a country outside thier own.

[Elfin]

Personally I think the medical services in Thailand are far better than anything you will get in Australia. In OZ if you need to see a Dr you have to make an appointment 2 weeks in advance. If you need an operation you are placed on a waiting list for anything up to 2 years or more. You have people laying on trollies for days in emergency departments waiting to see a doctor. In Thailand you can virtually walk in of the street and get a heart transplant.

Hmmm, I am an Aussie and I work in health care.

1. I have never had to wait 2 weeks to see a GP, I usually get in to see one the same day I call for a appiontment.

2. Yes there is a waiting list for elective surgery, but emergency surgery is conducted as soon as the staff can be assembled.

3. Yes, you may have to wait for long periods in an emergency department for non essential medical care. Thats why its called an emergency Department.

4. If you are prepared to pay for health care, like farrangs in Thailand, then you will get prompt care from a private hospital.

5. Unless a hospital has a stock of spare hearts sitting on a shelf, there is no way you can get a heart transplant in a month let alone a day.

Australian health care is some of the best in the world and medicare makes it fair and equitable for all Aussie.

I worked in Australian healthcare for 30 years, and I agree with your comments Wazza. I have had occassion to go to the McCormack Hospital in Chiang Mai on 4 occassions, and have nothing but praise for the staff in that hospital.

Now having endured the crazy Chinese health system for the past 5 years, I have nothing but praise for the Aussie Medicare system, and its public hospitals, so when people wrongly complain about it, I cringe!:jap:

[moetownblues]

Personally I think the medical services in Thailand are far better than anything you will get in Australia. In OZ if you need to see a Dr you have to make an appointment 2 weeks in advance. If you need an operation you are placed on a waiting list for anything up to 2 years or more. You have people laying on trollies for days in emergency departments waiting to see a doctor. In Thailand you can virtually walk in of the street and get a heart transplant.

Hmmm, I am an Aussie and I work in health care.

1. I have never had to wait 2 weeks to see a GP, I usually get in to see one the same day I call for a appiontment.

2. Yes there is a waiting list for elective surgery, but emergency surgery is conducted as soon as the staff can be assembled.

3. Yes, you may have to wait for long periods in an emergency department for non essential medical care. Thats why its called an emergency Department.

4. If you are prepared to pay for health care, like farrangs in Thailand, then you will get prompt care from a private hospital.

5. Unless a hospital has a stock of spare hearts sitting on a shelf, there is no way you can get a heart transplant in a month let alone a day.

Australian health care is some of the best in the world and medicare makes it fair and equitable for all Aussie.

I worked in Australian healthcare for 30 years, and I agree with your comments Wazza. I have had occassion to go to the McCormack Hospital in Chiang Mai on 4 occassions, and have nothing but praise for the staff in that hospital.

Now having endured the crazy Chinese health system for the past 5 years, I have nothing but praise for the Aussie Medicare system, and its public hospitals, so when people wrongly complain about it, I cringe!:jap:

The Australian health system does not even come close to that of Thailand and I have used both. Just a personal opinion tho.

[RaoulDuke]

Most of them are overseas working and get paid ALOT more. I've seen whole hospitals where the doctors are Thai and Indian and the nurses are Filipino. In the US anyway.

Where is this??? I sure would like to know.

This is everywhere in the USA and most of Canada. I think Indian doctors are far more ubiquitous than Thai doctors, but for the most part, this is very true. The Philippines #1 export is people, and most of them either go to North America to work in health care, or go to the Middle East to become physically and psychologically abused slaves and servants. Its funny how so many people in the USA are afraid to go to a hospital in Asia because they are afraid of how 'poorly trained' the staff is, not realizing most of the staff in the USA is trained at the same place. Of course, as a farang in a private hospital, you will get 10x better service and care in Thailand than you will in the USA. I certainly wouldn't want to be at the mercy of the GP's at the public hospitals, but Thailand does have at least a few very talented doctors, as long as you have money. I spent some time in a private Thai hospital and was astonished at how much better everything was, compared to the USA, from having your own private room, much more attentive staff, more effort to accommodate me, even the food was 10x better than in USA. Everyone from the janitor to the doctors were more professional and courteous, and they must have known what they were doing because everything ended up just fine. And they actually let me stay until I was ready to leave.

I cant speak for other countries, but healthcare in USA is atrocious, they wheel you out of the hospital as soon as you are conscious, because the hospital bed costs so much...or at least they can bill the insurance company for so much per day. And don't try to go to the emergency room, there is usually a 12 hour wait, because all the people without insurance use the emergency room as their primary physician. And you may be able to get an appointment with a GP or specialist in a week or less, but 1/2 the time, you end up seeing the PA (physician's assistant) instead of the actual doctor. This is especially true of specialists, despite the fact that you pay more and need a referral from your GP to see them in the first place. If you are lucky enough to actually talk to a real life MD, you will be lucky to see them for a whole minute, before they shoot off some script that may or may not work. And if it doesn't work, you get to come back, pay more copays, buy more drugs that might work, and wait. After going through this routine 3-4 times, paying for every visit, they might actually give you a referral to a specialist who actually knows what they are doing, but they will charge you just for the referral. But that is what happens when health care becomes a for-profit industry tainted by capitalism.

Edited November 12, 2010 by RaoulDuke

[Robby nz]

Unfortunatly I have a fair bit of experience with the health system here in Thailand and most of it under specialists.

Dont know about other countries but I can tell you that the specialities are narrowed down far more here than in NZ.

For instance in NZ for any cancer you would be refered to an oncologist.

Here there are specialists in many different kinds of cancer, like colan cancer, lung cancer, breast cancer etc.

I have been under a colo-rectal surgeon who specialises in cancers of the intestinal tract and at present am under a eurologist who specialises in cancers and other problems with the utinary tract.

In the first case there are 4 specialists in the Colo-rectal Dept and 5 in the urological dept in both cases supervised by a teacher, professor.

I would imagine here is much the same as in other countries where the specialists are concentrated in the big cities and those from outlying places get refered to them.

I suppose you can say they are overworked by other country standards for they see a huge number of patients in the public hospital where the work in BKK as well as being farmed out to some private hospitals and teaching studant doctors.

From what I have seen the system in the hospital I have attended, which is a teaching hospital with medical school and nursing collage attached, is geared to producing specialists rather than GP.s

[Bagwan]

My wife and I use only 4 doctors, whom we think are worthy of our trust, and I think it is significant that 3 of them are female and the other a farang. 

In conversation with one of the ladies I asked that given the levels of  bribery, nepotism and the abuse of the examination system in Thailand, would she say that some practicing doctors are a menace to their patients. She mulled it over for a short while and replied that she thought that I already knew the answer. No need to cross the t's and dot the i's there then.

Another of the lady doctors who we met when canvassing for a second opinion said that she was afraid for her grandchildren since upon her demise there wouldn't be a doctor in the family that they could consult with. She added that most young doctors were short on knowledge and ethics and overly concerned with money. 

The farang doctor told me that there were no more than 12 or 13 Thai doctors of his particular specialisation  for whom he had any professional regard. 

The best construction that I could place on medical services available in Thailand is that from a quality point of view it is patchy. There is a lot of gingerbread but not a lot of substance  underneath.  

[bobo42]

I cant speak for other countries, but healthcare in USA is atrocious, they wheel you out of the hospital as soon as you are conscious, because the hospital bed costs so much...or at least they can bill the insurance company for so much per day. And don't try to go to the emergency room, there is usually a 12 hour wait, because all the people without insurance use the emergency room as their primary physician. And you may be able to get an appointment with a GP or specialist in a week or less, but 1/2 the time, you end up seeing the PA (physician's assistant) instead of the actual doctor. This is especially true of specialists, despite the fact that you pay more and need a referral from your GP to see them in the first place. If you are lucky enough to actually talk to a real life MD, you will be lucky to see them for a whole minute, before they shoot off some script that may or may not work. And if it doesn't work, you get to come back, pay more copays, buy more drugs that might work, and wait. After going through this routine 3-4 times, paying for every visit, they might actually give you a referral to a specialist who actually knows what they are doing, but they will charge you just for the referral. But that is what happens when health care becomes a for-profit industry tainted by capitalism.

I completely agree with everything you said regarding the quality, and accessibility of care in the US. When in the US, I hold the act to seeking outside medical advice as a painful last-resort when I certain that I'm truly seriously ill. The waiting times and bureaucratic red-tape are unbelievable for the vast majority of encounters with a health care "professional" in the states.

When in Thailand, its a whole different story of course - I am spoiled for choice, and I'm able to walk into any number of facilities without prior notice and almost always have my needs met with a minimal wait and a minimum of fuss. I can get second, and even third, opinions from different doctors/hospitals in the same day, while spending considerably less time and money than I would just seeing a PA (or even sometimes just an RN) in the US. On the balance, I'll choose the health care options found here in Thailand over the US nine times out of ten for the effectiveness, speed, efficiency, and staggering array of choices... but that is what happens when health care becomes a for-profit industry tainted by capitalism. /snark

/but honestly there is no snark on my opinion of the US health care system, though it does have some brilliant facets, its mostly rotten. I just disagree with the cause you attribute to it.

[waza]

I cant speak for other countries, but healthcare in USA is atrocious, they wheel you out of the hospital as soon as you are conscious, because the hospital bed costs so much...or at least they can bill the insurance company for so much per day. And don't try to go to the emergency room, there is usually a 12 hour wait, because all the people without insurance use the emergency room as their primary physician. And you may be able to get an appointment with a GP or specialist in a week or less, but 1/2 the time, you end up seeing the PA (physician's assistant) instead of the actual doctor. This is especially true of specialists, despite the fact that you pay more and need a referral from your GP to see them in the first place. If you are lucky enough to actually talk to a real life MD, you will be lucky to see them for a whole minute, before they shoot off some script that may or may not work. And if it doesn't work, you get to come back, pay more copays, buy more drugs that might work, and wait. After going through this routine 3-4 times, paying for every visit, they might actually give you a referral to a specialist who actually knows what they are doing, but they will charge you just for the referral. But that is what happens when health care becomes a for-profit industry tainted by capitalism.

I agree with you RauolDuke. I cant comment with any authority on the US system, but after vast experience in Aus, I can honestly say that the for profit private health care system is dragging the whole system down. Not only do the charge high premiums, which require tax payer sudsdies (30%) but olso an increased tax rate for individuals that dont have private insurance (income tested). Private insurance doesnt cover you for all your health needs,and charge a fee above what the insurer will pay (called the gap), which the patient must pay upfront. In conclusion, the private health care system in Australia, costs the tax payers and users more per patient than the publice system, when all things are considered. Is less productive, more selective of the patients they will see, provide less services and give a poorer quality health care.

[asiawatcher]

Isn't Thailand the medical "hub" of Asia

Only for those who can afford it!

[newtronbom]

My wife and I use only 4 doctors, whom we think are worthy of our trust, and I think it is significant that 3 of them are female and the other a farang.

In conversation with one of the ladies I asked that given the levels of bribery, nepotism and the abuse of the examination system in Thailand, would she say that some practicing doctors are a menace to their patients. She mulled it over for a short while and replied that she thought that I already knew the answer. No need to cross the t's and dot the i's there then.

Another of the lady doctors who we met when canvassing for a second opinion said that she was afraid for her grandchildren since upon her demise there wouldn't be a doctor in the family that they could consult with. She added that most young doctors were short on knowledge and ethics and overly concerned with money.

The farang doctor told me that there were no more than 12 or 13 Thai doctors of his particular specialisation for whom he had any professional regard.

The best construction that I could place on medical services available in Thailand is that from a quality point of view it is patchy. There is a lot of gingerbread but not a lot of substance underneath.

My wife and I both use Bangkok hospital. Me Bangkok international, she Bangkok Heart. I have tried several other large and medium private hospitals, but none came close to the quality both professionally and service wise that we get at Bangkok H. It is also not the most expensive place to go generally, though can not compare prices with Gvt Hospitals. The only Gvt Hospital I would go to is Siriraj, but the wait time to see MD there is too long and very crowded. It does have high quality docs and staff though, also medication quite cheap too. Even with an appointment, very long waiting time. In any country, young doctors are short of experience and knowledge. They have just begun their careers. The concern over money is also logical when you realize what it cost them to start practicing and how long many of them went without income, or with very little. Much the same everywhere. As for "professional regard" between specialists, it's the same anywhere. Just look at scientists and physicists worldwide, they are even worse for disclaiming and rubbishing anothers work or theory. The general level and quality of medical care here, is much better than most countries and is far less expensive too. My Mum lives in NZ and I can say that she wishes she could be treated over here. She spent her whole working life in the medical profession, so I think she would know. All the same, you get what you pay for to a point, no matter which country you go.

[Utley]

I cant speak for other countries, but healthcare in USA is atrocious, they wheel you out of the hospital as soon as you are conscious, because the hospital bed costs so much...or at least they can bill the insurance company for so much per day. And don't try to go to the emergency room, there is usually a 12 hour wait, because all the people without insurance use the emergency room as their primary physician. And you may be able to get an appointment with a GP or specialist in a week or less, but 1/2 the time, you end up seeing the PA (physician's assistant) instead of the actual doctor. This is especially true of specialists, despite the fact that you pay more and need a referral from your GP to see them in the first place. If you are lucky enough to actually talk to a real life MD, you will be lucky to see them for a whole minute, before they shoot off some script that may or may not work. And if it doesn't work, you get to come back, pay more copays, buy more drugs that might work, and wait. After going through this routine 3-4 times, paying for every visit, they might actually give you a referral to a specialist who actually knows what they are doing, but they will charge you just for the referral. But that is what happens when health care becomes a for-profit industry tainted by capitalism.

No - that is what happens when you don't stand up for yourself and you allow other people to take advantage of you; capitalism has nothing to do with it.

[jfchandler]

I think it's worth noting that the statistics cited by the Med Association guy in the original article appear to reference only the numbers of positions and vacancies for general physicians and specialists in STATE (Government) hospitals. There's no mention of those kinds of comparisons among the private hospitals. Could it be that the specialists are largely choosing to work in the private sector instead???

I note that because in Bangkok, where I live and have experience, it strikes me as being just the opposite. On those occasions when I've gone to places such as Bumrungrad, BNH, Phyathai or St. Louis, they seem to be awash in stated specialists of all kinds (I won't go into the subject of whether they really know their stated specialty), and yet it seems hard to find a decent general practitioner, particularly one who appears to have any clue of things.

If anyone has a good recommendation for a general practitioner or internal medicine doc in BKK who's competent and sharp, I'd love to hear it...

There are certainly times when you need and want to see a specialist... But there also are probably more instances where a good general medicine doc is needed for all kinds of things related to hopefully maintaining one's good health, like when and whether to get vaccinations, health check-ups, what preventive tests to get as we get older, such as colonoscopy, and -- I think very importantly -- to serve as a good resource for recommending GOOD specialists when the need arises, not just sending you down the hall to whomever may be working that day.

Edited November 13, 2010 by jfchandler

[jfchandler]

And a tidbit from the recent past....

Medical Council Opposes Import of Foreign Doctors

http://www.thaivisa....oreign-doctors/

[hammered]

In the past year I have spoken to about a dozen students who were going to do and or were undertaking medical training. All bar one of them intended to move into cosmetic surgery at the earliest opportunity. I also know several Thai doctors with extremely good English and the right specoalities that have moved with little problem to work in a North America.