Hospital/Nurse Service Charges

[RHCP]

As most of you will know, many private hospitals here have in recent years introduced a way of extracting more money from us when seeing a doctor. Can one insist on not having these routine services such as measuring blood pressure, checking body weight and temperature, etc, as I don’t view them as necessary in the vast majority of visits that I make?

[lopburi3]

I would try to look at them as one of the most likely checks to find an unknown issue and get you the attention it may require. It serves you, doctor and if you have fever can help to limit the spread of disease. They list it as a line item on bills for reference reasons but any doctor will require this information so has always been a part of the total bill for service. I do understand that is may not be necessary every time but exceptions would remove the preventative nature of the service and could cause both physical and legal issues. Believe a firm and set procedure is justified in this case. It is really not an extra charge - just an itemized item now.

Insurance companies want such detailed bills and it seems some consumers must also as my home telephone bill 18 years ago in the USA ran several pages of breakdown for tax amounts (many) that made up the total.

If your doctor visit reads 600 for doctor and 150 for nursing charge just think of it as 750 baht per visit (which it would be if not broken down).

[Sheryl]

1. You can refuse these things if you want but it will not change the charge, which is unrelated to whether or not your vital signs are taken. (There are,in fact, other things the nursing staff do that are less visible to you, e.g. pulling up your medical records, managing patient flow, etc). Basically as I understand it, this charge is the hospital's while the other is the individual doctor's, and it is what the hospital receives in exchange for use of its facilities and staff (nursing, administrative, janitorial etc etc). It is not a specific fee for having your weight and vital signs taken. Those things are done because they are standard medical practice, anywhere in the world.

2. You may not think vital signs and weight are necessary, but as a health professional I am at a loss to think of a circumstance in which it would not be important in order to safely provide medical care. Even if not directly related to the reason for your visit, the presence of a fever or abnormal BP would have implications for what treatments/drugs you could or could not safely receive. And weight is relevant to drug dosage. It is basic information that any helatrh care provider needs to have before addressing whatever the patient complaint may be.

[Thanyaburi Mac]

One item I tend to decline is Tylenol along with other meds that may be prescribed. Seems like some hospitals automatically include these, so I automatically go back to the cashier, turn them in, and request a rewrite of the bill, and a refund for the difference.

Mac

[beano2274]

I paid Hospital service charges, but no tests were carried out, it is part and parcel of using the Hospitals.

[RHCP]

1. You can refuse these things if you want but it will not change the charge, which is unrelated to whether or not your vital signs are taken. (There are,in fact, other things the nursing staff do that are less visible to you, e.g. pulling up your medical records, managing patient flow, etc). Basically as I understand it, this charge is the hospital's while the other is the individual doctor's, and it is what the hospital receives in exchange for use of its facilities and staff (nursing, administrative, janitorial etc etc). It is not a specific fee for having your weight and vital signs taken. Those things are done because they are standard medical practice, anywhere in the world.

2. You may not think vital signs and weight are necessary, but as a health professional I am at a loss to think of a circumstance in which it would not be important in order to safely provide medical care. Even if not directly related to the reason for your visit, the presence of a fever or abnormal BP would have implications for what treatments/drugs you could or could not safely receive. And weight is relevant to drug dosage. It is basic information that any helatrh care provider needs to have before addressing whatever the patient complaint may be.

I do respect your responses as a health professional Sheryl but when I lived in the UK and visited my GPs, none of these vital signs were taken as standard practice. The doctor would listen to a description of the symptoms I gave then decided on how to proceed. There were some occasions when my temperature or blood pressure was taken as a result but in the vast majority of cases these vital signs were not taken. I think you will agree that doctors in the UK are no less responsible than doctors in Thailand.