Problems with Bangkok Hospital

[scott_cos]

Based upon my recent experience at Bangkok Hospital, the Thai government should abandon the medical hub project.

Living in Thailand a number of years, I was under the impression the major hospitals, especially those advertising their services to the international community were world class. How wrong I was.

Having recently had a run-in with Bangkok Hospital where the urologist was quick to recommend and try to rush me to kidney stone removal surgery without checking prior medical condition (and my cardiac doctor from another hospital advising – after the fact – the surgery could have caused a severe heart episode) to indignant and dishonest hospital staff and unbelievable billing (charged for a visit by a doctor that I never saw – explained away by hospital administrators as a way of “taking care of..” one of my doctor’s colleagues, to charges for a urine test, EKG and HIV test never given and other erroneous charges.

The hospital was truly more interested in getting at what was in my wallet as opposed to caring for my physical well-being.

A letter (and documentation) to the Hospital CEO and Chairman of the hospital Board produced no results (so far) however it is good to know that Joint Commission International (JCI) Accreditation is investigating their accreditation of Bangkok Hospital.

Maybe the international accrediting agencies will help by reigning in the hospitals but the government has to stop supporting these hospitals as the hub of medical care in the region.

I strongly suggest you use another hospital other than those in the Bangkok Hospital Group - there are better hospitals around that care for you as a patient and don't just want your money.

[beano2274]

Bangkok Hospital is well known for looking after the Arabs only am afraid to say.

A good urologist is Dr. Chulin Opanurak at Chula Hospital, I just had a vasectomy reversal and have been pleased with the whole service that was provided, although I did have to share a room with 3 other guys, as the private rooms were being renovated.

[Mobi]

In my experience, all the privately owned hospitals are as bad as each other.

Bangkok Pattaya seems to have been the first to start a multi layered pricing system (which to this day they still virulently deny but which is patently true) and overcharge farangs with whatever they think they can get away with it. But in recent years it seems that most, if not all, the top, non - state hospitals have jumped on the bandwagon. I have been a patient at many - certainly Bumrungrad, BNH, Samitiviej and Bangkok hospital in Bangkok as well as in Pattaya.

This business of not properly checking you medical records and medical history, even though you may be seeing a specialist at a hospital where you records are available to them on line is, in my experience, quite common. There has been more than one occasion when I have had to point out to my specialists that a suggested course of treatment or medication may be at odds with one of many other medical complaints or medications.They have then scrolled through the computer screen in front of them and have agreed with me.

I do hate to say this but I'm afraid it seems to have reached the point where Farangs are considered prime 'targets' - to have the maximum amount of cash extracted from them - and I honestly believe that the doctors have little or no conscience about doing this as they assume that we are only transient patients and in all probability they will never see us again.

I did hear that doctors at Bangkok Pattaya were on some kind of commission basis and this wouldn't surprise me in the least. If not commission, I am sure they are all judged on the amount of fee income and hospital charges they can generate.

I used to attend Bumrungrad regularly and remember a couple of years back, when asking one of my specialists how much a particular treatment would cost, he referred to a 'charge sheet' and told me that as I was an 'old' patient I would be charged at a lower rate than 'new' patients.

I have lost so much faith in all Thai hospitals that I haven't had my various medical complaints checked up by a doctor for over two years now, and as long as I appear to be in reasonably good health I will avoid them like the plague. Quite frankly I would rather have a load of blood tests run by an independent pathology lab, and make my own judgements on any 'anomalies' that may appear in the test results. God knows I have been doing it long enough, at great expense, with all these 'name' hospitals, that I reckon I can analyse the results as well as they can

To those who will tell me that I am talking rubbish and that there are good hospitals with honourable doctors; I will simply remind you that there has been overwhelming anecdotal evidence, in this forum and many others recounting story after story how farangs have been ripped off. This has been going on for years, and I am sorry but there is no smoke without fire.

[chiang mai]

Sorry to hear about your experience at Bangkok Hospital, have to say that mine are not that different - a well regarded Ophthalmologist who really wants to perform cataract surgery despite there not being any real need (per Bumrungrad and two UK ophthalmologists), an ENT unit that stops looking for throat problems at the back at the mouth and refuses to go further, a cardiologist who reads a heart stress test and doesn't spot the existence of a stent, and so on. Like you I get the idea that BPH is all about selling on but without the benefit of care.

On the other hand, I've just come back from having a series of tests at Bumrungrad and yet again I am extremely pleased with all aspects, much of course depends on getting a good doctor and I was lucky enough, with Sheryl's help, to see one of the very best. Cost wise it was not expensive given the volume and nature of the tests and the doctors fee was very reasonable but these things are always subjective I suppose.

[RHCP]

In my experience, all the privately owned hospitals are as bad as each other.

Bangkok Pattaya seems to have been the first to start a multi layered pricing system (which to this day they still virulently deny but which is patently true) and overcharge farangs with whatever they think they can get away with it. But in recent years it seems that most, if not all, the top, non - state hospitals have jumped on the bandwagon. I have been a patient at many - certainly Bumrungrad, BNH, Samitiviej and Bangkok hospital in Bangkok as well as in Pattaya.

This business of not properly checking you medical records and medical history, even though you may be seeing a specialist at a hospital where you records are available to them on line is, in my experience, quite common. There has been more than one occasion when I have had to point out to my specialists that a suggested course of treatment or medication may be at odds with one of many other medical complaints or medications.They have then scrolled through the computer screen in front of them and have agreed with me.

I do hate to say this but I'm afraid it seems to have reached the point where Farangs are considered prime 'targets' - to have the maximum amount of cash extracted from them - and I honestly believe that the doctors have little or no conscience about doing this as they assume that we are only transient patients and in all probability they will never see us again.

I did hear that doctors at Bangkok Pattaya were on some kind of commission basis and this wouldn't surprise me in the least. If not commission, I am sure they are all judged on the amount of fee income and hospital charges they can generate.

I used to attend Bumrungrad regularly and remember a couple of years back, when asking one of my specialists how much a particular treatment would cost, he referred to a 'charge sheet' and told me that as I was an 'old' patient I would be charged at a lower rate than 'new' patients.

I have lost so much faith in all Thai hospitals that I haven't had my various medical complaints checked up by a doctor for over two years now, and as long as I appear to be in reasonably good health I will avoid them like the plague. Quite frankly I would rather have a load of blood tests run by an independent pathology lab, and make my own judgements on any 'anomalies' that may appear in the test results. God knows I have been doing it long enough, at great expense, with all these 'name' hospitals, that I reckon I can analyse the results as well as they can

To those who will tell me that I am talking rubbish and that there are good hospitals with honourable doctors; I will simply remind you that there has been overwhelming anecdotal evidence, in this forum and many others recounting story after story how farangs have been ripped off. This has been going on for years, and I am sorry but there is no smoke without fire.

Difficult to prove conclusively but there is strong suspicion on my part that with regard to doctors, some of them will charge more when it involves a Westerner or if an insurance card is presented. Today I went to my usual hospital, which is a mid-ranged one, where I am used to being charged 400-500 Baht doctor's fee. Today it was 700 Baht for 5 minutes with a general practice doctor, not a specialist. One of the biggest problems in this country is that hospitals seem to have little or no control over what doctors charge, hence the doctors basically have a free hand to charge whatever they want. One can never know how much it will cost for a consultation beforehand which I believe to be an unfair practice.

The only way to determine if us Westerners are being charged more or not is for a Thai and a Westerner to see the same doctor with the same complaint. It would be interesting then to compare the bills.

[lopburi3]

All you have to do is ask and normally they will provide very accurate estimates. And it has always been the same price for myself and Thai wife and other Thai family members but does vary a bit between doctors. And prices have gone up a large amount in the last 5 years but that seems true at every hospital.

[Sheryl]

I have edited the title to be less inflammatory while still conveying the idea.

Was this at Bangkok Hospital in Bangkok, or BPH or where? (as there are many Bangkok Hospital locations, and they do differ in many respects).

Hospitals are buildings. they don't provide care or have attitudes. People working in them do, and they are not all the same.

There are some excellent doctors at Bangkok Hospital (in Bangkok, if that's the one you mean), some average ones, and some not so good ones. The same holds true for the other major hospitals. One has to choose carefully.

Problems with billing are also common and it is always essential to get an itemized bill and check carefully. I assume you got the charges for tests not performed deducted before you paid?

The bit about a charge for a doctor who did not provide services though is a new one to me and the explanation you report seems bizarre, which leads me to think it may not have been Bangkok Hospital in Bangkok but rather one of its branches in a tourist area, hear more of that sort of thing in such settings than in Bangkok....?

Re the failure to check the medical record that alas is a very common failing in Thailand, and even the better doctors tend to skip history -taking, checking for allergies and other medications etc. basically all the special precautions that are routine in the west, are often shrugged off here. They do it with Thai patients too, nothing specific to farangs. I suppose it is the "mai ben rai" philosophy at work, unfortunately that is not a good philosophy in the context of medical care.

[maccaroni man]

In my experience, all the privately owned hospitals are as bad as each other.

Bangkok Pattaya seems to have been the first to start a multi layered pricing system (which to this day they still virulently deny but which is patently true) and overcharge farangs with whatever they think they can get away with it. But in recent years it seems that most, if not all, the top, non - state hospitals have jumped on the bandwagon. I have been a patient at many - certainly Bumrungrad, BNH, Samitiviej and Bangkok hospital in Bangkok as well as in Pattaya.

This business of not properly checking you medical records and medical history, even though you may be seeing a specialist at a hospital where you records are available to them on line is, in my experience, quite common. There has been more than one occasion when I have had to point out to my specialists that a suggested course of treatment or medication may be at odds with one of many other medical complaints or medications.They have then scrolled through the computer screen in front of them and have agreed with me.

I do hate to say this but I'm afraid it seems to have reached the point where Farangs are considered prime 'targets' - to have the maximum amount of cash extracted from them - and I honestly believe that the doctors have little or no conscience about doing this as they assume that we are only transient patients and in all probability they will never see us again.

I did hear that doctors at Bangkok Pattaya were on some kind of commission basis and this wouldn't surprise me in the least. If not commission, I am sure they are all judged on the amount of fee income and hospital charges they can generate.

I used to attend Bumrungrad regularly and remember a couple of years back, when asking one of my specialists how much a particular treatment would cost, he referred to a 'charge sheet' and told me that as I was an 'old' patient I would be charged at a lower rate than 'new' patients.

I have lost so much faith in all Thai hospitals that I haven't had my various medical complaints checked up by a doctor for over two years now, and as long as I appear to be in reasonably good health I will avoid them like the plague. Quite frankly I would rather have a load of blood tests run by an independent pathology lab, and make my own judgements on any 'anomalies' that may appear in the test results. God knows I have been doing it long enough, at great expense, with all these 'name' hospitals, that I reckon I can analyse the results as well as they can

To those who will tell me that I am talking rubbish and that there are good hospitals with honourable doctors; I will simply remind you that there has been overwhelming anecdotal evidence, in this forum and many others recounting story after story how farangs have been ripped off. This has been going on for years, and I am sorry but there is no smoke without fire.

Difficult to prove conclusively but there is strong suspicion on my part that with regard to doctors, some of them will charge more when it involves a Westerner or if an insurance card is presented. Today I went to my usual hospital, which is a mid-ranged one, where I am used to being charged 400-500 Baht doctor's fee. Today it was 700 Baht for 5 minutes with a general practice doctor, not a specialist. One of the biggest problems in this country is that hospitals seem to have little or no control over what doctors charge, hence the doctors basically have a free hand to charge whatever they want. One can never know how much it will cost for a consultation beforehand which I believe to be an unfair practice.

The only way to determine if us Westerners are being charged more or not is for a Thai and a Westerner to see the same doctor with the same complaint. It would be interesting then to compare the bills.

you must come from a national health care system, really to complain about being charged less than 30 dollars for a dr visit at a hospital?

[retiredusn]

Guess I have to say it: I have used Bangkok Group several times over the last few years and have had Great service at a reasonable price. (Chanthaburi) I would recommend this hospital to anyone...........

[Sheryl]

.... Today I went to my usual hospital, which is a mid-ranged one, where I am used to being charged 400-500 Baht doctor's fee. Today it was 700 Baht for 5 minutes with a general practice doctor, not a specialist. One of the biggest problems in this country is that hospitals seem to have little or no control over what doctors charge, hence the doctors basically have a free hand to charge whatever they want. One can never know how much it will cost for a consultation beforehand which I believe to be an unfair practice....

Private hospitals have no control over what the doctor charges, the fee is set by the doctor. If s/he charges more than people are willing to pay, he won't get much business. This is how private medical care works. Even in countries with national health systems, physicians in private practice set their own rates (altho in the West they more often work out of their own offices. In Thailand the custom is to use the OPD facilities of a private hospital).

It is perfectly possibly to find out how much a consultation will cost in advance, you just need to ask specifically what that particular doctor -- whom hopefully you have specifically chosen, by name, based on your own research or someone's recommendation -- charges for a consultation. The fees vary among individual doctors.

Many foreigners seem confused as to the relationship between hospitals and doctors, probably indeed because they are accustomed to dealing with hospitals as part of a public health system. There are public hospitals in Thailand, and as in the West, they set standard fees. Also as in the West, waits are long and red tape considerable (in Thailand made harder for us by all forms, signs etc being written in Thai).

In the context of out-patient care in a private hospital in Thailand the situation is as follows:

Private hospitals make their facilities (consultation rooms, computer and medical record-keeping, book-keeping/fee collection, administrative and nursing staff, janitorial staff, medical waste disposal etc etc) available to doctors who have established "privilges" there. The doctors in essence rent this service from the hospital, although in most cases the hospital does not charge the doctor anything for that, instead making its profit through a flat charge attached to each consultation visit and paid by the patient (often, but less than accurately, described in English as a "nursing service charge") and by profits from the use of their pharmacy, lab, and imaging services when those are utilized.

It is actually a quite cost effective way of operating for physicians as opposed to having to set up, staff and equip their own private offices.

When you consult a doctor as an out-patient at a hospital you are in essence receiving private services from that doctor, not from the hospital. The hospital simply provides the physical infrastructure and support services for the doctor to work in. Beyond that the doctors function quite autonomously.

Which is why one encounters such different views and differing reports from people about care obtained at the same hospital. And why you should take the time to choose the doctor you consult rather than sleecting as hospital and expecting that choice to guarantee a certain level of care and commitment.

Please understand this and don't think in terms of being treated by Hospital X or Hospital Y. That's not what occurs. You get treated by a specific individual doctor working in a private, autonomous capacity.

Should also note that the hospitals referred to in this thread are all for-profit private institutions and make no claim to the contrary. Their primary objective as institutions is to make money. That is not a secret nor anything they hide. It may come as a shock to people who are unaccustomed to private medical care, but that is how it is and there is no need to post "exposes" about it.

Many doctors (and more t=[often than not, the best ones) work full time, at a comparatively low salary, in a public hospital and then offset an otherwise insufficient wage through private practice in their off hours. So their primary reason for having hours at a private hospital is to make additional income, and they do so at the expense of family and leisure time so as to be able to continue to serve in the public health system. In this context it makes total sense for them to charge what the market will bear. It is assumed that those who cannot afford this will access care through the public system and that those who consult them privately are willing and able to pay more for the convenience.

Lastly please note that there are non-profit alternatives other than just the government hospitals, and costs at the private non-profits are less than at the for-profits. They still need to recoup their costs, though (no government support).

[scott_cos]

I have edited the title to be less inflammatory while still conveying the idea.

Was this at Bangkok Hospital in Bangkok, or BPH or where? (as there are many Bangkok Hospital locations, and they do differ in many respects).

Hospitals are buildings. they don't provide care or have attitudes. People working in them do, and they are not all the same.

There are some excellent doctors at Bangkok Hospital (in Bangkok, if that's the one you mean), some average ones, and some not so good ones. The same holds true for the other major hospitals. One has to choose carefully.

Problems with billing are also common and it is always essential to get an itemized bill and check carefully. I assume you got the charges for tests not performed deducted before you paid?

The bit about a charge for a doctor who did not provide services though is a new one to me and the explanation you report seems bizarre, which leads me to think it may not have been Bangkok Hospital in Bangkok but rather one of its branches in a tourist area, hear more of that sort of thing in such settings than in Bangkok....?

Re the failure to check the medical record that alas is a very common failing in Thailand, and even the better doctors tend to skip history -taking, checking for allergies and other medications etc. basically all the special precautions that are routine in the west, are often shrugged off here. They do it with Thai patients too, nothing specific to farangs. I suppose it is the "mai ben rai" philosophy at work, unfortunately that is not a good philosophy in the context of medical care.

My experience was with Bangkok Hospital in Bangkok which I had gone to a couple of times before with no problems. But, as a representative in their Risk Management Department admitted, when they have problems with a patient, it seems there is a multitude of problems and not just one. I unfortunately was one of those patients with a multitude of problems.

The hospital did not give me an itemized list of charges until nearly two weeks after discharge and AFTER they had submitted charges to my insurance company. So here I am explaining to my insurance company why they needed to charge back costs to the hospital. Impression I got from the insurance company was they didn't care much what the bill was - they had approved it and paid it BUT it reflects back on my record when renewal time comes around. To this day, I do not know if they got things straightened out with the hospital.

Exactly one year before at the same Bangkok Hospital I went through a 12,000 Baht physical exam which is in their computer records. When they punch in my hospital number - my entire record should come up.

In his apology letter to me, the Chairman of the Board of the hospital group (yes, I had written a 12 page letter to him) explained that the doctor did see my former record and that is why an EKG (which was never given) was ordered up. Problem with his explanation - it is procedure at this hospital that ALL patients have an EKG before surgery. According to my cardiologist at another hospital - a cardiologist at Bangkok Hospital should have immediately talked to me, asked me history and done a few other tests prior to certifying me ok for the surgery. Cardiologist at the other hospital said I was at great risk for having a "heart episode" had I undergone surgery as ordered by urologist at Bangkok Hospital.

In mentioning attitudes, I was referring to the nurses on my ward. It was amazing, being charged 6,900 Baht for a room on an international ward and having 1) nurses that spoke very little English; 2) nurses that were indignant (at times) about my care and whom like the doctor, cared more about squeezing money out of me.

To be fair, after I compained about being given an expensive room after I had requested one at lessor cost (I was told there were none available - everyone paid the same - which was a complete lie), room rate on final bill was discounted substantially.

Regarding prior notice of charges, in fact, paperwork that the hospital gives you to sign DOES indicate the patient is entitled to an estimate of charges. However I never received one until I asked, several times, for one.

Risk Management Department rep explained charges for a doctor that did not treat me was an agreement between the urologist and that doctor as the urologist on duty was substituting for the other doctor whose charges were somewhat more than the urologist that was supposed to treat me. If it doesn't make sense to you - that's ok, it doesn't make sense to me either.

All in all it was a nightmare of an experience. Folks, especially farang, need to shop carefully before committing to a hospital. That is one reason why this"medical hub" program is such a dangerous enterprise for the country to promote. All we need is a few cases of international visitors traveling to Thailand and receiving substandard care and dying in the process and the country gets another black eye.

[khunbaobao]

My experience was with BNH hospital on Soi Convent, and it was a positive one.

For people with health concerns who've never come to Thailand because they've been worried about the health care available, I can offer my story here:http://khunbaobao.blogspot.com/2010/11/sick-on-holiday-bangkoks-bnh-hospital.html

Granted, it's only one man's opinion about one hospital, but perhaps it will spark a few others into sharing their positive experiences so newbies (and others) can make mental note of medical services in Thailand.

I'm sorry the original poster had a problem at the hospital he was at. Let's hope it was more an exception than a rule.

[SiamRose]

Hospitals are buildings. they don't provide care or have attitudes.

True, of course. But senior management in any commercial organisation can and do influence the way the employees, and even independent consultants, treat the customers.

Bangkok Hospital is well known for looking after the Arabs only am afraid to say.

Even their best customers are having problems with Bangkok Hospital.

Abu Dhabi: A renowned international hospital in Bangkok discharged against their will 10 Emirati patients who were in critical condition and still receiving treatment,Gulf News has learnt.

According to a source at the UAE Embassy in Bangkok, the embassy had to have all 10 patients admitted to other hospitals in Bangkok, on Monday. The patients had originally been admitted by the Bangkok Hospital Medical Centre (BMC) suffering with conditions including cancer, heart problems, paralysis and old age. The patients' expulsion followed a financial dispute.

[haveaniceday]

Lastly please note that there are non-profit alternatives other than just the government hospitals, and costs at the private non-profits are less than at the for-profits. They still need to recoup their costs, though (no government support).

Can anybody list or recommend any of these non-profit hospitals?

[Wavefloater]

In my experience, all the privately owned hospitals are as bad as each other.

Bangkok Pattaya seems to have been the first to start a multi layered pricing system (which to this day they still virulently deny but which is patently true) and overcharge farangs with whatever they think they can get away with it. But in recent years it seems that most, if not all, the top, non - state hospitals have jumped on the bandwagon. I have been a patient at many - certainly Bumrungrad, BNH, Samitiviej and Bangkok hospital in Bangkok as well as in Pattaya.

This business of not properly checking you medical records and medical history, even though you may be seeing a specialist at a hospital where you records are available to them on line is, in my experience, quite common. There has been more than one occasion when I have had to point out to my specialists that a suggested course of treatment or medication may be at odds with one of many other medical complaints or medications.They have then scrolled through the computer screen in front of them and have agreed with me.

I do hate to say this but I'm afraid it seems to have reached the point where Farangs are considered prime 'targets' - to have the maximum amount of cash extracted from them - and I honestly believe that the doctors have little or no conscience about doing this as they assume that we are only transient patients and in all probability they will never see us again.

I did hear that doctors at Bangkok Pattaya were on some kind of commission basis and this wouldn't surprise me in the least. If not commission, I am sure they are all judged on the amount of fee income and hospital charges they can generate.

I used to attend Bumrungrad regularly and remember a couple of years back, when asking one of my specialists how much a particular treatment would cost, he referred to a 'charge sheet' and told me that as I was an 'old' patient I would be charged at a lower rate than 'new' patients.

I have lost so much faith in all Thai hospitals that I haven't had my various medical complaints checked up by a doctor for over two years now, and as long as I appear to be in reasonably good health I will avoid them like the plague. Quite frankly I would rather have a load of blood tests run by an independent pathology lab, and make my own judgements on any 'anomalies' that may appear in the test results. God knows I have been doing it long enough, at great expense, with all these 'name' hospitals, that I reckon I can analyse the results as well as they can

To those who will tell me that I am talking rubbish and that there are good hospitals with honourable doctors; I will simply remind you that there has been overwhelming anecdotal evidence, in this forum and many others recounting story after story how farangs have been ripped off. This has been going on for years, and I am sorry but there is no smoke without fire.

Difficult to prove conclusively but there is strong suspicion on my part that with regard to doctors, some of them will charge more when it involves a Westerner or if an insurance card is presented. Today I went to my usual hospital, which is a mid-ranged one, where I am used to being charged 400-500 Baht doctor's fee. Today it was 700 Baht for 5 minutes with a general practice doctor, not a specialist. One of the biggest problems in this country is that hospitals seem to have little or no control over what doctors charge, hence the doctors basically have a free hand to charge whatever they want. One can never know how much it will cost for a consultation beforehand which I believe to be an unfair practice.

The only way to determine if us Westerners are being charged more or not is for a Thai and a Westerner to see the same doctor with the same complaint. It would be interesting then to compare the bills.

you must come from a national health care system, really to complain about being charged less than 30 dollars for a dr visit at a hospital?

I didn't get the impression that it was a complaint about the 700 baht charge, per se. I thought he or she was pointing out the proportionally high increase or perhaps the random nature of billing.

Edited November 23, 2010 by Wavefloater

[Mobi]

While I generally have no argument concur with what Sheryl has to say on this subject, I'm afraid there are just too many instances of poor/bad/downright shoddy medical practice and overcharging/scamming farangs in Thai private hospitals to just dismiss it all by saying that you should choose your specialist carefully.

I have had very good service in a number of hospitals and also some very bad experiences in those very same hospitals. It really is a medical lottery and the poster who suggested that is highly questionable to describe Bangkok a medical hub is spot on.

I have enough stories of both my own and friends' experiences to fill a book, but let me just tell you one.

About 6 months ago I fell over heavily on my right wrist and smashed a number of bones very badly. I was admitted to Bangkok/Pattaya hospital and a surgeon led a team of 4 doctors in a 4 hour operation to unscramble my bones and insert a metal T-pin to 'tie' them all back in place. It was very painful and there has been a long recovery. As far as I know, the operation was carried out with care and professionalism and was a success, although I am still experiencing pain and I doubt I will ever regain full use of my wrist.

Upon discharge, the specialist prescribed me pain killers and I asked him if he could prescribe something to help me sleep, which he did. Unknown to me, he prescribed me with a highly addictive 'anti-depressant' and repeated the prescription on a subsequent out patient visit. In fact, It was Sheryl herself, who warned me to stop taking these meds when I told her what I was taking, and it was a quite a task to wean myself off them. IMHO, the prescribing of these drugs, without even warning me of their addictive properties, was highly irresponsible, especially when there are so many safe, non-addictive alternatives.

If this surgeon had done such a thing in the UK I am sure he would have been censured and quite possibly 'struck off'. In all, I went back to see this surgeon 3 times for follow up inspection of my wound, and it was only on the last occasion, some 4 months down the line that I asked him whether I should be doing physiotherapy to get my wrist moving again. He then told me that I should have started doing exercises months ago, but he hadn't told me so how was I to know?

What this story clearly illustrates is that while some doctors may be highly qualified and skilled in their chosen fields, some with impressive overseas qualifications and experience, their general attitude to the needs and care of their patients is often sadly lacking. It seems that we are just a bunch of sheep queueing up to be sheared, and if the odd one gets trampled under foot or gets his head cut off by accident, then it is just all part of a day's work.

For many of them the Hippocratic oath and 'duty to patients' is a meaningless diatribe and their main motivating factor is to generate as much fee income as they are able and there is no effective law to make them do otherwise.

Incidentally, a couple of years back, a farang doctor working for Bangkok/Pattaya in an admin capacity, gave a talk to some local businessmen and admitted that they charged more for a 'farang' consultation than a Thai consultation because the farangs came armed with information on their condition, downloaded from the internet and always asked too many questions, which meant the consultations took longer.

Farang/Thai logic.....

Ad for public hospitals - well, the less said the better. All I will say is that on two instances that I know of personally, the hospitals failed to tell the patient or the patient's family that the patient was dying of HIV AIDs until it was too late to do anything, even though they were aware of the patient's condition from the start. In one instant the patient might have been saved had the husband been told the truth about his wife's condition.