Asean FTA May Cause Exodus Of Thai Doctors

[webfact]

Asean FTA may cause exodus of doctors

By Pongphon Sarnsamak

The Nation

The ease of movement under the Asean freetrade agreement might encourage skilled medical personnel to opt for better paying jobs outside Thailand.

"The Asean FTA is a scary thing," Dr Anuwat Sopachutikul said.

Anuwat, director of the Healthcare Accreditation Institute, was speaking on "bringing healthcare in Thailand up to worldclass level" at Siriraj Hospital, organised by the Thailand Productivity Institute.

Since there are no laws controlling medical workers or keeping tabs on their ability, skilled personnel can freely move to other Asean countries leaving Thailand bereft of good doctors, he added.

Even though the Medical Council has procedures to control the qualifications of doctors by requiring them to sit for exams before they are given a medical licence, there is a loophole that allows unlicensed doctors work freely under the supervision of a hospital. The government should conduct a study to analyse the positive and negative aspects of Thailand's healthcare system.

Anuwat also expressed concerns over the adverse impacts on the country's healthcare system brought on by the government's policy on making Thailand into a medical hub.

He said this policy would encourage skilled doctors and medical personnel to work in private hospitals to earn more money, which would adversely affect poor people.

"The government should not promote the country as a medical hub. In fact, it would be better if the government lets the private sector do this itself. Maybe all these hospitals will need is easy access for foreign patients to get treated here," he added.

Anuwat said the government should control the quality of hospitals, the price of services rendered and ensure that the latest technology is put to optimum use instead of promoting Thailand as a medical hub, because that would only benefit private hospitals.

"The government is not maintaining a balance between generating revenue and keeping healthcare services fair," he said.

The Health Service Support Department will on Monday hold a public hearing on the implementation of the medical hub policy at Bangkok's Ambassador Hotel.

-- The Nation 2011-01-28

[londonthai]

"there is a loophole that allows unlicensed doctors work freely under the supervision of a hospital"

that is scary.

how many thai (and foreigners coming from far away for the serious conditions) are aware, that they are treated by the butcher?

[bushwacker]

You make a very good point. But we also know that in Thailand that if you have to take an exam and cannot pass it .... then all you do is pay extra money and buy your license. For example, my GF needed to drive a pick up truck for work but had only driven bikes all her life. She practiced and could not get the hang of parking, or driving backwards. She went for the license and paid 1000 baht to the tester in lieu of taking the test. She past ..... hihihihihihihi .... got her license and now is one of the many poor nervous drivers on the road.

Same same with everything here.

[geriatrickid]

"there is a loophole that allows unlicensed doctors work freely under the supervision of a hospital"

that is scary.

how many thai (and foreigners coming from far away for the serious conditions) are aware, that they are treated by the butcher?

No it isn't, Interns are MDs and they perform many of the most miserable duties in hospitals, but they usually are not licensed to practice as physicians. Iterns typically write the exam after the internship. Some 1st year residents have yet to pass their medical licening exam. If interns were withdrawn from many big city hospital ERs, the health system would collapse. In many of the west's big hospitals some ERs do not have an experienced physician on duty between 02:00 and 07:00 hours or when there is a holiday. What is usually available is a senior resident. An experienced physician might be on call. Who do you think usually performs part of a lengthy surgical procedure? It is the surgical resident. They can clean out the wound or close up the incision. Cheap labour. Patients don't know that because they are passed out.

[silk]

"there is a loophole that allows unlicensed doctors work freely under the supervision of a hospital"

that is scary.

how many thai (and foreigners coming from far away for the serious conditions) are aware, that they are treated by the butcher?

You are righ, but I think Anuwat should be congratulated.

Quote: "Anuwat said the government should control the quality of hospitals, the price of services rendered and ensure that the latest technology is put to optimum use instead of promoting Thailand as a medical hub, because that would only benefit private hospitals"

Let's hope this will happen

[Kilgore Trout]

Great, another hub; hubba hubba

[asiawatcher]

I doubt there will be an exodus of Thai doctors - they are usually family guys and love their country way too much.

[tigermonkey]

I doubt there will be an exodus of Thai doctors - they are usually family guys and love their country way too much.

However, it could become very tempting for many young doctors, who work for small country hospitals for very low wages. We have four doctors at our local hospital, all under the age of 30 -- two single and two married with children. They each make between 30,000 and 35,000 Baht per month. They are all good competent physicians, and need to work long hours and shift work.

One, who is a good friend, works all of his evenings and days off as an electrician, so that his wife can stay home with the children.

There is a limit to patriotism.

[atyclb]

You make a very good point. But we also know that in Thailand that if you have to take an exam and cannot pass it .... then all you do is pay extra money and buy your license. For example, my GF needed to drive a pick up truck for work but had only driven bikes all her life. She practiced and could not get the hang of parking, or driving backwards. She went for the license and paid 1000 baht to the tester in lieu of taking the test. She past ..... hihihihihihihi .... got her license and now is one of the many poor nervous drivers on the road.

Same same with everything here.

Very unlikely a bribe will get anyone a passing grade on the medical board exam or even be an option. There is way too much ego and status involved among those in control, usually grads of famous schools and often did more training in usa.

Case in point, one private(non famous) U in BKK,, lets say Univ X, grads have a pass rate of 50% on the national exam, and those are wealthy kids. One would imagine if a bribe could insure a passing grade and students were unethical enough, the passing rate would be much higher. What does 50% mean? Not terrible, means that they will likely pass exam on second attempt.

The other dilemma is the lack of benchmark to compare a 50% pass rate with since grads of the famous schools are exempt from the national exam, although there was talk about requiring everyone from every university to take the national exam. Students may be quite competent but if they dont target studies specifically for yet another exam, the pass rate will be lower.

In general the quality of medical education throughout thailand is quite good. Prince Mahidol, the father of our current King, graduated Harvard and essentially imported the US system to thailand.. Typically thai grads do very well on usa(very tough) exams.

[ronrat]

Aside from singapore, which has exacting rules, what ASEAN country will pay more. Possibly Malaysia and Borneo but Thais won,t be overly comfortable in Muslim nations.

Edited January 28, 2011 by ronrat

[Bagwan]

Case in point, one private(non famous) U in BKK,, lets say Univ X, grads have a pass rate of 50% on the national exam, and those are wealthy kids. One would imagine if a bribe could insure a passing grade and students were unethical enough, the passing rate would be much higher. What does 50% mean? Not terrible, means that they will likely pass exam on second attempt.

This logic is flawed. Think about it.

[atyclb]

Case in point, one private(non famous) U in BKK,, lets say Univ X, grads have a pass rate of 50% on the national exam, and those are wealthy kids. One would imagine if a bribe could insure a passing grade and students were unethical enough, the passing rate would be much higher. What does 50% mean? Not terrible, means that they will likely pass exam on second attempt.

This logic is flawed. Think about it.

Can you be more specific?

BTW, the rule that allows non Thai doctors to work in Thailand without a Thai medical license is not really a problem. It allows competent licensed doctors from other countries to work without having to re-do all the exams.

Usually anyone licensed in a G7 country has undergone very tedious supervised training and taken very difficuly exams already.

[sparebox2]

I doubt there will be an exodus of Thai doctors - they are usually family guys and love their country way too much.

However, it could become very tempting for many young doctors, who work for small country hospitals for very low wages. We have four doctors at our local hospital, all under the age of 30 -- two single and two married with children. They each make between 30,000 and 35,000 Baht per month. They are all good competent physicians, and need to work long hours and shift work.

One, who is a good friend, works all of his evenings and days off as an electrician, so that his wife can stay home with the children.

There is a limit to patriotism.

Don't worry Dr. that takes 30-35K are those who don't speak (resonable) English. And they make up the majority of Thai doctors. Singapore hospital don't want them.

[sparebox2]

Aside from singapore, which has exacting rules, what ASEAN country will pay more. Possibly Malaysia and Borneo but Thais won,t be overly comfortable in Muslim nations.

Why not?

Southern Thai are mostly Muslim.

[geriatrickid]

"there is a loophole that allows unlicensed doctors work freely under the supervision of a hospital"

that is scary.

how many thai (and foreigners coming from far away for the serious conditions) are aware, that they are treated by the butcher?

Not many. As well, thIs would surprise some people to know that open heart surgery or some of the more complicated procedures are often performed by surgical residents in Thailand just like in the west. Sometimes, the medical devices sales rep will be present if they are having a go with a new piece of equipment. There are things patients never are told.

Edited January 22, 2012 by Scott
formatting

[atyclb]

"there is a loophole that allows unlicensed doctors work freely under the supervision of a hospital"

that is scary.

how many thai (and foreigners coming from far away for the serious conditions) are aware, that they are treated by the butcher?

Not many. As well, thIs would surprise some people to know that open heart surgery or some of the more complicated procedures are often performed by surgical residents in Thailand just like in the west. Sometimes, the medical devices sales rep will be present if they are having a go with a new piece of equipment. There are things patients never are told.

A fellow in CV surgery has already completed 5 years or more of a grueling surgery residency. There is a point residents do indeed have the skill and competence to do it. Lower level resident will typically assist with an upper level person, either attending or senior resident.

[Thai at Heart]

They are having problems with importing physicians into the UK because of English language ability.

I wonder which languages the respective countries will mandate as being necessary to operate as a physician in say Singapore? If they have to have a proven language ability in English or Chinese to a certain level, this will prevent a very large percentage of physicians even being allowed to apply.

Many medical staff do speak enough English to exist in the Thai system handling foreign patients. However, this doesn't necessarily mean it makes it possible for them to conduct their entire working day in a foreign language.

Is this the start of standardising the "languages" of Asean? Plenty of languages to choose from in that case.