Prices At Chiang Mai Ram Hospital

[DavidInSiam]

I have been a patient at Chiangmai Ram for 16 years.

Today, I went to have a small sebaceous cyst removed from the back of my neck. The surgeon there, Dr. Seri, said that the cost would be 15,000 Baht for the half-hour procedure.

I knew this was crazy, so I went to Sripat Hospital. I had the procedure done there for 1,800 Baht, including medicine.

Many other people I know are also complaining about the prices. Even the excellent Bumrungrad Hospital, in Bangkok, is cheaper than Ram.

Chiangmai Ram has lost me as a patient.

[jaideeguy]

Mee too......years ago I had several sebaceous cysts removed in the emergency room while I was in for a routine flu vaccine and the attending dr was a surgeon and I casually enquired about removing them while I was there and he said no plobrem and cut them off @ 1,000thb ea. They all returned about 4 yrs later.

But [with the exception of 3 or 4 of their best drs] I mostly go to the old Ram2 [Thepanya].....a little older, and like any hospital, you have to choose the best drs yourself, but at least they don't rip you off like Ram 1, which is lacking in maintenance and not the shiny new clean hospital that it used to be. It's starting to look like the run down Kad Suan Keaw next door.

[ProThaiExpat]

I suspect the surgeons themselves have a lot to do with the charges levied for their operations. Dr. Ekachai, a general surgeon at Ram did a skin lesion removal, excision biopsy with a two inch incision, for 1500 baht in the ER a couple of months ago. Of course the hospital charged as much in addition for the facilities and supplies.

A friend, a month later , had a herniated navel surgery by Dr. Ekachi there and shopped the price, government hospital falang clinic, Ram etc. and was quoted and he payed 15,000 surgeons fee. Ram started providing a separate paper outlining the surgeons fee recently so I suspect there has been a major change.

I had another surgery two months ago where a large skin lesion was removed by Dr. Annan, a plastic surgeon who works Nakon Ping Government hospital, Lanna Hospital and Ram and he charged me 15,000 baht. He insisted on using the operating room so I had it done at Lana, where the hospital fees are about 25% cheaper than Ram. I suspect he played "big surgeon" with me and when I challenged him on what I thought was too large a fee for an hour long skin excision, he said Plastic Surgeons get more that general surgeons.

I have reached the conclusion the the doctors at Ram, who also practice at the government hospital clinic for falang all collude with each other and have raised their fees for most surgeries. My plastic surgeons fee for my last excision equaled what I paid a surgeon in Australia six months ago for almost the same surgery and he did it in his office.

Two years ago when I had a number of lesions removed by the senior male dermatologist at Ram who said he charged much less that Bangkok doctors, lowered his overall fee for some laser work after I showed him what Yanee Hospital in Bangkok charged for the same work as advertised on their website.

I intend to shop surgeons fees in the future and have an agreement on what the fee is before letting them touch me. While I might not do much better, at least when I am hurting and show up at the cashier, I won't experience the sticker shock I have experienced lately.

Edited February 2, 2011 by ProThaiExpat

[DavidInSiam]

I received the following email from Chiangmai Ram. It is absurd, and implies that a full medical workup, including chest x-ray, etc., is required for any outpatient surgical procedure; such as having a tooth extracted or getting three stitches for a cut . . . .

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I have received your email already, and let me to explain you about the policy of Chiangmai Ram Hospital.

Our policy is about the safety of the patient’s admission in the hospital for operation.

The patient will have the blood tests, CBC, Urine exam, Chest X-ray, EKG and etc. All of the test should do if the patient’s age is 40 years old or more.

It is very important that the patient has to do examination by the Internist for check up before the operation, to find out that he has no risk for heath disease or the other problems, all purposes are for safety.

A few days ago, there was one case that the doctor performed the operation in his clinic without evaluation, the operation was minor, just excised the mass from eyelid. After the doctor infected local anesthetic, the patient has had cardiac arrest.

The CPR was done, but failed and he passed away. From autopsy result found that he had an acute MT. This is to inform you why Chiangmai Ram Hospital has a policy to reduce a risk, we have to evaluate you before the operation, so the cost was more expensive because of we would like to check with all necessary evaluation to save you sir.

We are sorry to make you difficult and disappointed; we would like you to understand us how important to save the patient from any operation.

Yours sincerely

Amnuay C., M.D.

Medical Staff Organization.

[ProThaiExpat]

As a ten year veteran of RAM, I would suggest to the internist that other than the obligatory pre-admission "examination", blood tests or other diagnostic procedures be not done as you have had recent such examinations.

I recently had a large skin lesion removed by the plastic surgeon at RAM, who insisted that it was an operating room procedure rather than an emergency room procedure. I said fine, lets have it at Lana hospital and when meeting with their on duty internist for their obligatory pre-surgery exam, I showed him my two month old general health checkup lab work from RAM, and he cleared me without an exam. Prior lesion excisions by Dr. Ekachai a general surgeon at RAM done in the emergency room were done without any clearance by the interist.

Four admissions for surgery at Ram three years ago were all cleared by their on duty internist, but not once did he perform an examination, he merely reviewed my chart and charged 500 baht. The operations all involved epidural blocks and sleep during the surgery, but the surgeries were on my thigh for a comminuted displaced femur fx. By the way, for the first two surgeries and 10 day stay, the duty internist showed up daily and reviewed by chart. My ortho said my advanced age, made him nervous and evidently he didn't trust his own knowledge of internal medicine. In the US, orthopedic surgeons usually proceed based on their own knowledge of internal medicine.

[elektrified]

The Doctors do not make the prices at Ram, the hospital does. Regarding Dr. Siri, he has got to be one of the most reasonably priced doctors in Thailand, considering his skills and reputation. Sometimes he only charges 50 Baht to be seen at his clinic! For a University professor?? He worked on me for more than 2 hours with the laser and only charged me something like 2,000 Baht. He will even tell you that if he has to see you at Sripat that it will cost more, and if he sees you at Ram that it will cost much, much more, and for simple procedures to come to his clinic.

In the USA, no doctor in his/her right mind would operate on someone without taking tests before-hand. It is for the safety of the patient. When I had hernia surgery at the surgeon's outpatient clinic a few years back, I had to go the day before and take blood and urine tests, a chest x-ray, etc. They need to know your physical condition before administering anesthesia. It is obviously the same here.

[ProThaiExpat]

The Doctors do not make the prices at Ram, the hospital does. Regarding Dr. Siri, he has got to be one of the most reasonably priced doctors in Thailand, considering his skills and reputation. Sometimes he only charges 50 Baht to be seen at his clinic! For a University professor?? He worked on me for more than 2 hours with the laser and only charged me something like 2,000 Baht. He will even tell you that if he has to see you at Sripat that it will cost more, and if he sees you at Ram that it will cost much, much more, and for simple procedures to come to his clinic.

In the USA, no doctor in his/her right mind would operate on someone without taking tests before-hand. It is for the safety of the patient. When I had hernia surgery at the surgeon's outpatient clinic a few years back, I had to go the day before and take blood and urine tests, a chest x-ray, etc. They need to know your physical condition before administering anesthesia. It is obviously the same here.

Elektrified:

I couldn't find Dr. Siri on Ram's list of staff, but many of the visiting CMU professors are not listed. May I have his clinic name and address with phone number and his speciality. Thank you

[DavidInSiam]

The Doctors do not make the prices at Ram, the hospital does. Regarding Dr. Siri, he has got to be one of the most reasonably priced doctors in Thailand, considering his skills and reputation. Sometimes he only charges 50 Baht to be seen at his clinic! For a University professor?? He worked on me for more than 2 hours with the laser and only charged me something like 2,000 Baht. He will even tell you that if he has to see you at Sripat that it will cost more, and if he sees you at Ram that it will cost much, much more, and for simple procedures to come to his clinic.

In the USA, no doctor in his/her right mind would operate on someone without taking tests before-hand. It is for the safety of the patient. When I had hernia surgery at the surgeon's outpatient clinic a few years back, I had to go the day before and take blood and urine tests, a chest x-ray, etc. They need to know your physical condition before administering anesthesia. It is obviously the same here.

Elektrified:

I couldn't find Dr. Siri on Ram's list of staff, but many of the visiting CMU professors are not listed. May I have his clinic name and address with phone number and his speciality. Thank you

[DavidInSiam]

According to an accountant at Ram, the doctors set their own prices. They can charge whatever they wish, up to a certain limit. Other charges, such as medicine, tests, etc. have fees set by the hospital.

You seem to have had good luck with Dr. Siri. That's useful information. Perhaps because I was well-dressed and told him that Bumrungrad is my primary hospital, he assumed I had deep pockets.

Dr. Siri did not request that I had any tests, prior to the 20 minute procedure to remove a small cyst. My reply to Chiangmai Ram's email follows:

None of this was the case. Dr. Seri examined my cyst for a moment and made an appointment for me to come the next day for the outpatient surgery. He said that it would take less than a half hour. He did not mention any of the (unnecessary) tests that you list in your email.

In fact, Dr. Seri only asked me one question about my medical history: whether I am allergic to any medicines. You can look at his notes.

Also, I have recently had all the tests you mention, at Bumrungrad Hospital. Dr. Seri did not ask about any of them.

What you are saying is that any outpatient surgical procedure at Ram should require all these tests. So, if I have a tooth extracted, or stitches for a minor cut, I would be required to have a chest x-ray, etc, beforehand. This is nonsense. It is not the policy at Ram (or any other hospital in the world) and you know it.

Ram’s reputation has gone down considerably in the last few years. The building is not well maintained, the clerical staff is poorly trained, and many of the nurses are resigning. The salaries you pay to your employees are ridiculously low (a friend of mine was an accountant at Ram for many years). In addition, the fees have increased tremendously.

Since my experience of Ram trying to grossly overcharge me, I have spoken with twelve other foreigners living in Chiang Mai who have similar complaints and have switched to other hospitals.

[Brian Allen]

.... twelve other foreigners living in Chiang Mai who have similar complaints have switched to other hospitals ....

Seems the important part of their so doing is to which hospital(s) and what were the consequences? (As most effectively and usefully described in your earlier Ram/Sripat post)

Any idea? I have an orthopedic surgery imminent and have only ever used Ram.

Thanks in anticipation - Brian