Do I Have A Right To Know..

[JungleBiker]

Hello Everyone,

I recently broke a leg and had two metal plates and 11 screws attached to my left tibia and fibula.

Can anyone tell me if I have a right to know the manufacturer or supplier, models and sizes of the screws and plates?

I think if I went to a garage to change the oil and filter, or the tyres, battery, etc, in my car I would be given this information if I asked. Surely what is inside my body is more important to me that what is inside my car.

I did ask one of the customer service people in the hospital and she said I should ask the doctor. So I asked if there was a person or department that deals with this stuff (e.g. orders and stocks the items and then crosses items off their stock list when it goes out of the door). She said no and again she said I should ask the doctor. I didn't really want to ask the doctor because I had already sensed that he did not want me to know and i didn't want to irritate the person who was still taking care of me. But anyhow, I did ask the doctor and he mumbled and flicked through his files and pretended not to be able to find the details and said the plates were from overseas, from AO. I said what is AO and he vaguely said.. "errr.. American Orthopedics or something like that". He didn't give me any other details and I didn't press him further because, as I already said, it seems he didn't want me to know and I didn't want to make trouble. I later searched the net and was not able to find any supplier or manufacturer of plates under that name.

Call me cynical if you like, but I believe the reason the hospital does not want me to know is perhaps because they have put stainless steel plates in my leg but may have charged the insurance company for more expensive titanium plates. Or they've charged for American-made plates but have used Chinese-made plates. It's not like the insurance company can look at my plates to check.

I'm also curious to know if when I have my plates removed, will they belong to me... will I be able to keep them? I'll ask the hospital sometime but would like to know what others think.

Thanks.

JB

[lopburi3]

Why don't you just ask for a 'detail' receipt? Everything should be listed on that and you can just say it is needed for your insurance claim. Hospitals have the normal cash receipt on payment but can all provide a detail (itemized) receipt on request.

[JungleBiker]

I was rather surprised how "un-detailed" the invoice was. The medical bills are paid directly by the insurance company to the hospital - the money does not go through my hands. I think the bills are deliberately opaque for the reason already mentioned above. I may be wrong but I guess that if I asked for a detailed receipt they will tell me "no need" because the insurance company is paying, not me. And if I do get a detailed receipt I expect it will just say "screws and plates" or "2 plates and 11 screws". The "un-detailed" invoice just said "medical supplies" and that apparently included the plates, crutches, bandages, etc, etc.

By the way, related to this topic, the costs seemed to be much more expensive that I had expected and so I wonder if the hospitals charge more (i.e. pad out the bill) when they know an insurance company is paying rather than the patient. I guess they assume the patient won't question the bill if someone else is paying. Also, knowing how endemic corruption is here, I guess that there is some "cozy relationship" between the hospital and certain individuals within the insurance company which results in the hospital bills being accepted/approved without question.

JB

[lopburi3]

Unless you ask for a detailed receipt all you get is a few item cash receipt. But they can all provide, even the government hospitals, if you ask for it. Normally you would ask for insurance report or itemized receipt but find they often do not know those terms but do know detail receipt. Normally it is just pressing a key on computer to print it out. You are also entitled to medical certificates of what has been done/your condition signed by the doctor if you request them.

[JungleBiker]

Unless you ask for a detailed receipt all you get is a few item cash receipt. But they can all provide, even the government hospitals, if you ask for it. Normally you would ask for insurance report or itemized receipt but find they often do not know those terms but do know detail receipt. Normally it is just pressing a key on computer to print it out. You are also entitled to medical certificates of what has been done/your condition signed by the doctor if you request them.

Thanks Lopburi3. I'll ask and see what I get.

[ProThaiExpat]

Each hospital operates differently and each has their own methods of making a profit. My only experience has been with Ram and Lanna hospitals in Chiang Mai and my experience has taught me how to prevent "extra charges".

I broke my femur three years ago and it was displaced and comminuted. Surgeons fee for first procedure was 12K baht and he advised that stainless steel was cheaper and after discussing that option with titatium, I chose the stainless steel. Three surgeries later and 30 days of hospitalizations over a year, my total cost was 220K baht.

My Orthopedic Surgeon was a professor from CM University as was his assistant.

9 months after the first operation, the plate broke do to my carelessness and it was replaced. Plates came from BKK as does my rare blood type. I have the broken plate that was removed and it is almost like jewelry in appearance.

My doctor was forever worried about my suing him for the slow recovery and repeated procedures and I concluded that he really did his best and my final result has been excellent, especially due to my age.

If you had a reputable doctor and went to a western style hospital, I am sure they would not risk law suits by substituting an inferior plate from what you agreed to since it will be easily proved if you have the plate removed. You may get more satisfaction from contacting a supervisor in the accounting department.

By the way, my doctor said that in Thailand they rarely remove the plate, while in the US they routinely remove them. My doctor admonished me on many occasions not to allow the plate to bear full weight as it was not designed to support my body weight, only to keep the bones in proper alignment so they would heal. I had a non-union of my fracture site and thus my recovery was prolonged and it wasn't until he went back in and packed the fracture site with bone graft material that I recovered in the standard three months, despite my age.

Edited April 6, 2011 by ProThaiExpat

[Sheryl]

You have an absolute right to obtain copies of your entire medical record. By law they have to provide it to you on request. (You'll have to go to the hospital in person to get them, and show ID i.e. your passport. there will be a small charge for the photocopying).

Although it may be hard to read the doc's handwriting, the operative note should include info on the plates and screws.

[JungleBiker]

Thanks ProThaiExpat,

If you had a reputable doctor and went to a western style hospital, I am sure they would not risk law suits by substituting an inferior plate from what you agreed to since it will be easily proved if you have the plate removed. You may get more satisfaction from contacting a supervisor in the accounting department.

Actually I wasn't really given a choice. I remember that soon after I arrived at the hospital and they told me they'd be doing surgery and putting plates in my leg, I asked if they'd be titanium and was told yes. A day or two after the operation, I inquired again about if the plates were titanium and this time the reply was hesitant and I was told that one plate was titanium and the other was SS. Later it was revealed that both are SS. Then as I already explained above, when I inquired about the source, model and specs, I was not given any clear information. That's why I am suspicious.

By the way, my doctor said that in Thailand they rarely remove the plate, while in the US they routinely remove them.

I want to have my plates out as soon as I can - hopefully next year. There's an ugly bulge on the front of my shin due to the plate just under the skin. My doctor also recommends to have them out. (More surgery = more money?). From what I've read on the Internet the bones will be less likely to break again if the plates are taken out. Also, SS contains a lot of chromium and some of that can get into your body. Chromium can cause cancer. This is another reason why I'd like to know where my plates were made - I'm sure there must be high and low qualities of SS plates.

My doctor admonished me on many occasions not to allow the plate to bear full weight as it was not designed to support my body weight, only to keep the bones in proper alignment so they would heal. I had a non-union of my fracture site and thus my recovery was prolonged and it wasn't until he went back in and packed the fracture site with bone graft material that I recovered in the standard three months, despite my age.

I didn't put any weight on my broken leg for the first month. Now (week 5) the doctor says I can put about 20% weight on the leg.

JB

[JungleBiker]

Thanks Sheryl,

You have an absolute right to obtain copies of your entire medical record. By law they have to provide it to you on request. (You'll have to go to the hospital in person to get them, and show ID i.e. your passport. there will be a small charge for the photocopying).

Although it may be hard to read the doc's handwriting, the operative note should include info on the plates and screws.

Okay, I try again to get the info.

[amnong]

Dear JB,

I have found you on farming in Thailand forum when had gone through your discussion in the forum.

my name is Amnong living in Lao, my family has been invested in agarwood plantation some of 3 hactares

1000 of agarwood trees are age over 6 years already. so I found that you posted on forum that it can produce rasin by CK kits

so I am really interested in that...

are you in Lao now?

I really want your help, I would like to contact with you personally, could you give me your email address/telephone number?

**email removed per forum rules***

I wish your leg return to normal soon

with best regards

Amnong

Edited June 24, 2011 by sbk