Medical Incompetence, Walk Or Complain?

[chiang mai]

The question is, what should we do when we come across a doctor that is clearly not up to scratch, one that gives us medical advice that is blatantly wrong and puts our health at risk and charges us a fairly large sum of money in the process.

Increasingly I'm hearing stories from friends and people I know ho have spent a lot of time and money on hospital consultations, only to find out later that the advice they were given was not only wrong but sometimes even dangerous. And I'm not talking about small town doctors and back street clinics here, more often than not I'm referring to major private hospitals where the consultation fees are in excess of THB 1,000 baht and the prescribed medicine costs are inflated by several hundred per cent.

My inclination is to complain to the hospital and to let it be known that I'm not happy, I like to think that at some point that action will have a positive effect. Others I know will simply walk away and get their medical problems resolved elsewhere because they are unwilling to complain or put poor performance down to TIT. I've initiated internal complaints against what one of the largest private hospital in Bangkok and probably the best known, they have an internal complaints procedure which kicks in as soon as a patient expresses their displeasure. But mostly it's all window dressing, a process that has a predetermined end where supposedly independent and senior staff investigate who did/said what, in recreating those steps doctors lie and claim to have done all manner of things they didn't thus the system there doesn't really work. But I like to think that if the hospital has to repeat that same process enough times, with the same doctor, there will be a benefit at some point.

I understand that it's difficult for a doctor to be right 100% of the time but I also think it's not difficult for a doctor to refer a patient if they simply don't know what the answer is, this nasty business of “saving face” is involved here somewhere, the question is, what would you do, complain or walk?

[chiang mai]

Here's some of the “””misdiagnosis””” I know of first hand:

An Orthopeadic doctor at a premier Bangkok's hospital where the patient complained of neck pain, despite there not being any trauma involved – diagnosis without ever examining the patient or leaving his side of the desk, excess computer useage and prescribed Tylenol. An MRI at another hospital later showed this to be a compressed spinal nerve resulting from age related spinal degeneration requiring surgical intervention. Cost;THB2,200, consultation time; under 10 mins..

An ENT specialist consulted because of difficulty in swallowing, the examination involved a cursory look in the patients throat and the treatment was a course of antibiotics plus four other remedial medicines. A subsequent visit to another doctor identified an enlarged thyroid containing four tumours that required a biopsy and surgery. CostTHB2,400, consultation time; under10 mins.

A gastroenterologist consulted about stomach bloating and abdominal discomfort, treatment involved five different laxatives every day for two months and x-rays of the abdomen every two weeks! An endocrinologist would later diagnose metabolic syndrome where the lipids, blood sugar and triglyceride levels were dangerously high, the patient was merely overweight and needed to shed ten per cent of his body weight. Cost over two months, about THB15,000, consultation time, several hours, cost of toilet paper, substantial!

An ENT doctor consulted because of neck/throat pain who diagnosed, “a sore tongue” and prescribed antibiotics. Further consultations elsewhere would later diagnose a stone in the Parotid Gland requiring surgery. Cost; THB1,800, consultation time; under 5 mins.

An orthopaedic doctor consulted about lower back pain, diagnosed a tender coccyx and sold the patient a nice soft hollow cushion to sit on plus various pain killers!! Cost (including cushion; THB 1,900, consult time under 10 mins. A later diagnosis after an MRI would show a prolapsed disc at S2.

A rural doctor who saw a patient with a temperature of 101 degrees, diagnosed flu and administered a B12 injection, this process repeated the next day at the towns hospital. Two days later the patient was diagnosed in Bangkok with Dengue Fever and spent three weeks on a drip.

[Jessi]

Here's some of the “””misdiagnosis””” I know of first hand:

An Orthopeadic doctor at a premier Bangkok's hospital where the patient complained of neck pain, despite there not being any trauma involved – diagnosis without ever examining the patient or leaving his side of the desk, excess computer useage and prescribed Tylenol. An MRI at another hospital later showed this to be a compressed spinal nerve resulting from age related spinal degeneration requiring surgical intervention. Cost;THB2,200, consultation time; under 10 mins..

An ENT specialist consulted because of difficulty in swallowing, the examination involved a cursory look in the patients throat and the treatment was a course of antibiotics plus four other remedial medicines. A subsequent visit to another doctor identified an enlarged thyroid containing four tumours that required a biopsy and surgery. CostTHB2,400, consultation time; under10 mins.

A gastroenterologist consulted about stomach bloating and abdominal discomfort, treatment involved five different laxatives every day for two months and x-rays of the abdomen every two weeks! An endocrinologist would later diagnose metabolic syndrome where the lipids, blood sugar and triglyceride levels were dangerously high, the patient was merely overweight and needed to shed ten per cent of his body weight. Cost over two months, about THB15,000, consultation time, several hours, cost of toilet paper, substantial!

An ENT doctor consulted because of neck/throat pain who diagnosed, “a sore tongue” and prescribed antibiotics. Further consultations elsewhere would later diagnose a stone in the Parotid Gland requiring surgery. Cost; THB1,800, consultation time; under 5 mins.

An orthopaedic doctor consulted about lower back pain, diagnosed a tender coccyx and sold the patient a nice soft hollow cushion to sit on plus various pain killers!! Cost (including cushion; THB 1,900, consult time under 10 mins. A later diagnosis after an MRI would show a prolapsed disc at S2.

A rural doctor who saw a patient with a temperature of 101 degrees, diagnosed flu and administered a B12 injection, this process repeated the next day at the towns hospital. Two days later the patient was diagnosed in Bangkok with Dengue Fever and spent three weeks on a drip.

Im sure there are many more stories like these. Its Disgusting.

[Sheryl]

I do believe it is worth making a complaint or at a minimum communicating with the doctor to let him/her know what the true diagnosis turned out to be.

Should of course remain civil and polite in the process, and provide clear factual details.

It can't hurt and it may help. Most doctors can and do learn from their mistakes and thus knowing that they missed a diganosisis is helpful in preventing them from doing the same in future under similiar circumstances. I'm less confident re any action by the hospitals unless there is really a large amount of complaints egregious in nature.