antibiotics and doctors in thailand vs usa

[farang000999]

In Thailand it seems like doctors are very willing to give you an antibiotic prescription and in the USA definitely not so much... wondering what is the difference in logic there...

[wym]

Not so much logic, more like cultural fashion.

Western doctors are more aware of the problem of resistant strains emerging and individuals needing to take responsibility to do their part for the overall community.

The fact that Thais just don't feel like they've had a good doctor's visit without having a whole handful of different colored pills.

[Puyai]

A doctor told me the same thing. His patients would think he's a bad doctor if they didn't come away with a truck load of pills.

But, giving children antibiotics for viral infections is doing more harm than good.

I think it has a lot to do with money. The more pills they sell the more money they earn. Unfortunately the heath of the general public doesn't come into it.

[maccaroni man]

Most of the Thai Dr follow the US board standards of practice as a matter of fact Bumingrad has all US board certified DR. The holistic community seems to be the only group talking rubbish about antibiotics. At the end of the day prevention is far better than the cure. In the US doctors are subject to map practice law suits and end up running far more test before treatment compared to a Thai Dr.

[CharlieH]

In my experience Thai doctors are more thorough and will only prescribe when required and often tell you , you dont need pills and some medications you may already have from the west are in fact not required as its old outdated practice/thinking.

I would suggest the doctors in the west are more likely to be pressured by medical reps/companies than any doctor in Thailand would be.

[Suradit69]

In Thailand it seems like doctors are very willing to give you an antibiotic prescription and in the USA definitely not so much... wondering what is the difference in logic there...

Typical rose colored view of life back in farang paradise and attempt to knock Thai doctors as somehow ill informed or indifferent compared to doctors in the west who are just as likely to give their patients packets of meds to get them out of the office and to make the pharmaceutical company reps keep giving them kick-backs.

Just concerning the over-use of antibiotics for one type of illness, sore throats, in the US:

"The financial cost of unnecessary antibiotic prescribing to adults with sore throat in the United States from 1997-2010 was conservatively $500 million," the study noted. The cost could have actually been 40 times more expensive because of diarrhea and other side effects from antibiotics.

or bronchitis:

We've known for years that antibiotics don't help in most cases of bronchitis or sore throat. And for decades, public health officials have tried to stop doctors from overprescribing antibiotics. None of that seems to have made a difference, though: Antibiotics are still being prescribed when they don't help — and could hurt, a study says.

http://www.npr.org/blogs/health/2013/10/04/229167826/despite-many-warnings-antibiotics-are-still-overprescribed

And in Europe

GPs wrongly assume that patients want antibiotics resulting in too many being prescribed, according to a Europe-wide study by Cardiff University.

http://www.bbc.co.uk/news/uk-wales-24644191

Edited February 13, 2014 by Suradit69

[Suradit69]

In my experience Thai doctors are more thorough and will only prescribe when required and often tell you , you dont need pills and some medications you may already have from the west are in fact not required as its old outdated practice/thinking.

I would suggest the doctors in the west are more likely to be pressured by medical reps/companies than any doctor in Thailand would be.

Exactly. You beat me to it. The rush to judgement about everything in Thailand and the blinding ignorance (or intentionally selective memory) of what goes on back in the wonderful world of farangs is amazing.

Edited February 13, 2014 by Suradit69

[sam sen]

i've seen it many times. a thai basically has the common cold, goes to see the doctor and comes back with 3 or 4 sets of pills; a mix of paracetamol, vitamins and antibiotics.

not sure why doctors here prescribe antibiotics for a virus, but they do on a regular basis.

if doctors feel they need to prescribe something wouldn't a smart doctor prescribe a placebo?

[oneday]

My personal experience is that doctors here do prescribe too many pills and I feel their motivation is due to patient expectation and possibly in private hospitals...money. Thai's just feel if they aren't given a number of pills they aren't being treated well. I just couldn't believe the amount and type of pills prescribed for my GF's father for his back pain. Some of the pills had to be gradually reduced to get him off them. Not a word from the doctor about their purpose of each pill or cautions probably because he wouldn't understand, which may be true due to his level of education. And the more pills you are given the more chance of interactions.

The pills given to my GF's father was at a hospital in Kalasin. I do not equate the level of care the same everywhere. You will find different levels everywhere with a greater level in the bigger cities, IMO. I have read reports on here of great care in some government hospitals.

[Rooo]

Moved to health.

[geriatrickid]

Thailand along with other countries in the developing world have refused to act responsibly in respect to the prescribing of antibiotics. Thailand and other countries with intensive factory farming have allowed the misuse and overuse of antibiotics in the food supply chain.

The end result are antibiotic resistant illnesses that can evolve and kill tens of millions of people should the conditions arise. It is a subject that too many vested interests do not want discussed. The chemical companies that pump out these antibiotics will spend as much as it takes to protect their sales.

[thailiketoo]

I go to an expensive specialist at an expensive private hospital in Thailand and he writes the generic names of the drugs down on a piece of paper so I can buy my own at my own pharmacy because the hospital pharmacy is too expensive. If I don't want to go to the Pharmacy here the motorcycle taxi driver will pick up pills for me. In the States the VA would mail my medication free and that was nice but here is a closes second for price and convenience.

[robblok]

In my experience Thai doctors are more thorough and will only prescribe when required and often tell you , you dont need pills and some medications you may already have from the west are in fact not required as its old outdated practice/thinking.

I would suggest the doctors in the west are more likely to be pressured by medical reps/companies than any doctor in Thailand would be.

Exactly. You beat me to it. The rush to judgement about everything in Thailand and the blinding ignorance (or intentionally selective memory) of what goes on back in the wonderful world of farangs is amazing.

I like how you defend everything about Thailand.. but here you are way of the mark. The ease they prescribe anti biotics here is totally different as in my country. Actually everytime you go here you get a bag full at a way too high price.

Not to mention over care and running hospitals like businesses is quite normal here. Even health care professionals from other countries think the same.. so i think you are out classed here mate give it a rest.

As for how good Dr's are.. I could really not make a judgement call there as I doubt Dr's are stupid here. Had some great Dr's but over care "especially in private hospitals to run up a bill" is normal here. I know that back home i never had to question the Dr intentions but I do here.

[farang000999]

i have never been prescribed antibiotics for a sore throat in the usa. they do a throat culture for strep.

but in Thailand i have never gotten a strep culture. do they even have them here?

they just give you antibiotics for a sore throat in Thailand

[robblok]

i have never been prescribed antibiotics for a sore throat in the usa. they do a throat culture for strep.

but in Thailand i have never gotten a strep culture. do they even have them here?

they just give you antibiotics for a sore throat in Thailand

One part of me likes that they give medicine easier the other part does not. The part that does not is the part that has been over treated a few times and luckily i am insured so its ok. But to want to keep someone in a hospital for 2 days for a broken toe and threaten with possible amputation is crazy. It is not the norm.. but private hospitals are famous for it especially the smaller ones.

Before the defender of Thais Suradith69 says that I don't see bad things in my home country... they are there but less and of course doctors get charged there. One is going to jail.. real big story of a guy treating patients wrong wrong diagnoses. So surely its not perfect but I see the fact that it is in the news and he is going to jail as a good thing. It shows that patients have a recourse and can win. Something that is real real hard here.

[masuk]

How about this? In Indonesia, when you see a doctor, a list of medications is given to the patient.

Invariably top of the list are multi-vitamins.

The patient then goes to the pharmacy, often part of the same medical complex, and the pharmacist then prices each item and returns it to the patient.

It's up to the patient to buy what s/he can afford. A few vitamin tablets, maybe 3 days worth of antibiotics.

Is it little wonder that antibiotic resistance starts in the poorer countries? The doctors are educated, and should know better than to do this.

[chiang mai]

Most of the Thai Dr follow the US board standards of practice as a matter of fact Bumingrad has all US board certified DR. The holistic community seems to be the only group talking rubbish about antibiotics. At the end of the day prevention is far better than the cure. In the US doctors are subject to map practice law suits and end up running far more test before treatment compared to a Thai Dr.

Just to be clear: about 15% of the doctors at Bumrungrad are US board certified, many of the remaining 85% are certified in other countries.

http://www.bumrungrad.com/en/meet-our-doctors-thailand

Edited February 13, 2014 by chiang mai

[Loles]

Yes Amigo, you are 100% rights. I'm always surprised also. You can buy 10 Kg antibiotics per day with out any prescription in pharmacy. In EU there are many rules to give you antibiotics cause the antibiotics are harsh with your digestive system.

[AussieSteve]

My experience so far with the Thai private health system has been pretty negative.

My GF's daughter had a temperature of 39 degrees for a couple of nights and GF was worried it was Gengi fever because she had sore muscles too. I said ok lets go and get some tests done at the docters. We went to the private hospital where she usually goes and the test come back she has the flu. Well thats ok I thought a few days in bed and everything will be good.

No .......Doctor says she must spend a day/night in hospital and it will be 3,800 baht for the room. To keep GF happy I agreed, anyway to cut a long story short. The one day was going to turn into 2 days until I insisted she come home, GF says Doctor wants her to stay, I say no she's coming home. In the end it cost me nearly 10,000 baht for the one day/night and a ton of medications plus she was on a Dextrose drip for 18 hrs. Of course GF had to stay overnight in hospital with her too.

I tried to tell GF that she would have been ok at home but it seems common practice that anyone with a bad cold/flu symtoms automaticly goes to hospital. They had given her a lot of pills to take after she came home too. What really made me angry was that it was such a waste of money, and I know that some of these drugs were antibiotics (the flu is a virus).

This just compliments a previous reply about private practice,

Initually I didn't know that the insurance policy GF had taken out on her daughter had lapsed. The GF's daughter is 12 so she isn't a baby.

[TallGuyJohninBKK]

There's a lot of misinformation and wrong information being dispensed here:

--Clearly, not all or even many doctors at Bumrungrad are U.S. board certified, though some are.

--Here in Thailand, you can buy a lot of common antibiotics over the counter without a prescription. In many other countries, you cannot.

--The concern over the over use and unnecessary use of anti-biotics is hardly limited to just "holistic" folks. The mainstream medical communities are increasingly raising alarms over this relating to antibiotic resistance and related factors.

--In my experience in both the U.S. and Thailand, doctors here in Thailand seem far more likely to over-prescribe medicines (not just antiobiotics) even when they're not necessarily needed. It certainly does occur in the U.S., but my experience is it occurs more here.

--Part of that may be due to the typical Thai perception that they haven't had a good doctor's visit unless they come away with bagfuls of pills. Another part of it may be due to the financial incentives (both personally and at the hospital level) that exist here and in the U.S. too for doctors to prescribe medicines.

[belg]

the profit on this is about 300%, that is why they even would sell you if you sneeze or fart

[thailiketoo]

Since medical care is the third leading cause of death in the USA I think Thailand is doing OK.

http://chriskresser.com/medical-care-is-the-3rd-leading-cause-of-death-in-the-us

The most shocking revelation of her report is that iatrogentic damage (defined as a state of ill health or adverse effect resulting from medical treatment) is the third leading cause of death in the U.S., after heart disease and cancer.

[djhotsox]

As for how good Dr's are.. I could really not make a judgement call there as I doubt Dr's are stupid here. Had some great Dr's but over care "especially in private hospitals to run up a bill" is normal here. I know that back home i never had to question the Dr intentions but I do here.

I'm not sure about ALL Dr.'s here but the Plastic Surgeons have got to be some of the best in the world! Some of the ladyboys they work on.....amazing (Thailand)!

[ghworker2010]

The RT cable TV network recently stated that US are guilty of writing too many perscriptions. They had a 5min doco about it and the problem of over prescribing in the US.

The thai dr's take the 'gun shot' approach and put people on antibiotics without doing proper checks. ie I had a prostatitis infection and they should have done C&S (culture and sensitivity) but of course they did not.

Dont ever buy antibiotics at bumrungrad pharmacy. It will cost 3 times as much. Just get the name and go to Boots or Watsons

[chiang mai]

Since medical care is the third leading cause of death in the USA I think Thailand is doing OK.

http://chriskresser.com/medical-care-is-the-3rd-leading-cause-of-death-in-the-us

The most shocking revelation of her report is that iatrogentic damage (defined as a state of ill health or adverse effect resulting from medical treatment) is the third leading cause of death in the U.S., after heart disease and cancer.

This seems to me to be nonsense, the link to the study that Kresser refers to is not found, I also have some serious doubts about Kressers mission in life but hey, that's just me.

[AngelsLariat]

This seems to me to be nonsense, the link to the study that Kresser refers to is not found, I also have some serious doubts about Kressers mission in life but hey, that's just me.

Natural News dot com reports similar things and only sheeple doubt them.

[robblok]

This seems to me to be nonsense, the link to the study that Kresser refers to is not found, I also have some serious doubts about Kressers mission in life but hey, that's just me.

Natural News dot com reports similar things and only sheeple doubt them.

You mean its a prime news site for the aluminium hat wearing part of the population ?

[chiang mai]

This seems to me to be nonsense, the link to the study that Kresser refers to is not found, I also have some serious doubts about Kressers mission in life but hey, that's just me.

Natural News dot com reports similar things and only sheeple doubt them.

Well this sheeple desists and prefers to read findings by the WHO, the BMA, the AMA and global or country specific organizations of similar standing and not nonsense written by people trying to sell books or make money from internet downloads, et al!

No more debate on this point from me, end of.

[thailiketoo]

Since medical care is the third leading cause of death in the USA I think Thailand is doing OK.

http://chriskresser.com/medical-care-is-the-3rd-leading-cause-of-death-in-the-us

The most shocking revelation of her report is that iatrogentic damage (defined as a state of ill health or adverse effect resulting from medical treatment) is the third leading cause of death in the U.S., after heart disease and cancer.

This seems to me to be nonsense, the link to the study that Kresser refers to is not found, I also have some serious doubts about Kressers mission in life but hey, that's just me.

http://chriskresser.com/medical-care-is-the-3rd-leading-cause-of-death-in-the-us

The link works for me. But I understand your point. Better to attack the messenger than the message.

[chiang mai]

Since medical care is the third leading cause of death in the USA I think Thailand is doing OK.

http://chriskresser.com/medical-care-is-the-3rd-leading-cause-of-death-in-the-us

The most shocking revelation of her report is that iatrogentic damage (defined as a state of ill health or adverse effect resulting from medical treatment) is the third leading cause of death in the U.S., after heart disease and cancer.

This seems to me to be nonsense, the link to the study that Kresser refers to is not found, I also have some serious doubts about Kressers mission in life but hey, that's just me.

http://chriskresser.com/medical-care-is-the-3rd-leading-cause-of-death-in-the-us

The link works for me. But I understand your point. Better to attack the messenger than the message.

Well no, not at all, if the message can be reviewed and assessed independently then anyone can form a view, it's just that the message he's talking about doesn't seem to exist any more (for me, Firefoc under 3BBB). I really do have an open mind on these things but I do need verifiable proof.