Chiang Mai Ram Hospital - very poor service, ridiculously high bill

[Zlabermacht]

I went to Chiangmai Ram Hospital because of a pretty bad throat infection. After about 10 days of antibiotics it wasn't going better at all, so I was obviously worried and I decided to go to this renowned hospital.
Other times I had health problems here, I went to normal hospitals, paid Thai prices and received average standard service, except one time I went to a private clinic and received a pretty good service for what I thought to be a pretty high price. But for some reason, this time I wanted to try the excellence: Ram Hospital, let's go.
I was immediately puzzled at the hall, as I was expecting something more luxury: it did look about the same of any other hospital I got into.
Even the nurse welcoming and escorting you through the premises didn't impress me, as it is a Thai standard, in any hospital you get that.
I was rapidly and I would say pretty much summarily checked by a comically high number of attendants (none of those being actually able to communicate in English), had to fill a form asking me a lot of very personal data, been photographed (..tf?!) and finally I acceded to the specialist doctor.
There came a very hurried check, in which no special equipment was used (except some tools which I hope had at least been sterilized beforehand), a very brief conversation and prescription was made: pills of another common antibiotic and come back in 5 days to see if we need to remove the tonsils. Next.
Then I was conducted to the cashier, had to pay more than 2000 baht, of which 1600 going to the hospital (for...?), and I was given two small blisters of the antibiotic, not even covering the full treatment.

This is crap, my friends.
In my country I expect to pay this much if I go to a private clinic, but the quality of the premises, furniture, equipment would then be MUCH higher than that. I don't question the quality of the doctor, which of course is the most important thing, but he only takes 400 baht, which for being in Thailand is a fair price, for such a 3 minutes visit.
The icing on the cake, was that I wasn't even given a certificate, a diagnosis I mean, not even informal! I wasn't going to (try to) use my insurance for such a little thing anyway, but I would have liked to read what was the opinion of the doctor about my disease, a medical name for that thing, anything. Nope.

So long story short, Ram Hospital appears to me like a completely overrated hospital. You can get better stuff anywhere for half of that price. And of course I am not going to give another 2000 baht in 5 days.

Edited December 13, 2014 by Zlabermacht

[AnotherOneAmerican]

Pharmacy would have sold you the antibiotics for 40bht.

Government hospital would have charged 60bht for doctor visit and 40bht for antibiotic.

CM RAM great cosmetic surgery clinic, not much use for anything else.

Edited December 13, 2014 by AnotherOneAmerican

[Zlabermacht]

Pharmacy would have sold you the antibiotics for 40bht.

Of course! Yet I went to the hospital to be given a careful look, as I was worried about the situation. But the price of that was much, much too high.

[moe666]

Pharmacy would have sold you the antibiotics for 40bht.

Of course! Yet I went to the hospital to be given a careful look, as I was worried about the situation. But the price of that was much, much too high.

People who have lived in Chiang Mai for a time know that Ram is over priced. It has been said many times here you go with the Dr. not with the hospital.

[slipperylobster]

Never hurts to get a checkup, annually.

I wonder what magic happens in a hospital, for somebody with the flu...virus....etc? They diagnose you and give you something for the symptoms. There is no surgery, or magical room service that they will preform.

When you are sick...go to a small clinic, and have them send your bodily fluids. Additionally, a stool sample and throat culture...to a lab. Have them check for anything out of the ordinary.

You can not cure a cold, virus...but if you have a respiratory infection, perhaps some antibiotics would help. First thing I do, when I feel tingling in the throat, is get some kind of nose spray (stops your sinuses from draining down the throat, causing infection).

Hospitals are for long stays and emergency procedures.

[AnotherOneAmerican]

Hospitals are for long stays and emergency procedures.

Not true in Thailand.

Hospitals provide first line free medical care to Thai citizens.

And low cost care to foreigners.

Clinics generally cost far more.

You aren't in America now Dorothy!

Edited December 13, 2014 by AnotherOneAmerican

[lopburi3]

Actually hospitals are for normal out-patient medical treatment here as most of the better doctors will be found working in them rather than having there own clinics.

In every hospital I have used here (half dozen private type) you ask for a medical certificate if you want treatment diagnose spelled out (not just to prove to boss why you were absent as it sounds). Otherwise it is as (hopefully) discussed with you. Same with insurance receipt (you ask for detailed receipt).

[TerryLH]

"And of course I am not going to give another 2000 baht in 5 days."

If you feel better in 5 days will you come back here and tell us the treatment worked?

I don't suppose you thought to ask what is wrong with you, did you?

[Kitsune]

Pharmacy would have sold you the antibiotics for 40bht.

Government hospital would have charged 60bht for doctor visit and 40bht for antibiotic.

CM RAM great cosmetic surgery clinic, not much use for anything else.

If the said government hospital does not refuses you care on the basis you're not Thai and tells you to go private.

[Zlabermacht]

Kitsune, on 13 Dec 2014 - 19:29, said:Kitsune, on 13 Dec 2014 - 19:29, said:

AnotherOneAmerican, on 13 Dec 2014 - 16:04, said:AnotherOneAmerican, on 13 Dec 2014 - 16:04, said:

Pharmacy would have sold you the antibiotics for 40bht.

Government hospital would have charged 60bht for doctor visit and 40bht for antibiotic.

CM RAM great cosmetic surgery clinic, not much use for anything else.

If the said government hospital does not refuses you care on the basis you're not Thai and tells you to go private.

Can this really happen? I find it difficult to think so.

Edited December 13, 2014 by Zlabermacht

[Zlabermacht]

Ok, someone said that it is "well known" (here on this forum, I suppose) that Ram hospital is so overpriced and stuff. So I have two questions for those people:
Q1 why there were so many Thai people in there? They didn't look stupid or misinformed, they rather looked like pretty wealthy Thai people. Maybe they do not pay the same prices as farangs do?
Q2 why was I suggested to go to the Ram hospital by my Thai teacher? She is a University teacher, nothing to do with sick buffaloes, gogo bars and other things most of you people out there associate with the words "Thai women". Perhaps she wanted to help but didn't really know? Perhaps it was because she knew that Ram hospital was so popular amongst farangs (I saw at least 5 of them in there) ? Or maybe because she likes the idea of the stupid farang spending a lot of money for nothing? I don't exclude that, I'm beginning to hate this kind of things which I start seeing more and more around, even since I begin to really understand the language.

Just wondering.

Edited December 13, 2014 by Zlabermacht

[balo]

It is the english speaking specialists you want to see in a private hospital, if you do not have a serious condition any hospital is good and you pay less. But when that serious conditions happens you're in good hands at Chiang Mai Rai hospital, they do have specialists educated in the EU/US.

[AnotherOneAmerican]

Kitsune, on 13 Dec 2014 - 19:29, said:Kitsune, on 13 Dec 2014 - 19:29, said:

AnotherOneAmerican, on 13 Dec 2014 - 16:04, said:AnotherOneAmerican, on 13 Dec 2014 - 16:04, said:

Pharmacy would have sold you the antibiotics for 40bht.

Government hospital would have charged 60bht for doctor visit and 40bht for antibiotic.

CM RAM great cosmetic surgery clinic, not much use for anything else.

If the said government hospital does not refuses you care on the basis you're not Thai and tells you to go private.

Can this really happen? I find it difficult to think so.

Not in a million years, the government hospitals are desperate for cash, even small amounts.

Treating a Thai for free Vs treating a foreigner for 150bht = foreigner first every time.

[AnotherOneAmerican]

Ok, someone said that it is "well known" (here on this forum, I suppose) that Ram hospital is so overpriced and stuff. So I have two questions for those people:

Q1 why there were so many Thai people in there? They didn't look stupid or misinformed, they rather looked like pretty wealthy Thai people. Maybe they do not pay the same prices as farangs do?

Q2 why was I suggested to go to the Ram hospital by my Thai teacher? She is a University teacher, nothing to do with sick buffaloes, gogo bars and other things most of you people out there associate with the words "Thai women". Perhaps she wanted to help but didn't really know? Perhaps it was because she knew that Ram hospital was so popular amongst farangs (I saw at least 5 of them in there) ? Or maybe because she likes the idea of the stupid farang spending a lot of money for nothing? I don't exclude that, I'm beginning to hate this kind of things which I start seeing more and more around, even since I begin to really understand the language.

Just wondering.

Q1

RAM charges a different price to Thai people (dual pricing).

And they accept payment from Thais medical private insurance.

Q2

Thai people are often ignorant of private hospital charges, if they have insurance, they don't care, if they don't have insurance they use the government hospital. Or maybe she thinks they speak good English at RAM, and knows how bad your Thai is (being your teacher).

Pointless as the doctors in all the CM hospitals generally have good English skills, and the other staff generally have little of no English skills. (Yes, I've used, CM RAM, McCormick, Lanna, Nakorn Ping, San Sai, CM Neurological hospital and Suan Dok)

@balo

Thai Doctors rarely work in one hospital, you often find the same doctor in RAM, Suan Dok, and Nakorn Ping in the same week. No need to use RAM. Not to mention most of the doctors claiming to have trained in the US, have been allowed to observe only, not allowed to practise as no liability insurance would be available to them. Allegedly only 50 doctors currently working in Thailand have ever actually worked in the US.

Edited December 13, 2014 by AnotherOneAmerican

[Sheryl]

Of the 1600 baht that was outside the doctor fee, I doubt more than 200-300 was a hospital fee, the rest will have been for the medication which will have been vastly marked up. Never, ever get your medication at a hospital pharmacy unless it is a drug that is controlled and not sold over the counter (not the case with antibiotics).

When you get to the pharmacy counter, make note of what the medication is then smile and tell them you already have it and have them subtract it from your bill.

[Issangeorge]

Thais, probably go to Chiang Mai Ram, because of Face, it is probably perceived to be the best hospital. The Thais that do go there probably have insurance, or more money than they can spend.

[NancyL]

The OP joined ThaiVisa less than a year ago and mentions having a Thai teacher, so perhaps he's a newbie. For years, CM Ram Hospital was the top hospital and considered the "go to" place for foreigners because of the English language skills of their staff and ease of access. You didn't have to wait long to be seen and they make it easy for you to navigate their system. Prices are accordingly high, esp. for medications.

In the past couple years, their standards of service have declined as CM has grown and they've become more crowded. The place is now downright dowdy and the remodeling is long overdue.

The OP clearly was expecting a five-star experience and CM Ram is a long way from being able to deliver this, esp. for a minor problem like his. He should have gone to the new Bangkok Hospital in Chiang Mai, where they are busy recruiting patients and would have treated him like a king, I suspect, and in much plusher surroundings. The outcome would have been the same, but he would have left feeling much better treated (but perhaps a little lighter in the wallet.)

Edited December 16, 2014 by NancyL

[Zlabermacht]

Nancy, I follow your reasoning and find it sounding, just one thing I don't get, which is what should matter or imply if I was a newbie or not.

[Zlabermacht]

Pharmacy would have sold you the antibiotics for 40bht.

Of course! Yet I went to the hospital to be given a careful look, as I was worried about the situation. But the price of that was much, much too high.

Errata corrige, AnotherOneAmerican. Yesterday I'd run out of medicines, so not still being ok (incidentally, to all of those making their comments implying that I went to the hospital for a little throat sore, a cold or something: google "tonsillar abscess" click on images and check yourself how badly it can go) saying, not still being ok I went to pharmacy to buy the same antibiotic. None of the street pharmacies had it, they didn't even know it. I had to drive to a very big pharmacy near Chiang Mai University that finally had it. Price, 380 baht for half the tabs they gave me at the hospital.

So I was WRONG. We all were WRONG.

Appearently, we all should fly lower, my friends. Newbies or great experts.

Bye bye

P.s. before some genius even tries it: my infection is not a thing you can heal with 40 baht amoxicillin. I know because I tried for days and the result was a very vicious infection. So, please.

Edited December 16, 2014 by Zlabermacht

[Sheryl]

Actually if equivalent pharmacy cost was 760 baht (380 *2), and hospital bill for medication + hospital fee was 1400 baht, there was indeed a significant saving at pharmacy. Hospital fee is rarely more than 200 baht so looks likely you were charged 1200 baht, give or take, for the meds there, more than 400 baht above retail price, which is about usual. Mark up on drugs is one of the main sources of profit for private hospital.

Re CM Ram: the care one gets at any hospital is as good as the doctor giving it (and quality of medical care is not related to the degree of luxury or amenities).. On the whole the best specialists are to be found at Sripat. However there are a few at CM Ram of unusually good qualification and seeing them there is easier (in terms of making appt, wait time) than at Sripat. Just a few, mind; majority not.

OP: how many days were you instructed to take the abx for? As you may know, a peritonsillar abscess cannot be treated by abx alone and would not be expected to resolve with only that. Treatment is either to drain the abscess (via needle aspiration or small incision) or to remove tonsils altogether. It may have been the doctor's intention to just have a few days abx first before doing this, which might explain the limited supply given. The first (draining the abscess) is more usual approach and if you are being pushed for total tonsillectomy might want a second opinion.

If they do an incision and drainage or needle aspiration, suggest that they culture the pus so obtained to guide further antibiotic treatment esp. since you have already had unsuccessful abx courses.

[NancyL]

I didn't mean to insult the OP in suggesting he is a newbie, just wanted to point out that his post indicated that perhaps he is a newbie and thus doesn't realize there are other, better options in Chiang Mai for someone who wants to receive five-star medical service. The advice he received from his Thai teacher is a little dated. For years, CM Ram has been the only game in town for "four star" medical service and (as I mentioned) their standards of service with regard to the patient experience for non-life threatening outpatient appointments has vastly declined.

It used to be that the patient made an appointment that was a real appointment. Now if you're told to come to see the doctor at 10 am, you're handed a queue card only to discover there are already 8 people ahead of you for the "clinic" the doctor is conducting from 10 am to 12 noon. What is this, Suan Dok? You can't find any English language reading material to pass the time while waiting. The support staff all seems to be busy playing with their phones rather than looking to direct you to where you pay your bill. The days of a cute nurse leading you to the cashier by the arm are gone. The doctors barely look at you during the consulations and heaven forbid they should actually do a physical exam. They just order tests and then look at the results. It's like they're all so busy at CM Ram these days they can just skate by on their reputation, at least with regard to out-patient customers.

That being said, I've seen them provide splendid care recently for in-patients with very serious conditions and respond quickly when someone came into the ER with a potential heart attack.

If someone wants ease-of-access, and five-star out-patient treatment -- CM Ram is not the best place to go in CM. As Sheryl just pointed out, though, there's more to think about in selecting a hospital then the quality of service. Give some thought to the quality of the doctors, also.

Edited December 16, 2014 by NancyL

[Zlabermacht]

Sheryl, I thank you for your support and advise which I am sure you make in good faith, but I couldn't prescript that antibiotic by myself, nor one of my best friends, which is a doctor but not a specialist, could. I had to take an examination by a person with experience, and before going to RAM of course I did read the doctor's CVs on the hospital's website and went the morning I knew I could find the best one.

Yet I was rather nervous some days ago because of the money paid, but now - call me simple, I probably am - the treatment is having a good outcome, it wasn't an obvious one (this antibiotic turns out to be not a common one) so I am pretty happy to pay little more than 1000 baht for a good clinic eye looking at my problem.

You are not 100% correct about peritonsillar abscess, the surgical treatment was not necessary at that time, if little it can reabsorb and it is doing so.

Yet of course a definitive solution would and will be to have the tonsils removed, but there is no hurry for that and I will be doing it the next time I visit my country in Europe (I have, as a tax payer, free medical assistance for these kind of things).

bye

[AnotherOneAmerican]

Pharmacy would have sold you the antibiotics for 40bht.

Of course! Yet I went to the hospital to be given a careful look, as I was worried about the situation. But the price of that was much, much too high.

Errata corrige, AnotherOneAmerican. Yesterday I'd run out of medicines, so not still being ok (incidentally, to all of those making their comments implying that I went to the hospital for a little throat sore, a cold or something: google "tonsillar abscess" click on images and check yourself how badly it can go) saying, not still being ok I went to pharmacy to buy the same antibiotic. None of the street pharmacies had it, they didn't even know it. I had to drive to a very big pharmacy near Chiang Mai University that finally had it. Price, 380 baht for half the tabs they gave me at the hospital.

So I was WRONG. We all were WRONG.

Appearently, we all should fly lower, my friends. Newbies or great experts.

Bye bye

P.s. before some genius even tries it: my infection is not a thing you can heal with 40 baht amoxicillin. I know because I tried for days and the result was a very vicious infection. So, please.

Plenty of generics, same antibiotic, different name.

You just needed to ask the pharmacist for a similar antibiotic.

Mind you, if you needed more than the course you were given, that indicates the one you were given is unsuitable to treat your condition.

Please name the antibiotic you were prescribed @ 400bht.

"but in recent years the emergence of beta-lactamase-producing organisms has required a change in antibiotic choice.15 Results of studies16,17 suggest that 500 mg of clindamycin administered twice daily or a second- or third-generation oral cephalosporin be used instead of penicillin.

Another study recommends using penicillin as the first-line agent, and, if there is no response within the first 24 hours, adding 500 mg of metronidazole administered twice daily to the regimen. All specimens should be examined by culture for antibiotic sensitivity to ensure appropriate antibiotic coverage.

Three main surgical procedures are available for the treatment of peritonsillar abscess: needle aspiration, incision and drainage, and immediate tonsillectomy. Three recent studies have compared needle aspiration with incision and drainage for the treatment of peritonsillar abscess."

A quick look at the names suggests dozens of brand name 'cephalosporin' antibiotics available.

Edited December 16, 2014 by AnotherOneAmerican

[mat999]

RAM was like heaven compared to Suan Dok hospital. We got a long time with an old guy who was obviously an expert, he spotted stuff a younger doc missed. He gave lots of great, un rushed advice. The price was very reasonable. I get queasy so it was nice to see free water, have aircon and comfy seating. Heaven.

Suan Dok hospital on the other hand was like hell. Young docs that disagreed with each other, horrific overnight shared rooms. It didnt feel clean, it was probably a bit cheaper but it was worth paying 5 times the price to be in RAM. I never visit hospitals so perhaps my view will change when that changes.

Edited December 16, 2014 by mat999

[Loptr]

Ok, someone said that it is "well known" (here on this forum, I suppose) that Ram hospital is so overpriced and stuff. So I have two questions for those people:

Q1 why there were so many Thai people in there? They didn't look stupid or misinformed, they rather looked like pretty wealthy Thai people. Maybe they do not pay the same prices as farangs do?

Q2 why was I suggested to go to the Ram hospital by my Thai teacher? She is a University teacher, nothing to do with sick buffaloes, gogo bars and other things most of you people out there associate with the words "Thai women". Perhaps she wanted to help but didn't really know? Perhaps it was because she knew that Ram hospital was so popular amongst farangs (I saw at least 5 of them in there) ? Or maybe because she likes the idea of the stupid farang spending a lot of money for nothing? I don't exclude that, I'm beginning to hate this kind of things which I start seeing more and more around, even since I begin to really understand the language.

Just wondering.

It appears you have your panties in a twist because you think you were over charged and didn't receive the service you expected... Just what did you expect for a sore throat, for them to roll out the machine that goes "bing"?

Edited December 16, 2014 by Loptr

[evenstevens]

You can't find any English language reading material to pass the time while waiting. The support staff all seems to be busy playing with their phones rather than looking to direct you to where you pay your bill. The days of a cute nurse leading you to the cashier by the arm are gone. The doctors barely look at you during the consulations and heaven forbid they should actually do a physical exam. They just order tests and then look at the results. It's like they're all so busy at CM Ram these days they can just skate by on their reputation, at least with regard to out-patient customers.

been a very happy satisfied out patient of c/mai ram hospital for 13 yrs plus

i find your above remarks or slagging very disturbing, against highly respected qualified specialist doctors and staff of c/mai ram hospital

perhaps one day u may need their services, to save your life

if so...pray that karma prevails

a lovely afternoon to all

Edited December 17, 2014 by evenstevens

[lopburi3]

Perhaps you do have a good doctor? We have only had the experience of that hospital on one occasion some 15 years or so ago but found it to be well below expectations (was a using Bangkok government hospital at the time which was far cleaner and more professional) and had to visit an international clinic around the corner across from shopping center to obtain successful treatment for grandchild. Our expectations for Chiang Mai are really not that high - but this was not a positive experience.

[ThaiPauly]

Dr. Chalermpong the ENT specialist at CMR saved my life 4 years ago.

He is a very professional doctor and does take time with his patients, even to speak about football!!

I am currently receiving treatment for Ulcerative Colitis at the hospital , the nurses in that department are brilliant and I am very happy with my doctor.

[evenstevens]

nice one thaipauly,

have been a patient with dr charlempong , for 5 yrs ( once a month)

with his absoulately great professionlism in his feild, he has kept my poor hearing going, without needing hearing aids

he is a gem of a human being,,and a very ardent liverpool fan,and also very knowlegable football pundit

his supporting team in the E.N.T. clinic are a joy to behold, from my observations i have never ever seen them gawking into mobiles,always take your hand to the cashier

and the waiting room is sufficiently comfortable,with some mags available plus a good T.V and a very clean mens/lady loos to go with it

and taking into consideration that i have two other doctors on my books at the c/mai ram who are incidently just as professionally as dr charlempong service etc etc

i find nancy l ...posts and comments on this thread very misleading, but thats just my opinion

a foggy good morning to all

[Sheryl]

There is no such thing as a hospital where all the doctors are good and it would be very unusual for a hospital not to have at least some good docs. Certainly CM Ram has some excellent specialists as well as some not so good ones.

There does seem to be a consensus that the hospital has declined with respect "frills" and amenities which some people expect from private hospitals targeting the international market. Fair enough, but this has nothing to do with the quality of medical care.

Personally I like my hospitals to be hospitals, not hotels or resorts, and I grit my teeth when I pass the valet parking and fancy lobbies of the "top end" private hospitals. Nonetheless I still use them when they have the best doctor for my need. I would likewise use hospitals that charge "top end" fees but don't deliver on the amenities, if they happen to have the doctor I want.