Royal Phnom Penh Hospital: caveat emptor

[Beau Curt]

Warning: this posting includes damning testimony regarding a prominent Phnom Penh institution

ten days ago I woke up with a very swollen left foot, immediate cause unknown
I was unable to walk, simply could not stand the pain

the next day I went to the newly opened Royal Phnom Penh Hospital
I had been well treated in the past at one of its precursors and anticipated the same quality care I had received before. Besides, I had been to several Thai hospitals in Bangkok, where I had received excellent treatment that I considered fairly priced. So I had no reason to be on high alert

the Thai Drs. who saw me were very good: the Cardio Vascular specialist in particular
@ 77 still going strong with 50+ years experience in various NY hospitals

the problem is the Doctors are associated with a new hospital with very few patients
there were more nurses at the nurses' station than patients in the waiting room (lobby)
the Doctors were obviously directed to enhance treatment
thus, via very questionable, certainly unethical, maneuvers, my visit morphed into an opportunity to generate badly needed business

I had simply never considered doctors as shareholders before, not to mention the effect that might have on my diagnosis and prescribed treatment

first, they said I would need an Ultrasound on my leg: $160
reasonable, except for the price

when I complained that as advertised on a big poster in the lobby, a 64-slice CAT scan cost only $125, the "mistake" was promptly corrected: revised down to $116

I am in the habit of bargaining with Tuk-tuk drivers, but have no experience having to bargain with my doctor!

the ultra sound exam was also problematical
after a lengthy examination, two lights on the screen suddenly went out
the doctor pointed to the blank screen and declared: "There, see, DVT!"
curious charade: patently false and very unethical as DVT (deep vein thrombosis) could have been my problem, but was not
I guess no one had clued him into the large furuncle on my left foot, which he had not even included in his examination

the original doctor now said the the abscess (infection) needed to be lanced and drained
reasonable, but no Novicane he said; I would need a general anesthetic because the pain would be too severe (??) for me to tolerate
that would have brought me to a fully-staffed operating theater
the estimated cost sheet listed operating physician, anesthesiologist, and 7-8 nurses
plus a 2-3 day stay because I would need antibiotics drop by drop

just to lance a boil??
baloney

I felt increasingly queasy as the charges kept mounting

when I inquired whether I could pay in installments, the answer was a firm: No!
I had to pay everything up front

one might have thought if you were attempting to rip someone off, since very little was at risk, you could at least give him a little extra time to pay

when the estimated costs exceeded $3,000 with more to come, I paid the bill for the tests ($140) and departed ...

I was asked several times by the business office if I had medical insurance. One has to wonder what those charges would have been had I replied "yes."

the next day I went to a local medical lab and got a full range of blood tests:
normal in all respects
the lack of leukocytes (white blood cells) suggested that the abscess diagnosis might be off base

a friend, who happens to be an MD, gave me a referral to a small clinic (Naga Clinic) run by a French doctor
in short order they scheduled an operation for the next day,
but first, just to be sure, they asked me to complete the Ultrasound examination by having the abscess looked at early the next morning

I shuddered, remembering the exhorbitant cost I had already paid once at the Royal Phom Penh Hospital
not to worry as the cost was estimated at $15 (vs. $116 at RPPH)

the next morning the entire operation was performed in 35 minutes by a very competent Khmer doctor, alone in his office without a nurse, after a single shot of novicaine
Charge: $120
(which compares rather favorably with the nearly $4,000 the Thai hospital was trying to squeeze out of me ...)
I was feeling so good that I walked all the way home

the infection was in fact a huge blood clot, the source of which is still unclear
I suspected that somehow it was caused by a muscle cramp that I gotten the night before in that location by sleeping without covers under a fan
Doctor said: perhaps the cramp caused a blood vessel to rupture
from now on I will wear socks to bed!

I am now on a 3 month regimen to treat venous insufficiency ...

one learns early on to accept bad news when it comes from someone wearing a lab coat
no second guessing tolerated
but if you have occassion to go to the Royal Phom Penh Hospital, you would be well advised to have your guard up (or your billfold open)!

A final note on nomenclature: Royal Phom Penh Hospital suggests royal sponsorship of some sort. In Thailand this would certainly be the case, or lèse majesté might be invoked. In fact the "royal" in "Royal Phom Penh Hospital" is translated not as រាជ (riec), but merely by a transliteration of the English word. More shenanigans.

[mike2011]

Thanks for the info. I am not surprised at all. I wanted to get a checkup on a concussion in Siem Reap. 230 USD before seeing the doctor upfront. Just fees. That Siem Reap place belongs to Bangkok Hospital group, as does the joint you went to, i trust. Later, I saw a Russian trained Khmer doc who correctly diagnosed the concussion and that nothing had been broken. I had slipped in the bathroom at the Mandalay guesthouse. I almost broke my neck because of their use of the wrong tiles. Very dangerous.

USD 15 for an ultrasound sounds about right.

I have had my experiences with the Bangkok group in Thailand. Doctors 'misdiagnosed' me suggesting cancer and causing excrutiating pain in order to make me consent to a whole list of suggested measures. In fact, a simple test disproved all and NOTHING needed to be done. Just take it easy and avoid pressure on the spot that caused pain. The Bangkok Hospital docs did the exact opposite. Talking to my physician in my hometown the man assessed the treatment I had received as causing bodily harm and pain and thus criminal. It seems that the practices and ethics of that company show a sad consistency.

[Beau Curt]

mike,

scary story

yes, I agree

I dont know anything about the Bangkok Hospital group in Thailand, but think that they may have been among a number of hospitals that were callled to task for gouging tourists

I purosely did not name names as they are a TVF sponsor ... and I did not want the posting quashed before its time

sad day when you cannot trust your doctor to offer you the very best treatment (but not in excess of that) for a fair price

[mike2011]

My experiences with Thai publi hospitals are very good. I am talking of the provincial hospitals, not the district hospitals. Some of these institutions are way better than any private hospital (e.g. in Philok). The prices are a fraction of the private ones at best. I do my checkups there. Of course there is some waiting and the facilities are not like a three star hotel. But in terms of efficiency there are good and no sales talk.

This might reduce the probability being forced to deal with places like the one you described. By the way, other posting on other fori confirm your experiences.

[Jessi]

I had an ultrasound in a X Ray clinic in PP about 4 years ago the cost was $15.

and very professional.

One of the main reasons I left Cambodia was because of the lack of medical knowledge.

Now I have my check ups at the Government hospital in Korat Thailand, excellent staff,

you will have to wait long periods to see a Dr but its worth it. Not a lot of English spoken

but one can still get by.

Stay away from the BKK hospital group unless you have Insurance.

[Sheryl]

Unfortunately government hospitals in Cambodia are not very good. Nor are they at all inexpensive. Not at all comparable with Thailand.

There are some competent doctors to be found in Cambodia but one has to ferret them out, and not in all specialties. For anything at all serious or complex, best to go to Thailand or Viet Nam.

[TheSiemReaper]

Unfortunately government hospitals in Cambodia are not very good. Nor are they at all inexpensive. Not at all comparable with Thailand.

There are some competent doctors to be found in Cambodia but one has to ferret them out, and not in all specialties. For anything at all serious or complex, best to go to Thailand or Viet Nam.

This... I use GP services in Cambodia for anything more than that, I'd be in Thailand in a heartbeat.

[mike2011]

Hospital infections are a serious risk in Cambodia as they are in some other areas in SEA. I contracted an atypical pneumonia after a friend had visited a cousin in a hospital. Many places lack minimal hygiene.