Tips for a newbie about navigating the Thai Health Care System?

[Jack59]

Hi!

My wife and I are visiting Thailand for the next 2 months. We'd like to do some medical procedures while we're in Bangkok. What advice would you all have for us about how to best navigate our way through the system?

We'll pay ourselves, all cash. We have basic tourist visas. We're not paying with insurance. We're both around 50 years old.

We don't speak or read a word of Thai. But for us, the language is only important to the level of mutual communication. In other words, we don't need to have long chats with doctors or staff or receive beautiful brochures in English. If we can understand the main points with no miscomprehension, that language level adequate.

I'd be interested in any tips that you might have in general for newbie. I've read through posts on the internet and on this forum in particular (for example, this helpful article on this forum about the different levels of hospitals in Thailand), but I'd love to get any advice based on your real-world experience that you'd think is important for someone jumping in for the first time!

On specific stuff, here's what she and I are looking to do:

- We need to get blood tests done. I've read that private clinics in Bangkok are cheaper and faster than going through hospitals. Any suggestions?

- My wife wants to get a lipoma removed. So we need to find a doctor, get it checked and arrange a surgery. Odds are that it's benign, but it's always better to get it checked out, so we'd also like to do a biopsy. How would you suggest we find a doctor and arrange these steps?

- I have some neurological issues I have to deal with. I need to do a bunch of tests for sure, then depending on the results I might have to do some basic procedures. In the U.S., it's the bread-and-butter work for a neurologist. In Bangkok, what would you recommend? Should I find a neurologist through a hospital? Just look on the internet and call a few?

Thanks a bunch!

Jack

[Sheryl]

Need a little more information here:

• what type of blood tests?
• where is the lipoma located on her body?
• what sort of neurological issues/tests/procedures?

Definitely should not just go to a hospital and ask for a neurologist, need to select the best one for your needs, but for that I need to know what the problem is as neurologists have sub-specialities and different areas of focus.

[oncearugge]

Without well developed Thai Language skill (or the assistance of a Thai/English interpreter) you will find navigating the Thai public health system virtually impossible. The hospitals are crowded and waiting times can be very long.

Everything you need can be found in the link

https://www.bumrungrad.com/

There are cheaper options but best stay away from "clinics"

[Jack59]

Everything you need can be found in the link

https://www.bumrungrad.com/

There are cheaper options but best stay away from "clinics"

----

Wow... I'd been told specifically to stay away from Bumrungrad. Too expensive, too bureaucratic, takes too long, overkill for minor procedures...

Sheryl, sorry I wasn't more specific. Blood work is the usual complete blood count, liver function, diabetes, cholesterol. The lipoma is a superficial subcutaneous lipoma on the torso, just below the surface of the skin. The neurology work would probably be classified as clinical neurophysiology, if that helps. It'd start with EEG; probably nothing, but I have to check once in a while, and in the event something unusual is found, it could require further tests or procedures.

Thanks.

Jack

Edited November 9, 2015 by Jack59

[Sheryl]

For the lipoma, a general surgeon will do. I suggest Dr. Narongsak at Saint Louis Hospital which is a comparatively inexpensive non-profit located on Sathorn road (near the Silom area of Bangkok -- surasak station o nthe BTS). http://www.saintlouis.or.th/index.php/component/doctor/index.php?option=com_doctor&task=searchEn He trained in Australia. Usually no appointment required.

For the blood work I suggest you just get the lowest price check-up package at St Louis, this is 2,800 baht and includes all the tests you mentioned (though for "diabetes" it is only the fasting glucose; if you also need an Hbac1, ask them to add it on, will cost more). The package also includes an EKG, urinalysis, tests of kidney function and chest Xray, you can refuse the last if you want. It is still cheaper than getting these tests ordered separately by a doctor. No appointment needed but do not eat from midnight the night before. You will get all the results within a few hours.

Alternatively you can do the same thing minus the EKG at Phyathai 2 hospital (near Victory Monument) for 2,500 baht.

For the neurologist I still just do not have enough information. What is the EEG for? (seizure disorder?) and what sort of "further tests or procedures" might be needed? As I explained, neurologists have specific areas of clinical focus. If it is a suspected seizure disorder then I need to steer you towards someone in that area. The other consideration is that I do not want to send you to one place only to have it turn out you need additional tests that cannot be done there. An EEG can be done anywhere (though will have to be ordered by a doctor, which may be an issue if the indication is not apparent) but other tests might not be as readily obtained depending on what they are. Please provide more information.

[inbangkok]

Everything you need can be found in the link

https://www.bumrungrad.com/

There are cheaper options but best stay away from "clinics"

----

Wow... I'd been told specifically to stay away from Bumrungrad. Too expensive, too bureaucratic, takes too long, overkill for minor procedures...

Sheryl, sorry I wasn't more specific. Blood work is the usual complete blood count, liver function, diabetes, cholesterol. The lipoma is a superficial subcutaneous lipoma on the torso, just below the surface of the skin. The neurology work would probably be classified as clinical neurophysiology, if that helps. It'd start with EEG; probably nothing, but I have to check once in a while, and in the event something unusual is found, it could require further tests or procedures.

Thanks.

Jack

Bumrungrad is an absolutely outstanding hospital. Yes, it is expensive compared to others.....but it is well worth the price in my opinion. As for anything at Bumrungrad taking "too long".....I would say that is laughable. They are all about providing service as it is a for profit business. People love to bitch about Bumrungrad being expensive. As long as you can get over the fact that is is indeed expensive, I am sure you will be very pleased with the level of care you receive.

[abrahamzvi]

Without well developed Thai Language skill (or the assistance of a Thai/English interpreter) you will find navigating the Thai public health system virtually impossible. The hospitals are crowded and waiting times can be very long.

Everything you need can be found in the link

https://www.bumrungrad.com/

There are cheaper options but best stay away from "clinics"

if I were you I would stay away from "clinics". For an adequate medical attention for a foreigner one should go to thr international hospitals like Bamrungrad or Bangkok Hospital, where one can get the best and most professional attention. They are not cheap, but compared to the US they are.

[al007]

I have lived inThailand some eight years, I am probably in the top 10% of foreigners as regards wealth, I have no medical insurance

I am 70 yrs old, and have had several medical problems in the last year

My advice is that the care you can get in Thailand is exceptional, you can also get ripped off as elsewhere in the world, stay street wise

If money were no object my understanding is Bumrungrad is the very best, also where the King goes, but we do not always need to ride in the Rolls Royce, especially if we have no insurance

There are many smaller hospitals that will be very good, recently I was an inpatient in the ICU unit at the Rachapreuk Hospital probably the fourth in size in KhonKaen, they were very good and reasonably priced, I have no health insurance

I have watched Sheryls advice for a long time, and would suggest following her advice to be a very good idea

Be lucky, and enjoy thailand

[BKKdreaming]

I normally go to St Louis Hospital , less than a 10 minute walk from the BTS ,

prices are good , English is spoken ,

waiting times are short , less than 15 minutes most of the time

Bumrungrad is great , much more plush and you pay for that ,

Sometimes it is very crowded when its vacation time for the Arab countries ,

Wherever you go , bring something to read , listen to or watch , makes the time pass because if you are waiting for test results it just takes time !

[lomm]

At the last years I tried some hospitals except Bumrungrad for my wife' her daughter and my self.

My opinion is that for realy small problem every hospital is O.K.

For real problem or checking Bumrungrad is better.

Clinics are good to got the document for the driving licens.

[user82374298374]

Wow... I'd been told specifically to stay away from Bumrungrad. Too expensive, too bureaucratic, takes too long, overkill for minor procedures...

Utter nonsense posted by those likely too cheap to pay for quality care. Bumrungrad is a fantastic hospital; I've been there for various types of treatments and procedures, and received only quick, top-notch care from knowledgeable medical professionals, some of whom speak better English than I do.

It's more expensive than other Thai clinics and hospitals, but still much cheaper than in the West. I can get same-day and weekend appointments with specialists (no requirement in Thailand to be 'referred' by a GP; you need a cardiologist, go see a cardiologist with no bureaucratic obstacles) almost every time I ask for one, and I've never received a misdiagnosis or been overcharged for services.

Where they do bite you is the cost of medicine; they charge double what you can buy the same medicine for at a Thai pharmacy (still cheaper than in the West). So, I typically buy the first round of any medicine I need from Bumrungrad, then get subsequent doses from Thai pharmacies.

Bumrungrad offers the best customer-service experience of any hospital I've ever used - because, unlike arrogant Western medical 'professionals', they know that I am a customer, and can take my trade elsewhere. Unless you're on the low end of the income spectrum, I strongly suggest you check them out.

Edited November 10, 2015 by disambiguated

[user82374298374]

if I were you I would stay away from "clinics". For an adequate medical attention for a foreigner one should go to thr international hospitals like Bamrungrad or Bangkok Hospital, where one can get the best and most professional attention. They are not cheap, but compared to the US they are.

While I generally go to Bumrungrad, which is fantastic, I've also been to Bangkok Hospital at their Pattaya branch (confusing nomenclature, heh). I was impressed with them, too, and would recommend both Bumrungrad and Bangkok Hospital without reservations, except the aforementioned pharmaceutical price-gouging at Bumrungrad (get your first doses from their pharmacy, then get subsequent ones from ordinary Thai pharmacies).

[mercman24]

not sure about your problems but SUKUMVIT HOSPITAL for me, and had a "waterworks" scare 6 weeks ago,feared the worst, go along, i see 3 different doctors, pee test, a scan like they do for pregnant ladies, (forget name) they show me pics and talk me through it, nothing untowards thank goodness, and give me tablets, all for the princely sum of 4,000 baht, in and out in 3 hours,and a nice clean new hospital to boot.

[Shiver]

I recently went to the Phuket branch of Bangkok International. The service was just fantastic (but reflected in the prices). I don't think I had to wait for more than 2 minutes in between each procedure, from check-in, weighing, blood pressure test, then the actual procedure, and then the routine exit strategy. They took my blood first so that by the time the procedure was done the blood panel was ready. All extremely efficient.

One good thing about medical speak is that they use English for all the words, so if you know the right words then you and they will understand.

If they want to take a biopsy then personally I'd be reluctant and just ask for it to be removed. If it's benign then it won't matter, but if it had something that made them scratch their head then you've already put a hole in it and left it wide open to metastasize. [i'm not a doctor I hasten to add].

One last thing; The specialists often spend certain days at certain hospitals, so you may want to phone ahead to know when the appropriate doctor is available for whatever issue you are looking to deal with. Using English should not be a problem for all but the most basic Municipal hospitals.

Edited November 10, 2015 by Shiver

[twix38]

Re Bumrungrad

We have impressions from our own experiences.

I could not swallow easily and wet there and had Endoscopy - rushed and diffculty administering.

Result was prescription that I later googled to find out they were anxiety tablets. Told I was ok and no further checking was needed.

Returned to UK a month later and Doctor sent me for Gastroscopy. I had Barratt's Oesophagus - pre-cancer condition.

I would find a good doctor foremost and if he works at a cheaper Hospital go there. I can still remember the name of the doctor I saw I needless to say I will never return to Bumrungrad. Expensive and in my case useless!

[arjunadawn]

Last year had EEG at Vajanii Hospital, Lad Prao Road. No complicated questions, investigations- just said I want EEG. Quick, professional, competent eeg read. I paid 1,000 baht. The doc skipped his doctor's fee because I just needed the data not his expertise. So, perhaps double this amount as the cost? Small hospital, clean, fast, also has packages like Sheryl noted.

I had my shoulder surgery and a EENT Surgery at Bumrungrad. I was 100% pleased.

[Sheryl]

It is possible to have good and bad experiences at any hospital. It all comes down to the individual doctor -- most of whom have hours at more than one place.

I would caution against equating "efficiency" in the business sense (no waits, quick turn around etc) with quality medical care. Likewise against equating the appearance of the facility or its comfort with the quality of medical care given.

[bazza40]

Don't go anywhere near a government hospital; mostly they hand out medicines and placebos. Low standard surgery.

The majority of private hospitals have some English-speaking doctors. If you cannot speak any Thai, they will make sure you are matched up with an English-speaker. They do make a substantial profit from their in-house pharmacies.

It's a bit like dentists here - you can tell how advanced they are by the state of the equipment. If you don't like what you see, walk out.

While I haven't needed their services myself, Bumrungrad has a world-class reputation.

[Nemesis7]

Jack, try Saint Louise Hospital in Bangkok

[Sheryl]

Don't go anywhere near a government hospital; mostly they hand out medicines and placebos. Low standard surgery....

Sounds like your exposure to Thai government hospitals has not included any of the tertiary level facilities. Which conduct extremely complex specialized surgeries (open heart; organ transplants etc) and are world class.

BTW the prior poster who said the King utilizes Bumrungrad is incorrect. The Royal family uses and has always used Siriraj, a government hospital (and one of the two best ones).

[Naroge]

Having been a customer of Bumrungrad for many years, I now stay away from it. Too much of a medical "factory" rushing the patients through in shortest possible time. And difficult to find anyone interested to discuss your total medical "picture". Each doctor just look with a very narrow view.

At BNH and Samitivej I have gotten much more face time with the doctors and more willingness to discuss my overall medical situation.

That's just my experience.

[thailanddogerator]

Pay a guide or translator to visit hospitals with you !

[thailanddogerator]

OH I LOVE IT ! Someone who knows nothing and keep talking...

Don't go anywhere near a government hospital; mostly they hand out medicines and placebos. Low standard surgery.

The majority of private hospitals have some English-speaking doctors. If you cannot speak any Thai, they will make sure you are matched up with an English-speaker. They do make a substantial profit from their in-house pharmacies.

It's a bit like dentists here - you can tell how advanced they are by the state of the equipment. If you don't like what you see, walk out.

While I haven't needed their services myself, Bumrungrad has a world-class reputation.

[akentryan]

If you are going to be in Thailand for a while I would suggest you pick a location that you will enjoy while here. Bangkok is not for me. Phyathai Hospital in Sriracha runs monthly specials including fairly complete blood tests, EKGs, etc usually costing from 2,000 to 4,000 baht. I drive up from Pattaya as the savings is well worth it. Contact Gavin Waddell, the International Marketing Direxctor at Phyathai at [email protected]. He can match you up with what you need. I have never used this hospital for anything other than tests. I use Pattaya Memorial in Pattaya but I will never again use Bangkok Hospital Pattaya as they are test, scan, and x-ray hungry. Bumrumgrad in Bangkok has always been my choice if my problem is serious. Not very cheap anymore. They wanted a 500,000 deposit before they would even admit my wife. Good luck in any event.

[Balance]

I am assuming that the reason you do not have the work done in the U.S. is that you do not have health insurance.

You can get a list of the top Medical tourist hospitals, and you should stay with a hospital. Some of the larger ones have U.S. board certified physicians. Most any general surgeon can deal with your wife's issue. Neurology is a different issue, and can become complicated if the problems are difficult to diagnose. Generally, Thai doctors will not refer to another physician not on the staff of the hospital. For example, generally you are better off at a teaching hospital if you have a out of the main stream problem or issue. Thai doctors are very reticent to talk about their experience or to be vetted by a patient. Review the resumes (available on-line) of the neurologists at one or more hospitals. Look for people who have some training or interest in the area of your concern someone who has had some of their training in the U.S. or Europe This will help with the cultural issues.

If you could find a medical guide or consultant to guide you through this, I would recommend spending the money. But, I am not sure anything like that exists.

If you are not confident as you search, I would strongly recommend getting some health insurance in the U.S. I am on Medicare and Kaiser Permanente is my integrated provider. Excellent primary care along with speciality care, with access to any physician.

Good luck

[Jack59]

Wow, thanks to everyone for the great advice I've gotten here.

I'm sorry to have brought Bumrugrad Hospital into the talk. It wasn't my intention to start a debate about its merits and costs.

In our case, we would like to get health care at good standards, but since we're paying out of our own pocket, cost is definitely an issue. I understand you get what you pay for, but as many posters point out, it's often possible to get the same level of quality health care, often from the same doctors, but without all the additional services and luxury that a high-end provider might offer. Since I'm new to the Thai health system, I wanted to get some feeling for where that line is, so I really appreciate the views that you all have given, especially and particularly because they span such a range of opinions. It really gives great real-world insight into how things work! Thanks!

We do have insurance in the U.S., but it's complicated. Stupidly complicated, sigh. No point in getting into the details here, but I'm sure many of the Americans here know what a mess it can be in the U.S. depending on dozens of variables about your circumstances. Plus, on a practical note, my wife and I will be travelling for several months on a (decades-long delayed honeymoon dream) trip, so the blood tests and neurology work has to be done wherever we are. The blood tests are more of a commodity product and we'd just like to find a reasonably-priced option with good hygiene and accurate results, but as many of you point out, neurology is trickier, quality is highly variable and it's much more focused on specialty, so it's where I'm putting my attention now. As for the lipoma, removing it is just an elective procedure (at home, it's classified as cosmetic in our situation) that we figure would be both more hassle-free and cheaper than in the U.S.

I'm sure the comments here will form a great base of information for many other people in the future as well, but I definitely know that it's already proving to be very helpful to my wife and myself, so I really thank you all. We very much appreciate!

[chubby]

so, jack, do you not have a "bronze" plan with a $6500 deductible health coverage in the US? seems like most things, it's good to have some continuity of care, unless like your wifes its a one-off procedure, though , even those sometimes, require aftercare ...........

hmm, neuropsychiatry , how does that differ from regular psychiatry , i wonder

Edited November 15, 2015 by chubby