Seeking recommendation for regular medical checkup

[peterdwje2]

I'm 59, male, haven't had regular medical checkup for 2-3 years and thinking of doing so. Would someone with recent experience pls recommend a place and doctor? Concerns would be cost, tests being done right, and doctor.

 

I've read previous posts here on the need to educate oneself about checkups, what's needed and not, etc. But have not seen specific recommendations for places and doctors. Though I guess it's hard to know if the tests are being done right.

 

Thank you.

[lopburi3]

You might want to indicate where you are located and if you have any conditions presently for best advise.

[peterdwje2]

3 hours ago, lopburi3 said:

You might want to indicate where you are located and if you have any conditions presently for best advise.

Sorry, thanks -- I'm in Bangkok and have no particular conditions, just looking for regular checkup.

[Spaniel]

From March 8 thru the 12th Bumrugrad Hospital Is holding a Health Fair at the hospital.     According to their ad they will be offering discounts on health checkups  and other medical procedures.      You should stop by the hospital and see what they have to offer.

[lopburi3]

If costs are a factor the most expensive facility in Thailand might not be the best choice for him - even on sale - especially if tests lead to more tests.  But if nobody can offer first hand recommendations perhaps could be an option.  Expect most of us older readers are beyond check-ups and having active treatment for one thing or another so our primary doctors schedule tests as needed.  

Edited March 9, 2017 by lopburi3

[Sheryl]

I'd suggest either Samitivej or St Louis based on what I have experienced among the places I have tried. Samitivej will cost more than St Louis.

 

Another option, and by far the eeast expensive, if you don't mind crowds and longer waits (and have a Thai speaker who can accompany you, or speak Thai yourself) is Chulalongkhorn hospital.

 

Actually all the hospitals "do the tests right", where they differ greatly is in the quality of the review of the results.

 

And in all of them, you need to come in already knowing what tests you need. You will otherwise be steered toward a more expensive package than you need but that still omits a test or two of relevance.

 

AT 59, if you have not had a colonoscopy in the past 10 years then you should (though it can be scheduled on a different day than the rest of the check up).

 

If you have not done a stress test in say past 5 years - or had one with less than ideal results -- ,ditto.  If you have had one and it was fine and you have no known cardiac risk facors,  then can probably wait a few more years.

 

Digital prostate exam is a must (and you may have to request it, Thai doctors tend to shy away from it). There are different opinions re PSA but personally I'd say yes, just be cautious and informed on how any elevated result is dealt with.

 

Otherwise the standard tests are:

 

CBC

creatnine

ALT, AST

lipid  panel: HDL, LDL, triglycerides

urinalysis, stool test

 

The above will usually be covered in  the lowest cost, or next to lowest cost, package. PSA and stress test will appear only in higher cost packages, so ask about adding them on to the lower end package, may well come out cheaper.

 

Upper end price wise packages in Thai hospitals usually include abdominal ultrasound, this is in part because of a high incidence of primary liver cancer in Thailand which is very rare in the West; it is also because private hospitals like to make money and ultrasounds tend to disclose all manner of benign cysts which people then feel compelled to investigate or biopsy etc etc. Abdominal ultrasound  is not  a recommended p[art of routine check ups in the west. Likewise they often include "cancer markers" like CEA, which are not recommended as they are very non-specific but hospitals like them for the same reason they like the ultrasounds -- lots of healthy people will have elevations leading to more tests etc etc. Unless you have a specific history of GI cancer in the family, CEA would not be recommended. Ditto alphafetoprotein (for which in Thailand they use an unusually low threshold as normal -- this goes back to the problem with liver cancer here, but applied to westerners it ends up with a lot of false "positives").

 

Which is a long-winded way of saying it is not the case that the more tests the better and unnecessary tests , especially ones of very low specificity, can cause more problems than they prevent.

 

 

 

 

 

[al007]

I have learnt a lot and had five annual check ups and some bad things like cancer missed

 

I have had a lot of experience of  Chulalongkhorn hospital., and the highest respect for it 

 

The prices are very acceptable, but sometime queues can be long like 3/4 hrs, but for my budget worth it

 

See the doctor first, let that doctor tell you what tests to have the form fillers often miss some tests you need, and in the past this happened to me, for instance when first my PSA became elevated I tried to go back; four years ago it was done but not 2 and three years ago, and in those days i knew less and did not check

 

I even had Ultrasounds and they missed things

 

Today I am being monitored on a monthly basis but in future if I progress away from that general checks ups will be at Chula despite living in Issan

 

Even on the two different forms from Chula there are maybe a couple of hundred tests, one form is white and another yellow, I have had maybe fifteen plus comprehensive series of  blood tests there, and today I still have to say please recheck with the doctor you did not check that box, it comes back with the box ticked, the doctor tells the nurse and she gets it wrong, My lovely Thai wife hides and say do not question or argue !!

 

CHECK CHECK AND CHECK

 

Make sure the report is properly evaluated, outside Bangkok I had an MRI and at a Different time a CT, the people originally interpreting the results missed the obvious and cancer indications

 

I had a colonoscopy and no biopsy was done, I promise I have now learnt a great deal

 

In Thailand I know today the patient has to have more input and participation than in maybe other countries

 

Despite having seen some bad things here I still have a very high regard for what can be achieved here, but be very careful on the doctors you select and I still prefer the medical care to the NHS in the Uk that I also class as very good generally

 

My problems were added to because I blindly trusted the doctors and I also blame myself

 

If after the results you do not feel comfortable get a second opinion

 

On my first MRI my urologist read the written report but neither looked at the scan or large negatives, I remember at the time thinking he is not doing enough BUT i never challenged just went away happy because he said no problem  Stupid me  Yes and I should have known better, and am not a timid Thai

[al007]

 

I am putting in three sheets of possible tests at Chulalongkhorn hospital, for me on which one to select I would want a doctor not a receptionist, and that was where my story started going wrong, I did not see the doctor to pick the selection, but have learnt the hard way