… THAI DOCTORS AND HOSPITALS – Finding and Managing Quality Medical Care

[palmtree]

12 hours ago, hormone said:

Here is where I would be a little more cautious although basically I agree with @brutox on pretty much everything-- especially the GOD syndrome! 
-----
By the way: what is the difference between God and a cardiac surgeon? 
...

God knows HE is not a cardiac surgeon...

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OK back to serious: I am 100% in favor of wider public education on body functions and health issues.  But when one searches for "what's wrong with me?"...  this is where Dr Google can be detrimental if not used properly.  Here's why.

Herein lies the major difficulty for (allow me to say it like that) lay people or people with insufficient medical knowledge:
All the references shown here (and they are quite good for lay people!) go from the medical diagnosis --> explain the symptoms/ signs/ testing and treatment ...
It is the same problem with most (not all) medical textbooks.  You read on stroke for example and you learn what causes it, how it manifests, what the clinician will find on examining the patient, the tests to diagnose a stroke and the treatments. 

To the opposite: In clinical medicine, the doctor will be facing a bunch or more or less coherently explained symptoms related by patient or family and then must make sense of all this and come to a working diagnosis, refine it and prove it (or disprove the serious ones, at the least). 

So if you are searching for what is your diagnosis, search engine queries can be frustrating, panicking or worse just plain wrong out in left field.  Obviously with advances in AI things will improve!  But you need to be as complete as possible.  For example, Brutox' daughter's case (appendicitis) could very well also sound like menstrual cramps if only a few symptoms are put in, until you enter fever and maybe for example that she is 2 weeks from her previous period...
Another eloquent example would be: muscle pains, chills, sore throat, runny nose, mild headache and fever.  To most of us this sounds (and in the appropriate context would likely be) a flu-like illness... covid... Until you put in that you went to Central Africa and returned a week ago... and then we have malaria as no 1 diagnosis!  

I do totally agree though is that if you are given a diagnosis by a physician, by all means do research it on APPROPRIATE medical sites.  And there you can find a good description of symptoms and diagnostic findings as well as recognized / recommended treatments. 
 

Given this, isn’t part of the job of the diagnosing physician to ask the questions?  That sounds like a big part of deficiencies being cited here.

[hormone]

32 minutes ago, palmtree said:

Given this, isn’t part of the job of the diagnosing physician to ask the questions?  That sounds like a big part of deficiencies being cited here.

From my direct observations of Thai physicians, indeed some of them tend to ask (too) few questions and zoom in on a diagnosis (as opposed to THE / the correct) diagnosis too quickly.  

[brutox]

3 hours ago, palmtree said:

Given this, isn’t part of the job of the diagnosing physician to ask the questions?  That sounds like a big part of deficiencies being cited here.

As @hormone cites above, asking questions is an important part of a physicians job .. and yes, a big part of the deficiencies being cited are physicians not capably asking questions .. Thai medicine is not western medicine.

The point of this thread's opening post is being an informed consumer of the medicine that is available in an imperfect healthcare system .. be sufficiently knowledgeable to recognize and question when you are being poorly served.

Give physicians their due, sure .. but, not blindly .. trust, but verify .. and for gawd's sake, shop for a physician, not a hospital.

[Ackruu123]

I will add my 2 cents.

I work in the field of Oncology in the US as an allied health care professional  (I am not a physician).

Many years ago I went to a social event and was seated at the same table as a General Practitioner.  We began talking about our jobs and he started to lament that he wasn't doing anything exciting in medicine. He worked for Kaiser Permanente and went to his assigned clinic everyday and saw patients who had new ailments.  Kaiser Permanente is a large health care company in California.

I told him that he was doing more doctoring than any of the physicians I worked with.  By the time the patients get to us, someone was already figured out that they have cancer.  That's the key.

The physicians I work/worked with operate from a pretty well defined playbook.  They dole out treatment based on the stage of the disease, manage any side effects from treatment and see the patient for one or two follow ups.  This is much easier than seeing a guy who walks in off the street, rubs his hand over his belly and says "I get intermittent  pain here."

I have no reason to believe that the guy I was talking to way back when wasn't a competent doctor.  However, in the US, most medical students are hoping to get accepted into a residency in a highly specialized and highly lucrative field.  The residency programs can afford to be selective and only accept the best and brightest.  In a way, that leaves the "also rans" to work on the front lines of medicine. 

My GP back home is a guy I don't particularly like.  He is overweight and strikes me as being lazy.  However, he has never been wrong.  He has been a doctor for a long time and I think the number of years a GP has been practicing probably helps avoid a misdiagnosis.  He has seen it all before.

Thanks for the thread.  

[hormone]

After reading many comments posted during the week of of June 1st- June 8th  on Ed Sweeny Appreciation thread I would like to point out a few potential gaps/ traps that we can easily fall in when we chose healthcare in a foreign country. 

The comments are mostly related to the minimally invasive procedure they are planning (at the time of writing this) for Ed.  I am in no way trying to "badmouth" the people who have commented.  After all, medicine is a vast and highly complex field, the information can be opaque.   Also I am in no way trying to belittle/ devalue the people taking care of Ed Sweeny, that is not the point, I have not spoken to them, I don't know what they know and what they don't know. 

As humans, we fear sickness, death, uncertainty.  Maybe we fear uncertainty the most.  A big part of a doctor's job is to reassure patients.  Many cultures have a deep respect for the (medical) doctor, especially a specialist doctor.  Some cultures even go so far as to take their word for the gospel, if I can use that example.  What the doctors says is usually taken as truth, as gold.  And when the doctor tells us "this is the best (something) for you" we feel reassured.  When the doctors say it with confidence, we often feel so much even better!  In many (if not most) cultures the doctors learned to project confidence, so as to onboard the patient with the diagnostic and therapeutic process.  

Obviously if someone tells me they are going to make a hole in my skull, insert a metal rod and suck/ cut some piece of bad tissue out of my brain, that someone better sound like they know what they are doing.  But I would like to know more about this doctor's ability to perform said procedure... Here are some questions you can ask and the reasons why  :
- is this the standard procedure for my case/ disease?  Is this a new procedure (especially when involving something high tech...)? 
- Is there an alternative procedure (and please explain) ?
- how many times have you done THIS procedure before?   And the alternative procedure? 
- did you learn this procedure during your specialty training?  or at  a seminar ? or... ? 
These 2 last questions are super important, especially for more recent procedures!  Because learning during specialty training implies greater supervision from seniors vs learning "on your own" or at a seminar or with a "techno gadget" maker representative.  Some things are super simple to learn/ use, others more complex.  People need to learn, repeat, practice.  That's why doctors USUALLY learn in supervised environments. 

The doctor can tell me "this procedure is the safest, has the least complications..."  Or "this tool is the most advanced, the most amazing!"  That is all great, but as Brutox compared earlier, this is all about the hardware.  The software, or the programmer is the one manipulating the tool, and this is more important.  The best tools in the wrong hands can have results by far inferior to the average tools in the best hands...

 

[hormone]

Continuing on the topic of falsely reassuring novelty / the most up to date treatments...

Now as an intelligent and curious customer (or patient) I can read about the technology or treatment on line.  Excellent.  I can search reputed sites, such as Mayo Clinic.  Excellent.  But when you search like that, it will give you results for what they do at the Mayo Clinic...  (FYI if someone does not know Mayo Clinic is one of the world's most famous hospitals and known for groundbreaking treatment in multiples fields... )

This is where we need to check the APPLICABILITY and REPRODUCTIBILITY of results.  Hence: Mayo Clinic is not Sri Racha Hospital...
In the thread on Ed's current health problems, a link is posted to explain the minimally invasive brain surgery procedure.  This link is about the Mayo Clinic experience.  It seems amazingly positive, of course. But one needs to ask oneself:
- Who are the docs who "used" procedure X in the information I found?  What is their training level?  How experienced in the field are these docs?

- In what way could their training level and the training level of others working with them (nurses, anesthetists...) differ from the doctor + nurse + anesthetist in front of me using the same technology?  Most complex procedures are team work.  A surgeon needs good scrub nurses/ assistants to pass the right tools at the right time.  Difficult for the assistants to know new tools if they have not used them much before...

- How big was the study I found?  This correlates to how much experience they have, but also with variable statistics: with a small sample size, the real result could be within a wide margin of uncertainty.  This means that maybe if they did the procedure on 15 people and it was amazing in 14 patients, someone else repeating the same study could have 7 people with amazing results and 8 with terrible... Obviously every new procedure starts with a new small study.  Doctors try it once, twice, wow it works and you do more.  Then word spreads around.  But complex procedures remain very complex the first times you perform them.  Only with time and practice do you become familiar and proficient with them. 

 

[Phoenix Dave]

I, for one, take everything coming from Mayo with a huge grain of salt, as do many ex patients. In my case I felt like that joint was better at separating me from my money than from my cancer.

[Pheat]

1 hour ago, Phoenix Dave said:

I, for one, take everything coming from Mayo with a huge grain of salt, as do many ex patients. In my case I felt like that joint was better at separating me from my money than from my cancer.

Dave can you go into more detail 

[brutox]

1 hour ago, Phoenix Dave said:

I, for one, take everything coming from Mayo with a huge grain of salt, as do many ex patients. In my case I felt like that joint was better at separating me from my money than from my cancer.

 

36 minutes ago, Pheat said:

Dave can you go into more detail 

Hey men, let's not dwell on a bad medical experience at an American hospital .. the thread focus here is Thai medicine - informing untrained laymen about: (i) avoiding bad medical decisions, and (ii) making good medical decisions, in a system which is very opaque and not at all as reliable as its public perception.

There is need on this thread for case studies recounting bad/good medical outcomes here in Thailand .. experiences from which we can pickup useful bits and pieces are welcome.

But, please post the stuff that is irrelevant to Thailand elsewhere .. I'd really like to keep this thread focused on being an instructive go-to resource for anyone who might be dealing with the many unseen vagaries of the Thai medical system.

Thanks.

Edited June 9 by brutox

[Phoenix Dave]

Very well, I apologize for the TF, if that is how my post was seen.

Instead I will comment that I was highly satisfied with the service, treatment, and outcome from my Urologist at Samitivej Sukhumvit. I never felt like I was being spoken AT, my questions and concerns were encouraged, all options were presented, with clear pros and cons for each explained. The course of treatment I selected was followed, even though it wasn't the exact recommendation of the doctor.

[hormone]

1 hour ago, Phoenix Dave said:

I, for one, take everything coming from Mayo with a huge grain of salt, as do many ex patients. In my case I felt like that joint was better at separating me from my money than from my cancer.

 

11 minutes ago, Phoenix Dave said:

Very well, I apologize for the TF, if that is how my post was seen.

Instead I will comment that I was highly satisfied with the service, treatment, and outcome from my Urologist at Samitivej Sukhumvit. I never felt like I was being spoken AT, my questions and concerns were encouraged, all options were presented, with clear pros and cons for each explained. The course of treatment I selected was followed, even though it wasn't the exact recommendation of the doctor.

@Phoenix Dave : I think your 2 comments are interesting as they bring up the very important concept of patient satisfaction!  There are many factors that drive patient satisfaction, and a lot of them are actually not related to the medical outcome per se.  I refer you gents to this article:

https://www.wolterskluwer.com/en/expert-insights/what-is-patient-satisfaction-and-why-does-it-matter

THE most important driver (factor) of patient satisfaction is usually communication between patient and doctor/ other health care providers.  Probably the 2nd most important are the patient's expectations of care.  The actual outcome of your care is also very important but strangely not always dominant (it usually depends on the seriousness of your condition).  Other things such as the environment where you are being examined/ treated, waiting times, cleanliness, management of your pain or symptoms are also quite important but many times a physician with great bedside manner will allow the patient to forgive other less optimal aspects of their care, as you feel reassured/ understand better what is going on. 

Let me give weird but true examples:
1- Doctors with great bedside manners but who miss diagnoses "often" (hard to define...) get sued less that amazing diagnosticians who have a shitty personality...

While other patients will forgive the doctor's poor manners as long as the outcome is good...

2- People are willing to forgive being examined in a dirty soiled room (for example with dried blood on the exam table...) because the doctor communicated well and alieved their fears...

While other people will be super happy because the environment was amazing, even though the doctor completely missed the problem...

3- Some patients absolutely want tests done, even if the tests are not useful.  But they feel reassured by these tests... so depending on if tests are done/ not done, they will feel more or less satisfied...

Patient satisfaction had been for some years more and more measured and used as an indicator of quality of care.  But when I say patient satisfaction may not be related to medical outcome it is (pushing to the extreme) like "well we missed the diagnosis, but you will die happy in a nice place... " .  So if we survey you, you will be satisfied... 
Obviously many aspects related to patient satisfaction DO have ++ importance in the whole "medical consultation" process: good communication ensures the doctor listens to your symptoms (so more chance of finding out what is wrong), ensures patient onboarding with work up + treatment.

Many private hospitals here in Thailand (and in the world) have understood this well and they apply Thai hospitality principles towards patient satisfaction: rapid initial welcoming/ orientation when you arrive, nice waiting room, constant updates on your wait times/ where you are in the process, lots of smiles, free juice, breakdown of the whole visit into multiple smaller encounters which keep you moving and active-- you feel like something IS happening. 

[palmtree]

^^^

It occurs to me that one of the issues is that in the case of a bad outcome, there is often no way for the patient to evaluate the quality of the doctor's recommendation and diagnostic ability.  It is not like ordering a package that either arrives or doesn't.

Unless there is obvious incompetence that directly leads to negative consequences, it's hard to know whether the doctor did a "good" or "bad" job.

In the case of Joker, it does appear that there was a clear original missed diagnosis. But let's say the diagnosis had been correct - how do we know the outcome would have been different?

It really is outcomes that matter.   Are there statistics of that by doctor in Thailand?

And then, of course, there is the other issue that a cancer doctor is likely to have a higher percentage of negative outcomes just due to the nature of the illness they are treating.

[brutox]

11 hours ago, Phoenix Dave said:

Very well, I apologize for the TF, if that is how my post was seen.

Instead I will comment that I was highly satisfied with the service, treatment, and outcome from my Urologist at Samitivej Sukhumvit. I never felt like I was being spoken AT, my questions and concerns were encouraged, all options were presented, with clear pros and cons for each explained. The course of treatment I selected was followed, even though it wasn't the exact recommendation of the doctor.

Thank you Phoenix D .. so, you were highly satisfied with the Samitivej Sukhumvit (Bangkok) service .. family members and I have found some good medical care there .. not because of the hospital as much as for  the doctors I did homework on who practiced there .. I rejected two, that I recall.

Which path did you map out to get there? -- by first selecting that hospital by reputation/reference/however, or first selecting a doctor by professional profile that happened to practice at that hospital?

If the former, did you take a number in the queue for the next available doctor in the rotation, or were you offered an opportunity to vet and select a doctor from their urology department?

I took my son there for an appendectomy .. interviewed the first surgeon they recommended, who I passed on .. not enough experience to be cutting open my kid, even for an uncomplicated procedure .. found a much more experienced surgeon in the 'Goldilocks' zone about which I cited in the original post .. the discussion was awkward for the hospital and the first surgeon .. the  face issue ..  but, the more senior surgeon I favored was helpful in smoothing it over.

First and foremost, a doctor who checked my priority criteria, not the hospital's.

[palmtree]

33 minutes ago, brutox said:

Thank you Phoenix D .. so, you were highly satisfied with the Samitivej Sukhumvit (Bangkok) service .. family members and I have found some good medical care there .. not because of the hospital as much as for  the doctors I did homework on who practiced there .. I rejected two, that I recall.

Which path did you map out to get there? -- by first selecting that hospital by reputation/reference/however, or first selecting a doctor by professional profile that happened to practice at that hospital?

If the former, did you take a number in the queue for the next available doctor in the rotation, or were you offered an opportunity to vet and select a doctor from their urology department?

I took my son there for an appendectomy .. interviewed the first surgeon they recommended, who I passed on .. not enough experience to be cutting open my kid, even for an uncomplicated procedure .. found a much more experienced surgeon in the 'Goldilocks' zone about which I cited in the original post .. the discussion was awkward for the hospital and the first surgeon .. the  face issue ..  but, the more senior surgeon I favored was helpful in smoothing it over.

First and foremost, a doctor who checked my priority criteria, not the hospital's.

Do doctors in Thailand solely work out of hospitals, or do they have private offices as many in the US do?  It seems that this discussion has been centered around hospitals; are we missing a sector of doctors or not?

[brutox]

7 hours ago, palmtree said:

... it's hard to know whether the doctor did a "good" or "bad" job.

In the case of Joker, it does appear that there was a clear original missed diagnosis. But let's say the diagnosis had been correct - how do we know the outcome would have been different?

It really is outcomes that matter.   Are there statistics of that by doctor in Thailand? ...

The Joker's misdiagnosis could have made a difference, depending on how fast his stomach cancer was advancing .. for his age and sex, the 1-year survival rate for stage 4 stomach cancer (when he was finally correctly diagnosed) was 20% .. unsure how rapidly the cancer advanced, but if they had correctly diagnosed him two months earlier when it might have been maybe stage 1, or 2, or 3, the 5-year survival rate would have been 65%, 35%, or 25%, respectively .. who knows what happened in the two months he went misdiagnosed and untreated.
Good doctor based on statistics .. ummm, I rather doubt it .. maybe someone is tracking them, but you can imagine the outcry here by physicians .. lack of transparency is a chronic problem throughout Thai society.

Most hospitals publish only scant information on their physicians .. Bumrungrad Hospital and MedPark Hospital (both in Bangkok) are the best I have found for disclosing their physician's backgrounds, from which you have to make a subjective decision about whether they are a good bet based on their history.

With that starting information, I evaluate their backgrounds in context to the criteria I listed in the opening post .. then, I do an Internet search to discover what other professional credentials they might have (research, publications, organizations, etc.) .. I've had great results finding very competent doctors here and the best medical care I've had living in 11 countries (including the US) .. but, I had to dig deep to find them .. worth it.

.

[hormone]

9 hours ago, palmtree said:

It really is outcomes that matter.   Are there statistics of that by doctor in Thailand?

And then, of course, there is the other issue that a cancer doctor is likely to have a higher percentage of negative outcomes just due to the nature of the illness they are treating.

Indeed outcome does matter.  There is also complication rate which is often used as a marker of quality of care in western institutions.   As far as I know, there are no such statistics here in Thailand, for outcome or complication rate.
Indeed what a loss of face for the lower ranking docs here...

And @palmtree you do point out an important aspect:  Dr X's outcome statistics will also be modulated by the complexity of cases that this Dr takes on.  If you treat a fair share of sicker patients, you are more likely to have poorer outcomes.  But in western world we will usually balance that out by comparing similar types of physicians (oncology specialists within university hospitals). 

[hormone]

2 hours ago, palmtree said:

Do doctors in Thailand solely work out of hospitals, or do they have private offices as many in the US do?  It seems that this discussion has been centered around hospitals; are we missing a sector of doctors or not?

Thailand's medical system is expansive, with both private and public hospitals and clinics or "private" offices.  This article (that I find reliable as banks here have a clear interest in medical business...!) shows the divide:

https://www.krungsri.com/en/research/industry/industry-outlook/services/private-hospitals/io/io-private-hospitals

Summary + a few pointers on how to interpret the numbers:

- Over 38 000 facilities in Thailand that offer "some form healthcare" --> 65% private (clinics and hospitals), 35% are public

- 98% of these facilities are classified as "primary health care"  including 24 800 private clinics

- Out of the remaining 2% of facilities which comprise of 2ary and 3ary level health care (all of these should be hospitals or very large very specialized clinics), there are 370 private hospitals and 294 public ones. 

- Of note, amongst the 24800 private clinics, you have (numbers unknown to me) tons of cosmetic/ beauty/ rejuvenation/ "men's health" clinics: just walk into any Thai shopping centre or large building and you will see multiple such clinics.   In BKK and major cities, I would say these are clearly the most visible part of the non hospital health care system.

- Thailand has a also a lot of "private practice" clinics for general practitioners.  While these may not be completely private and cater to a mix of public (social security) and private/ surcharged patients, they offer the basic coverage for the population in every day health care needs in a large portion of Thailand (basically out of urban areas).  A lot of times these clinics are "family run businesses" where the father is the doctor, mom is the nurse or general manager, the son or daughter is studying medicine and helps out as "nurse" or attendant... or even does small procedures to practice.  Eventually the newly graduated GP will go work at family clinic and inherit the business.  The clinic will often also provide the medication (or have a related pharmacy next door from uncle...).  For common colds, bladder infections, small wounds or any bogus medical certificate it can be a valid option. 

- In rural areas, outside of major cities, hospitals will be mostly only primary care level (public). Quite often they are "run" by (= the main work force is) freshly graduated doctors who have not completed a specialty training yet and are "paying their dues" to the government (for their medical education) for 1-2 years before being admitted into a specialty training back into a university hospital...  My recommendation would be: avoid unless you are in dire straits... 

- In remote areas, including the ever popular islands (Samui, Tao, Phangan, etc) the "real medical" (as opposed to cosmetic) clinics are more visible especially in more touristy spots.  They are a mix of private (mostly) and public clinics and many have a small "emergency" (1-2 stretchers and some equipment) for emergency cases.  While ok for run of the mill issues, I would qualify them more as an aid station (if I compared to military medical organization). 

- The advantage of a private hospital from a large organization (BKK hospitals for example) is that the physicians working there will almost always have more experience than the interns or young docs working in government hospitals and they have specialist back up (even if only by teleconsultation).  But if anything is serious, request to be brought to BKK (or self evacuate if you can, as they will of course charge you for the evacuation!). 

[hormone]

1 hour ago, brutox said:

The Joker's misdiagnosis could have made a difference, depending on how fast his stomach cancer was advancing .. for his age and sex, the 1-year survival rate for stage 4 stomach cancer (when he was finally correctly diagnosed) was 20% .. unsure how rapidly the cancer advanced, but if they had correctly diagnosed him two months earlier when it might have been maybe stage 1, or 2, or 3, the 5-year survival rate would have been 65%, 35%, or 25%, respectively .. who knows what happened in the two months he went misdiagnosed and untreated.
Good doctor based on statistics .. ummm, I rather doubt it .. maybe someone is tracking them, but you can imagine the outcry here by physicians .. lack of transparency is a chronic problem throughout Thai society.

Obviously without having all the info it is hard to "estimate" but reasonably specialist doctors agree that when a diagnosis of stage 4 cancer is made, it was most likely already stage 4 or at least stage 3 a few months before (1-2-3 months) and earlier diagnosis will not result in curative treatment although it may prolong life.  

Some cancers are notoriously hard to diagnose at early stage, usually from lack of specific symptoms i.e. no/ very symptoms until too late or because they have the same initial symptoms as a flurry of common and benign illnesses.

Another counfounding factor is that the same organ can have different types of cancer, which may be confused as the same type of cancer:  ex. for the stomach, there are 3 broad categories: gastro-esophageal junction cancer (GEJ) and gastric carcinoma (GC), which are "true" stomach cancers and also gastric lymphoma.  GEJ is more agressive and more likely rapidly fatal compared to GC 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148370/

Finally, and this relates to the cancer being hard to differentiate from other more common and benign problems, even though there are recognized diagnostic pathways, one needs to balance out "when to work up" someone vs overloading the health care system and with the risk - benefit assessment. 
For example if you submit everyone who has "(upper) stomach pains" to a gastroscopy (fiberoptic camera) immediately, you will have a super high negative rate of diagnosis, you will overload the gastroenterologists' capacity to scope other types of patients who really need it and you also will eventually have resulting complication rates "for nothing" (that would not have happened if you did not do the scope and who otherwise have a normal scope procedure, with trivial or no findings).  These complications can range from aspiration pneumonia to esophageal or stomach perforation... And depending on the number or people you scope, the number of complications might be higher than the number of stomach cancers you detect! 

[GhostRider666]

own experience:
Private hospitals are just thief's..

Not only delay your healing process, but also delay correct diagnose  causing hospitalization.

Try keep you as hostage as long as possible, specially when insurance company stand for expenses..
Pattaya BKK Hospital, Pattaya Memorial Hospital
for sure rest of private hospitals  are members of same gang!

 

[Billy Shears]

All this shopping around for the best doctor is well and good, IF you have a big family to support you. If you're alone and sick, you usually take whichever doctor is assigned to you and listen to their instructions. 

@brutox If your were alone and needed an appendectomy, would you have been able to get out of bed and start interviewing doctors?

[Phoenix Dave]

7 hours ago, brutox said:

Which path did you map out to get there? -- by first selecting that hospital by reputation/reference/however, or first selecting a doctor by professional profile that happened to practice at that hospital?

I selected the doc from a list of seven that were recommended on web ranking sites at the time. Only 2 were in Thailand. This doc wrote several very inquisitive/informative emails. Most just posted their pricing structure.

I recognize that I got lucky, but I was searching from the states, specifically for non-US doctors. It had become clear that the insurance would only cover the services I didn't want, and so I would be paying out-of-pocket.

[brutox]

26 minutes ago, Billy Shears said:

All this shopping around for the best doctor is well and good, IF you have a big family to support you. If you're alone and sick, you usually take whichever doctor is assigned to you and listen to their instructions. 

@brutox If your were alone and needed an appendectomy, would you have been able to glde man get out of bed and start interviewing doctors?

I hear you .. you gotta' have a back-up team, Billy.

Having reliable, close friends who know me quite well is for me critical for expat lifestyle .. no different I guess than for a single man with no nearby family support living in his home country.

In addition to my 4 Thai adult kids (who can handle most any non-critical issue), I count amongst my close circle two veteran expats capable of knowledgeably navigating a critical medical solution if I become incapable .. in the worst case, if I am in critical condition and 'seeing the light', everyone clearly knows my instructions about advanced life support and my two buddies are close enough to support my kids (or, step in themselves) to pull the plug when it is no longer worthwhile.

Even if I die, they are close enough to my family to have the 'keys' to attend to all accounts (financial, legal, estate, and otherwise) which might get more complicated than my kids can handle.

We've all seen these guys here .. I won't burden my kids with any uncertainty about critical healthcare .. as me, my buddies back them up, too.

[brutox]

24 minutes ago, Phoenix Dave said:

I selected the doc from a list of seven that were recommended on web ranking sites ...

That's an additional tool that could be useful .. share?

[freedom42]

5 hours ago, brutox said:

That's an additional tool that could be useful .. share?

When I search for doctors, I like to look at their training and if they have done a year or more overseas (USA / Europe / South Korea / Japan etc) I will choose to see them. I actually had the discussion the other day with my 67 year old psychiatrist in Manarom Hospital about doctors in Thailand that have the "god complex". He actually agreed on many points about how doctors that have not gone abroad tend to be unwilling to listen to you and just diagnose you with "book learning". I chose this guy as he specializes in Sleep Medicine and did two years in Chicago. I have also seen two top orthopaedic surgeons in Bangkok Hospital BKK that were exceptional. They were both doctors in the Thai military and both told me "I make money cutting people open, but I don't cut people open to make money". Both are heads of their respective units in the BH Orthopaedics department. I will put their names here and if someone chooses to see them, they may or may not have the same experiences I had, but these guys are on my "best of" list. 
https://www.bangkokhospital.com/en/doctor/dr-tayard-buranakarl
https://www.bangkokhospital.com/en/doctor/dr-pornthep-mamanee

I also have seen the "top" spine surgeon at BNH, who is always pushed on the AseanNow forum by a certain woman. I would never go back, as he had his mind made up that the ONLY procedure that would help me was what he wanted to do without offering any other options (He wanted to do a 4 level lumbar fusion, when it wasn't needed and I still haven't needed surgery since I saw him 3 years ago)

I like to use NewsWeek for their rankings- again I always do my own research based on the rankings. https://www.newsweek.com/rankings/best-specialized-apac-hospitals-2024https://www.newsweek.com/rankings/best-specialized-apac-hospitals-2024

This site doesn't rank doctors, but it seems to be a comprehensive list. The guy who writes the articles is a bit of an alarmist in the way he uses exclamation points all the time.  

https://www.thailandmedical.news/pages/thailand_doctors_listings

 

 

[brutox]

1 hour ago, freedom42 said:

When I search for doctors, I like to look at their training and if they have done a year or more overseas (USA / Europe / South Korea / Japan etc) I will choose to see them. I actually had the discussion the other day with my 67 year old psychiatrist in Manarom Hospital about doctors in Thailand that have the "god complex". He actually agreed on many points about how doctors that have not gone abroad tend to be unwilling to listen to you and just diagnose you with "book learning". I chose this guy as he specializes in Sleep Medicine and did two years in Chicago. I have also seen two top orthopaedic surgeons in Bangkok Hospital BKK that were exceptional. They were both doctors in the Thai military and both told me "I make money cutting people open, but I don't cut people open to make money". Both are heads of their respective units in the BH Orthopaedics department. I will put their names here and if someone chooses to see them, they may or may not have the same experiences I had, but these guys are on my "best of" list. 
https://www.bangkokhospital.com/en/doctor/dr-tayard-buranakarl
https://www.bangkokhospital.com/en/doctor/dr-pornthep-mamanee

I also have seen the "top" spine surgeon at BNH, who is always pushed on the AseanNow forum by a certain woman. I would never go back, as he had his mind made up that the ONLY procedure that would help me was what he wanted to do without offering any other options (He wanted to do a 4 level lumbar fusion, when it wasn't needed and I still haven't needed surgery since I saw him 3 years ago)

I like to use NewsWeek for their rankings- again I always do my own research based on the rankings. https://www.newsweek.com/rankings/best-specialized-apac-hospitals-2024https://www.newsweek.com/rankings/best-specialized-apac-hospitals-2024

This site doesn't rank doctors, but it seems to be a comprehensive list. The guy who writes the articles is a bit of an alarmist in the way he uses exclamation points all the time.  

https://www.thailandmedical.news/pages/thailand_doctors_listings

Some good stuff here, freedom42 .. nice.

We share some of the same checkbox criteria I cite in the opening post as indicators of quality physicians .. they work.

The ThailandMedicalNews registry of physicians includes useful background information to fill in some of those checkboxes .. as @hormone wrote, actually ranking a physician, in order, amongst peers involves a lot of subjectivity and I think unlikely to find anything like that here in Thailand for the cultural reasons mentioned earlier.

The Newsweek-Statistica hospital rankings gives no explanation of their methodology .. we could probably search JCI-accredited hospitals and cross reference them with locations for 'Starbucks+Au bon Pain' and get a pretty good sense for the quality of the hospital, as 'medical hardware' .. 555.

But to me, the hospital is secondary to the physician .. the 'software'.

Good intel freedom42 .. thanks for contributing this.