Wednesday, June 20, 2012

Under discussed topic - Health Care in Phuket

Here is a subject you won’t often here much about or see many blogs on, health care in the Phuket area.  I know it is not a great subject and sort of a downer if you are anxiously planning your dream vacation to paradise, but let’s face it, sh*t happens sometimes and it is helpful to know a little in advance of needing these services.  I am by far no expert on the various services here in Phuket, although through experience I have had a chance to sample several of the hospitals and dentist.
Let’s start with the easy one, dentist; there are lots of them spotted around Patong and Phuket Town as well as all the other areas of the island.  Of the ones I have used, they are all quite competent and seem to specialize in pain free dentistry, a high priority on my list.  Some, perhaps over half specialize in teeth whiting services and of the people I have talked to that have utilized these services were quite pleased.  The good thing is the prices are very reasonable, as example, I had one tooth pulled for less than 1,000 baht and several filled for under 800 baht each, don’t try doing this in the US.  So if you are here and have any kind of tooth discomfort or pain, I would not hesitate going to one of the local dentist.  As a side note, most speak very good English, which is most helpful when explaining your particular problem.

For small ailments or cuts and scrapes, a visit to the local pharmacy may be all that is required.  Most of the pharmacies I have stopped in have staff that speaks at least a bit of English and some are excellent English speakers.  Here in Phuket you can get many medicines and drugs that you can not get elsewhere without a prescription.  The pharmacists I have spoken with are usually very knowledgeable about simple remedies for minor ailments or minor cuts and bruises.  And as with the dentist, the cost of medicines at your local pharmacy is very reason, to the point of perhaps being considered cheap.  Don’t worry about finding a pharmacy when you need it (except in the very early morning hours, they do have to sleep), there are countless pharmacies all over the island and most are open from 9am until 9 or 10pm.  Some do stay open later, but that is usually in the Patong night life district around Bangla Road (hey some men need a little help after a successful evening on Bangla Road).

Heaven forbid you should have something major happen concerning a medical condition, there are several world class hospitals located here on Phuket.  I have personally had experience with four of these hospitals and will not comment on those that I have not visited.  As a bit of history and to put my comments in some context, I have lived in Phuket for the past four years and have experienced two major heart attaches as well as other minor aches and pains, including two minor and one not so minor motor bike accidents.  I have also spoken to friends that have had other medical conditions as well as motorbike accidents and been to the local hospitals.

By far the best hospital as far as services offered and comfort is the Bangkok – Phuket Hospital and is rated as one of the top hospitals in the world.  This is where I went with each of my heart attaches and am still here to write this blog.  OK, maybe I am being a bit sarcastic but with the one in 2009, I actually did died some 15 times, the heart stopping completely, but was able to survive thanks to the doctors and care at Bangkok Hospital.  I say this not to down grade International Hospital, located up the road from Bangkok-Phuket Hospital on the bypass, but as an illustration.  When I first present with my symptoms at International Hospital, they though it was a stomach problem and attempted to treat me for only that.  Since I had already had 3 previous heart attaches, I knew it was more than just a stomach problem.  But the doctor there tried to insist on doing an Endoscopy (where they shove a tube down you throat), which I refused.  He kept insisting saying he needed to see what was in my stomach, to which I replied, ”Wait a minute and I will show you!” since I was throwing up so much.  They did keep me over night to be on the safe side and charged me about 30,000 baht, not inexpensive.  Next after my heart attach the following evening, I eventually ended up at Bangkok-Phuket Hospital where they went all out to save me, immediately implanting a temporary pacemaker.  After many tests and diagnostic procedures and some wrangling about costs we went ahead and did an angioplasty and a permanent pacemaker implant.

Cost was an important factor for me since I do not have health insurance, so luckily Bangkok-Phuket Hospital’s doctors’ worked with me to keep the costs within my budget.  Now I do not want you to think that Bangkok-Phuket Hospital is inexpensive and is by far the most expensive one of those I have experience with.  And the added expense does show when you first walk in the door there, it is by every standard a modern, clean, well run hospital, right down to the comfortable waiting areas and central air-conditioning.

About a year after my heart problems, I experienced a liver and kidney infection, which Bangkok-Phuket Hospital cured immediately.  And I continued to go there for my quarterly heart checkups.  So this past January when I again felt the symptoms of a heart attach, rushed back there for treatment.  This time the situation was a bit worse and I needed a triple bypass, which should have cost 500,000 baht all in.  But again lacking insurance and being way beyond my brother’s ability to cover, I had to tell the doctors no.  They were quite upset, mentioning that without it I would die, but facts are facts and I could not afford it, so I figured it must be my time to go.  But the leader surgeon intervened and went to the administrator and got him to waive the fee (nice!).   So I had the operation, not really any fun and seemed to be recovering OK, so they released me, but not before demanding I pay the remainder of the 500,000 baht.  I mentioned that the surgeon had gotten the fee waived, which he confirmed, so they let me out paying only for the room and associated services, about 35,000 baht.
The recovery process at home did not go well and I returned to Bangkok-Phuket Hospital to be re-admitted, but was refused, saying I still owed the balance of a couple hundred thousand baht.  After some discussions, this didn’t go well partially because of language and partially because I was in no condition to argue; I took an ambulance to the government run Vachira Hospital down the road about 3-5 kilometers.  To say the least Vachira Hospital is different in appearance than Bangkok-Phuket Hospital, no shiny reception lobby, no comfortable seating anywhere to be found, generally not as modern a hospital.  Plus it is crowded; being the government run hospital it is much less expensive and for the Thai’s in some cases offers free medical help.  But given these differences does not affect the level of care provided by the staff, although the number and level of English speakers in limited.  After several hours of being shuffled about in various halls within the hospital, I was placed in a ward with 15 other people in various states of health.  I was in Vachira Hospital for about a month and a half and the last 2 weeks actually had a very nice private room with air conditioning, private bath and a couch where my girlfriend could sleep.

This is a very important point in Thai hospitals, having your significant other stay with you is essential.  I discovered this on my first visit to the hospital, but it became abundantly clear while recuperating in Vachira that without Oi (my Thai wife) I would not have survived.  Unfortunately the Thai hospitals appear to be under staffed in nurses and nursing assistants.  But in the long run I recovered completely while at Vachira due to the fine care of the doctors and nurses and thank in no small part to Oi and the best part of the experience was the cost, only 32,000 baht for a month and half of round the clock care and medicines.  This included the charge for the private room for two weeks.  If you were to compare this to the cost of Bangkok-Phuket Hospital, the cost would have been at least 3 or 4 times as much.

The fourth hospital I have had experience with is the Patong Hospital, which is conveniently located in the heart of Patong.  It is also a government run Hospital and is similar to Vachira Hospital although not nearly as large or extensive.   I have never stayed in Patong Hospital over night but do go on a weekly basis to treat and dress the remaining surgical scars on my ankles from the triple bypass.  These wounds are very deep and taking a long time to heal, obviously since it has now been almost 5 months since the surgery.  Again like the other hospitals I have received excellent care from the staff.

OK to recap, the hospitals on Phuket are very good and if cost is no object, I would recommend Bangkok-Phuket Hospital in terms of services provided and efficiency.  To be honest the biggest drawback to Vachira and Patong Hospital are the wait times, because they are government run and inexpensive, they are crowded causing long waits to see doctors.  If you have an emergency, it is no problem because they will take you in through the emergency room.  But for minor problems or illnesses there is definitely a much longer wait at the government run hospitals, but the up side to waiting is the lower costs.

I feel that I should also mention that because it is a commercial hospital, Bangkok-Phuket Hospital does offer elective type surgeries that I am sure are excellent and less expensive than other parts of the world.  Of course in my experience I have found that the cost of the services offered at all of the hospitals in Phuket are far less expensive than any other part of the world.
Please if you are planning a vacation in Phuket, do your homework and get the necessary vaccination and bring any prescription medicines.  It would be a good idea to have a brief discussion with your doctor about you trip and any precautions you might need to take.  IF you are already here, don’t worry, the medical establishment can take care of whatever ails you and probably for a lot less than at home.

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