Friday, February 1, 2013

Friday, February 01, 2013


(pic ANNIE tripped in classroom)
Well I guess we have all had it at one time or other – those Thai hospital bills when you go in for a minor ailment in Thailand and are sent packing with piles of pills and a big bill.

It’s happened to me many times and I have vowed I will not tolerate it again. Yesterday Annie my five year old daughter had an accident at school. She tripped and cut her chin.

We got frantic calls from the school saying they were taking her to the Emergency Room at a hospital in Minburi and the school asked mum and dad to go and see her.

It did not look serious but they wanted to put stitches in. They wanted me to stay for the minor surgery but would not let me hold her hand. Her cries brought tears to my eyes. But it was over quickly.

Then came the sit down with the doctor time. He wanted to give her antibiotics and painkillers.
Antibiotics? In my day muy mum just used to clean and sterilise the wound on the spot.  Painkillers – the most pain inflicted was during the operation. Now the pain had gone.

I objected. The doctor insisted. She needs antibiotics or the wound could become infected. Duh.  She needs painkillers, or she might be in pain.  I bowed in resignation one more time, even though I no longer look up to many doctors here.  I have even been conned into overnight stays for Matthew, 3, costing over 20,000 baht with all those plus pluses.

The process is, first the –doctor –  then you pay the cashier- then you pick up your pills. My bill for a small classroom accident was 3,998 Thai baht £84.46p. Its only then that you find out what the pills actually are.

Then I looked at the painkillers. 886 baht (£17.69) for a small bottle of paracetamol syrup! – Actually the bottle was built to contain, according to the label 250 mgs of paracetamol.

If I had known he was giving me paracetamol I could have bought it for a few baht at the nearest 7/11.

And the antibiotic was Augmentin coming in at 962 (£20.36) baht for powder which did not register on my kitchen scales – at the bottom of a 228 mg bottle.

Surgery was 2000 baht (£42.31) and the rest of the bills comrpised 50 baht charges well - see above

Wow – can anyone better those prices? This stuff seems to go for peanuts on the net.


  1. Try Bangkok Pattaya, where they charge you 50 baht for the small bag they put your pills in, BEFORE you get your bill

  2. I went to Pattaya Memorial Hospital for a check up on some shoulder pain and left 15 minutes later nearly 3,000 baht lighter,mainly for medication I could have picked up for a few hundred baht at most in a local pharmacy.
    At least I know i have Rotator Cuff Tendonitis.

  3. Antibiotics for a cut like that in Britain would of course not be administered as a matter of course nor would painkillers unless the patient was patently distressed by deep pain.
    A tetanus jab might be wise if she had not had one recently.
    Augmentin is just amoxycillin in the clavulanate form which allows for better absorption
    and is used as a preventative anti-bacterial infection given by injection after surgery among other oral uses for existing infections resistant to ordinary amoxycillin. My doctor in the UK refers to it as the "domestos" of antibiotics.
    Are stitches now classed as surgery? Mmmmm. Still, we are in a tropical climate and open cuts can quickly become infected - certainly, I whack on antiseptic cream on any cut where the skin is broken here in Thailand.
    The thing is,the medical world is dealing with an emerging problem where bacteria are increasingly becoming resisitant to anti-biotics through over use and one wonders just why the Thai medical establishment prescribes its use willy nilly simply to pad a bill.
    Rather sums up the Thai in my book.
    Mind you, the overall cost of Annie's treatment here is still cheaper than a trip to the vet in the UK!
    That paracetamol trick is a great con. I get prescribed it as soon as I walk into the hospital and is a great little earner. Almost as good as the obligatory taking of my blood pressure even if I'm only seeking help for a twisted ankle.

  4. "Antibiotics? In my day muy mum just used to clean and sterilise the wound on the spot"

    - yes, but you were not growing up in a tropical climate where infections spread like wildfire, and shower water in potentialy unclean, were you.

    It is standard practice in TH to give antibiotics when you have any minor surgical proceedure, including stitches.

    however, the jist of the story is correct. over prescription to hike up the bills is very common.

    personal, i pay the bill, say thank you, and then through the pain killers away. i take the antibiotics though (reluctantly).

    best thing is to use your own judgement before rushing to a hospital.

    hope daughter is fine now.

    1. I agree that in a tropical climate all cuts have to be taken care of to prevent infection but don't agree that antibiotics are ALWAYS given. I had 2 carcinomas removed from my back recently in PIH Pattaya and was not prescribed antibiotics to ingest - only antibiotic cream. Also no painkillers were prescribed (or needed!).

  5. I have several times refused medicine at the hospital even after I paid the bill and they have had to change the receipt and given me money back.. Why should you pay 100 baht for paracetamol when the same is 10baht at the pharmacy on the street..

  6. Had worse than that many a time...Bangkok Hospital is much worse, Bumrungrad similar.

    What i usually do and dependant on the situation, I get the breakdown of the medicines and then simply tell them never mind and take that list to the pharmacy up the road and ask them for same same......10 times cheaper.

    A recent visit to a hospital in Indonesia however for my little girl with a 'sore tummy'...ended in a 6k baht bill, docotrs doing x rays and wanting her to stay in overnight for observation. I declined the overnight, relented on the xrays as you never know and we were in a foreign land where everyone looks the same....but the doctors fee there was $100US alone.

    We have been very lucky to find a childrens doctor in bangkok at a hospital known to all, but her will never prescribe medicine or over acting for kids unless absolutely necessary....he has sent us away on previous visits with no medicines at all. Class he is all the way, great doc.

  7. The 886bt covered both the painkiller AND amti-biotic. Still way over the top!

    The 962bt was for "medical supplies" which comprise gloves, cotton wool and all the trivial bits and pieces.

    The school should have insurance whih would have paid - if not where was the health insurance for your kids and family?

    1. My son is insured. Do not know why annie appears not to have been.

  8. 962 baht for cotton wool, small bandage, dab of anti septic cream? (stitching)? Shome mishtake surely?

  9. Hospitals and gp surgeries are businesses in Thailand so the bill will be padded. Having doctors and surgeons on a commission related to the bill is not morally acceptable but that's the way here.

    Sam has the sensible approach, look at the bill and accept only what you feel is necessary. Medication you can usually get outside cheaper.

    But if one's child is involved, you may have no alternative but to go along with the doctor's advice. They know you won't take chances with a youngster's health.

  10. Andrew - schools - private and government normally (should) provide accident insurance for all pupils. Our son goes to a small private Thai school and is covered for accidents in and out of the place.

    Now on to the subject of medical treatment in Thailand. Medical care is a business; it's that simple.

    for example, prescribing antibiotics for viral illnesses is the norm, and in fact most Thai people expect to be given them. Even the educated Thai middle class don't know the differences between a viral and bacterial infection. Couple this with the fact that many doctors get a percentage cut for prescribing ABC's brand of pharmaceuticals and you have pretty much a nation literally conditioned and addicted to taking mostly unwarranted medicines.

  11. Love the cheeky kids phot. by the way. Reminds me of mine...

    1. Well thank you John - they're certainly cheeky - not from me of course

  12. Try Bumrungrad--- my 2nd bill was 9000baht for consultation, blood test & the usual items but I told them
    don't give me pills as I know the wholesalers in Bangkok where to get them. They gave some not all, anycase. My condition got no better as had dizzy spells & hypertension, plus high BP so I flew back to my own country & went to see my Doctor. Guess what, he told me they had given me medication for the lower body not the heart etc where my problem lay ---- I nearly went into shock--holly hell??? I know next time but I am 100% better since he changed the medication! I remember Newsweek said Bumrungrad was the top hospital in the world & now I am convinced some of these dingaling Doctors wouldn't have 2 clues.

  13. I had to go to vet to get the proper medicine, in dog form. Bangkok-Phuket's swanky, overpriced skin centre was going to charge me 1000 baht per visit to get each dose. Needed about 5 doses.
    I did complain, many times- totally ignored. Should send a letter to whomever gives them ISO rating. This is five star? I tell my family and friends back home, no way travel here for medical work.

    1. Try a local and smaller animal pharmacy if you know the name of the medication for your animals. It's what I do. Complaining will never get you anywhere with a Thai. Adapting to their way of doing things may pay dividends. Criticising them will not endear them to you.

      There are rogues out there, but there are some good guys.

  14. Doi,
    The dog medicine was for me!! I had to go to a vet to get what I needed because the hospital cared more about money then the patient. In fact the dermatologist really was rather ignorant, too in way of telling me what I needed to know to not get re-infected. In a Lie-land where cheating on exams and plagiarism is par for the course, why would doctors be any different ?