Surgery at Bangkok Hospital in Chiang Mai
Today I checked into the newly opened Bangkok Hospital in Chiang Mai, Thailand for some minor day surgery. I don’t normally like talking about medical conditions, but several years ago I found a small bump, about the size of a small marble, on the right side of my head, below the scalp, a few inches above my ear. It wasn’t painful but it did concern me a bit and since I was aware of it I assumed it stood out like a beacon to everyone else. I went to a dermatologist and he told me it was probably a lipoma, a benign tumor composed of misplaced body fat but it should be looked at to be sure. He recommended having it removed, then and there, in his office and sending it off for a biopsy.
The procedure went smoothly, he put in a few stitches and less than a week later the results came back negative (positive for me, negative for cancer). He also told me; since he couldn’t be sure if he had gotten it all that it might, in several years, grow back. Fast forward to today. It did grow back, maybe a bit larger this time and I wanted to have it removed and checked again. Thailand has a great reputation for good medical care at reasonable prices so I elected to get it done here. I know that Bangkok Hospital in Bangkok has a fabulous reputation and I wanted to put their new facility in Chiang Mai to the test.
I went into the Bangkok Hospital on Sunday to make an appointment. Because I am living here I wouldn’t consider it medical tourism but I wanted to get the job done. The reception area was a large atrium, well-marked, with signs in English and Thai. The room was, as expected from a new facility, sparkling clean and polished and smelled of new paint. The staff all wore smart uniforms with name tags designating which languages they spoke and were very professional and polite. There were fresh flowers everywhere, I assume for the opening ceremonies a few days before, and a few workers still putting some final touches on not quite finished construction. After explaining the problem, I was told that I could have an appointment, with a surgeon, at 10:00 AM the next day.
Hoping that they could do something that day Sarah drove me to the hospital. I went to reception, told them I had an appointment and a clerk escorted me to a room where a nurse, dressed in what looked like, what used to be a traditional white uniform in the US, white hat included, checked my weight, pulse and blood pressure. She then escorted me to the surgeon’s office and by 10:10 AM I was sitting in his small but well-appointed office discussing options with him. He was friendly and professional, serious but you could tell that he had a sense of humor. He also spoke very good English. After examination he said it appears to be a normal lipoma (a normal abnormality?) and suggested removing it surgically. I asked when could we do the procedure and he said as soon as they can get the operating room prepared if I wanted; did I want local or general anesthesia?
I opted for the local and after a short wait I was shown to a dressing room where I changed into a sterile gown and was escorted to the operating room. I am no judge of how an operating room should be outfitted but to me it looked just like the ones you usually see in the movies and on TV. Things beeped, lights flashed, compressors compressed; that sort of thing. All the equipment appeared to be new, the stainless steel looked polished and the room smelled of fresh paint. There were four people already there, a couple of nurses, someone that appeared to be a technician and a young girl whose job apparently was to pat me on the hand and shoulder and tell me everything was going to be okay. I was asked to lay on a gurney; hooked up to a blood pressure cuff and oxygen monitor and told the doctor would be right in. This was obviously going to be a bigger deal than what they did at the dermatologist before.
Someone came over and shaved the side of my head and then someone else wheeled a metal frame over my head and they attached paper around the shaved area and taped it to the frame. The surgeon came in, stuck his head under the little paper tent they had made for me and discussed the procedure. He said it should take about half an hour, I should feel some pulling and tugging but not much pain and to let him know if there was pain. He gave me the injection to numb my head and began cutting. The girl that was there for handholding and patting met me under the tent and sympathized every time I grimaced.
As he predicted I could fell tugging, a lot of it quite hard, and pulling. I could even hear what sounded like tearing from time to time. When he would cauterize the wound I could feel a warm sensation. There was a bit of pain but nothing excruciating. At one point he put some more pain killer in because apparently the lipoma had attached itself to muscle and he was going to have to dig a little deeper. Eventually he said that he thinks he had gotten it all and I shouldn’t have to worry about recurrence. I could then feel him tugging as he put in some stitches and I could hear the threads slipping over each other as he made the knots tight.
When I was stitched up he showed me what he had removed. It looked like a piece of fat about the diameter of and half the length of my middle finger. It was definitely not what I would call a pleasant experience but all things considered not too bad. At a few points during the procedure I questioned whether I should have opted for the general anesthesia but now that it was over I was happy that I didn’t.
They removed the little tent, had me move to a gurney and wheeled me into the recovery room. I spent about half an hour there then was shown back to the dressing room. I got dressed and for some reason, they brought a wheelchair to take me to the waiting area. Maybe they didn’t want me to run because I hadn’t received the bill yet.
The bill, with everything for that day, including the pathology report came to 17, 290 Thai Baht or about $540 USD. I was told to expect three follow-up visits where the surgeon would check his work and change the bandages which would cost 490 Thai Baht or about $15 USD. I shudder to think what this type of procedure would cost in the United States.
Many people that I know who live in Thailand have “catastrophic” medical insurance policies to insure them in case of a bad accident or a major medical condition and that works great for them. Most people I know pay cash for their regular treatments. Since I retired I still maintain a regular medical insurance policy from the United States because, as I understand it, if I don’t continue it I can’t get it back. I will file this visit to Bangkok Hospital on my insurance but, because of the cost of care here in Thailand, I don’t expect to get reimbursed for anything because, even after this visit to the hospital, I don’t expect to meet any of the deductibles or copays.
I don’t like going to the hospital and I sure don’t like discussing anything about my health on the Internet. I have however had a lot of people ask what the medical care a retired person can expect in the places I visit is like and I thought I would make an exception and share this one medical experience I have in Thailand. I have heard many positive stories from friends here that need far more care than I do. The few times I have encountered the system in Thailand, in my opinion, the care seems good, there seems to be more concern, empathy and respect for the patient, I have never had to experience more than a few minutes wait and the overall cost is by far better than what I have experienced in the United States.
This is just one experience and I am not interested in starting a healthcare debate on this blog. This was my experience, as I saw it, and I am sure ask 100 people and get 100 different opinions.
… As I about to hit “publish” I am three days from the operation and I have had two followups/bandage changes (the surgeon was there and each appointment took less than 30 minutes, start to finish). Everything looks good. This was a positive experience for me and reinforced the notion that there are other places in the world where good healthcare is available at a more reasonable price.
15 September 2014 UPDATE: Today I had a followup appointment with the doctor that did my little surgery at Bangkok Hospital in Chiang Mai, Thailand. We met in his office, he examined the incision he had made and asked me a few questions. It all took about three minutes. He then shook my hand and said something I have never heard a doctor say before, “Everything looks good. Thank you for coming. THERE IS NO CHARGE FOR TODAY’S APPOINTMENT.”