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Old Jun 18th, 2012, 06:05 PM
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Medical tourism in T'land

Don't know if this is the place for such questions but does anyone have advice, opinions, or stories to share on this topic. Other more pertinent web addresses welcome. I could use a total knee replacement, if i wish to continue walking through life. Thnx all.
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Old Jun 18th, 2012, 06:26 PM
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Google Bumrungrad Hospital in Bangkok. Their website has all kinds of useful info. They were the first hospital outside the US to be accredited by JCAHO. They have excellent quality of care. They are perhaps the most expensive hospital in Bangkok, but prices are still very reasonable in comparison to the US, for instance.
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Old Jun 18th, 2012, 07:52 PM
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this is a fantastic hospital that kathie has suggested... we have toured it and came away very impressed..
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Old Jun 19th, 2012, 07:19 AM
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Mcbeanie who posts on this forum has done medical tourism in Bangkok, having had work done at Bumrungrad. She and her husband have been very happy with their results. I hope she will jump in here!
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Old Jun 19th, 2012, 09:03 AM
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Jumpin' in, Carol!

Yes ~~ Kathie, rhk and simpsonc510 are all correct ~~ Bumrungrad is THE place for medical tourism. Between my husband and me, we have had several surgeries there, all successful. As Kathie say "It is 'the most expensive'", but I think it is the best! My knee replacement in the US was $40K+, excluding doctors' fees, and my ortho surgeon here was involved in the training of the Bumrungrad surgeons. The cost at BIH will be all-inclusive and will undoubtedly be much less expensive. Some US insurance policies will reimburse you for procedures there ~~ mine will! The one concern with a knee replacement there is the length physical therapy; however, that will not be a problem if you can stay in SEA for 3 months+. Good Luck!
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Old Jun 19th, 2012, 12:41 PM
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You should check with the orthopedic surgeon to see when it is ok to travel back to the US. The biggest problem is the knee getting stiff during a long flight. After surgery you will be in a passive motion machine to gently keep your knee moving whenever you're in bed for about the first two to four weeks. Post-op Physical Therapy is essential too.

Not trying to dissuade you from having the surgery done overseas, just pointing out some things to put on your list of things to consider. As stated above, try to stay in the area for several weeks for PT as well as follow up with the surgeon.

Good Luck.
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Old Jun 19th, 2012, 04:24 PM
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As I have considered laser eye surgery in Thailand, I am also somewhat interested in this thread.

I looked through the web-site for Bumrungrad (unfortunate name) and have found a pricing schedule for many surgeries. It seems as a knee replacement would work out to about one third to half of the cost of the same surgery in the US, based on Mcbeanie's figures.

http://www.bumrungrad.com/en/realcos...ealCostPid=508

In Australia, most hospital funds cover the cost of this type of surgery as long as you get a referral from a GP, so overall it would make sense to have it done at home, BUT, laser eye correction is still seen as "cosmetic" and hence, not covered.
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Old Jun 23rd, 2012, 04:33 PM
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My advice is simple - get the work done at home.
Whatever the service looks like - and appearances can be deceptive in a country where face is all important - is there IS a problem in Thailand there is virtually NO COMEBACK at all.
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Old Jun 23rd, 2012, 04:38 PM
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Bumrungrad is NOT accredited by JCAHO - it is JCI a separate company set up by the former for hospitals outside US - this is no guarantee of medical care either - it is really just a key to getting insurance money.
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Old Jun 23rd, 2012, 06:43 PM
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Also, there are at least three hospitals certified by JCI in Bangkok. I much prefer the care I got at Samitivej over Bamrungrad, which I got the feeling was treating me like a cash machine.
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Old Jun 23rd, 2012, 07:08 PM
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Yes, the current accrediting body for Bumrungrad and for other hospitals outside the US is JCI. But what I said was "They were the first hospital outside the US to be accredited by JCAHO." Which is correct. They were originally accredited by JACHO before JACHO formed JCI.

Yes, one doesn't sue for malpractice in Thailand. But it is possible to buy insurance (at least in the US) to cover any problems.

Michael is quite right, there are a number of excellent hospitals in Bangkok that are internationally accredited.
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Old Jun 23rd, 2012, 07:29 PM
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To me the best hospital is where they have the best equipment, laboratory and where the best doctors are at. IMO, and with some local insight, Bumrungrad is the best and is the most complete. Yes they are expensive comparing to the other hospitals in town but you want the best and the cost is much less than in the US or Europe.

The best doctors also practices at more than one hospital but most of the best in their fields can be found at Bumrungrad as well.
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Old Jun 24th, 2012, 11:38 AM
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Saving money is a good idea but you must realize that the rehabilitation on a total knee is recommended to begin in a rehab facility immediatly after the discharge from the hospital, normallly 3 days. The normal stay in rehab facility is 5-7 days based upon the patients' tolerance for the excercises and the range of motion they can attain before leaving the facility. You would have to fly home First Class in order to keep the leg fully extended though some airlines Business Class have sufficient legroom.
Though now retired 5 years but keeping up with the literature and poking my head in the O.R. rooms from time to time were I performed probably near a thousand partial and total knee transplants I must be honest and tell you that 11%-12% of the procedures do not have the patient better off 12 months after surgery. There are many reasons for that and only some are because the patient did not follow the correct protocol. I share this with you so that you go forward well informed. I had a 96% success rate with hip replacements because the nature of the surgery is quite difference and the recovery is much quicker.
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Old Jun 24th, 2012, 12:59 PM
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One would want to stay in Bangkok for the initial phases of rehab. For any surgical procedure you would want to spend a fair amount of time where the procedure was done for rehab, monitoring healing, etc. I can't think of any medical procedure one would want to have done during a two or three week vacation. You have to allow time for healing and follow-up (even for laser vision correction).
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Old Jun 25th, 2012, 02:36 PM
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is there a need to return to the US on a single flight?

Could the OP bunny hop across the Pacific - stay in HK, Hawaii, West Coast (assuming the OP is from somewhere other than the West Coast) for a few days?

Just asking because I'm curious.

I wrote a trip report (not labelled as such) on a medical visit to Bumrungrad some years ago and it's somewhere out there in cyberspace.

If you are in need of glasses, Tong's husband does a great job! Better than the Kaiser doctor I use at home. Not only that, but the frames he sold me have elicited more comments than my crazy hair - and that's something!
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Old Jun 27th, 2012, 09:12 PM
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@MichaelBKK, i see 2 hospitals in BKK with that name, although they do seem related. Samitivej Sukhumvit Hospital and Samitivej Srinakarin Hospital.. Can you offer any further news on joint replacement surgery at these institutions? Thnx.
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Old Jun 30th, 2012, 03:47 PM
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I'm a journalist in Victoria, Canada who's exploring the issue of medical tourism. I'm hoping to connect with Canadians who have obtained or are considering surgery or other medical care outside Canada. You can contact me at deborah-dot-wilson-at-cbc-dot-ca
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Old Jul 12th, 2012, 01:01 AM
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JCI and JCAHO are not the same - JCI is set up by the JCAHO (or JC) specifically to give accreditation to foreign hospitals. (e.g for the Medical tourism trade).

It makes extra money for the non-profit organisation, cashing in on the medical tourism that is a result of the shortcomings of the system it already accredits. (In 2007, JCAHO made a profit of over $9 million )

The organisation itself is self monitoring and the criteria which are not the same as those for US hospitals are self-established by the JCI.

One alarming feature is that about 90% or more of those institutions who apply are accepted. - to be accredited the institution has to apply and then pay.

One must also question the value of an organisation responsible for accreditation of what is arguably the worst healthcare system in the Western world – the USA.

Wikipedia - “[As] it is certified by no one but itself, therein lies the problem. And the fact that a hospital, etc., "invites" a certification is implication of itself. And the hospital or entity desiring "certification or accreditation" must PAY FOR the same. So, if you pay for a survey, YOU GET accredited or certified. This is fraud.”

I'm sure that in general the JCI in general contributes something to world healthcare standards – but exactly what has never been independently measured or quantified.

In Thailand however there is one more factor that HAS to be included – that of local corruption and nepotism.
We all know what is right and wrong, cultural interpretation is only an excuse for an incorrect action
As seen on this site, in Thailand it is so often not what you know but who you know that carries the day.
We know from recent court cases that Bumrungrad is capable of huge blunders, so the need for some sort of outside accreditation is paramount, especially now as so many hospitals in Thailand are targeting the highly lucrative Medical Tourism Trade.
In Thailand the certificate is ALL important – it is the be-all and end-all – in thailand the paper is more important than the person – sadly the “paper” can be forged or acquired by improper means.......and the person – well they can be silenced. There have even been allegations of murder involving the exposure of medical malpractice.
Many visitors to Thailand grossly underestimate how all pervasive corruption is in Thailand; it's not just about giving a policeman a hundred baht to continue on your way. It's about falsifying documents – education from infant school to degrees, land deeds, government reports and contracts, employment contracts court cases not one iota of thailand is exempt from some form of corruption or another …..
So if a hospital claims to be accredited here – I'm afraid my advice would be to take it with a pinch of salt.

e.g. - Can you imagine a medical industry in your home country without a comprehensive ambulance service???

Life expectancy in Thailand is somewhat lower than in 'less developed' countries like Vietnam and China, which indicates that some more can be done to improve health in the country
No...not in Thailand I'd recommend that if you need healthcare of any significance, that you get it done in your home country where you understand the law and the language and are assured of good comeback in the event of a mistake.

As far as I can make out neither Bumrungrad nor any other no hospital in Thailand has ever had JCAHO certification. (I would be very vary of any such claims too) ......and remember any certification may not cover the whole establishment.

"up to 2008 the hospital had not as yet expanded its accreditation portfolio to take in other accreditation schemes representative of parts of the world outside of the US, such as Australia and Europe and the United Kingdom." - wiki
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Old Jul 12th, 2012, 06:53 AM
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KW, I'm sorry, you really don't seem to undertand the nature and process of accreditation. All accrediting bodies review the program (hospital, university, etc) at the invitation of the institution. Accrediting bodies are non-governemental, so can only review programs at their invitation. The institution requesting accreditation must pay for the site visit and must pay annual fees to retain their accreditation. This is not fruad, this is how accrediting bodies are self-supporting.

Whoever worote the Wiki was clueless about accreditation.

It is expensive to become accredited. So institutions try to make sure that they are well pre-pared for the process prior to 1. the application, 2. the site visit. Experienced site visitors are often called upon by institutions to do a pre-accreditation visit to give feedback to the institution on things they need to improve. The accrediting body reviews the application before scheduling a site visit, and will not schedule a visit unless the paperwork indicates that the criteria for accreditation are met. Site visitors validate the info give in the application and evaluate criteria not easily evaluated by written report.

I would think that the proportion of hospitals requesting accreditation in the US and receiving it would be in excess of 90%. Failing an accreditation site visit is a serious matter, and institutions do not generally schedule a visit until they are fully ready.

Medical errors occur every day, in Thailand, in the US, in Canada, in Europe. Accreditation does not keep errors from occuring. Corruption is not limited to Thailand or less developed countries.
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Old Jul 13th, 2012, 07:43 AM
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Kathy - your post doesn't seem to address anything I posted.

You can of course choose to discredit wiki - many do - but they are proven to be as reliable as Britannia.

I do have a fair grasp of the accreditation process - the reservations expressed in Wiki ae held by many both in US and elsewhere. I don't see anything in your latest pst that contradicts anything I've said - but it has to be said that I think your claim that BMG ever had JCAHO accreditation is erroneous.

It is probably worth bearing in mind the terrible state of the US healthcare system at home and (the worst in the Western world - and the most expensive) - this of course makes places like Thailand look vey attractive, especially win hospitals imply that they have the same standards as JC hospitals.

What is not obvious to many is that this does NOT include the staff themselves or the organisation and qualifications of the medical staff from top to bottom
Furthermore it does NOT have any affect on the patients chances of comeback if there is a problem.
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