Healing On The Cheap – My Experience As A Medical Tourist

I’ve generally had great experiences with hospitals in Thailand, notably those at BNH and Bumrungrad. However, if you shop around you can find extremely good deals, especially because the specialists at Bangkok Hospital, Bumrungrad, etc, usually do some work at public hospitals as well, where the same procedure will be considerably cheaper. A friend of mine got his meniscus worked on for a fourth the cost of the procedure at Bumrungrad and with the same caliber of doctor, only it was at a public hospital and there were students observing in the operating room. For those looking for imaging, MRI’s, etc, I have to highly recommend Prachachuen Imaging Center, which is about a 100 baht taxi ride from the Mochit BTS station (fyi get off on the opposite side of the street as Chatuchuk Park). Some of the staff spoke pretty good English and the cost was 8,000 baht (255$) for an MRI without contrast (11,000 with), whereas its more like 14-15,000 (446$-478$) at Bumrungrad (and anywhere from 450-1,500+ USD in the States).

Obviously the biggest obstacle in this whole gambit is finding staff that speak good English, as most will list English under “Languages Spoken,” but four times out of five this means they can sputter out all of 20 butchered Ingrish “words” and who knows how much they comprehend. Yesterday it took me five minutes to figure out that “Whosskaaaluuh” means “vascular.” It really baffles me why this is still such a problem at a hospital like Bumrungrad given how much of their business comes from medical tourists fleeing the criminally inflated prices of health care in the US and elsewhere. Most of the doctors have gone to school or done fellowships and so forth in the US or UK, which begs the question of how much they could have possibly learned from these experiences without good English skills. Anyway, that point aside, I have one major complaint, and perhaps this is a knock on medical practices everywhere.

I understand that Western Medicine generally suffers from overspecialization and fails to see the body as a system–one that includes those pesky, but objectively real subjective experiences–but this has gotten so bad that many of them don’t even see “the leg” or “the arm” as a system. I have multiple injuries in my right leg, which makes getting an accurate diagnosis utterly frustrating. I saw an orthopedic foot/ankle specialist and brought an MRI of my knee to get his opinion on how much the calf and knee injury is impacting the ankle injury. He said, “oh, I don’t know much about the knee and don’t know how to read this MRI.” (Blink, blink.) “Huh?” Shit, by this time I can read the damned thing pretty well myself! He was obsessed with the X-ray he ordered of my right foot, but it strikes me as very strange that he didn’t feel it necessary to take one of the left foot and compare them. Instead, he compared only the right foot against his textbook of what angles various bones should be aligned at. He suggested I go show my MRI to the orthopedic knee specialist, which I did.

This guy’s Ingrish was particularly horrible. I showed him the 3-year-old MRI, which the radiology team at Prachachuen said looked fine. He took a quick look and said (if you will allow me to interpret) that he was worried about my meniscus and that I should get a new MRI. I did so and took it to him. He then told me something to effect of “I’m not a specialist in reading MRI’s, so you should take this to such a specialist.” (Blink…blink…blink.) You are an orthopedic knee specialist! And you can’t read a damned MRI!?! What the hell did I just pay you for in these two consultations? And if he can’t read the MRI with any degree of certainty why have me get a new one and bring it to him for that second consultation? Perhaps I should not be so harsh, as much could have been lost in translation. Anyway, I can’t really complain. It was only about 1,200 baht to see this guy (38$). Despite his proviso of ignorance regarding MRIs, he still claimed to see a medium sized tear in my meniscus that warrants another opinion and this claim is commensurate with my internal experience and levels of pain.

Lastly, I saw a Physiotherapist who was extremely good! Doctor Pantasak Tansakul and his physio team (especially Khun Umanoot) are top knotch: fantastic English, humorous, knowledgeable, and extremely nice. Doctor Tansakul taught me a few things in five minutes that are already helping significantly. If memory serves I only spent 3,000 baht (95$) for an hour of his time and an hour of Khun Umanoot’s time down in the physiotherapy center.

I’m going to try a month or two of rather intense PT/rehab–about two hours per day–before looking into surgical options. I have a badly torn posterior tibialis, a right foot that points an extra 15 degrees or so outwards relative to the left, a gastrocnemius torn at the medial head, a weak and slightly atrophied right hamstring, “joint effusion”/Baker’s cyst, and a possible meniscus tear. Hopefully I can get strong enough to avoid surgery, but if it comes to that, I’m in the right country.

In closing I’ll share a little experiment:

I built this rehab and workout station in about 30 minutes for about 30$ worth of 2” PVC pipe. I have already figured out how to do about 9 exercises on it and suggestions are more than welcome.

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