Accidental Tourist: Visiting the Bumrungrad Hospital in Bangkok

Accidental Tourist: Visiting the Bumrungrad Hospital in Bangkok

75
SHARE


There’s been a lot of recent speculation that more Americans will be taking their elective medical problems overseas. In 2008, Deloitte’s Center for Health Solutions estimated that 750 thousand Americans travelled overseas for medical care in 2007, and forecast a eight-fold increase by 2010 In a 2009 update, Deloitte found that the 2008 financial crisis devastated overseas medical travel, but still forecast 1.6 million US citizens going abroad for medical care in 2012.

Among overseas medical destinations, no facility is mentioned more than Bumrungrad (last syllable rhymes with “hot”) Hospital. Bumrungrad is a privately owned but publicly traded 550 bed acute care hospital in central Bangkok. On a recent trip to Thailand, I stopped at Bumrungrad to find out what all the shouting was about and was really impressed with what I saw.

Bumrungrad’s CEO is a courtly, silver-haired Virginian named Mack Banner, who spent most of his career in the US investor-owned sector. Though the hospital was founded in 1980, it moved into its new facility in 1997, just in time for the Asian financial crisis. The facility was Joint Commission (International) certified in 2002, and one fifth of its physicians are US Board certified in their respective specialties.

In 2008, the hospital opened a beautiful 21 story Clinic building next door, housing 30 specialty clinics and most of its medical staff. Bumrungrad’s Clinic Facility is Mayo-esque, enabling patients with particular specialty problems to be worked up, evaluated and cared for on a single floor. The hospital subsequently renovated its inpatient rooms, which resemble those of the Asian-themed Washington DC Park Hyatt in elegance. The hospital is a sunny, happy place, with apparent high morale and very high service standards. English is spoken widely throughout the hospital.

Bumrungrad’s physicians are independent of the hospital economically, though the hospital provides billing and other clinical support for its medical staff as if they were a group practice. Bumrungrad’s home grown electronic medical record system was impressive enough to be purchased by Microsoft, and it became the core of their Amalga product.

According to Banner, Bumrungrad sees one million patient encounters in a given year (which include inpatient admissions, outpatient clinic visits and diagnostic tests). Perhaps not surprisingly, given that it’s on the other side of the world, only about 5% of those patient encounters are Americans, divided roughly 50-50 between the American expatriate community in Thailand and near Asia and American tourists in Asia.

Most of the latter group of Americans Banner referred to as “accidental tourists” who encountered a medical problem while traveling and ended up at Bumrungrad for their medical care. He put the number of American patients who travelled to his facility for elective care at “a couple thousand” in a given year, hardly a flood, but understandable given the lack of non-stop air service from the US. American patients are outnumbered two to one by patients from the Middle East, whose numbers have grown ten-fold in the past decade.

Fully 71% of Bumrungrad’s patients pay cash for their services, and the hospital defines its trade area as a six-hour flight circle around Bangkok. So Tokyo, Beijing, Shanghai, Taipei, Manila, Seoul, Kuala Lumpur, Singapore, Sydney, Nairobi, Mumbai, Dehli and the United Arab Emirates all fall inside the circle. The hospital maintains sales liaison offices in seventeen cities inside the circle that connect to the business and diplomatic communities in those cities. One of the most active of those offices is in Mongolia!

However, Bumrungrad is also a significant urban hospital serving central Bangkok. It operates an emergency room, a neonatal ICU and has extensive urban hospital service lines and obligations. Its physicians do medical outreach to long suffering Burma, next door, and its Medical Foundation funds care for indigent patients in Thailand.

Package prices for medical care at Bumrungrad are remarkable by American standards. A total joint replacement (hip or knee), including diagnostic tests, all physician fees and hospital care, can be done at Bumrungrad for around $16 thousand. US and coronary bypass graft surgery for a little over $30 thousand. Low Thai pay scales certainly help make the care affordable. Veteran ICU nurses at Bumrungrad make about $2500 a month US, plus health insurance, while starting nurse salaries approximate $800 a month.

Complication rates and infection rates are lower than or equal to those in comparable US and international health facilities. The hospital maintains a Cost Estimator on its website enabling interested patients to see the range of charges for recent patients with 46 different clinical problems.

Bumrungrad’s medical staff is virtually 100% Thai national. The father of Thailand’s King Bhumibol Adulyadej was a physician who trained at Harvard. (The present King of Thailand was actually born at the Mt. Auburn Hospital in Massaschusetts.) For this reason, Thai culture highly values medical training. One gets the impression that the Thai medical community is virtually 100% self-sufficient, though it maintains proud linkages to international training venues.

Thai medical education standards are very high, and a significant number of Thai medical graduates do their fellowship training in Britain and the US. But rather than seeking employment in the British National Health Service or entering practice in the United States as their elders did, an increasing number are returning to practice in Thailand.

Bumrungrad is seeing increased domestic competition for international travelers from the massive Siriraj Hospital, a principal teaching facility of the Mahidol University (named after the King’s father) whose formidable campus looms over the West Bank of the Chao Phraya River. Many of Bumrungrad’s physicians trained at Siriraj. Siriraj cares for the Thai royal family, and recently built a shiny new 345 bed private pavilion for its medical faculty.

Banner acknowledged that competition for the international medical tourist is also heating up. A decade ago, their main Asian competition was the Mt. Elizabeth Hospital in Singapore. But Duke, Johns Hopkins, Cornell and Cleveland Clinic are opening projects in China, Qatar and the United Arab Emirates that will enable middle Eastern and Chinese patients to receive state of the art private care in locations closer to their homes.

While it is not reasonable to expect massive numbers of Americans to travel half-way around the world to Thailand, Bumrungrad made an impressive case that world medical standards have caught up to America’s. While the US continues to supply much of the rest of the world with biomedical research and clinical innovation, it’s not obvious why citizens of the Pacific Rim or central Asia need travel to America for world-class health care. It’s available to them in their own back yard.

Note: Author received no consideration for his visit or writing this posting. Bumrungrad’s management graciously endured his visit.

Jeff Goldsmith is president of Health Futures Inc, which specializes in corporate strategic planning and forecasting future health care trends. He is also the author of “The Long Baby Boom: An Optimistic Vision for a Graying Generation.”

Leave a Reply

75 Comments on "Accidental Tourist: Visiting the Bumrungrad Hospital in Bangkok"


Guest
Apr 28, 2015

This part of the process took less than 45 minutes
using Pro-ER. Well, surely not as much as the ones reading the news online.

You can call your Attorney General’s office to find
out the state of limitations in your own state.

Guest
Apr 7, 2015

Another thing to consider is the material of the shed.
Around 700 hundred years ago the Dorset people vanished from the
face of the Arctic. For example, the Antarctic and Arctic
regions are experiencing receding snow lines and increasing sea levels because of the
changing weather, and wildlife migration patterns are also disrupted by conditions that
are in a constant state of flux.

Guest
Mar 20, 2015

By carrying out this you can slim down the cars and trucks you would like to bid on. The experts, who have many years of experience in this
field, often suggest junk car owners to sell out their
vehicles to charitable institutions. A couple of the companies listed are only interested in wrecked or non-working newer cars but there are
wreckers who will take the older vehicles for parts.

Guest
Mar 16, 2015

The steel entire body of the auto is always worth one thing,
even if it is getting scrapped. When looking to sell your junk car, it is a good idea to first establish ownership of the vehicle, as many companies that buy junk cars
only do so from titleholders. According to the brand and
the functional condition of the vehicle, they offer a good amount starting from the least to
the highest.

Guest
Mar 10, 2015

Please continue on Page 2 for more on Who Pays lawyer for workers
compensation (Merle) Unemployment Benefits.
Although there are some unexpected instances that may be the cause of accident, the water park owner still
has the responsibility of ensuring the safety of the people.
However, misfortune often strikes on him by causing debilitating on the job injuries.

However it does have other meanings where the law and trials are concerned.

Guest
Mar 7, 2015

However, in no event shall the setoff provided in the Statute in lieu of payment of workers compensation attorney
here (Jenifer)
benefits diminish the period for filing a claim for benefits as
provided in Florida Statute 440. Although there are some unexpected instances
that may be the cause of accident, the water park owner still
has the responsibility of ensuring the safety of the people.
Common employer mistakes that lead to employee lawsuits related to wages and hours
laws include:. TTD or Temporary Total Disability;
TPD or Temporary Partial Disability; PPD or Permanent Partial Disability.

Guest
insurance comparison Thailand
Feb 12, 2015

If an automobile is owned by you, it’s required for legal reasons you have some insurance onto it. The cost of coverage differs in one company to another and in addition based on several aspects within the policy. Nevertheless, this does not mean you need to pay a complete lot of money for it. There are some true ways by which you may get finance insurance.
insurance comparison Thailand http://www.compareka.com

Guest
sawa
Feb 4, 2015

Look on the website of the hospital and check the profile of the doctors VERY carefully, then cross your fingers and hope for the best. The hospitals are very clean and the nurses the best in the world but what shall I say about the doctors??
Also check out the Vejthani hospital, they have a joint centre and do more treatments/ops than Bumrungrad, and is cheaper.
Be alert all the time, dont just believe what you are told by the staff

Kingston hotel B1500 per night, shuttle service

Guest
Lindsay
Jan 31, 2015

How does one book an appointment for treatment at the Bumrungrad Hospital for physiotherapy? My daughter has a C5-6 spinal cord injury which left her a quadriplegic 6 years ago. We would like to go there for 2-3 months this summer. Which hotels nearby would you recommend?

We live in Toronto – Canada and any insight would be greatly appreciated.

Thanks

Guest
sawa
Feb 4, 2015

Look on the website of the hospital and check the profile of the doctors VERY carefully, then cross your fingers and hope for the best. The hospitals are very clean and the nurses the best in the world but what shall I say about the doctors??
Also check out the Vejthani hospital, they have a joint centre and do more treatments/ops than Bumrungrad, and is cheaper, same doctors
Be alert all the time, dont just believe what you are told by the staff or doc

Kingston hotel B1500 per night, shuttle service

Guest
Dec 7, 2014

Hi everyone, it’s my first visit at this web page, and paragraph is actually fruitful in favor of me, keep
up posting these posts.

homepage (Darrel)

Guest
Sep 10, 2014

It’s going to be ending of mine day, except before end I am reading this impressive
article to increase my know-how.

Guest
Sep 2, 2014

I like this post, enjoyed this one regards for putting up. “The basis of optimism is sheer terror.” by Oscar Wilde. FRESH JOB VACANY

Guest
Aug 26, 2014

After going over a few of the articles on your web site,
I seriously like your technique of blogging.
I saved it to my bookmark website list and will be checking back in the near future.
Take a look at my website as well and tell me what you think.

Guest
Shane
Jul 25, 2014

I have lived in Asia for a number of years and up until recently, I used Bumrungrad almost exclusively for the medical treatment of myself and my family. However, due to a couple of very unsatisfactory treatments that my wife and I have received in the past 12 months, we will never go back there. Whilst they have great facilities, and their doctors are extremely good in terms of technical expertise, the hospital has become nothing more than a production line i.e., get as many patients as possible through the doors, and then recommend the most costly treatment without ever discussing or considering less expensive and/or alternative and less invasive treatments. I would suggest that more than 80% of their clients now come from Arab countries who are cashed up and who mostly would know nothing about what a good and caring medical provider actually looks like. I have spoken to numerous people from western countries, who like me are disgusted in the level of service and care they have received from Bumrungrad and refuse to go back there. If you are 100% certain of the exact type of treatment / surgery that you want/need, then Bumrungrad is for you, but if you want your doctor to explore and discuss options e.g., non surgical procedures, or less invasive procedure; go elsewhere!

Guest
Jul 8, 2014

Continuing . . .

And, I have to report that I am dissatisfied with the quality of care provided. First, during my initial visit with the surgeon, I felt very rushed, with his terse responses to questions and his unwillingness to engage in an interactive discussion of the focal problem. This behavior, combined with his difficulty in speaking clear English, made for a frustrating first encounter. But, I decided to proceed nevertheless, given that he invented this particular colorectal technique and has trained a number of colorectal surgeons in how to do it.

After a brief examination of my derriere, he assured me that it was superficial problem and would be “no problem” to repair. I had brought along MRI films on a DVD and asked if he wanted to see them (so that he could gain an idea as to the location of the internal opening and the fistula track). He waved away the DVD, commenting that he didn’t need to see them because he could tell that the problem was superficial.

The long and short of it is that as I was waking up from the procedure the following day, he mumbled something about not having been able to find the internal opening and therefore having to do a fistulectomy. No further explanation — which I would thought was warranted, given that the procedure differed from what we had agreed to the previous day. Even though still dazed from the nerve block and anesthetic, I tried to engage him a discussion of what he did and the implications of the same — e.g., was the internal opening still there and what was the prognosis for a new fistula down the road. But, he was in a hurry. “I have other patients to see,” he said, as he left the room.

Later that evening he stopped by my hospital room, and I again sought to receive an explanation as to exactly what procedure(s) he had done and the longer-term implications of them. All I could learn was that he did a combination LIFT and fistulectomy, which he later wrote on the medical record as a “fistulotomy. (When I later asked him to make it clear that he had performed a fistulectomy, not a fistulotomy, he responded, “They’re the same thing” — which they are NOT.)

Among other strange comments that he made during the brief visit were the following:

> the fistula had been a “high, transsphincteric” one, not the superficial intersphincteric type that he had assured me was the case. (This representation struck me as extremely strange, in that four (4) other CRS with whom I had consulted in the States before deciding to have the LIFT done in Thailand — including one who had inserted a seton at one point to keep the track opening for draining — had all described it as a superficial intersphincteric fistula. I asked him to draw out the track; and, what he drew bore no resemblance to what other CRSs had drawn out after their examinations in the States.)

> I asked him to tell me what he did. He hurriedly ran through a confusing description that indicated that he had left the internal open untouched (given that he said he couldn’t locate it), and had “cored” out the fistula track. I later learn, when visiting his fellow (during my last post-surgery visit) that he had also left the fistula track intact in the space between the internal and external sphincters, removed that portion of the track that passed through the external sphincter. (In brief, then, what he described in the scribbled medical record as a “combination LIFT procedure fistulectomy” was in reality only a fistulectomy of the track as it passed through the external sphincter. He had not cut through the track in the intersphinteric space to tie the two ends so that nothing else could move from the internal opening down the track. (At one point, he mentioned that track in the intersphincteric space was “very soft, very soft” — the meaning of which he didn’t explain.) And, he had not closed off the internal opening (because, he said, he couldn’t find it).

Yet, fee was that of a full LIFT plus fistulectomy, i.e., app. $3,015.

I had to return 10 days after my discharge due to pain in the wound area, as well as what seemed like stool or liquid incontinence. He did a quick examination, mentioned that there was a “little infection” and then prescribed additional antibiotics. Still wanting greater clarity around what he did and the longer-term implications, I tried to draw more information out of him. But, after his brief examination, he busily writing — which when done was followed by an “okay, you can go now.”

It was only when I met with his fellow during my second and final post-surgery visit that I learned that (a) contrary to what the surgeon had stated several times, the healing period required would be more on the order of 12 to 14 weeks, not the “4 to 6 weeks” that surgeon had tossed out (several times) PRIOR TO the procedure and, (b) no actual LIFT procedure had been done, only a fistulectomy of the track as it passed through the external sphincter.

I feel strongly that I was taken advantage of in a “bait and switch” manner. At this point, I can’t be certain what he actually did and why. All I know is that I am still in pain. Whether the pain is due to the self-absorbing sutures that are apparently still in place at a very sensitive location in the derriere (are get pressed hard whenever I sit) OR due to a continuing low-grade infection — this I do not know.

What I do know is that, based on my personal experience, I would NEVER recommend this place to anyone else, particularly if the need is for any kind of colorectal procedure. Not is it over-priced and something of an assembly-line approach to medical care, some doctors (including mine) can barely speak English, are taciturn to the point of being dismissive and rude, and are in too much of hurry to finish with a given patient to answer questions in meaningful degree of thoroughness. As far as I am concerned, I was thoroughly ripped off.

“Caveat emptor.”