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Having just returned from my third trip since my major back surgery in 2005 at Bumrungrad ( pronounced Bahm-roong-raht) International Hospital in Bangkok. I still am in awe of the quality, efficiency, cleanliness, ethics, technology, friendliness, and professionalism of this entire organization. Even as I approach medicare qualifications here in the United States, I will crawl back to Bumrungrad for my medical needs, if at all possible. Going there now is more like coming home, compared to a dreaded hospital visit here in the United States.
FLASHBACK
I am lucky enough to have one of the best – but unfortunately retired – orthopedic surgeons in Palm Beach County as one of my very close friends. We searched for treatment options here in Florida as well as in the other states. The more I searched, the more fears I had.
My fears are not of the operation itself, or about the professional capabilities of the doctors here in the United States but because of the out-of-control staph infection rates.
Having done frequent eco-tour trips to Thailand, I suffered severe back pain during one of these trips and, reluctantly, went to a hospital there where I received the best care possible, considering the fact that I was flying home to Florida the next day.
With no appointment, and insurance that probably would not cover medical care in Thailand, I was immediately admitted and spent almost half a day being attended to by a physician that was truly concerned about my well-being, in a private room and a sauna facility so clean I would not have hesitated to eat off the floor. The doctor was able to give me some relief but said it would only get me home.
Walking out, I fully expected the bill to be a couple of thousand dollars. To my surprise, the bill was $27. And this also included the prescriptions!
When I got back to Florida, I did further research of hospitals in Thailand and Bumrungrad continually popped up.
I told Dr. Jones here in West Palm Beach of my experience and said I was very impressed and thinking of having the surgery done over there since the staph infection rate is almost nil and the cost is about 5% to 10% of what it is here in the States.
Actually my deductible would have been more here than what I finally paid in Thailand.
His immediate reaction was shock. He said that I would be making a big mistake. After all, Thailand is considered a 3rd world country and one just doesn’t take chances where one’s health is concerned.
However, he said, he would research it and get back with me. In less than an hour he called back and said “go for it”. Bumrungrad is one of the finest hospitals in the world.
For about six years prior to my surgery at Bumrungrad in Dec 2005, I suffered with the pain of spinal stenosis. If you recall, 2005 was one of the most active hurricane years in history. We went through two hurricane eyes and was skirted with another. I made an appointment and canceled, made an appointment and canceled, and this went on so many times I was afraid this surgeon who was emailing me from Bangkok probably thought I needed more mental than orthopedic care.
Anyway, by the time Hurricane Gamma was threatening our state I emailed him to cancel again, saying that I was hurting so bad I could not stand up for more than 30 seconds without being in excruciating pain, but I was unwilling to leave my business. I told Dr. Nanthadej that we had not only gone through the English alphabet for the hurricane names, but we were now in the Greek alphabet. As a postscript, I added that we should use the Thai alphabet.
By this time, we were on first-name basis. When I finally did make the appointment, he said he really enjoyed my humor. This was a relief to me as I thought he may send me to the psychiatric ward.
We hit it off almost immediately. Although he had read my MRI from the United States, he said he wanted to see me personally before finally deciding on surgery. Well, one look and he knew I was in bad shape. He asked if I would be ready for surgery day after tomorrow. I said I’ll take it right now, if possible. He also assured me that there had been no cases of staph in the orthopedic section of the hospital since he began working there and did not know of any in any other departments.
By that afternoon I was all through pre-op and was scheduled for surgery two days later. I learned that this speed is fairly normal at Bumrungrad Hospital, not the weeks or months required here in the USA.
Leaving his office, I felt so comfortable, knowing that I had made the best decision of my life and that this surgeon was going to do his very, very best for me. And he did.
He actually may have done too good of a job as – almost immediately after coming out of the recovery room – I was virtually pain-free and felt as though I could lift small buildings with a single hand!
I was in the hospital for four days and could not have received better care. My biggest worry was meal choice: should I have the thinly- sliced tuna in red wine sauce or the lobster salad?
There were many more choices prepared by four different chefs, even a “McBumrungrad" delivery of McDonald’s hamburgers right into your room.
Simply put, I was overwhelmed and felt so stupid that I had suffered so long and the ordeal was almost pleasurable. Since then I have been back for just a general physical, along with several others. Again, each one was a first-rate experience and left with every confidence in the world.
RETURN TO BANGKOK
Unfortunately, almost six months ago, I took a hard fall after stumbling over one of our eight Pembroke Welsh Corgi dogs, but that’s another story.
Anyway, my back pain returned but not nearly as bad as it had been. So this time, after major hurricane season was over, I made my one and only appointment with Dr. Nanthadej and was able to keep it.
After the warmest of greetings and a big hug – very unusual by Thai standards, but he did train nine years in Chicago – we sat down to business and he ordered an MRI.
He got me started immediately on some pain medication but sent me down to Dr. Chomchai, a pain management specialist, for a second opinion. With only a few minor adjustments during the first week of my visit, I was back to being all but pain-free.
Fully expecting more surgery, I was elated to hear it was quickly being ruled out.
While there, I also had my first colonoscopy and was really dreading that. I don’t know what the big deal is about this as I remember nothing and it was painless. I have an 18-minute DVD of the procedure and the skill that Dr. Poungpen exhibited is nothing short of incredible.
My friend came along during this trip, and had a hernia repair which he had let go too long for them to do lapriscopically. He spent two days in the hospital.
He disagreed with me about the food being so good, but I think they must have had him on a bland or different diet. He said he was not given a menu like I had experienced.
Anyway, he is up and running and back to work. He too was very impressed with his doctors and the whole “Bumrungrad Family.”
The cost of the entire procedure was not enough to equal his deductible, which would have been about 10 times more here in the United States.
The new International Building in the Bumrungrad complex is finished up to the 16th floor. It is a 22 story building. . What a beautiful and tranquil building, to now house more than 1,100 doctors. It is as efficient as we found it in 2005.
The quality, cleanliness and efficiency has not suffered a bit, even though over a million patients a year are going through the doors now.
The doctors that I have come in contact with are all first-rate. It must be a great honor for them to be working at such a prestigious facility. I would not think twice now about having the most serious of surgeries performed there if the procedure was offered.
I never saw an organization – from the lowest to the highest levels of service – exhibit such true concern so that everything they were doing was of the highest of standards and benefits the patient.
FREQUENTLY-ASKED QUESTIONS
In the three years since my surgery, here are the questions that people mostly ask:
- 1. Why did you go to Thailand for surgery and how did you select Bumrungrad?
My overwhelming fear of hospitals here is due to the very high staph infection rate as well as all hospital-acquired infections (HAI’s).
It has even worsened with the emergence of drug-resistant strains, but current reports say this is in regression.
Because of different reporting methods, it is hard to find exact percentage data but I suspect the infection rate is high since four out of eight people I know personally have gotten staph complications after surgery in hospitals here in the United States just this year 2009.
Bumrungrad claims less than 00.40% for all forms of HAI’s (Hospital acquired infection). It is almost impossible to get like vs. like comparisons since it is not uniform in the way hospitals report medical metrics, but in all measures, Bumrungrad reports at least twice as favorable figures to more than 40 times better than other participating hospitals and I believe it.
The place sparkles inside and out. I even observed cleaners rappelling from ropes, cleaning windows high up on the outside of the building! This simply is unaffordable in the United States.
In my choosing this hospital, cost was a secondary factor. I selected Bumrungrad as it continually kept popping up on search engines as number one and, at that time – and I think still – it is the only JCI-accredited hospital in Thailand.
I found out during my initial trip that many very wealthy and famous people go there for treatment. I saw first-hand the people who can afford the very best were coming to Bumrungrad.
I was actually afraid the first time because the internet just seemed to present too favorable a picture. We went two days early to check it out for ourselves, but we needed only minutes to see that it was the right decision.
I am sure there are other good hospitals in Thailand, and certainly less expensive by Thai standards, but I checked out only one and nixed it immediately. If you forego the very important JCI accreditation I would certainly be concerned with the HAI rate, Unscheduled readmit within 15 day and direct surgical mortality percentages. All of these are much lower at Bumrungrad than reported averages worldwide.
Should time permit, I will check out other hospitals in Thailand on my future trips.
- Will the cost of the specific treatment provide sufficient savings to justify time and travel?
Costs at Bumrungrad are a fraction of those in the US, but for eye, skin, and dental procedures the difference may not justify the trip. Along with check ups, treatments like these may be worth considering as add ons to a business or leisure trip. I personally have received refunds on several procedures, and never paid over the original estimate.
- 3. Will my insurance cover the cost?
This depends on your insurance.
However, more and more insurance companies in the United States are offering international coverage and costs should be substantially less. You would have to check with your provider, and possibly even negotiate a new and less-expensive policy. There are now numerous insurance offerings catering to the medical tourist.
My total cost has never met my high deductible. Bumrungrad – or whatever hospital you are dealing with – will tell you what insurance programs they accept.
- 4. How long is the flight and how do you determine the amount of time to stay over there?
Flight time varies from what region of the United States you are coming from. Plan on about 24 hours – which sounds brutal. However, the longest flight, which is 10 hours or a bit more, allows you plenty of time to sleep and relax.
Contact your doctor over there and ask how long you should expect to stay and recuperate before flying back.
The airlines will usually work with medical tourists to adjust flight schedules, if accompanied with a doctor’s recommendation.
At present there are no direct flights that I know of from the United States to Bangkok. I actually enjoy getting out in Tokyo, Osaka, Hong Kong, Taipei or Seoul to stretch my legs before the final leg. Fares are reasonable, and not in the thousands of dollars that many people think. People living on the West Coast enjoy flights that cost well under $1,000, even for last-minute tickets. For those of us on the East Coast, air fares are just slightly above $1,000 for economy tickets. A doctor’s visit alone could run that much here in the United States.
- 5. How do you select a doctor?
I let the hospital suggest a doctor from the initial email. Then I checked credentials. Most have training in Europe and the United States if that means anything. English is spoken fluently by most as well as the nurses. There are over 100 interpreters for other languages employed by Bumrungrad.
From that first appointment, I became very comfortable with Dr. Nanthadej, the hospital’s initial recommendation, and could not be happier with him or with the specialists that he suggested. There is a find a doctor function on Bumrungrad’s website.
For back problems I would highly recommend Dr. Nanthadej; for gastro-intestinal conditions, Dr. Poungpen; for pain management, Dr. Chomchai, and for general medicine, Dr. Wiwat.
Dr. Sunantha, my anesthesiologist for the first surgery, even came in and introduced herself and assured me she would take very good care of me.
My personal thoughts are: if you are not top rate, you don’t last long at Bumrungrad.
- 6. What if something goes wrong?
This was another concern of mine and I was perhaps more worried about what people would say, should something go wrong, since it is still very uncommon to go overseas for treatment. I quickly became so comfortable with my surgeon that I knew he was going to do his very, very best so that the question for me became a non-issue.
It is a misconception however that international patients have no recourse in Thailand. There is an independent medical council to review problem cases (they can revoke doctor or even hospital licenses.) There is a consumer protection board. Patients can and do sue for malpractice. It is just not a jackpot-by- jury mentality as in the US. The first (and often last) thing that happens when a problem arises is that the doctors and hospitals discuss how to make things right with the patient according to Kenneth Mays, marketing director for Bumrungrad.
It is time for Americans to learn that medicine is a “practice” and that a lawsuit for millions of dollars hurts everyone. Insurance, pharmaceutical companies, doctors and hospitals build this into their costs, and we all pay for it, and it is at a high cost.
Give me a doctor that can practice his profession and not be bogged down with the system. I found many at Bumrungrad
- 7. Where do you stay and what can you do as a medical tourist?
Bumrungrad has a connecting facility for extended stays and for family members. This time, I found it to be more expensive than I cared to pay – although it is worth every penny. Our US dollar does not buy what it did in 2005.
There are many hotels of different price ranges all around the city of Bangkok but, because Bangkok traffic can be horrific, I would select one that is close to a BTS Skytrain station or a subway train station.
We have stayed at hotels such as the Ambassador, the Zenith, the Chaophaya Park and the Immfusion, but there are hundreds of others. Just check the internet.
I would stay a few days at the Bumrungrad Hospitality Suites or Residences after any major surgery, simply because it is immaculately clean and it is connected to the hospital.
As for tourism, there are many things to do in Thailand if you are able, and with your doctor’s approval.
Some of my favorites are the Grand Palace (a must), the Chatuchak Weekend Market and its surrounding areas, The Aquarium at Siam Paragon, and the Chit Lom area.
Further away are the Nong Nooch Gardens in Pattaya, which is the Disney World of botanical gardens.
There is Phuket further south for the beach, and Chiang Mai as well as Chaing Rai further north for the mountains, but these destinations require air travel; the train or bus may be too hard on a recovering patient.
I have been to Thailand more than 20 times and I never run out of things to do.
I have heard of Americans never meeting their surgeons, and of patients being wheeled into the operating room with “Operate Here” written on their body. This is never going to happen at Bumrungrad. It is an incredible place. Not only is it affordable to most, but many of the richest people in the world are coming here simply for some of the best health care on earth.
Bruce Pearson Boynton Beach, Fl
