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A comment from K. Thai Woman (ณารา)

Note: The following comment was kindly given by K. ณารา. For some reason, she couldn't post it in my blog. So I posted it on her behalf. I tried to put it in the comment section. But it didn't work, so I added it as another blogs in the Reflection Series.

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Since I could not paste in the comment section in your personal blog, I paste it here.

I had a different experience on medical treatments I received when I was in Thailand. Unlike in the US, I felt caregivers, doctors or nurses, treat patients as if they were not capable of understand anything in medical field. From my observations especially in small to middle towns, patients are patronized rather than being treated as patients.

One of many examples I countered: I took my mother to see her doctor at a public hospital. Along with us was the x-ray film, which my mother had it done under the doctor’s order. After over an hour of waiting it was finally our turn. The doctor looked at the x-ray and he, without any explanation, ordered for another x-ray. When we got back with the new one, again he looked at the x-ray. Without further explanation, he prescribed medications for a month of supply. I was told to bring her back for another check-up and possibly another x-ray. Obviously, questions came into our minds. My mother, an old uneducated woman, with no choice must oblige. I questioned the doctor of his findings. The answered was nothing serious. I politely insisted for more information. His response was I should not be overtly concerned.

He would like to spend time explaining to me, but he had many patients waiting. The nurse then ushered us out. She advised us that it was better to see him at his private clinic where he could spend more time with us. We left filled with anxiety and concerns. We did and, of course, we had to pay much more there. Yet, the information received was still unclear.

I frustratingly discussed with friends who are in medical fields. The response was they are not used to being questioned so that the ability to convey into simple terms for average patient to understand is quite limited. Everybody has his own place/role. Caregivers have the role of giving care. Patients have the role to receive it gratefully, no questions asked. In your case, your family received a good care with little cost because, I believe, you are in the same field. You are the insider not and outsider like my mother and I.

To me, it broils down to money: you want more or can afford more, you pay more. Services are rendered to whomever has more purchasing power. A capitalistic way!

From my observations, in small towns we looked up to caregivers especially doctors more of noble men with superiority. In the US, doctors are equal as everybody else; it’s just a profession. From that equality, doctors and patients, together, build mutual respect and trust. I must say I rarely see that in Thailand except in big hospitals in big cities like BKK, which has more educated/sophisticated and wealthier residents.

When I had my surgeries, my doctors made sure I clearly understand the procedures. I could ask any questions came to mind. I could call them back for further questions though I might not get them on the phone instantaneously. But, they normally called back. I, in effect, understand what went wrong with my own health. I thus gave them my trust to perform operations on me.

I must say Thai patients do not resort to lawsuits because of kindness, but because they do not know better with whatever reason: illiteracy, understanding, lack of guidance how to pursue, lack of courage and supports, etc. K. CIT very well touched on this.
One can not say US health care is in good shape. It has many flaws. One big flaw is in the special interest groups who use their influences to get legislatures in the Capitol hill to pass laws in their favours. Downtown DC is filled with lobby firms. Health insurance and pharmaceutical industries have the most powerful ones. The last bill on senior citizen drugs, which was passed last year, is a manifestation of the powerful lobby by drugs industry. The ‘architect’ who pushed for this bill is now working for a drug lobby firm. The Tort reform, which is on Bush’s agenda, is another one by the health insurance industry.

There are many issues in US health care system that need be addressed and fixed. May be we should look at this industry with different mindset: as a not-for-profit business. Over ten years ago, a professor at HBS did a research study on volunteerism. He suggested applying volunteerism into a mix with business practice for hospitals and health care industries. It seems his study has yet been materialized.

P.S. It would be nice and kind of you, if you could post all this in your blog for me. I did many attempts, but to no avail. I personally do not like to go to personal blogs. Many thanks.
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Create Date : 29 มีนาคม 2549
Last Update : 29 มีนาคม 2549 2:26:46 น. 31 comments
Counter : 591 Pageviews.

 
แวะมาทักทายค่ะ


โดย: Malee30 วันที่: 29 มีนาคม 2549 เวลา:15:52:16 น.  

 
"Most people in urban area are low education. If I told them all the truth about his/her health problem, not only they will be frustrated, also they will spreaded the misunderstanding among their relatives. The suitable way, not the best way exactly, I will told them as necessary" said one of my doctor friend.

Now I think this kind of veiw is reduced, by many mean. The people have many medias to improve their knowledge and understanding. The doctors, who have been done in the way you (K. Thai woman) described, has changed their ways of practice. This is seem nice for everyone. The doctor, nowadays, give more explaination, send more investigations, and precribe more medications.

But the more public concern in the health industry, the more expensive health cost the patient has to pay for. Just like in USA, onlyif you have a headache, you will undergo many investigation, e.g. CT scan or MRI and many blood tests. Finally all you have been diagnosed as stress induced headache.

Many of my friends, they are the doctor, also complained many patient's problems in the same way. From this story, I can conclude that every coin has two face.... Just hope that in my case, I will got the right one!!!


โดย: dont wanna no วันที่: 29 มีนาคม 2549 เวลา:22:52:56 น.  

 
“Most people in urban area are low education. If I told them all the truth about his/her health problem, not only they will be frustrated, also they will spreaded the misunderstanding among their relatives. The suitable way, not the best way exactly, I will told them as necessary" said one of my doctor friend.”

This is exactly what I meant, we (I use we to include all of us who have higher education) tend to presume that the less educated are not capable of understanding. The bias mentality is already fixated to such notion. We tend to believe that they should strive to our level.

On the contrary, I think it is our responsibility especially caregivers should be able to communicate at a certain level to make them understand. This is what I call the ability to connect. Having grown up in the working class environments, I assure you that once we communicate to the level they can comprehend meaning using simple language/terms they will be capable of perceiving the information. The ability to connect is a challenge task that once it is overcome (though it is rather difficult), the success will ensue.

I’d like to refer to Mr. Meechai Weravaithaya. Whenever there is a discussion about AIDs control or population control, his name was always mentioned. His success is an example that many nations try to follow. Mr. Meechai, a technocrat, is one of a kind: graduated from abroad, which by then was quite something. During his campaign to promote birth and/or AIDs control, he applied some skills, which I believe contributed to his success:
- ability to recognize problems
- ability to connect
- flexibility

When he realized that majority of country folks could not understand his messages about using condoms or they were shy about this subject, he changed ways to communicate. He made the presentations more to their levels: simple and funny (to break the taboo). He was able to capture the audience attention. They were connected to him. As a result, he received their co-operations resulting him to achieve what he set out to do.


โดย: Thai Woman IP: 68.48.34.34 วันที่: 1 เมษายน 2549 เวลา:3:55:19 น.  

 
Communications are always problems for Thai medical caregivers.

In the US, doctors will be reponsible for giving information in the parts that strictly require doctor's opinion such as definite diagnosis, necessity to do or investigate or something like that.

Nurses and other trained educators will have roles in giving patients with relevant levels of education. So, basically, they are willing to sit and talk with the patients and give liberty to the patients to ask for what they would like to know.... in my opinion, more than what it is in Thailand.

However, this kind of services is never free krub... Everything will be charged to patients' account. But, in Thailand, we may not have such resources to allocate into communication issues.

I may have add more comments later krub.


โดย: A.T. IP: 129.82.33.85 วันที่: 1 เมษายน 2549 เวลา:4:01:20 น.  

 
My friends told me that the medical practice is an art. We can draw the same elephant, but the result is definitely different. So the doctors like the artists, they can cure you but may be in different way. Also they can tell you about your diseases in different ways. So we (Thai patient) who have not much money to make the choice, should pray for the "right" artist for our sickness.

Anyway, I myself, fortunately, have never been in that such situation krab :-D


โดย: dont wanna no วันที่: 8 เมษายน 2549 เวลา:1:44:33 น.  

 
แวะมาทักทายนะครับ พี่... สบายดีนะครับ.....


โดย: POL_US วันที่: 8 เมษายน 2549 เวลา:15:02:22 น.  

 
มาสวัสดีปีใหม่ไทยครับ ขอให้คุณ A.T. และครอบครัว จงมีแต่ความสุข ความเจริญ และความสันติสุขปลอดภัยนะครับ


โดย: piangdin วันที่: 12 เมษายน 2549 เวลา:13:35:45 น.  

 
Happy Thai New Year ka.
I wish you and your family are happy and healthy na ka.
;)


โดย: the phu IP: 58.136.205.143 วันที่: 13 เมษายน 2549 เวลา:22:57:36 น.  

 
แวะมาดูว่าเมื่อไหร่ คุณ A.T. จะ update blog ครับ

สุขสันต์ปีใหม่ไทยนะครับ
ขอพรประเสริฐจงเป็นของคุณและครอบครัวทุก ๆ คนครับ


โดย: piangdin วันที่: 14 เมษายน 2549 เวลา:3:32:10 น.  

 
Medical issue is another one that is interesting to discuss beside education.

The medical cost in here is so expensive compare to Thailand. I don't know whether or not because of the cheaper price in care, so you don't *&%$# and moan about how they treat you.

Just take it and leave.

Next.....



โดย: PatPDX IP: 70.162.170.169 วันที่: 3 พฤษภาคม 2549 เวลา:9:43:22 น.  

 
อย่าเพิ่งเข้าใจผิดว่าว่าอะไรนะคะ

ดิฉันเองก็โดนอย่างนี้ เวลาไปหาหมอที่เมืองไทย

แบบรอนานนนนน มากกกกกก เข้าไปแบบจ๋อยๆ แล้วก็ออกมาอย่างจ๋อยๆ

แต่ค่ายานี่ทู้กถูก


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=================================
Note: My life has been intertwined with works and many others. New responsibility has emerged, resulting less and less time for my ordinary life. Although, a love to write is still intact... But having less time is related to having less imagination.... Therefore, I could not come up with new writings for quite some times.

It might be a good time for me to leave this forum for moment.... Please take it as Mr. A.T. is having a sabbactatical leave or something like that....

As noted above, my love to write is still the same... and will not be changed. Sometimes somehow, I hope I could come back and give some thoughts in this blog once more.

Cheers,
Mr. A.T.
June 6th, 2008

=================================


Hello,

My pen-name in Pantip is amatuer translator. Actually, I'm a lousy translator with lame translation. My pen-name is somewhat misleading, I have no background in linguistics what-so-ever. Anyway I love to read, write and communicate with people...

Reading is my most favorite hobby. I read everything from shopping bags to articles in theoretical physics. I do research and teaching for my living. So, reading, writing, thinking and doing research works are my everyday routine.

I would like to define myself as a person who is accepting new ideas and adopting those into my way of life.

I believe in power of knowledge/education. I think every society can be a better society with knowledge. Ignorance can be dispelled by it. Humanity can live sustainably and harmoniously with each other along with its biosphere with understandings in the nature surrounding it.

Apart from my philosophical thoughts reflecting who I am, I can tell you something I like or love in particular;

I love dogs.... Particularly, labradore retrievers.... One day, I would like to spend my time and life with them as a big part of my family.

Zhuge Liang is my hero. With his wisdom and faithfulness, he led a tiny army to a mighty and formidable kingdom. He left his humble residence with a hope to come back. But, sadly, he had never returned and died far far away from home in a horse carriage in a battle field. If I could choose where I would, I would say where-ever my lovely wife was nearby.

I value happiness and my family as my first priority. My profession and my philosophy come in the second. Pursuit in wealth has never been in my desire.

I'm glad to be your friend, and look forward to seeing you around krub.

Best wishes,
A.T.
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