Medisch
Onderstaand is een deel van een nieuwsbrief van een verzekeringsmaatschappij, die wij ontvangen. Er staan wat zakelijke mededelingen in maar ook een aantal zeer harde feiten over doktoren etc. Kortom, lees en verwonder (hoewel dat na al mijn posts eigenlijk niet meer....).
Case study: Hospitalization in Vietnam
When you're hospitalized, you shouldn't be worrying about the quality of the hospital or the ethics of the doctor. Hospitalization in Vietnam, however, is not that straightforward. This brief article will give you an overview of the hospitals, doctors, infrastructure, and the culture of the medical practice in Vietnam.
Update on hospitals
• The Vinmec International Hospital in Hanoi is now ‘getting international’ after securing more rotational French doctors. Bookings with these doctors are now available.
• The obstetrics and childcare services of the Hanh Phuc Hospital in HCMC have been very popular as of late. It is now even mentioned on the Thomson Group website.
• Hoan My Hospitals have been divested by Fortis Health Care of India, with 80% of shares purchased by New Zealand entrepreneur group Richard Chandler Corporation.
The doctors
• All hospitals employ Vietnamese doctors and sometimes freelancers and consulting foreign doctors. Check the managed by information on hospital websites when booking at a particular hospital.
• A few things you should know about local doctors:
• Foreign language—Vietnamese doctors may speak English well but can have trouble with pronunciation and with understanding the nuances and idioms of native English speakers.
• Doctors prescribe what pharmaceutical labs ‘persuade’ them to sell, similar to what a sales agent would do for a commission.
• Client versus patient—Generally you will be considered as a client rather than a patient. As a result, Vietnamese doctors do not usually refer to specialists in other hospitals even if your case is beyond their area of expertise.
• Doctors know it all—doctors do not want to lose face by referring cases to their peers. Doing so would be admitting that they don’t know how to treat a particular case. The doctor will try everything. “We try our best’ is their line of defense. Suggesting a second opinion is not a local practice.
• Doctors don’t share their knowledge—don’t expect any information, pedagogy or explanation regarding their diagnosis. They consider this their trade secret.
• Doctors are not psychologist—they will deliver their diagnosis bluntly, or not.
The infrastructure
The Viet Sing International clinic is a case study.
• Located in the very posh Pacific Place building in Hanoi, the centerpiece of the hospital is a US$1+ million lab with testing machines (GE or Siemens).
• Consultation rooms and emergency exits are distributed around the ‘latest equipment in the aquarium’, museum or clinic.
• Contracts for maintenance, chemical testing, and supplies are subject to ‘hard discounts and commissions’, if given at all to the original supplier. However, it is common knowledge that the key to medical best practice is professionals and the latest supplies, not machines.
The cultural environment
• Vietnamese don’t question the authority of doctors.
• Vietnamese doctors will assess your wealth to see what level of cure you can afford. The poor are sent home with a few painkillers and advised to work on a will. Richer patients may be referred to a friend place for more expensive treatment. For any question about evacuation for treatment in Singapore or Thailand, their response may be ‘sorry we don’t speak Singaporean’.
• Newspapers and the geomancy have a strong influence on what is curable or not in Vietnam.
• Staff can be corrupt as in the recent case of the lab director who photocopied of the same ‘good results’ and delivered them to thousands of patients, saving his time and pocketing testing supplies money.
• Paper pushers—I experienced first-hand a nurse who gave me blood type test results as type A, and not the (correct) Rhesus positive, because “I did not ask for it.”
The overcharging
• At international clinics, the consultation cost is US30+ for tests and medicines. The average outpatient consultation is U$150-200, which is roughly one month’s salary for the average Vietnamese. There is often much testing at the first signs of being ill.
• The usual cost of medical in the region is the benchmark for the insurer. A CT Scan or IRM can costs roughly $100 at a Vietnamese hospital and $350 at a ‘high-end’ clinic sub-contracted for the same CT scan. Some clinics charge the same as Singapore, Tokyo or New York-based practitioners.
• The reason that you pay a high insurance premium (that increases year-after-year) is due to ‘medical inflation’, or the ‘missing link’. Clients pay the insurer and the insurer pays the clinic. There is no link to regulate the 3 parts. Insured members want the best treatment at whatever the costs, hospitals offer the best because the cost is irrelevant, and insurers pick up the bill and then invoice the client at premium renewal.
• Vietnamese doctors are authorized to sell medicines, but this is changing. They receive commissions from pharmaceutical companies, which explains why local doctors prescribe bags of medicines. As they do not want to reveal their trade, the pills come in a bag with colors, no box, no printed notice, and just a prescription with pill color and intake frequency.
Conclusion: Who can you trust?
Bron:
Insurance in AsiaCase Study Hospitalization in Vietnam - Insurance in Asia
Goh, ik had het zelf geschreven kunnen hebben. Dit mede omdat Minh de genoemde feiten uit eigen ervaring kan onderschrijven. Als ze naar ons vaste privé-hospitaal in Nha Trang gaat en ze krijgt medicijnen voorgeschreven, staat de naam van de dokter bij de medicijnen en wordt die naam ook in de computer ingevoerd. Tja, lijkt op......
Ook heeft ze wel eens pillen gekregen zonder naam, bijsluiter etc..
[OffTopic/On] De zich orthopeet noemende nitwit, die mijn dochter in NL heeft behandeld, kan beter naar Vietnam verhuizen. Bovenstaande profielschets is hem op het lijf geschreven. [Offtopic/Off]