News Forum - Aussie woman’s mystery illness diagnosed 7 years after holiday to Thailand

[palooka]

GPs can be lazy buggas.

Friend at 84 years complained for 5 years about lower back pain left side.  Diagnosis: Arthritis.

Changed GP. Diagnosis: cyst as large as an orange growing on his left kidney.

Method of discovery. Lower back scan.

If the quack isn't fixing the problem, CHANGE Quack.

[Faz]

  On 1/17/2023 at 11:29 AM, cowslip said:

There is no GP system in Thailand.

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Who do you think you're referred to at a government hospital for a diagnosis, then?
Many of these GP's specialise and operate private clinics.

[cowslip]

  On 1/17/2023 at 12:17 PM, Faz said:

Who do you think you're referred to at a government hospital for a diagnosis, then?
Many of these GP's specialise and operate private clinics.

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Ae you American?

That's not a GP system......it doesn't exist in the USA either.

Even at government hospitals the doctors you first meet are not GPs - they are usually a specialist in something - the admin will try and send you to a doc or the doc on duty may then pass you straight on to a specialist because he can't diagnose you.

There is a small GP training course in Thailand but it is regarded s a second class option and most doctors don't do it.... they are obliged to work at government hospitals for 2 or 3 years before they set up on their own in a more lucrative field.

Doctors are not tied to any particular hospital - you may come across a doctor in various different hospitals.

You are also overlooking how a proper GP operates, they don’t just take care of “walk-ins” in hospitals , in the GP or “family doctor” system patients sign up to a clinic rather than a hospital for long periods – this means their records are kept for life and passed on from one clinic to the next so the patient builds up a life-time history that docs can refer to…No of that happens in Thailand. The norm is for people to walk into there nearest facility when they feel they need it and just hope for the best.

Edited January 17, 2023 by cowslip

[KaptainRob]

Ask any expat living in Chiang Mai for referral to a GP and Dr Morgan is our Thai GP, married to a Welshman ... she's got taste 

  On 1/17/2023 at 12:27 PM, cowslip said:

That's not a GP system......

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What is  a 'GP system' supposed to look and operate like?

[Faz]

  On 1/17/2023 at 12:27 PM, cowslip said:

Ae you American?

That's not a GP system......it doesn't exist in the USA either.

Even at government hospitals the doctors you first meet are not GPs - they are usually a specialist in something - the admin will try and send you to a doc or the doc on duty may then pass you straight on to a specialist because he can't diagnose you.

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No.

There are plenty of general practitioners in Thailand, who also specialise in a particular field, same as UK GP's. Here's just a few of your non-existent GP's in Thailand 
https://www.thailandmedical.news/pages/thailand_doctors_listings?pages=1&category=18

[Khunmark]

  On 1/17/2023 at 10:18 AM, cowslip said:

Gnathostomiasis in remote northern Western Australia: the first confirmed cases acquired in Australia

You miss the point - you don't need a specialist, you need diagnosis....... the whole point of a healthcare system is to initially try and find out what you suspect the problem is then call in the specialist.

This is in fact a major problem with the Thai healthcare system is they have no proper GPs etc, hover in Australia they do and this sort of thing shouldn't be overlooked.

In Oz they have this disease here is a paper from 2011 outlining some cases.

“Gnathostomiasis in remote northern Western Australia: the first confirmed cases acquired in Australia” ….

https://www.mja.com.au/journal/2011/195/1/gnathostomiasis-remote-northern-western-australia-first-confirmed-cases-acquired

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I am one of the first to criticise a system where doctors aren’t afforded the framework to make more independent clinical judgements. However, with over 6000 rare diseases world and numerous overlapping symptoms, it’s unreasonable to expect your local doctor to make an accurate diagnosis on a disease he/she has never come across. 

[cowslip]

  On 1/17/2023 at 12:36 PM, KaptainRob said:

Ask any expat living in Chiang Mai for referral to a GP and Dr Morgan is our Thai GP, married to a Welshman ... she's got taste 

What is  a 'GP system' supposed to look and operate like?

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General Practitioners (GP) or Family Doctors are the first point of contact for healthcare

GP system or Family healthcare is simply not a well established concept within Thai society nor in Thai medicine

They provide referrals to all specialists and, if necessary, to a hospital. GP’s are the gatekeepers for the influx of patients to secondary or tertiary tiers of specialised and academic health care. 

The Thai medical educational system gives hardly any attention to specialisation as a GP/Family Doctor. Although there is some postgraduate training available in general practice a general practitioner is still regarded as a ‘second tier’ doctor and will usually work within a hospital only. They are often recently qualified doctors who are waiting to “do their time” before moving on to a more lucrative branch of healthcare

An effective GP system guards against over treatment , it failed in the case of the OP as the patient was treated ineffectively for years.

Seeing various “specialists” instead of an initial “screening” system leads to unnecessary treatments all through the Tai healthcare system. Quite often patients re unaware of this they think they needed all those blood tests and operations because the hospitals certainly aren’t going to tell them.

Thailand has on the face of it well-developed healthcare secondary and tertiary care structures although the quality and training may not in fact match the “face”. It is nevertheless lucrative.

But, they offer very little in the form primary care services in the community. No money in this…..except in the long term it could save the country trillions.

There is no Thai equivalent of a Family Doctor or General Practitioner clinic, or similar healthcare providers which are seen throughout the West, the exception being the USA. Thai people are don’t register with any one healthcare provider and usually attend any hospital that’s convenient when they feel a need. 

The problem is they don’t establish a reliable medical history, and the medical establishments they visit may vary in quality and ability to diagnose and treat – resulting in different, repeated or conflicting therapies.

Edited January 17, 2023 by cowslip

[cowslip]

  On 1/17/2023 at 12:47 PM, Khunmark said:

I am one of the first to criticise a system where doctors aren’t afforded the framework to make more independent clinical judgements. However, with over 6000 rare diseases world and numerous overlapping symptoms, it’s unreasonable to expect your local doctor to make an accurate diagnosis on a disease he/she has never come across. 

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THat's not how primary diagnosis works - for instance you can eliminate various diseases and then suggest is may be an unspecified parasite. This would use information from the patient - such as having come back from Thailand and there are other instances of this - it is common for people in Issan to develop live cancer (one of the highest instance in the world) from eating home made nam prick. It doesn't require a specialist to deduce this.

By coincidence I was tested for this on a visit to the UK. Referred by my GP.

[cowslip]

  On 1/17/2023 at 12:42 PM, Faz said:

No.

There are plenty of general practitioners in Thailand, who also specialise in a particular field, same as UK GP's. Here's just a few of your non-existent GP's in Thailand 
https://www.thailandmedical.news/pages/thailand_doctors_listings?pages=1&category=18

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see my post to your colleague.

[cowslip]

Be clear there is no proper GP/Family doctor system in Thailand. primary care is very poor.

[cowslip]

  On 1/17/2023 at 12:42 PM, Faz said:

No.

There are plenty of general practitioners in Thailand, who also specialise in a particular field, same as UK GP's. Here's just a few of your non-existent GP's in Thailand 
https://www.thailandmedical.news/pages/thailand_doctors_listings?pages=1&category=18

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You should then realise that General Practice IS a specialised field in itself.

Edited January 17, 2023 by cowslip

[Faraday]

  On 1/17/2023 at 12:58 PM, cowslip said:

Be clear there is no proper GP/Family doctor system in Thailand. primary care is very poor.

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There isn't a GP system in Thailand that is exactly the same as the UK.

If I was to go to BKK hospital & see a GP (see below link), & then go to another BKK hospital in another province, the notes can be called up.

https://www.phukethospital.com/center/general-medicine-clinic/

This is the same with other hospitals that are part of the same group.

It also exists in Government Hospitals.

Primary care here is not poor. I know this due to first hand experience with many family members.

Do you currently live in Thailand?

Tip #

Don't keep contesting this, as myself & others, are not looking for an argument.

[Pinetree]

  On 1/17/2023 at 1:10 PM, Faraday said:

There isn't a GP system in Thailand that is exactly the same as the UK.

If I was to go to BKK hospital & see a GP (see below link), & then go to another BKK hospital in another province, the notes can be called up.

https://www.phukethospital.com/center/general-medicine-clinic/

This is the same with other hospitals that are part of the same group.

It also exists in Government Hospitals.

Primary care here is not poor. I know this due to first hand experience with many family members.

Do you currently live in Thailand?

Tip #

Don't keep contesting this, as myself & others, are not looking for an argument.

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Cowslip is after an argument, as most of his posts on this subject are plain wrong, biased, or distorted.,  I suspect that he has a beef with the system here.  Its far from perfect but I for one prefer it to the UK. 

[Faz]

  On 1/17/2023 at 1:10 PM, Faraday said:

Don't keep contesting this, as myself & others, are not looking for an argument.

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You can't argue with idiots.
They'll drag you down to their level, then beat you with their experience.

[Khunmark]

  On 1/17/2023 at 12:56 PM, cowslip said:

for instance you can eliminate various diseases and then suggest is may be an unspecified parasite

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And you don’t know that this didn’t happened. Her condition is notoriously difficult to diagnose.

[cowslip]

  On 1/17/2023 at 2:14 PM, Khunmark said:

And you don’t know that this didn’t happened. Her condition is notoriously difficult to diagnose.

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It isn't difficult to diagnose, it's down to not many people know about, once they've heard of it  diagnosis is not that difficult. A simple skin test will confirm.

Edited January 17, 2023 by cowslip

[Faraday]

  On 1/17/2023 at 4:49 PM, cowslip said:

It isn't difficult to diagnose, it's down to not many people know about, once they've heard of it  diagnosis is not that difficult. A simple skin test will confirm.

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Clearly it is difficult to diagnose - perhaps you don't appreciate how a clinical diagnosis is reached?

[cowslip]

  On 1/17/2023 at 9:28 PM, Faraday said:

Clearly it is difficult to diagnose - perhaps you don't appreciate how a clinical diagnosis is reached?

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yes, indeed I do understand the 4 tenets of diagnosis, do you?

[Faraday]

  On 1/17/2023 at 9:39 PM, cowslip said:

yes, indeed I do understand the 4 tenets of diagnosis, do you?

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Carry on, Mr Cowslip 

[Adventuresome]

I avoid street food. A friend did a tour that was a 1 day trek. When they finished (on a beach), the company had food laid on : cooked fish and chicken from table buffet. So he ate, but his friend didn't

The friend that ate had so bad food poisoning that he had to remain in the hotel room and miss his flight. His friend took the flight and went ahead to wait for him. 

A girl that my sister worked with came back from Asia and after a couple of weeks had terrible headaches. Nothing would relieve it and she went to a specialist. They looked at her eye and determined that there was something wrong. So they operated on her : they had to pop out her eye, and scrap parasites that were eating her optic nerve. She had eaten fried water bugs, but the parasites in the bug hadn't been killed and had migrated to her optic nerve to eat it. They told her there could be more of them and she might have to go back to do it again.

[TheDirtyDurian]

  On 1/16/2023 at 6:00 AM, Pinetree said:

Young people on their year out often want to try local cuisine under local conditions, without realizing the dangers of uncooked or poorly cooked street food here. Never touch it myself.  As for the diagnosis after so many years, nothing surprises me about the incompetence and lack of knowledge of NHS Doctors.  They didn't diagnose my first case of Dengue Fever despite having classic symptoms, and telling them that I had just returned from Asia.  She is lucky the penny dropped with that lot at all.

Cue lots of comments of how the UK NHS is wonderful; it just isn't.  

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You didn't get the rash? ️️ 

[Pinetree]

  On 2/17/2023 at 11:00 AM, TheDirtyDurian said:

You didn't get the rash? ️️ 

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I had the lot, bleeding into the joints, high fever, immense joint pain.  It took the SHTM in London to diagnose it with a simple blood test. Even the Indian Doctor at our local A and E missed it.