The GP post (Hua Hin) in times of Corona
At Christmas it all looked very predictable for the Be Well GP in Hua Hin. Start up and then slowly grow to the desired result. The Covid-19 outbreak kicked things up a notch after February. “It is mainly the uncertainty that bothers people,” says founder and former Venlo resident Haiko Emanuel.
Be Well is the first out-of-hours GP service in Thailand and was set up by two Dutch people, the recently retired Dutch GP Daan van Groenewegen (64) and his friend/entrepreneur Haiko Emanuel (61). The post is located in a new building on the luxury bungalow and villa complex the Banyan.
Thailand has a well-developed health sector, especially compared to other emerging markets in Asia. The sector has always been a high priority for the Thai government. Patients throughout the country have access to care.
Haiko: “Strangely enough, however, the Thai healthcare system has hardly any professionally organized 'primary care'. Thai patients traditionally go to the hospital, also for a cold. There are small clinics, but they mainly provide specialized services. The training system also does not have specialized training for general practitioners, as in the Netherlands.
The group that particularly misses professional primary care are the Western expats who have chosen Thailand as a permanent residence, or wintering place, usually after retirement. They miss their GP for basic care, as a guide to specialized care, and as a confidant.” In addition, in this crisis, some expats have to stay longer in Thailand, do not have enough medicines with them or have to have a check-up. “Sometimes we even get medicines from the Netherlands,” says Haiko.
The announcement that Be Well also provides (flu) vaccinations has brought many patients to the post. Some people are so afraid of going out that they want to get the shot at home, or even outside the Be Well building…
That confidential advisor in particular plays a major role in the current Corona crisis, although Hua Hin is not directly a breeding ground for the virus with 15 cases. It is the concern in particular that leads patients to turn to Be Well. Since the start, more than 2000 people have found their way to the post. 320 of them have registered as 'members'. Half of the patients come from Europe, divided almost equally between the Dutch, Swedes and Swiss. These are countries that, as in the Netherlands, are familiar with the primary care system and are looking for a relationship with 'their' general practitioner.
The biggest complaint of the Dutch in Thailand is not the quality of the hospitals, but the problem of finding the right specialist and the tendency to overtreat & overmedicate the private hospitals. General practitioner Daan Groenewegen: “In the Netherlands I have to make an effort to get patients into a hospital, in Thailand the challenge is to get them out again…”.
Membership is a condition to use the 24-hour home care services. New members undergo an extensive medical test with ECG and blood & urine tests. Members also receive a 'medical passport' that can be used for any emergency medical treatment elsewhere in Thailand. Membership renewal costs THB 1.200 per year, including the annual medical check-up. Members of Be Well also receive discounts on the services of local hospitals (particularly for scans, operations and admissions) after being referred by Be Well. Because many foreigners have little or no insurance, cost control is also an important task for Be Well's GPs.
What do the Dutch health insurers think about this initiative: The Dutch health insurers are positive about Be Well. Dirk Pons, medical director DSW (insurance): “Previously, the Dutch were directly dependent on hospital care, while there is now a high-quality first-line facility that can treat a large proportion of complaints. These are lower costs while maintaining quality”.
And the Thai hospitals, don't they see Be Well as a competitor? The leading private hospital in Hua Hin, Bangkok Hospital, is very pleased with the arrival of Be Well. The hospital cannot (cost) efficiently carry out simple consultations and home visits and would like to see this primary care at Be Well. Be Well can then send targeted referrals to this and other hospitals for, for example, radiology, specialized consultations, operations and admissions. Bangkok Hospital also sees a role for Be Well in communicating with Western patients. Thai patients rarely enter into a discussion with a doctor, Western patients are usually used to dialogue.
The post in Hua Hin started at the end of December 2019 with two Thai doctors, a physiotherapist and two nurses. They are advised & supported by the Dutch general practitioner Daan Groenewegen, who is affiliated with the center as a medical consultant and who regularly visits Thailand. Groenewegen also owns the Medisch Centrum Driebergen, which functions as a knowledge and training center for Be Well.
There is also an Advisory Board consisting of retired general practitioner Gerard Smit from Hoogvliet, who lives in Hua Hin, retired cardiologist Ben van Zoelen from the Diaconessen Hospital in Utrecht, and former cruise ship doctor Chris Taylor. Be Well has applied for a work permit for the 55-year-old Englishman Tailor to become General Manager at the end of April.
The doctor's office is open 7 days a week. On weekdays from 8.00 a.m. to 18.00 p.m. and on weekends from 10.00 a.m. to 16.00 p.m. The team members also make home visits and the doctors are available at night for emergencies.
More information: www.bewell.co.th
No GPs in Thailand?
Where I live in the north of Thailand
I know three GPs, there are more. They work in the hospital during the day and have a GP practice from 18.00 pm, which does the same as I was used to in the Netherlands: a pill for anything and everything, a flu shot, care for injuries.
I think there are GPs all over Thailand.
And medicines? In abundance.
So…………?
In Hua Hin there is (was) indeed not a single general practice. If there was something you always had to go to the hospital.
I agree with you, my wife in Sri Thep has 2 general practitioners, only my wife goes to the hospital to check her diabetes because a month's worth of medicines costs 30 bath for residents of the province and GP medicines are more expensive. whatever medicine you need 30 bath in hospital
The doctors you appoint are mainly specialists who have a private clinic after their service in the hospital, which is usually open from 17.00 p.m. Through years of experience, many are also able to be a real doctor. But often still Thai style. A visit to the doctor is therefore usually accompanied by a bag full of medication. A doctor who does not prescribe anything is not a good doctor. It seems so.
Thailand has absolutely no general practitioners. Those clinics that open after 1800:XNUMX PM are busy hospital doctors who earn a little extra by prescribing pills and powders from their own, very small, pharmacy. In case of something serious, you are advised to consult a doctor in a hospital.
In my neighborhood there is a clinic with a retired doctor from Sirirat Hospital. Nothing but praise for this man who still wants to help patients at his age. The doctor near the Ministry of Employment where I always get my medical certificate for my work permit every year, is also 69 years old but still works.
Both speak perfect English.
Nothing but praise for the initiative by these Dutch doctors. Too bad it's so far away. But the Thai. doctors, called "Schnabbelaars" by some, are fortunately present here and, in my opinion, also knowledgable in any case. What I miss in the article are the fees charged by our compatriots. Judging by the decor, which looks nice, I think few Thais pass by with a sore finger.
Great Be Well. Hats off.