Medical care in the land of smiles is generally good -- at least in the bigger cities like Bangkok and Chiang Mai. In rural Thailand it can be kind of dodgy. In addition it is relatively inexpensive and there are actually "medical tourists" -- people who come here for a holiday and while they are at it have some medical problem taken care of as well.

Having said that, I just want to point out a few problems I have encountered.

First is the problem of greed. While it is true that the medical profession seems to suffer from this serious character flaw to a greater extent than other fields, it is a tad worse in Thailand than other places I am familiar with. This results in over testing -- doing unnecessary and expensive medical tests. In addition, drugs at hospitals and clinics are more expensive than if you buy them at a pharmacy yourself (and nearly anything can be legally purchased without a prescription). If you visit a doctor you will probably be sold a lot of medicine at an inflated price. The medicine may very well include antibiotics which many people feel are over prescribed in Thailand.

A further, and more serious problem, is unnecessary and dangerous surgery. A recent study showed, for example, that 70% of births at private hospitals in Thailand were by cesarean section. If this is accurate, it is disgraceful.

Finally, a personal anecdote. Several years ago, I discovered that I had a hernia. A doctor at one of the foremost private hospitals in Thailand told me it required surgery. He said prior to surgery I needed to wash daily with an expensive antibacterial soap and that several relatively expensive medical tests would be required. I would need to be admitted to the hospital and have a general anesthesic prior to the operation. I would need to remain in the hospital for 3 or 4 days and would be unable to work for about a month.

This troubled me a bit so I did some surfing on the internet. I found a place in London that specialized in hernia repair. I checked them out thoroughly, including having a doctor in London (the brother of a friend) investigate them. I decided to have the surgery done in London. Why?

First, the cost was the same but more important were the following. The anesthesia was a local one (not being put to sleep). No special medical tests were required. As promised, I walked into surgery and walked out myself. I went back to my hotel room and two hours later walked a mile to the nearest pub. The next day I took the train to see a friend in Cardiff. I stayed with him for several days and then returned to Bangkok where I immediately went back to work.

In terms of medical care, it is wise to check, double check and recheck. That, however, is generally truer in Thailand than it is in other places.