You Gotta Love the Hong Kong Public Hospital System

What’s the best thing about the public hospitals in Hong Kong? In true Hong Kong fashion, it’s the price. It seems as if anything you need to get done there costs just HK$100 (approximately US$13). And, yes, you can pay using your Octopus card. I wouldn’t be surprised if a heart transplant costs HK$100.

About three months ago I fell down on Nathan Road. Okay, I admit it, I had been drinking (I hardly ever drink alcohol any more and as a result when I do, my tolerance is way down and I keep forgetting that). I was crossing the street, I stepped up on the curb, turned my ankle and came crashing down on my elbow. I could wiggle my fingers and toes so I figured that nothing was damaged.

The pains didn’t go away so after two months, I went to the hospital. They took two sets of x-rays, I spoke with a doctor and they gave me four or five different kinds of pills. HK$100. I had a small fracture on the bone just above my ankle; no damage to my elbow visible in x-rays. They also gave me a follow-up appointment 3 weeks later with an orthopedic specialist.

That follow-up was today. The form tells you that if you’re 15 minutes late, you won’t be seen, so be on time. Nothing there about what if I’m on time and they take more than 15 minutes to get to me. I was on time, even a little bit early. After paying my HK$100 I was taken to a waiting area with 30 seats and at least 60 people waiting.

After 75 minutes, my number was called. The doctor looked at my ankle and touched it once. He said no operation needed. He offered me some pills for the almost constant (minor) pain I’m in but I told him that the ones they gave me last time did nothing. I asked if they had anything stronger. No. Morphine? No. Medical marijuana? No.

Then I said, but what about my elbow, that hurts more than my ankle. He looked at it. He touched it once. He pronounced me a victim of repetitive stress injury. “Tennis elbow.” But I fell on it. Tennis elbow – what’s your job? Computer crap. Tennis elbow.

Okay, so what can I do about it? They can give me a splint. You mean like the support bandage thingie I got from the drug store? No, something a little bit stronger. So he gives me a piece of paper and off I go to the occupational therapy section. After ten minutes there, they give me a piece of paper telling me to come back in 3 weeks. I say to them, all I need is a splint, I can’t get that today? No. I’m in pain, I can’t get something today? Come back in 3 weeks.

And that is one of the reasons that private doctors and private hospitals continue to flourish in Hong Kong.  If you want to get an appointment the same week or you want a doctor to spend more than a minute with you, you have to pay. The public hospital system is over-burdened and constantly challenged by over-worked staff – there are continual shortages of doctors and nurses both because of budget constraints and also the inexplicably controversial issue of bringing in medical staff from abroad.

My company does supply me with medical insurance. And if I go to one of the doctors or clinics on their list, it’s often free. But my experiences in these clinics has been no better than the service I get in the hospitals.

So sometimes I’ll go see my own doctor, most often a Scottish gentleman with an office in Clearwater Bay. He charges between $750 and $1,000 a visit (my insurance will reimburse me around $200) but he’ll spend half an hour with me. And if the pains haven’t improved in the next couple of weeks, I suppose I’ll be giving him a call.

Dentists in Manila?

This has been an expensive and depressing 24 hours for me.

It started last night when Spikey, my 10-1/2 year old golden retriever, wouldn’t eat.  He never turns down food.   He later ate a bit but in the morning also just lay there staring at the food bowl.  So off to the vet, who thinks he may have tic fever, which he says is common among dogs in Sai Kung.  Shots, blood and DNA samples sent off to a lab for confirmation.  And back to the vet tomorrow.  Today’s bill was HK$3,000.  Who knows how much tomorrow?

Today was also time to pay up at the dentist.  And for the work that I had done over the past several weeks, it came out to HK$14,000.  Not covered by insurance.   Yes, I know, it’s incredibly expensive.  But this guy is incredibly good at what he does.   And while I’ve had dental work done in Thailand in the past in order to save money, I don’t have the same travel flexibility that I used to have.  So I figured that I’d bite the bullet (pardon the pun) and just get it done here.

Except that this week I got a toothache in another place.  Seems that a root canal I had done several years ago – done by a dentist who charges far less – hadn’t been properly done.  And so on top of the tooth, past the root, I’ve developed an abscess.   Apparently I have two options here – they can remove the crown and post, redo the root canal, clean things out, give me a new crown and post.  And I would guess that would cost around $25k or more here.   Or I can have micro-surgery, where they leave everything in place, slice open my gum and clean things out and stitch me back up.  Buddha only knows how much that one would cost.

While a root canal would entail several visits over the course of 2 or 3 weeks, the micro-surgery can be done start to finish in one day.  So I think I’m going to have to get it done outside of HK to make it more affordable.  There’s a dental center in Bangkok that I’ve used in the past with good results so I’ll send them the x-ray and ask for a quote.  But for a variety of reasons, it would be easier for me to get this work done in Manila if possible.

I have no experience with dentists in Manila.  I figured I’ll contact Asian Hospital in Alabang (which is run by Bumrungrad).   If anyone else out there can recommend a dental center or dentist in the Philippines who has experience doing this kind of intricate work, I’d be most appreciative.

Oh, the kicker to my day?  I left the pain killers the dentist gave me on my desk at work.  If nothing else, I suppose that gives me incentive to get to the office early tomorrow.

Sigh.

A Cautionary Tale

I’m up at 2 AM, wide awake, because my life has been severely disrupted today and I cannot sleep.  What this bodes for work tomorrow, I can’t even begin to predict.   So while I’m awake, I thought I’d share another Spike Is Stupid tale with you.

Before I started the new job, my sleeping habits had gotten quite peculiar.  I was just sleeping 3 or 4 hours at a time, mostly during daylight.  I had tried to adjust that in the week before starting work but I was not successful.  So, time for modern pharmacology and sleeping pills.   I got some Stilnox and they worked great, or so I thought.  I’d take one and fall asleep within 5 minutes.

Never mind that I have obstructive sleep apnea and my doctor told me that these things should be avoided.  I kept taking them on weeknights, not on weekends, to ensure I was getting to sleep early.  Each day, I’d get up before my alarm and get into the office early.

But each day, by 1 or 2 PM, I was so tired that I was barely making it through the afternoon.  I told myself that it was simply a matter of getting used to my new schedule and a heavy workload after so many months on the bench.

By the 4th week, I found I had the worst stomach ache – all day, every day.  It was getting seriously distracting.

Now, while all of this was going on, my gf wanted to take diet pills.  I looked at the pills, read the list of possible side effects, told her it was too dangerous and she shouldn’t take them.  She ignored me, said she was just going to take them for a short time and went ahead.  Sure enough, she got those side effects and it was serious enough that we had to spend a day at the hospital before she said I was right and stopped taking them.

So when I told her about the stomach ache, she immediately connected it back to the sleeping pills.  She asked me about possible side effects.  Me, I’m so smart about her pills, I never checked mine.  I finally pulled out the warning sheet, along with an electron microscope to read it, and discovered that everything I was suffering from was a possible side effect of the pills.   And, oh, it said “don’t take this if you have apnea.”  Duh.

I stopped taking the pills 5 nights ago.  The stomach ache is gone.   My energy level is decent throughout the day and I even have some energy left to go out for a bit after work.  I’m not sleeping that well but in fact I rarely do.

Fortunately, I stopped taking the pills before any real damage was done and before I had a chance to get addicted.  Hopefully I’ve learned a lesson here as well.  I’m never doing this again.  And this time I mean it.  (Until the next time?)

I wish that the other issues in my life could be dealt with so simply.

Asian Hospital & Medical Center

We were up this morning at 6 AM so that we could get to the Asian Hospital and Medical Center by 7:30.  At 7 in the morning, traffic in Manila was light enough for us to be able to get from Makati to Alabang in about 20 minutes.

The hospital is 8 years old and actually looked newer.  There are signs all over that they are about to commence their second expansion phase, building a new 12 story building.  Our taxi driver told us that, much like Bumrungrad, locals consider this to be one of the most expensive hospitals in town.

The hospital is not as luxurious as Bumrungrad, which many have said resembles a five star hotel.  No McDonald or Starbucks here, but there was a Mr. Donut, a Delifrance, a different coffee shop chain, flower shop, magazine stand and cafeteria, plus a Mercury Drugs and Quik-Stop across the street.  When we were finished and it was time to go, there were no taxis to be seen anywhere but the hospital reception desk was happy to call a taxi service for us.  As mentioned, we arrived before 7:30 AM and both of us were finished with all tests by 2:30.

(I compare my experience here with Bumrungrad in Bangkok because that’s where I’ve gone for my annual physical for the past several years and because Bumrungrad is a part-owner of this facility and has some sort of management or consultative role in how things are run here.  The overall cost is such that compared to doing this in Hong Kong, it’s cheaper to fly here and stay in a nice hotel and get it done rather than stay home and do this there – at least using private hospitals and doctors.)

During our time there, the executive health center seemed almost deserted, the reason being that they only accept a maximum of 12 appointments per day and we represented two of the only four appointments they had today.  The result is that we got a lot of attention and never had to wait too long for any of the procedures on the list. It does not seem as if they are receiving many medical tourists yet.  Each of the hospital staff that I met asked me how long I’d been living in the Philippines and “where in the Philippines” I lived.  Everyone of course spoke fluent English though several of the nurses asked if I could speak Tagalog.  The staff were all friendly and helpful.  Like Bumrungrad, the experience is 180 degrees different from that of going to a hospital in the US – far less stressful.

There were at least two tests here that I hadn’t had before – a bone density scan and a virtual colonoscopy.  However, I couldn’t do the latter because they want patients to certain preparations starting three days before and I couldn’t find some of them in Hong Kong.  I still had to pay the whole package price but was told that I could come back at any time in the next six months and take the test for free.  I bought those things I’d need now so I’ll be ready for the next time.

I would estimate that the doctor spent roughly twice as much time reviewing the results of my tests with me as the doctor at Bumrungrad.   I also spent about 20 minutes with a nutritionist reviewing recommendations – though a part of that time was spent discussing a computer crash she’d had the night before!

My girlfriend also underwent a full check-up, something she’d never done before so many of the tests were new to her.  She hadn’t really wanted to do this; her attitude is that you only see a doctor when you know something is wrong and she didn’t want to know if anything was wrong.  But I joked with her that if she was going to go with me anyway, if she didn’t get the tests done for herself then the staff was going to look cross-eyed at me (“What a selfish guy!  Takes care of himself but doesn’t take care of his wife!”) and maybe purposely screw up my results.  Joking of course, but she had alluded to certain potential health issues so I thought it was important to get more details and hear things directly from professionals.  The news in her case was mostly good and in those few cases where it was less than good, she took the consultations and information seriously.

As for me, my results were mostly okay, though there were one or two surprises – not happy ones and not in those areas that one might have expected (given the fact that I’m a smoker).  Overall, given my age, I’m probably doing about par for the course, worse than some but better than most and hopeful that next year’s tests will show some improvement over this year’s.

And I’ll be happy to come back here a second time.  Of course I’m not a doctor and have no medical training, so can only base this on my previous experiences as a patient.  Aside from the choice of Manila over Bangkok (let’s face it, there’s a lot more to see and do in Bangkok than Manila), I was happy with the way the tests were conducted, the professionalism of the staff, that there were less patients there (which meant a more relaxed feeling during the day, less waiting time more attention) and that the doctors spent more time with us.

If you’ve got any questions about things that I didn’t cover (or didn’t cover enough for you), feel free to check the hospital’s web site or ask me.