If you have a heart problem, always check medication

[bapak]

In my work location I am almost on a daily basis in contact with older expats, many of which have a heart problem of one sort or another.

Over the year I have frequently heard complaints that they had attended a certain hospital in Hua Hin (I am very wary of Thailand draconian libel laws) and been prescribed medication which was not suitable for a person with a heart condition.

I have heard this a number of times.

Just yesterday a German student with a pacemaker, and whose heart situation was well known at the hospital, attended the hospital for a matter unrelated to his heart and was prescribed some medication. He told me that as soon as he took the medication he felt like his heart was exploding. He ended up in ICU for 4 days.

Last year I attended this hospital on a matter unrelated to my heart. My file with detailed heart history was sitting on the doctor's table. Anyhow, I was prescribed a certain pill.. Now I am always wary of any new medication, so before taking it I emailed my GP in Sydney and asked advice. Very short message came back.. Take it and you will be dead tomorrow. I then looked it up on the internet, and there it quite clearly states that is should not be used by anyone with a cardio condition.

I typed out a formal letter to the director of the hospital outlining what had happened. Did not ask for apology or anything similar. Just suggested that he speak to the doctor. The letter was personally delivered to the director's office and I expected at least a written acknowledgement. After several weeks, my wife phoned the director's secretary (who she personally knows), and inquired about the letter. She was told that they never respond to such letters.

Anyhow, the moral of my story is always check another source when prescribed medication if you have a cario problem.

[Big Boy]

I do that for every prescribed medication in Thailand not because of a heart condition, but because TIT.

To date my wife and I have both been prescribed unsuitable on 2 occasions each. This has happened at 2 different Hua Hin hospitals. A quick check on the computer before taking can save a lot of problems. OK, I don't think anything would have been as bad as, "Take it and you will be dead tomorrow," but there does seem to be a 'I know best' attitude amongst many Thai doctors.

When confronted with the evidence, they have always changed the meds, but never with an apology.

[PeteC]

I wouldn't be surprised if it was similar to Home Pro or Lotus where clerks get direct commission from suppliers thus push their products. Knock the scheme up a few levels to include doctors and pharmaceutical companies.

From direct experience I knew a GP back in the 70's who got commission directly from a particular hospital based upon the number of patients he admitted. So.....things like this do happen. Pete

[Big Boy]

I wouldn't be surprised if it was similar to Home Pro or Lotus where clerks get direct commission from suppliers thus push their products. Knock the scheme up a few levels to include doctors and pharmaceutical companies.

Certainly happens in the UK.

[PeteC]

Yes, probably happens in most places. But.......at least prescribe the correct medicine that won't damage the patient! Hippocrates wasn't Thai so perhaps oaths aren't part of things? Hopefully though just a small bit of ethics and morality creeps into things. Pete

[bapak]

I am 82.. with a triple bypass 19 years ago and since been supplemented with 3 stents. Certainly do not want any help on the path to Nivarna. Age is taking care of that.

Locally, the only heart doctor I trust is Dr Polpat at the Hua Hin Heart Clinic.

[richard]

Very common here in HH (expect it is all over the country). I always put my cards on the table and state that all medication must be okay-ed by my doctor. The hospitals know him and respect his judgement.

[Big Boy]

I must say that prescribing by Petcharat Hospital has always been exemplary, and we've never had a problem. Our Dr there always checks the book for potential reactions first.

[musungu]

I can also say that my experience with Petcharat Hospital is excellent and nothing to do with the heart and whilst it is 45 mins from HH I am very happy but I can also not afford Bangkok Hospital HH ( whether they may be better or not)

[J.J.B.]

I wouldn't be surprised if it was similar to Home Pro or Lotus where clerks get direct commission from suppliers thus push their products. Knock the scheme up a few levels to include doctors and pharmaceutical companies.

Certainly happens in the UK.

Where does it happen in the UK? No pharmaceutical company would ever pay a doctor to prescribe a product. There were cases of this happening but over 20 years ago and strict regulations have to be adhered to. This is not only true for the UK but all members of the EU and doctors in much of the developed world including the U.S. and Australia.

Mr Plum was highlighting questionable payments by Pharma companies a few years ago and it is not only illegal in much of the world but subject to eye-watering fines such that even the most aggressive of companies wouldn't attempt it.

It is true that doctors in the UK and elsewhere frequently prescribe products that interact with other drugs and this is a large part of a pharmacist's role, to check the accuracy of a prescription. With thousands of medications to choose from it is hard to always know how patients taking multiple therapies will fare and the Pharma industry plays a critical role in physician education.

So, no, there is no collusion or inducement to prescribe in the UK and much of the rest of the world, despite what you might like to believe, and spreading such claims is irresponsible.

[Big Boy]

The inducements are in the form of silly gifts. I've seen it happen - no I won't give examples, but some doctors in the UK are definitely influenced by reps bestowing offerings.

[J.J.B.]

The 'silly gifts' were indeed silly and are now banned in the UK, much to the chagrin of receptionists with a craving for ballpoint pens and sticky notes. Since 1996 these gifts were limited to no more than £5 in value (it increased to £6 in 2006) and had to be directly related to the practice of medicine. So, it was mainly cheap throat torches, tongue depressors, cotton buds and the like. If you have insomnia, take a read of some of the cases bought against Pharma companies by the Code of Practice Committee of the ABPI, who tried to claim that golfing umbrellas gifted to doctors stopped them getting wet from their car to the front doors of patients' homes when conducting house calls!

Times have moved on and no gifts or inducements are allowed. This also extends to any form of support or hospitality and many companies have now opted not to sponsor doctors' attendance at medical conferences, such is the fear of even appearing to be non-compliant. Over the past six years following the financial crash and on-going Eurozone crisis, tens of thousands of drug reps have been laid off as doctors no longer see the point in seeing them. Yes, doctors were only too happy to enhance their remuneration through the generosity of Pharma companies and their ilk.

But it's all good, now patients only have to be worried about whether the doctors know enough about what they are being prescribed, lest they should be found 'dead in the morning'.

[Big Boy]

OK, my knowledge goes back 3 years - sounds as if things have changed.

[nanyang]

OK, my knowledge goes back 3 years - sounds as if things have changed.

Almost an admission that you're wrong about something - now there's a first.

[bsdk1960]

OK, my knowledge goes back 3 years - sounds as if things have changed.

Almost an admission that you're wrong about something - now there's a first.

and if you could post one positive comment ,that would be the first for you