Looking for recommendation of the Best Hospitals & clinics in Hochiminh City Vietnam. An insider view of HealthCare system and practices.
So many expatriates coming into a new Asian country, like Vietnam or Indonesia, will turn to facebook group of expats and ask for a hospital recommendation like “I am new in town, what is the best hospital to go for my family?”, followed by hundreds of comments and advice by more or less “long-termer” experts.
You can not get a good advice for 4 reasons:
In this article, as a professional insurer, we will share our experience as:
As in most developing country a network of key relationships is king. It’s not what you know, but who you know.
Let’s face it, why would an excellent expat doctor settle in Vietnam when he is in high demand in his own country at 250$/consultation? How can he get enough expats willing to pay such a high price when the average is 40$/consult? Why would he learn Vietnamese to catch wealthy Vietnamese patients? How can he get practice registration on his own with the Ministry of Health complicated screening for licensing foreign medical doctors?
A- expats doctors come and go,
B- settling legally your own practice has become impossible for foreign clinics
C- You need a specialist to cure you, not a hospital. If you find this gem professional, he is likely to be Vietnamese and not speaking your language. Rare or serious conditions are difficult to find and to explain… in any language. Try explain your psychological aftermath of a neuro-surgery and get fine re-education both physically and mentally?
D- Counter intuitively, best Vietnames doctors are… at State-owned hospital
E- The best surgeons have queuing Vietnamese patients, some of them ready to pay cash to get ahead… all without any invoicing therefore non-taxable.
I am not sure if the hippocratic oath exists in Vietnam, but the mindset of most doctors in Vietnam is to consider you a client rather than a patient. At times, if you understand the language and their prescriptions practices, you feel you are a loyal client, what we call in commercial practice a ‘repeat business’. Unfortunately, the practice is more the rule than the exception.
The experience of the insurers with international hospitals may not be associated with milking the cow repeatedly (a Vietnamese practitioners favorite) but more like the golden egg hen. Or sometimes, the transaction money is in the air medical evacuation.
A- A fancy brand new hospital with a flurry of expensive machinery, “go by the look and feel” at international hospitals where the main criteria is english speaking and Hospitality facility (single room shiny suite) is not a good idea. You are looking at a specialist to treat the problematic medical condition of yours.
B- Go by the Facebook group recommendations by expatriates is the surest way to get a transactional high priced treatment for a basic condition. By the numbers of expatriate cases, the head specialist surgeon can not have encountered many tough cases. The most critical cases are by the hundreds monthly at Vietnamese hospitals like Cho Ray or Bach Mai. Tu Du maternity accommodates 150 deliveries/day, they know their stuff! Neurosurgery of Cho Ray is a 100 cases/day a good 3600 brain operations/month.
C- Go to private Vietnamese hospitals is counter-intuitively not the best thing to do, as you end-up with average doctors charging lower international prices. Nurses take care and speak english. A transactional medicine, they will make sure you buy the treatment they know and have in-house, regardless of the best procedure for your medical condition being available elsewhere.
D- Generally speaking doctors keep their knowledge and clients secret. Referring you to a fellow medical specialist is both the loss of a paying client, plus a loss of face with regards not having the competency and expertise to cure you.
E- the most serious cases, whether for foreigners or wealthy locals, are evacuated and treated by specialists in Thailand, Singapore or Europe.
In Vietnam, most hospitals and private practice patients are in effect a client. Medicine is ‘transactional’: illness, procedure, treatment, transaction, payment, follow-up, transaction, payment, medicines, transaction, payment… if you see what I mean.
A holistic approach to medicine needs Ethics, Brain and energy… in that order. You need someone detached from money making when you are critically ill. More than anywhere, in Vietnam, it is not “what you know but who you know” that is important when getting a referral.
Let’s take an example of Mr Lee, is diagnosed with minor cancer, depending on which hospital and the oncologist he meets, he may have 4 choices all very convincingly sold by the specialist: amputation, chemotherapy, radiotherapy, wait and see or painkillers!
Of course for each he may get various pricing depending on the clinics and, at times, the surprise to get specialist consultation at one clinic and surgery at another hospital -which you did not select in the first place-. Considering those specialists are the best in their specialty, perhaps they truly believe they are your best option, or they are biased or simply dont know of any other better alternative for your condition. Of course you found brain and energy, when you needed the most is Independent and Ethical advice on your best course of action.
1- Excellent Vietnamese doctors open their own hospital/clinics then fall into 4 main categories of problems: not attracting the fellow excellent specialists -competitors-, management issues, investment capital shortage to invest in state-of-the-art equipment and maintenance or simply focus on transactional profitability… If you get lucky, you can get a consultation with the founders or private clinics, they are famous in their own field, thus they dare start their one practice.
2- Excellent foreign surgeons, won’t have the volume of patients and the capital to acquire land, build and run a private hospital. Therefore they end-up in Thailand, Singapore or a western country.
3- Best Vietnamese professors are not at private clinics, they enjoy good life at State-Owned Cho ray, Bach Mai, Hospital 115… because they can get rewarded from best of both worlds:
In short, a good advice is to have a network of friends that include long-term expatriates, a couple of hospital heads of department or clinic founders. Their best advice will be in your ‘best health interest’. One other possibility is to know a good insurer’s assistance service, they surely know where they wont send their clients ever again for certain types of surgery -price or treatment wise-.
The best way to ‘Secure your access’ to the Best hospitals in Asia is having the deep pockets of a good insurer to arrange medical evacuation and to back you up.
P.S. Let’s get rid of a myth that insurers will send you to the cheapest location avoiding the expensive hospitals and evacuation at all costs. This is eventually true for lousy insurers with staff looking at short-term savings. Most reputable insurers know the costs of a bad treatment in the first place with complications incurring multiple subsequent hospitalisations. From an insurer point of view, doing a surgery 1-once and for all, at the best center of excellence is the cheapest and smartest way to keep the insured client alive and happy.