Future of Thai medicine: Siriraj charts course

Future of Thai medicine: Siriraj charts course

New private hospital deals with issues of the future: Asean free flow of labour from 2015, paying for free healthcare, overcrowding, advanced medical education.

siriraj

A new medical complex at Siriraj Hospital, the oldest medical school in the country, stands by the Chao Phraya River. Siriraj is set to officially open its private offshoot, Siriraj Piyamaharajkarun (SiPH), tomorrow (Photo: Siriraj Hospital).

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Siriraj launches private hospital

New facility aims to help the state-run medical centre compete when Asean integration takes effect
25/04/2012 
Apiradee Treerutkuarkul

Thailand's oldest medical school is launching a new private hospital as an alternative for patients and a means for it to cope with the impending free flow of medical personnel after the launch of the Asean Economic Community in 2015

The faculty of medicine at Siriraj Hospital, which turns 124 years old this year, will officially open its private offshoot Siriraj Piyamaharajkarun (SiPH) tomorrow on the anniversary of its founding by King Rama V.

The new hospital, located by the Chao Phraya River, is a 14-storey building with 177 outpatient rooms, 284 inpatient rooms, 17 operating theatres, and 61 intensive care units.

"Siriraj Piyamaharajkarun is an alternative for patients who can pay out of their own pocket for better services yet want to receive the same quality treatment as offered by the original Siriraj Hospital," said Dr Pradit Panchavinin, director of SiPH.

The state-owned Siriraj Hospital receives more than 2.8 million patients a year but has only 2,221 beds and 851 doctors. Overcrowding and long wait times are unavoidable.

The new facility will also serve as a model for state hospitals to offer international standard care, be self-sustainable and contribute financially to the medical school.

While Siriraj Hospital's faculty of medicine is responsible for producing medical doctors for the country, as a non-profit medical school hospital it loses 10 baht for each 100 baht invested in medical studies, research and development.

According to Dr Pradit, SiPH will rely on services from doctors and medical staff from Siriraj Hospital who will each rotate to work at the new hospital for around five hours every week.

Fees will be 20% lower than those charged by leading private hospitals, he said.

During the first phase, the hospital will operate only partially. It is scheduled to offer full services in 2015, the year when the AEC comes into effect.

The liberalisation means medical workers will be allowed to work in any Asean country. There are concerns that the AEC will lead to an influx of foreign doctors and nurses coming to work in Thailand or a local brain drain if Thai medical professionals seek better opportunities in other Asean countries.

A study on the impacts of trade in health services among the European Union countries by the International Health Policy Programme found that while a free flow of health workers could improve economic efficiency - the receiving countries benefited from the additional medical personnel while the sending country benefited from remissions  [remittances] - but the sending countries also experienced brain drains.

The study found that the number of medical doctors in the United Kingdom increased from more than 130,000 in 2000 to more than 150,000 in 2007. The country also had the highest number of foreign medical doctors, mostly from India, South Africa, Pakistan, Ireland and Germany.

The study, however, reported a medical brain drain in Romania. More than 1,700 physicians, mostly surgeons and anaesthesiologists, registered to work in Britain, Germany and France during January-August 2011 mainly due to better financial incentives.

Dr Pradit said the launch of SiPH would increase incentives for health professionals to stay in the country.

He said he hopes the new private-style hospital will also reduce the number of medical professionals leaving state hospitals - where they have to work hard for a low pay - for better compensation at private operations.

Medical Council of Thailand president Amnat Kusalanan said the issue of trade liberalisation has both pros and cons. But medical schools, the first frontier as producers of medical doctors and health workforce, have no choice but to adapt to the coming changes

Running international courses on medical studies is one of the strategies some medical schools have adopted.

Dr Amnat said the council may need to adapt itself as well. Currently, all new medical school graduates have to pass tests in medical knowledge and patient examination in Thai before receiving a medical practice licence. However, it may have to make an English-language version of the medical knowledge test available when regional liberalisation comes into effect three years from now.

(Source: Bangkok Post, Siriraj launches private hospital, New facility aims to help the state-run medical centre compete when Asean integration takes effect, 25/04/2012, Apiradee Treerutkuarkul, link

Health Care Economics Vocabulary

Siriraj Hospital - "the oldest hospital in Thailand located in Bangkok on the west bank of the Chao Phraya River  opposite Thammasat University's Tha Phrachan campus... with a capacity of more than 2,000 beds and more than one million outpatient visits per year, Siriraj is one of the largest and busiest medical centers in Thailand. ... its tertiary care unit is the referral center for all hospitals in Thailand... The hospital was founded by King Chulalongkorn in 1888, two years after a worldwide cholera outbreak" (See Wikipedia)

Asean Economic Community (AEC) - the gradual joining together of Asean countries economically that is happening now and will happen faster after 2015, reduced tariffs to increase trade and free flow of workers between countries (See Wikipedia)

patient - someone who is receiving medical treatment คนป่วย, คนไข้
medical treatment - the process of providing medical care การรักษา
treatment - Same as "medical treatment"
outpatient
- a patient who lives outside of the hospital and only goes to the hospital to receive medical treatment
inpatient - a patient who is living in the hospital in order to receive medical treatment

personnel - people who work for a company or organisation
medical personnel - doctors, nurses and other skilled health workers working for a company or organisation
staff - workers, employees พนักงาน
medical staff - the doctors, nurses, physical therapists, pharmacists and other trained health care workers that work at a hospital
workforce - all the people in an area or country available for work, all the people who work for a company แรงงาน
health workforce - all the nurses, doctors and other skilled health workers working in a country (or for one company)

complex - an area that has several parts
medical complex - many buildings that are part of a hospital
medical school -
a college for training doctors, a school of medicine (See Wikipedia)
faculty - a group of departments in a college which specialize in a particular subject or group of subjects คณะ
faculty of medicine - a medical school
Faculty of Medicine Siriraj Hospital, Mahidol University -
(See Wikipedia)

offshoot - a company or organization created or developed from a larger one
private offshoot -
a private company created from a larger non-profit or government organization

A new medical complex at Siriraj Hospital, the oldest medical school in the country, stands by the Chao Phraya River. Siriraj is set to officially open its private offshoot, Siriraj Piyamaharajkarun (SiPH), tomorrow (Photo: Siriraj Hospital).

public hospital - a government-run hospital, that provides services at low or no cost 
private hospital - a hospital that provides special services at higher cost
state - government รัฐ
state-run - an organization or company that is operated by the government (also probably "state-owned" too)
state-run hospital
state-run medical centre
launch - to start selling a new product or service to the public เริ่มวางขาย
Siriraj launches private hospital
launch of the Asean Economic Community in 2015
facility - a building used for a particular purpose

integration
- the process of combining with others to create a single unit or system การรวมเข้าด้วยกัน, การผสมผสาน bringing together many separate pieces to work together as a unified whole
Asean integration - the gradual process of joining together the states of Asean economically under the Asean Economic Community (AEC)

Siriraj launches private hospital. New facility aims to help the state-run medical centre compete when Asean integration takes effect

alternative - another choice ตัวเลือก / ทางเลือก
alternative for patients - another medical treatment choice for patients
cope - to deal successfully with a difficult situation รับมือกับ (See glossary)
means - methods; ways
means for it to cope - a way or method that can be used to solve a problem
impending - will happen soon
the impending free flow of medical personnel after the launch of the Asean Economic Community in 2015

Thailand's oldest medical school is launching a new private hospital as an alternative for patients and a means for it to cope with the impending free flow of medical personnel after the launch of the Asean Economic Community in 2015

anniversary - a date when you celebrate something that happened in a previous year that is important to you วันครบรอบ
founding - starting an organisation, company, political party, etc.

The faculty of medicine at Siriraj Hospital, which turns 124 years old this year, will officially open its private offshoot Siriraj Piyamaharajkarun (SiPH) tomorrow on the anniversary of its founding by King Rama V.

operating theatres - a room with special equipment for surgery (See Wikipedia)
intensive care unit (ICU) - a special area of a hospital where people stay who are in a serious condition and in danger of dieing (See Wikipedia)

The new hospital, located by the Chao Phraya River, is a 14-storey building with 177 outpatient rooms, 284 inpatient rooms, 17 operating theatres, and 61 intensive care units.

pay out of their own pocket - pay with their own money (not from health insurance or from their company)

"Siriraj Piyamaharajkarun is an alternative for patients who can pay out of their own pocket for better services yet want to receive the same quality treatment as offered by the original Siriraj Hospital," said Dr Pradit Panchavinin, director of SiPH.

overcrowding - too many people in a small space
unavoidable - impossible to stop from happening หลีกเลี่ยงไม่ได้ อย่างเลี่ยงไม่ได้

The state-owned Siriraj Hospital receives more than 2.8 million patients a year but has only 2,221 beds and 851 doctors. Overcrowding and long wait times are unavoidable.

model - something that is so good that people should copy and imitate it (try to do the same thing)
serve as a model
serve as a model for state hospitals

standard - high level of quality or achievement
international
- between countries ระหว่างประเทศ
international standard - detailed descriptions of what a high quality service or product are that are used by rich western countries (for example ISO standards)
ISO standards -
(See Wikipedia
international standard care -
high quality medical care that meets high international standards
sustainable
- able to be successfully continued for a long time ยั่งยืน, ถาวร
self-sustainable - does not need to receive money from the outside
contribute financially - give money to

The new facility will also serve as a model for state hospitals to offer international standard care, be self-sustainable and contribute financially to the medical school.

profit - money that you make from selling goods and services after all your costs have been paid กำไร
non-profit - an organization that is not run to make a profit (like most companies)
development - the gradual growth and formation of something
research and development (R&D) - the activity of creating new and useful products or processes (here in the treatment of diseases) (See Wikipedia)

While Siriraj Hospital's faculty of medicine is responsible for producing medical doctors for the country, as a non-profit medical school hospital it loses 10 baht for each 100 baht invested in medical studies, research and development.

rotate work - change jobs with other workers every period of time (week, month) so that people work at different jobs 
rotate to work at the new hospital

According to Dr Pradit, SiPH will rely on services from doctors and medical staff from Siriraj Hospital who will each rotate to work at the new hospital for around five hours every week. Fees will be 20% lower than those charged by leading private hospitals, he said.

partially - partly; not completely
scheduled - planned to happen at a particular time or day ตามตารางเวลา
services - บริการต่างๆ things produced in service industries, not a physical good that can be bought, a waitress and a cook in a restaurant provide a service, technically: a sequence of activities that does not result in ownership of the outcome (See Wikipedia on services and the goods and services continuum)
offer full services - be able to provide customers or patients with all the services they have planned and promised
comes into effect - starts 

During the first phase, the hospital will operate only partially. It is scheduled to offer full services in 2015, the year when the AEC comes into effect.

liberalisation - relaxing rules in an industry, making the rules governing an activity less strict; when laws or attitudes become less strict and people are allowed more freedom of action (See glossary) เสรีภาพในการแสดงความคิดเห็นหรือแสดงออก
concerns - worries ความกังวล
influx -
when many people or things come into a place
influx of foreign doctors and nurses coming to work in Thailand

brain drain - many smart, trained and economically valuable workers leave a country to make money in richer countries (See Wikipedia)
local -
in this country (here: Thailand)
local brain drain - skilled workers leaving Thailand, to make more money in other countries
medical professionals -
highly trained and skilled medical workers such as doctors, nurses and physical therapists
opportunities - situations where it is possible to do something that you want to do
seek better opportunities

The liberalisation means medical workers will be allowed to work in any Asean country. There are concerns that the AEC will lead to an influx of foreign doctors and nurses coming to work in Thailand or a local brain drain if Thai medical professionals seek better opportunities in other Asean countries.

impacts - effects on different people and things
trade - the buying and selling of goods and services การค้าขาย
impacts of trade in health services
improve - to make better ทำให้ดีขึ้น
efficiency - waste little time, energy and resources in doing a task (minimize time, energy and resources in performing a task) (See glossary) การทำงานอย่างมีประสิทธิภาพ คุ้มค่าเวลาและใช้พลังงานหรือต้นทุนในการผลิตน้อย เพื่อให้ได้ผลผลิตมาก
improve economic efficiency
remittance -
 money sent back to their country by a worker working in a foreign country (See Wikipedia)
registered - officially recorded as a business with the government (and given permission to operate) (
incentives - a reward to encourage people to do something สิ่งกระตุ้น  รางวัล ผลตอบแทน
financial incentives -
money given to people to make them do things

A study on the impacts of trade in health services among the European Union countries by the International Health Policy Programme found that while a free flow of health workers could improve economic efficiency - the receiving countries benefited from the additional medical personnel while the sending country benefited from [remittances] - but the sending countries also experienced brain drains. The study found that the number of medical doctors in the United Kingdom increased from more than 130,000 in 2000 to more than 150,000 in 2007. The country also had the highest number of foreign medical doctors, mostly from India, South Africa, Pakistan, Ireland and Germany. The study, however, reported a medical brain drain in Romania. More than 1,700 physicians, mostly surgeons and anaesthesiologists, registered to work in Britain, Germany and France during January-August 2011 mainly due to better financial incentives. Dr Pradit said the launch of SiPH would increase incentives for health professionals to stay in the country.

compensation - money or other benefits that an employee receives for the work that they do
private operations - running an organization as a business (not part of the government)

He said he hopes the new private-style hospital will also reduce the number of medical professionals leaving state hospitals - where they have to work hard for a low pay - for better compensation at private operations.

Medical Council of Thailand - the organization that regulates the medical profession and practice of medicine in Thailand (See website
practice of medicine - the work of doctors; when a doctor helps patients by giving them treatments for diseases 
medical practice
medical profession - all the doctors in a country and the regulations and standards they guide their work
practice - something that people do regularly; a way of doing something การปฏิบัติ
licence - official permission from government to do a business or some activity ใบอนุญาต
medical practice licence - official permission to work as a doctor in a country

issue - a problem that needs to be considered;  a subject that people discuss or argue about ประเด็น
trade liberalization - allowing buying and selling of goods between countries with tariffs, taxes and other barriers to trade 
cons - disadvantages ข้อเสีย
pros and cons - the good points and bad points about some possible choice  or decision
frontier
- the newest things that people have not done yet, places where they have not gone yet
have no choice but to - must do, have to do
adapt - change to meet new situation ทำให้เหมาะ, ทำให้เข้ากับ, ปรับ
have no choice but to adapt - must change to meet and work in a new situation
strategies - long-term plans for how to succeed in the future กลยุทธ นโยบาย
patient examination - when a doctor looks closely at a person's body to determine what their health problem and disease is (See Wikipedia)

Medical Council of Thailand president Amnat Kusalanan said the issue of trade liberalisation has both pros and cons. But medical schools, the first frontier as producers of medical doctors and health workforce, have no choice but to adapt to the coming changes.  Running international courses on medical studies is one of the strategies some medical schools have adopted. Dr Amnat said the council may need to adapt itself as well. Currently, all new medical school graduates have to pass tests in medical knowledge and patient examination in Thai before receiving a medical practice licence. However, it may have to make an English-language version of the medical knowledge test available when regional liberalisation comes into effect three years from now.

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