Four years ago, I had a total hip replacement at the Veteran’s Administration’s flagship facility in Orlando, FL.
In December 2022, I had the other hip replaced at Samitivej Hospital in Sriracha, Thailand.
Much of the procedure was the same, but the overall approach and experience were very different…
VA To The Rescue
In 2018, I returned to the States for a much-needed hip replacement. I’m from Orlando, which is home to the Veteran Administration’s showcase medical facility at Lake Nona.
Over the years I had heard mixed reviews about VA facilities, but I can say without a doubt this is one of the finest hospitals I’ve ever set foot in.
The sprawling full-service medical facility is well-organized and manned by smiling, helpful people.
After some x-rays and a consultation with an orthopedic surgeon, it was confirmed: I needed a new hip. The earliest date I could get in the operating room was seven weeks down the road. I settled in for a longer-than-expected stay with my family.
The surgery was scheduled at the crack of dawn, and I was under anesthesia before the sun came up.
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I woke up mid-afternoon and was assured the operation was a success.
When I woke up the next morning there was a physician’s assistant standing next to my bed with a walker…
“Get up Sergeant Walters,” he said. (In this VA facility they call you by your last known rank). “You’ve got no excuse now. Let’s take that new hip for a spin!”
After a few trips up and down the hallway, my surgeon popped in to check a few things and said, “Call your brother, you’re going home.”
I was stunned.
“But I’ve only been here one night,” I said.
“Nobody gets better hanging out in a hospital,” he said. “We’ll send you home with some ice packs and a supply of painkillers, don’t worry.”
In less than 36 hours after a total hip replacement, I was on my brother’s sofa watching football and eating pizza.
The VA sent some physical therapists around a couple of times, but I could do all the exercises myself, so I didn’t continue that part of the program.
In 10 days, I was riding my bike two hours a day.
During the past four years, I’ve had no issues.
The Thai Way
During the late summer of 2022, I could hear my surgeon from the VA’s words echoing in my ears… “That left hip is starting to go too,” he said. “See you in five years.”
I thought about it every morning when I dragged myself out of bed and to the gym. When I started visibly limping, I knew the time had come.
I went online to start planning a trip from where I live in Thailand to the States to get my other hip replaced. The sticker shock of a round-trip ticket from Bangkok to Orlando almost knocked me down.
I had to find another way.
There are no VA facilities located outside the States, so I couldn’t get a new hip for free unless I went back home. My health insurance in Thailand won’t cover the procedure because it was a pre-existing condition.
I’d need to come out-of-pocket for either a plane ticket and a few months’ expenses in the States or pay cash to have the procedure in a Thai hospital.
Medical tourism is a giant industry in Thailand. Millions of people from all over the world come for every treatment imaginable.
The health care industry is renowned for highly trained doctors, immaculate facilities, and wallet-friendly fees. Most treatments, including major surgery, cost a third of those in North America. I started shopping for hospitals near me in Thailand.
First, I contacted Bumrungrad International Hospital in Bangkok. BIH is the most famous of the five-star medical tourism hospitals in Thailand and a place I’d had treatment before. They quoted me 650,000 Thai baht (about US$18,650) for a total hip replacement including a three-day stay in a private room.
Next, I contacted the most prominent hospital in the city I live, Bangkok Hospital Pattaya. This is another state-of-the-art facility that is also well-known for medical tourism and they quoted me 570,000 baht (about US$16,360) for the same procedure and a similar stay.
An old friend recommended I try a private hospital in Sriracha, a city located about 45 minutes north of Pattaya. Sriracha is near the massive port of Laem Chabang and several sprawling industrial parks that house a myriad of factories.
The hospitals that serve this area are focused on the local community and thousands of foreign nationals living and working in the Eastern Economic Corridor.
After some research online, I chose Samitivej Sriracha Hospital, part of a chain of upscale private hospitals in Thailand. I contacted their international department and made an appointment to see an orthopedic surgeon.
Samitivej Hospital is just like all the other private hospitals I’ve seen in Thailand—immaculate and staffed with friendly people. One gets the feeling of being in a nice hotel rather than a hospital.
I sat in the Starbucks sipping coffee until the nurse came for me. My surgeon was a 40-something Thai doctor who has been trained in Japan and Germany who spoke perfect English. He only does hips. He looked at my x-ray and confirmed my self-diagnosis. I needed a new one.
We could schedule the operation for the next week.
He explained that they used two types of medical devices for this operation, one made of titanium and plastic, the other of a space-age ceramic material. He said the ceramic lasts longer and costs more.
I was pleasantly surprised when they sent two quotations, giving me the choice of which medical device I wanted. The price was 450,000 baht (US$12,510), significantly less than the high-visibility medical tourism hospitals quoted.
I replied to their quote and let them know I would be paying for this operation out of my own pocket and ask if a discount would be possible. They replied with a new quotation of 405,000 baht (US$11,259) that included the more expensive ceramic device, and I made the appointment.
Two appointments were set, one for a pre-operation physical examination, blood work, EKG, etc. The surgery would take place the next day.
The hospital called the day before the first appointment to say there was no reason for me to go all the way home after the exam; they would admit me to the hospital that day and I could stay overnight. They assured me that I would not be charged for the extra night stay.
On the morning of the operation, the anesthesiologist came to my room to talk about the procedure. She was a young Thai doctor educated in the States. She asked if I preferred general anesthesia or a spinal block. I really didn’t know the pros or cons of either, so she explained it to me.
About an hour later another doctor came to talk about pain management. She explained that I would be on a morphine drip for the three days I was in the hospital but gave me some choices when it came to pain medication to take home.
“We don’t overmedicate our patients,” she said. “We don’t prescribe strong opiates like Oxycontin for this kind of recovery. It isn’t necessary and the side effects are detrimental to the patient’s overall health.”
I was secretly relieved. After my first hip replacement, the VA sent me home with a big bottle full of powerful opiates that I could only stand to take a few days.
The pain management specialist and I settled on some painkillers and anti-inflammation medications for me to take once I was discharged.
The surgery was performed right on time, and I was taken to what would be my home for the next three days. The private room was a well-designed 50-square-meter studio apartment on a high floor with a sea view.
All the amenities one would expect at a five-star hospital were available, including high-speed internet, a myriad of TV channels, and a food menu with way too many choices.
After-Care
Just like in the States, the doctor insisted I get up on the new hip the first day with a walker, but they limited my physical activity. They were much more concerned about me somehow damaging the new device, so I did what they said and took it extremely easy.
On the morning of the fourth day, the surgeon came to my room, examined me, and said, “OK, you’re good to go.”
My bill for three days was exactly as they had estimated. There was no extra charge for anything. The tab for the medication I would need in recovery was already included.
Two months later, and I’m back to walking 10,000 steps a day down Jomtien Beach.
Comparing My U.S. Surgery Experience With My Thai One
The similarities…
• Both surgeons who performed this major surgery (total hip replacement) were qualified, knowledgeable, and well-practiced.
• Both facilities were clean, well-organized, and staffed with caring health care professionals.
• Both operations appear to have been performed in the same manner. The scars are even the same shape.
• Both operations were successful.
The differences…
• The cost of this operation in the States is about 1,300,000 baht (US$36,140), which does not include medication. My operation in Thailand cost 405,000 baht (US$11,259) and included everything.
• The Thai hospital could get me into surgery right away. The U.S. hospital was busy, and I had to wait seven weeks.
• The hospital stay in the States was one night. The stay in Thailand was three nights.
• The Thai hospital gave me a choice of which device I wanted to be implanted. The U.S. hospital did not.
• At the Thai hospital, I was able to bargain and get a discount. Although I didn’t need to at the VA hospital, I think that is frowned upon in the U.S. health care system.
• The Thai hospital gave me a choice of which type of anesthesia I preferred. I never even knew there was a choice at the U.S. facility.
• The Thai hospital consulted with me on pain management and allowed me to choose which kind of medication I preferred. The U.S. hospital doped me up with heavy opiates.
• Discharge from the Thai hospital was easy and quick. There was a fair amount of paperwork on the way out of the U.S. hospital, and I had to wait an hour at the pharmacy for the medications I’d need to recover.
• Aftercare from the U.S. hospital was good as physical therapy teams were available to come to my house. The Thai hospital didn’t offer such therapy but directed me to YouTube videos that could explain the best exercises in English.
Two months on, and the recovery has been similar. It certainly helped that I had been through the procedure before.
It should be said that I was lucky enough to have these surgeries at state-of-the-art medical facilities. So, hopefully, that makes this a fair apples-to-apples comparison.
Both the U.S. hospital and Samitivej Sriracha Hospital are professional and effective health care service providers that I would use again.
But if I’m paying for it, at a 300% discount, I’ll be having my surgeries in the Land of Smiles.
Sincerely,
Bart Walters
Contributor, Overseas Living Letter
