Malaysia is touted as a retirement haven with international standards.
This clinic went on to win best clinic 2015!
Be careful. I lived 2 years and found standards variable and the hidden dangers of incompetence and negligence are not worth the glossy exteriors.
the article goes on to say;-
The president of the Australian Society of Plastic Surgeons and former head of plastic surgery at the Royal Melbourne Hospital, Professor Mark Ashton, reviewed the treatment and care Mr Aiple received in Malaysia for the coronial investigation.
He said the multiple surgeries Mr Aiple had would never have been performed in Australia, and the care he received afterwards was grossly inadequate.
The Coroner’s report states Mr Aiple had several open wounds that were oozing fluid, and carers found him in pain in his hotel room, with his bedsheets covered in blood.
Professor Ashton told the coroner Mr Aiple would have been treated as a “high-risk” patient in Australia, not as a moderate risk as noted by the Malaysian surgeon, Dr Nasir Zahari, due to being 124 kilograms and morbidly obese.
The review also noted the level of anti-blood clotting treatment administrated was below Australia’s recommended levels.
The coroner's report is here:
http://www.coronerscourt.vic.gov.au/resources/5316e1f9-00af-…
Things I noted:
The initial coronial finding was death by natural cause from DVT. The coroner did not investigate further.
The mother prevailed upon the coroner to investigate further, and she did.
The report notes the patient's risk factors, large number of procedures, and issues with recovery.
The report also notes that the recommended dose of blood thinners was not given (the doctor evaluated the patient as lower risk and dosed accordingly). This is likely the issue that resulted in the death, combined with rushed recovery and international flight so soon after surgery. Interestingly, a higher dose would likely have made the wound care issues worse, so I imagine the need to balance clotting medication with wound recovery.
I also note that the reviewing plastic surgeon recommends recuperation periods (up to six months between surgeries) that if followed would make medical tourism impossible (I can't judge if such recovery periods are warranted or not, but it seems strange that the Malaysian doctor would perform a second surgery a week later, where the Australian surgeon suggests multiple surgeries over 18months or 2 years. That is a big difference).
I also found it worth mentioning the Malaysian doctor trained in Australia and Scotland and the reviewing local doctor had headed the plastic surgery board noted for issuing severe warnings against medical tourism.
The mother made a lot of the wound treatment, and the Australian plastic surgeon agreed is was sub-optimal, but nobody is suggesting the would care contributed to the death. And the patient himself felt well enough to fly and head home after the flight rather than seek any medical help.
Lastly, that the mother was represented by Maurice Blackburn, so there may be an issue of pursuing this matter beyond medical outcomes.
My conclusion is the truth lies somewhere in the middle. It is in the Malaysian hospital's interests to promote medical tourism and schedule a heavy load of surgery. It is in the Australian surgeons interest to say it is too risky no matter what. And sadly, for the dead bloke and his family, he made poor choices to get too much done, and was over confident in his recovery, or at least took big risks (no mention is made of why he didn't stay longer to recuperate, so we are left assuming he felt well).
The problem with your reasoning is that you do not know the extent of what failed surgery does, especially decades after.
For example, if a dental implant fails, your assumption is that it falls out and you've lost your money.
What if the failure also meant loosing the bone surrounding said implant? What if that meant being unable to place any other false teeth. What happens to your ability to eat? What happens downstream when diet is affected?
I once treated an African man in public healthcare. His culture has a rite if passage that involves smashing all their front teeth against a rock. My job was to make him look employable. The dilemma extended well beyond missing teeth. The underlying facial bones were fractured and lost. He required extensive bone augmentation and plastics for us to even begin to gain traction. The cost was well into the hundreds of thousands and there are thousands like him. The case was binned.
The take home is this, not all failures can be remedied and in some cases, even money doesn't help. You just have to suffer.
How many Australian dentists never make errors? Not all of them.
So it becomes a question of risk management.
Can I do things to manage the risk with an Australian one? Sure, seek one who has been in business a while, but not so long that they aren't current. Check for their feedback online and via word of mouth. Check their credentials. Check they haven't been banned by AHPRA.
Can I do almost all these things with an overseas dentist? Yes, except AHPRA. Your argument relies on Australia's system being effective at weeding out poor practitioners before they can have many poor outcomes. For care like dentistry especially, this isn't going to counter initial errors the first few times they are made, only if there is a systemic problem or extreme adverse outcome.
The doctor in the case posted was qualified at a uni in Melbourne, and is apparently well credentialed and respected. It isn't clear to me that the treatment given was in error, it is arguably in line with recommendations (except the study on which the doctor based a 3 day course of anti-clotting meds suggested a higher dosage, but the manufacturer guideline was the lower). The DVT episode obvious in hindsight (as the Coroner noted) may not have been so obvious when the visible post-surgical complications were around wound care.
As a health consumer I can choose not to have many procedures done all at once, which seems sensible, and likely alone would have avoided this death.
I can also guarantee that I will pay 4 or 5 times the cost of the same procedure in a facility abroad, should I get it here. It is pretty easy for a people with a high income and good health insurance to argue there is no circumstance to take the risk on medical tourism, but for somebody like the dead man in this case, who faced the need for costly treatment in Australia that was likely unaffordable (it seems he was unemployed after leaving the ADF) the option wasn't local quality care or care abroad, but no care here with ongoing issues that were causing depression, or treatment abroad with the hope of a result, but an elevated risk of failure.
We know the outcome in this case, but anecdotally there are many, many successful counter examples.
Your views on the matter are sheltered by a life protected by consumer commissions, a strict registration body and a revered legal system. It is hard to even fathom how loose the medical standards are in SEA (excluding Singapore).
It is unfortunate I have the burden of knowledge and experience in both medicine and SEA. I can understand your viewpoint, especially regarding alleged life or death procedures. Maybe my income blinds me to some of the decision making criteria but unlike a building or a car, mistakes on the human body can be irreversible. These mistakes can seem trivial but they manifest in advanced age.
I have seen outcomes such as patients who cannot recline in fear of aspirating stomach acid into their lungs, an inevitable occurrence that causes mental anguish at the thought of it. Implants that sever nerves causing permanent burning pain requiring strong opioids and antidepressants just to manage.
This may not change your mind and that's fine. I concede that I do not know everyone's circumstances but I know factually that a lot of the outcomes people boast about are actually disasters yet to come.
There are always dodgy operators in SE Asia, but the big operators should be fine, a lot are part of listed company.
this won best clinic in 2015 after this surgery
What are the criterias for winning best clinic and who judges these things?
the malaysians gave them this award. you may do a google to reveal the sources if you really want us to know this. The main point of the post was to warn others as medical insurance has been posted before and many use it without being aware of potential dangers.
@Peccadilloes:
My point was this - an award is only as meaningful as the party that awards it.
In Australia, we don't have such a ridiculous award. There are awards for particularly achievements in the medical field but a best clinic? Surgical outcomes are monitored over decades. The fall out rate of study cases is very high even in government clinics. It is incomprehensible that a public clinic has the capacity to prove their clinical abilities much less boast success rates.
If you can accept the depth of difficulty in judging a clinic, you'll surely realise how absurd the notion of this award is.
Only complete morons travel overseas for medical tourism.
I know a lady in America whom is a friend of the family… her son was in his mid 30's who has a life threating condition to which he needed a kidney transplant. we was already on a waiting list and was also only given months to live if he didn't get a donor. as a last resort the mother took her son to china and got a transplant from a healthy doner. paid lots of money to secure the life and survival of her son to which no matter how much money could have yielded the same result in America. moron no so much loving mother, much more,
Where did the organ come from? You've heard about Chinese jails right? Also a transplant isn't just a fix and then you're done. Life expectancy is greatly reduced after having a transplant (obviously it's an extension if you're terminal, but you're lucky if you get 10-20 years).
not placing everyone in the same basket is probably what you should have gotten from that story.
not everyone that is a medical tourist does things for the same reason.
as a parent I can understand why she would do it.
I'm sure if the law allowed the mother to give her life to same her son I'm she would have given him the other kidney she had left for him. even if it was for 2 years or 3 years or 10 years.
are you a parent? I'm sure your parents would do the same for you, or would they?
@Archi: Organ harvesting and the morality of taking a organ from someone who has been murdered specifically for that purpose is what you should have gotten from my post, instead of ignoring it. If I needed a transplant, would I pay to have someone murdered for their organ? Often someone who has commuted no crime and is persecuted based purely on their religion? No. This is a consequence of medical tourism, like you mentioned.
well you just assumed that's what happened… like you are assuming everyone that is a medical tourist is moron…
I don't deny the facts that those sort of things happened and that's not what I said… but YOU directly implied and assumed that's what happened in my story, that's where I disagree with you.
@Archi: I said it was a cost of medical tourism, I didn't infer that's what happened to your friend's son. But you certainly can't rule it out.
TLDR just wanted to add, people die in Australian surgery too, and like 80% of our doctors are asian anyway
Who awarded it best clinic of 2015?
read earlier reply above;-
Peccadilloes 18 hours 16 min ago
the malaysians gave them this award. you may do a google to reveal the sources if you really want us to know this. The main point of the post was to warn others as medical insurance has been posted before and many use it without being aware of potential dangers.
Strange that both the dead son and the Mum were talking about their perceived lack of care, yet they didn't seek any treatment on his return to Australia. It seems they were unable to perform good assessments of risk or priorities, so might not have been good candidates to direct their medical care in a less paternal health system.
I have no doubt that there are medical horror stories in SE Asia, much as there are here, and I also am sure the risk of complications in SE Asia is higher.
But the fact that every case like this gets big media stories, with terrifying quotes from local medics exposed for the first time in history to some price competition, leads me to conclude the risks are likely to be overstated.
Would I head to Malaysia in poor health for drastic surgery? Probably not. But I might get a dental implant or similar and take the risk for the thousands of dollars in savings.