A Glimpse of Medical Tourism in Vietnam

KC and I have managed to stay healthy (knock on wood) these past 2+ years, but we’ve needed to see a few doctors along the way: a yellow fever shot required to get in and out of Zambia; a crown to replace an old filling… that sort of thing. KC had an old hernia injury that could stand repairing, so we decided to investigate options when we arrived in Vietnam. Here’s a journal of our experience, tracked mostly for the benefit of others who may be considering medical tourism in Vietnam.

Journal

Sunday: I arrived in Vietnam and flew from Ho Chi Minh City to Da Lat (40 minutes, $75).

20141115_112231[1]

Reception area for the VIP suites at the Hoan My Hospital

Monday: I emailed our Airbnb hosts to ask for a recommendation of a private hospital where I might find some English speakers. I wasn’t at all sure they would be able to provide one, as Da Lat is small (~200,000 people), not exactly a medical tourism hotspot like Seoul, Bangkok, or Istanbul. Nonetheless, our hosts sent a link to a local hospital with a webpage in English.

I also did a little research on hospitals and found some helpful reviews and blog posts. It seemed that if we waited until getting to one of the 3 biggest cities (Ho Chi Minh, Hanoi, or Da Nang) the international hospitals had a reputation for charging high rates to foreigners (but still significantly lower than American prices, of course). Eventually, I read one report of a British couple who made an emergency visit to a hospital here in Da Lat and reported excellent care with a very “local” price. The tour guide who took them to the hospital (and insisted upon staying with them all day) claimed that they were lucky to be sick in Da Lat where they don’t yet see a lot of foreigners, so they were still charged a fair price by local standards. Based on this research, we decided to investigate hospitals in Da Lat.

Thursday: KC arrived in Da Lat after a 2-week side trip to Bali for surfing.

Map of greater Da Lat area

Map of greater Da Lat area

Friday: We rented a scooter for a reconnaissance drive to the hospital. We entered at the registration desk and stood around looking confused until someone motioned us to the desk.

I had prepped a few simple phrases on Google Translate describing what we needed, and that seemed sufficient. The receptionist waved us to some chairs and shortly an interpreter arrived. From this point on, we had an interpreter (the pharmacist!) accompanying us and it was fairly straightforward.

Although we had expected to merely investigate, we were soon sitting with a doctor who examined KC and then sent him for an ultrasound. At each step along the way, we paid cash (prices below). Within an hour of arrival, we left with fasting instructions and an appointment for surgery at 7:30 the next morning! So much for our recon trip…

Saturday: We arrived at the hospital at 7:30. It was a bit of a perplexing start because we weren’t sure where to go, so after wandering around (looking confused again) a hospital employee deposited us at the same registration desk as yesterday and pantomimed that we should wait there for 5 minutes. Twice we were asked for our “paper” but as we’d not received so much as a receipt yesterday (!), we couldn’t comply. Being the only foreigners, though, we were easy to identify and soon we had another interpreter and were on our way.

The first order of business was lab work: blood tests, another ultrasound, and an x-ray. While we waited for the results, our interpreter showed us our room options. (And I do mean “our” room, as it quickly became apparent I was welcome to stay also.)

Pre-surgery consultation to review medical history and blood test results

Pre-surgery consultation to review medical history and blood test results

Option 1: The normal room was pretty industrial: 3 basic hospital gurneys in a large basement room and a bathroom. No windows, TV or visiting chairs. Cold. ~$18/night.

Option 2: Although this was a minor procedure which at home may have been an outpatient experience, we’d been told to expect 3-4 days of recuperation in the hospital (old style!), so it took about 10 seconds to decide on the “VIP” option: a suite with 2 western style beds, flat screen TV, a small fridge, desk, wifi, a sitting room, and a beautiful view of landscaped flowers and a wooded hillside… $41/night.

We left KC’s overnight bag in the room before meeting briefly with the head of the surgery department to discuss allergies and medical history, then returned to the room to change into hospital scrubs.

Surgical ward - I accompanied KC to this point and then the interpreter recommended I relax in our room until after the surgery

Surgical ward – I accompanied KC to this point and then the interpreter recommended I relax in our room until after the surgery

While KC was under the knife, I went home and worked for a few hours. KC said the surgery went well, although the epidural in his spine was not sufficient, so they had to put him under with general anesthesia. As a result, KC spent much of the afternoon in the post-op recovery room and had only woken an hour before I returned.
We had nurses in and out hourly checking on KC’s IVs and asking about his pain level, etc. The final check was at 9 pm and then we were left uninterrupted until 7 am the following morning.

Sunday – Tuesday: Every morning, a nurse came at 7 am to check KC’s temp and blood pressure, followed by a second nurse to give him a shot of antibiotics and a third to change the dressing on his incision, followed by the surgeon who came by for a quick status check. The doctor didn’t speak English so he usually brought an interpreter. (One day he brought an entourage of 4 people with him – probably a teaching moment, although the interpreter confided that a couple of nurses thought KC was handsome, so…??) Then we were left alone until early evening, when the nurses came for another round of shots and dispensed meds via the IV port in KC’s hand (he took very few pills while in the hospital).

Our room had wifi and cable TV. For English options, we had access to 3 movie channels (subtitles in Vietnamese), CNN, and a Vietnamese news station in English.

The hospital doesn’t provide meals, so I was in charge of food. There is a small restaurant in the hospital with traditional Vietnamese food (never more than $1.30 for homemade noodle soup or chicken/fish and rice), but I took the scooter back and forth to town a couple of times, picking up fruit and yogurt at the grocery store or hard-boiling eggs at home for breakfasts. The food from the restaurant worked well for lunch and dinner.

Enjoying the sunshine and scenery of the hospital grounds

Enjoying the sunshine and scenery of the hospital grounds

The room was cleaned daily by the housekeeping staff.

The nurses spoke little English but one carried a smartphone and used a translation app to explain what she was doing or what the medicine was for/how to take it (under the tongue, etc.). Each day she came in with a few more English phrases and it was obvious she was working hard to communicate effectively. It was sweet to see the staff getting more confident in speaking English as the days passed. On the other hand, they seemed completely mystified by our attempts to say “thank you” or “hello” in Vietnamese… this is the same everywhere we go in town. We are clearly butchering their language so badly that they don’t recognize even the most basic of phrases!

Wednesday: Departure day. We were woken at 6 am (eeesh!) for the daily check of KC’s vitals and so assumed we would see the doctor early as well and be discharged quickly. But no, the doctor didn’t appear until around 8 am and told us we could leave at 1 pm. So we twiddled out thumbs waiting for the final injections. And the bill.
Our total bill, including the aforementioned pre-admission consultation and ultrasound, lab work and surgery, in-hospital drugs and take-home meds, as well as 4 days in our VIP lodging, came to around $600.

Here’s a breakdown of the major portions of our bill (in Vietnamese dong and USD based on the current exchange rate):

  • Friday’s initial consultation and ultrasound: 235,000d ($11)
  • Saturday’s pre-surgery bloodwork, ultrasound and x-ray: 949,000d ($45)
  • Surgery + recovery room: 3,804,000d ($178)
  • In-hospital drugs and all the little things they charge for (rubber gloves, bandages, etc.): 4,100,000d ($192)
  • Take-home meds: 565,320d ($27)
  • Lodging (4.5 days): 3,267,000d ($153)

20141115_111932[1]The checkout process really impressed me: the receptionist/concierge for the VIP rooms had been helpful during our stay, acting a few times as interpreter and making sure we knew to dial “0” if we needed him for anything. On checkout day, he asked me if I wanted receipts for insurance, and when I said yes , he zoomed into action. Within 15 minutes, he had compiled documentation in English with a detailed description of the surgery, the surgeon’s notes, an itemized list of every medicine dispensed (dates, quantities), and costs for each item. He then sent me to the hospital’s pharmacy with the doctor’s prescribed medicines for the upcoming week at home, and a hand-written note for the pharmacists to ensure I got a receipt in English for insurance.

When 1:00 pm arrived and the final antibiotic injection was complete, we waited for a bit expecting a nurse to arrive with a wheelchair to escort us out, but that didn’t happen. Eventually I went to the reception and asked whether we could leave. He responded that we could stay as long as we liked, but he could call us a cab whenever we were ready. (We were ready!)

KC recovered nicely at home, and he had a follow-up appointment 10 days later to remove the stitches.

Reality Check

Overall, we had a very good experience and can recommend the Hoan My Hospital in Da Lat. What they may have lacked in a few areas, they certainly made up for in competence, cleanliness, professionalism, enthusiasm and price, but nonetheless there are a few “cons” to consider.  (These issues may be irrelevant in the larger international hospitals of Saigon or Hanoi.)

20141115_093815[1]1) We aren’t certain that the procedure was performed using the most current technique; a hospital in the US might have done laparoscopic surgery, leaving a much smaller scar and resulting in a shorter recovery time.

2) They weren’t prepared to handle a foreigner of KC’s size. For tall fellows, I recommend buying a pair of scrubs before you leave home!  (see photo… the nurses couldn’t stop giggling, and apologizing, and giggling, and apologizing…) And it’s probable that the epidural wasn’t dosed properly for a 6’2″ male, resulting in the need to knock him out.

3) Our interpreters were adequate but not fluent. If we’d needed something complex I might have had second thoughts due to the difficulties in communicating. One option might be to bring your own interpreter. There are many English-speaking guides in Da Lat and the ones I’ve spoken with briefly, speak fluently. Not sure how they would do with medical terminology, though…

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10 comments

  1. Fascinating and so well described.

    1. Thank you!

  2. much like our experiences here in Turkey – how glad we are to be here and not in that ‘3rd World’ country the UK! We also benefit from buying into the state insurance system which pays the majority of our fees (incl prescriptions) and we pay a nominal top-up for being attended to at a private hospital. If we use the state hospitals and clinics then our treatment is without charge, regardless!

    1. Just one more reason for me to high-tail it back to Turkey for my next filling. (As if I needed another.)

  3. Wow….while overall it sounds like a positive experience (and interesting), Steve and I agree that you two are much braver than we are!!!

    1. The only “brave” part was KC allowing me to drive the scooter in Vietnam traffic until he recovered enough to drive. 😨

  4. It seems kind of daring to get surgery in a foreign country, but you found a good place and I’m glad things went well for KC. I’m surprised and impressed that there was such good service in Vietnam for foreigners (and for a reasonable price too), especially in a small city.

  5. Especially given the prices we would have paid (even with insurance) had we waited until returning to the US… it seemed worth the “risk” and it paid off well.

  6. […] out like our friends from goal42.  In the three years they travelled they braved such things as elective hernia surgery in Vietnam, being hustled in Egypt, and exploring throughout Southern Africa.  Makes me feel pretty timid […]

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