Why is Cambodia's Health System Still Struggling ?

phuketrichard · Post by **phuketrichard** » Thu May 18, 2023 5:56 pm

Kammekor wrote: ↑Thu May 18, 2023 5:28 pm
John Bingham wrote: ↑Thu May 18, 2023 4:54 pm
phuketrichard wrote: ↑Thu May 18, 2023 1:56 pm Could it be that even the locals have no faith in the doctors & nurses when they know courses, grades, degrees can all be brought?
and meds are not always real.
I don't think that is so prevalent anymore. Many doctors have degrees from abroad where it wouldn't be possible at all. A bigger problem is that a lot of doctors pretty much stop learning after graduation and sell their books, while doctors in many other countries are more likely to subscribe to medical journals, attend conferences etc and keep up to date.
1,600 graduated. How many do you think will go abroad for more studies? How many will end up in local health centers without more studies? How many will start up their own private 'clinic' marketing their mediocre services at high rates tomorrow?

How many are really qualified now? Remember the protests around 2019 from the students, complaining about the difficulty of the exams, asking the Iron Man to intervene and let them pass nevertheless?

I know quite a few excellent Cambodian doctors, but generally I avoid them like the plague unless they're recommended by a (foreign) doc I trust.

Why do so many that have money, travel to Thailand or Vietnam for health care and if they have serious money, Singapore?

How many Khmers travel abroad to study to be a a Dr ( you'd have to be very wealthy to do so) an return to work in Cambodia? Any stats out there?

Ong Tay · Post by **Ong Tay** » Thu May 18, 2023 6:29 pm

John Bingham wrote: ↑Thu May 18, 2023 4:54 pm
phuketrichard wrote: ↑Thu May 18, 2023 1:56 pm Could it be that even the locals have no faith in the doctors & nurses when they know courses, grades, degrees can all be brought?
and meds are not always real.
I don't think that is so prevalent anymore. Many doctors have degrees from abroad where it wouldn't be possible at all. A bigger problem is that a lot of doctors pretty much stop learning after graduation and sell their books, while doctors in many other countries are more likely to subscribe to medical journals, attend conferences etc and keep up to date.

In fact, continuing medical education is required of doctors in the US who want to maintain their accreditation. Not sure if it's required to maintain licenses.

John Bingham · Post by **John Bingham** » Thu May 18, 2023 6:34 pm

phuketrichard wrote: ↑Thu May 18, 2023 5:56 pm

How many Khmers travel abroad to study to be a a Dr ( you'd have to be very wealthy to do so) an return to work in Cambodia? Any stats out there?

It's probably not so much of a thing now and many are dying off but a lot used to study in Russia or France on scholarships.

Post by **Freightdog** » Thu May 18, 2023 7:04 pm

John Bingham wrote: ↑Thu May 18, 2023 4:54 pm
phuketrichard wrote: ↑Thu May 18, 2023 1:56 pm Could it be that even the locals have no faith in the doctors & nurses when they know courses, grades, degrees can all be brought?
and meds are not always real.
I don't think that is so prevalent anymore. Many doctors have degrees from abroad where it wouldn't be possible at all. A bigger problem is that a lot of doctors pretty much stop learning after graduation and sell their books, while doctors in many other countries are more likely to subscribe to medical journals, attend conferences etc and keep up to date.

This is at least one part.
I spoke with a Khmer Doctor a few years ago, and he was talking about having what sounded like the old 3 square meals per day, but with plenty of rice. It’s an attitude that has been modified quite healthily in the last 3 decades at least. There’s quite a few professionals for whom professional development stops at licence issue. I fly with a fair number, all too often, these days. So, it’s a global issue, too.

One robust debate that I have time and again at home is that no one questions the man in the white coat. If he says take the medicine, there is no effort to establish what the medicine is, or what it’s for. Doctor clever, patient stoopid.
Having seen a package of pills issued by prescription for a single patient, with no less than 3 different types of antibiotics in it-
A self respecting doctor would not, should not prescribe like that.
The dispensing chemist should not issue meds like that.

Kammekor · Post by **Kammekor** » Thu May 18, 2023 7:36 pm

Freightdog wrote: ↑Thu May 18, 2023 7:04 pm
One robust debate that I have time and again at home is that no one questions the man in the white coat. If he says take the medicine, there is no effort to establish what the medicine is, or what it’s for. Doctor clever, patient stoopid.
Having seen a package of pills issued by prescription for a single patient, with no less than 3 different types of antibiotics in it-
A self respecting doctor would not, should not prescribe like that.
The dispensing chemist should not issue meds like that.

To question a doctor about the medicine prescribed one needs quite some extensive knowledge about the human body, diseases, and pharmacology.
I think you're asking for too much for most in this country. But maybe worldwide.

How many people know about the difference between viruses and bacteria?
How many people know about the different kinds of antibiotics, which kind to use use in which case?

newkidontheblock · Post by **newkidontheblock** » Fri May 19, 2023 4:52 am

I was scolded for examining a doctor’s certificate once. It was disrespectful to challenge.

Medical degrees from Cambodia are not recognized in Singapore.

schlarry · Post by **schlarry** » Fri May 19, 2023 5:17 am

Way too much money being made by predatory microfinanciers who take land offered as security

Why would they improve healthcare or reduce the cost?

Is there any research documenting whether this practice was a factor in support by the poor for the KR, or to what extent? JB?

Pretty sure many clinics and hospitals have shareholders in govt, so improving the cost of healthcare would be a conflict of interest

In addition, doctors are offered commission by pharmacies on prescriptions, hence the scripts with 20 of the same medicines with different names

Ong Tay · Post by **Ong Tay** » Sat May 20, 2023 10:51 am

Kammekor wrote: ↑Thu May 18, 2023 7:36 pm
Freightdog wrote: ↑Thu May 18, 2023 7:04 pm
One robust debate that I have time and again at home is that no one questions the man in the white coat. If he says take the medicine, there is no effort to establish what the medicine is, or what it’s for. Doctor clever, patient stoopid.
Having seen a package of pills issued by prescription for a single patient, with no less than 3 different types of antibiotics in it-
A self respecting doctor would not, should not prescribe like that.
The dispensing chemist should not issue meds like that.
To question a doctor about the medicine prescribed one needs quite some extensive knowledge about the human body, diseases, and pharmacology.
I think you're asking for too much for most in this country. But maybe worldwide.

How many people know about the difference between viruses and bacteria?
How many people know about the different kinds of antibiotics, which kind to use use in which case?

There are some credible online sites for looking up medications, health conditions, etc. They've been a valuable resource for me to check what exactly it is a doctor prescribed. Usually, I just learn more. But in one instance I found that a particular drug I'd been prescribed by a Viet doc was taken out of use in the US and EU due to a severe side effect! Said website also suggested alternative meds. I've also used sites to cross check diagnoses...

WebMD, Med Line +, Drugs.com, and the NHS sites are all quite good references. Of course not a substitute for actually seeing a proper doctor.

newkidontheblock · Post by **newkidontheblock** » Sun May 21, 2023 9:08 pm

I never heard of doctors in Cambodia getting commissions by pharmacies… it’s usually the opposite.

Locals go to the pharmacies for seeking treatment. Person at the pharmacy counter sells whatever medicine she thinks is needed, bypassing a visit to the doctor.

Doctor wants to protect his business. He hands out bags of mystery pills. He’s afraid that it his patients knows the medicines in the bag, they would go to a pharmacy instead of him next time. More so the traditional Khmer doctors, while the foreign doctors explain and write prescriptions of what’s being done.

Father in law is getting worse, missus had him sent to Siem Reap referral hospital yesterday. Now he has a chest tubes. Everything at the hospital is a deconstruction of medical equipment. Figuring out function then building something that can carry out that function.

EKG consists of metal bands for the legs and arms with small metal cups with wires for the chests. Chest tube suction canister looks like a big vegetable jar with two holes drilled in lid, one for vacuum suction, the other for the chest tube. The chest tube is taped to the chest with an adhesive bandage only.

And this is the big hospital for the province with more serious cases being sent to Phnom Penh.

BklynBoy · Post by **BklynBoy** » Sun May 21, 2023 10:22 pm

a few times my friend told me he got meds from doctor and i asked what they were. He didn't know. I asked him to ask the doctor but he said the doctor wouldn't tell him. I was explaining how you should be informed of the meds your taking. His rationale was that if the doctor told him, then he can bypass the doctor and just go to the pharmacy.

This was awhile ago so possibly misremembering but does that sound like the norm?

Why is Cambodia's Health System Still Struggling ?

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Re: Why is Cambodia's Health System Still Struggling ?

Re: Why is Cambodia's Health System Still Struggling ?

Re: Why is Cambodia's Health System Still Struggling ?

Re: Why is Cambodia's Health System Still Struggling ?

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