Thai Hospital

There are many noticeable differences between U.S. and Thai hospitals including hierarchy structures, doctor pharmacist relationships, and documentation.

The organization of the Thai hospitals is very different than the U.S. There are community hospitals in each sub-district that takes care of a small group of patients and are for common illnesses. If the patient has a medical problem that is more complicated, they go to a district hospital.  If the patient is very illl and in need for a more complicated procedure or in need of specialization, the they go to a government hospital.  The patient must move their way up the hierarchy in that order if they want to avoid a fee.  Some patients choose to pay the fee and go directly to the  government hospital.

Schools in Thailand are working to improve inter-professional relationships.  The medical school preceptors encourage their residents to refer to the pharmacists or interns to ask them questions about medications.  There seems to be a stronger collaborative effort towards achieving the best patient care in Thailand than the U.S.  However, the hospitals make noticeable differences in the Thai white coat to distinguish a doctor from a pharmacist.  A Doctor's white coat is long sleeved and the edge of the coat reached just above the knee.  A pharmacist's lab coat is typically short-sleeved and is only waist length.

Technology is not as prominent in Thai hospital pharmacies.  The computer documentation is a new development.  Many still record everything on paper and then keep the information in a binder.  However, the prescriptions doctor's write include the diagnosis, the results of the physical examination, and chief complaint so that pharmacists can accurately decide if the proposed medication regimen is appropriate.

Overall, I think that the Thai have some great pharmacy practices that should be implemented in U.S. pharmacy practices to help improve our patient care system.