By Hans Bos, from (translated) 

At Christmas it all looked very predictable for the Be Well general practitioner post in Hua Hin. Start up and then slowly grow to the desired result. The Covid-19 outbreak accelerated things after February. “It is the uncertainty that is bothering people in particular,” says founder and former Venlo resident Haiko Emanuel.

Be Well is the first out-of-hours GP service in Thailand and was also set up by two Dutch people, the recently retired Dutch general practitioner Daan van Groenewegen (64) and his friend / entrepreneur Haiko Emanuel (61). The station is located in a new building on the luxury bungalow and villa complex de Banyan.

Thailand has a well-developed health sector, especially compared to other emerging markets in Asia. The sector has always been a high priority for the Thai government. Patients have access to care across the country.

Haiko: “Strangely enough, however, the Thai healthcare system has hardly any professionally organized” primary care “. Thai patients traditionally go to the hospital, also for a cold. There are small clinics, but they mainly provide specialized services. The training system also has no specialized general practitioner training, such as in the Netherlands.

The group that misses professional primary care in particular are the Western expats who have chosen Thailand as their permanent home or wintering place, usually after retirement. They miss their GP for basic care, as a guide to specialist care, and as a confidential advisor. ” In addition, in this crisis, some expats must stay longer in Thailand, do not have sufficient medicines with them or need to have a check up. “Sometimes we even get medicines from the Netherlands,” says Haiko.

The announcement that Be Well also provides (flu) vaccinations has brought many patients to the post. Some people are so afraid of going out that they want to get the shot at home, or even outside the Be Well building…

This confidential adviser in particular plays a major role in the current Corona crisis, although Hua Hin is not immediately a breeding ground for the virus with 15 cases. In particular, it is the concerns that is driving patients to Be Well. Since the start, more than 2000 people have found their way to the post. 320 of them have registered as “members”. Half of the patients are from Europe, almost equally divided between the Dutch, Sweden and Swiss. These are countries that, just like in the Netherlands, know the system of primary care and are looking for a connection with “their” GP.

The biggest complaint of Dutch people in Thailand is not the quality of the hospitals, but the problem of finding the right specialist and the tendency for overtreatment & over-medication of the private hospitals. General practitioner Daan Groenewegen: “In the Netherlands I have to make an effort to get patients in a hospital, in Thailand the challenge is to get them out again …”.

Membership is a prerequisite for using the 24-hour home care services. New members undergo an extensive medical test with ECG and blood & urine tests. Members also receive a “medical passport” that can be used for any emergency medical care elsewhere in Thailand. Membership renewal costs THB 1,200 per year, including the annual medical check-up. After referral from Be Well, members of Be Well also receive discounts on the services of the local hospitals (especially for scans, operations and admissions). Because many foreigners have little or no insurance, cost control is also an important task for Be Well’s GPs.

What do the Dutch health insurers think about this initiative? The Dutch health insurers are positive about Be Well. Dirk Pons, medical director DSW (insurance): “Previously, the Dutch were directly dependent on hospital care, while now there is a high-quality first-line facility that can treat a large number of complaints. These are lower costs while maintaining quality ”.

And don’t Thai hospitals see Be Well as a competitor? The leading private hospital in Hua Hin, Bangkok Hospital, is very happy with the arrival of Be Well. The hospital cannot perform simple consultations and home visits (cost) efficiently and would like to see this primary care at Be Well. Be Well can then send targeted referrals to this and other hospitals for, for example, radiology, specialist consultations, operations and admissions. Bangkok Hospital also sees a role for Be Well in communicating with Western patients. Thai patients rarely discuss with a doctor, Western patients are usually used to dialogue.

The post in Hua Hin started at the end of December 2019 with two Thai doctors, a physiotherapist and two nurses. They are advised & supported by the Dutch general practitioner Daan Groenewegen, who works as a medical consultant at the center and regularly visits Thailand. Groenewegen also owns the Medical Center Driebergen, which acts as a knowledge and training center for Be Well.

There is also an Advisory Board consisting of retired GP Gerard Smit from Hoogvliet, who lives in Hua Hin, retired cardiologist Ben van Zoelen from Diaconessen Hospital in Utrecht, and former cruise ship physician Chris Taylor. Be Well has applied for a work permit for the 55-year-old Englishman Tailor to become General Manager by the end of April.

The GP post is open 7 days a week. On weekdays from 8 a.m. to 6 p.m. and on weekends from 10 a.m. to 4 p.m. The team members also make house calls and the doctors are available at night for emergencies.

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