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Published on November 14, 2007

Having been given extra responsibilities in the management of Bangkok's Piyavate Hospital, Prof Nithi Mahanonda is determined to introduce a system which he believes will lift the standard of medical practice in Thailand.

Nithi, who is the hospital's vice president, was handed more management responsibilities when chairman Boon Vanasin turned recently to politics. For Nithi, it was something of a dream come true.

Having worked in medicine for 23 years, he has often dreamed of developing the potential of Thai doctors by changing the old way of attending to patients and lifting the standards of medical practice.

He points out that Thai doctors have little time to talk to patients because of the mass services of state hospitals. The system is good for neither patients nor doctors, he says. Doctors gather little information about patients' illnesses and run the risk of misdiagnosis. Patients, on the other hand, deserve better care and should feel satisfied that they are being cured. He believes the present relationship between doctors and patients is not good.

"There should be no compromise in the curing [process]," he says.

Moreover, Thai doctors - particularly those who work in private hospitals - have no chance to develop their vocation. This is because they earn money according to the number of patients they see, and not from a salary.

"These doctors rarely attend international medical academic conferences, which provide opportunities for them to develop their vocation and expand their visions of medical advances. This, in turn, affects the development of Thai medicine," he says.

Nithi, who is also director of cardiology at the Perfect Heart Institute, believes that if doctors work in group practices, they can develop their medical knowledge. He has proved the principle works in practice by gathering doctors to work as a group at the Perfect Heart Institute.

"Boon [Vanasin, Piyavate's chairman] initiated the plan to gather doctors to work together. It is quite successful at the Perfect Heart Institute, so now that I have more management power at Piyavate Hospital, I will expand the idea to other departments. Boon supports me in doing this," Nithi says.

He explains that Piyavate Hospital will pay salaries for the groups. There will be a leader in each group, and the doctors will manage their own workload. The hospital will not focus on the number of patients they see each day, but rather on the quality of service. At present, one doctor sees an average of 50 or 60 patients per day. He believes the appropriate number should not exceed 20 per day and a doctor should be able to spend about 20 minutes with each patient.

"In this model, doctors will have more time to take part in international medical forums and develop their knowledge. I believe Thai medical standards will be lifted in just a couple of years if doctors change the way they work," he says.

At present, the operational model is used in Piyavate Hospital's heart health centre and ear, nose and throat department.

Nithi believes the new system can be a source of strength for Piyavate in its marketing efforts, and will support the plan of chairman Boon Vanasin to make the hospital a medical hub in Bangkok.

Nithi, 49, is the founder of the Perfect Heart Institute, which was established two years ago. The institute has leased an area in Piyavate Hospital and the hospital has become a 50-per cent shareholder in the institute.

He graduated from Mahidol University's Faculty of Science and served his internship at Siriraj Hospital, where he worked for eight years. He later worked at Bangkok Hospital before moving to Piyavate, where he has become a shareholder.

Nithi says Piyavate Hospital is also planning to focus on complementary and alternative medicine, which he believes is gaining greater acceptance.

Plans to make Piyavate a medical hub are also going well. Its TRIA Integrative Wellness centre, which will combine medical technology with traditional healing therapies as well as nutrition and fitness programmes, will soon be open. TRIA will have complementary and alternative medicine practitioners, massage experts, sports-science trainers, counsellors and life coaches to cover all aspects of health.

The hospital's luxury residential accommodation for foreign patients is also complete. Most of its foreign patients come from the Middle East. The hospital employs brokerages in many countries to advise patients about treatment at Piyavate Hospital.

"The hospital will invest about Bt10 billion according to a five-year plan ending in 2010. We earned a net profit in the past two fiscal years but it seems we will suffer a net loss this year due to the huge investments [being made]. However, the hospital's [financial] performance will be recover after the investment plan to make it a complete medical hub in 2010," he says.

Although Nithi maintains his share of the patient load as a cardiology specialist as well as being a top executive of the hospital, he says the responsibilities are not too tough. He sees his patients in the mornings and becomes an executive in the afternoons. If he has time left, he goes to a gym.

"Although I have to manage the hospital along with attending to patients, I'm not stressed. I think my job is very much fun. I still go to exercise every day because I'm a cardiologist, so I should be a good example for my patients," he says.

Nalin Viboonchart

The Nation