Medication Use

So, we are working on a workshop to train public hospital pharmacists and administrators to conduct drug utilization reviews and interventions to optimize medication appropriateness and outcomes. There are many challenges to implementing change here, especially related to the current policies in place. Incentives for cost-effective outcomes seemingly do not exist. Many drugs are available without (or with) a prescription - including antibiotics, cardiovascular meds, many more. For the private hospitals, medications are not a cost center, but rather they are a revenue center. I am told that physicians in private hospitals receive reimbursement for prescriptions they write (and their patients fill). People I have met that are not employed in the health care system have consistently told me that Thailand is 'overmedicated' - all physician encounters result in prescriptions, even if the patient is only seeking advice or reassurance. All in all, it is a challenge to disentangle and understand the health care system in Thailand. Comments are welcome.

Reflections on the inauguration from afar (click here for link)

While you were (hopefully) watching history being made yesterday morning, I was also viewing the inauguration live on CNN.com, but it was almost midnight (the only English speaking TV channels I get are AlJazeera and Bloomberg). I was awed by the anticipation, the ceremony, the pomp and pagentry, Obama's speech. I was watching alone, desperately trying to stay awake, but at the same time I was so moved to see the thousands (millions?) of people on the Mall, so excited, so hopeful. Before the inauguration, I read this article (see link - click on the title to this post) in the Nation, one of Bangkok's English-language newspapers. This small, seemingly insignificant piece of news buried on the inside pages, made me realize what a great nation we live in. One lesson I have learned is that I will never take our liberties for granted!

Thai Food I

By request, I am sharing some thoughts and visuals on Thai food. I must clarify most of these meals were associated with working meetings, in case anyone might think I am having too much fun! Unfortunately, I cannot identify many of the food items, since I didn't do the ordering, and my Thai is not yet up to par. I can say, aahaan aroi maak!

A fantastic Shabbat in Bangkok

I'll keep this brief, since most are probably not interested...I spent Shabbat at one of the Chabad Bangkok synagogues, Beth Elisheva. It was a very interesting mix of cultures - Ashkenazi, Sephardi, Israeli, Romanian, Korean, Thai, Long Island, South Florida, etc. etc. Of course, the prayers are univeresal so that was comforting (my Hebrew is a lot better than my Thai). Rabbi and Rebbetzin Joseph and Nechama Kantor were gracious hosts. And the cholent was excellent! If you are interested in more details of the dinner conversation and some of the people I met, let me know - I would love to share with you!! Also, for more information on Jewish life and history in Thailand, see http://www.jewishthailand.com/templates/articlecco_cdo/aid/421323/jewish/Overview-Judaism-in-Thailand.htm Next week I'll arrive before Friday sundown and take some pictures, for those who are interested. So, today (Sunday) I am in the office preparing a list of quality indicators that we can measure using multiple hospital clinic databases (yes, I am working!!!)

Scenes from a Thai Pharmacy School I

I thought I would share with you some scenes around the Chulalongkorn Faculty of Pharmacy building. The cafeteria has excellent, inexpensive Thai food, and a Dunkin Donuts (but alas, no Splenda or Equal). If you click on the cafeteria picture, you can read the menu.

Dogs are everywhere in Bangkok, and scores live in 'Pharmacy Hall', which is open-air. I took some snapshots that are not appropriate for posting (mating season). Students and faculty seem to just ignore the dogs, but you do have to watch where you walk!

Wait! Chelsea, you're not a Thai dog! Now, be good a good dog while I'm away...

PINK LADIES

Pink is the official color of Chulalongkorn University and the color to wear on Tuesday in honor of the King. Lucky for me, I have quite a bit of pink in my wardrobe, so people cannot tell that I am 'farong' (a foreigner). I had lunch with Dean Pornpen Pramyothin (she is on the right, Dr. Niyada in the middle). The lunch was for members of the Ethics Committee, of which the Dean chairs. This is a committee that makes recommendations to the national Pharmacy Board about cases of pharmacist misconduct. Apparently it is customary for the Dean to open up the lunch to faculty, before the confidential deliberations begin. Of course, excellent Thai food was served (see picture).

Happy New Year!

New Year's is a real celebration here! Banks and offices have been closed since the day before, but shops are open. Dr. Vithaya and Dr. Niyada have been very helpful in getting me adjusted, settling in, although I don't need much.

Check out the pictures of my apartment! The first picture is the view from my balcony.

For comparison, I posted a picture of the luxury bath in the 5-star Bangkok Peninsula Hotel. Can you see the difference?

I've arrived

This will be a short post sonce I do not have Internet access yet in my apartment so I am resolved to typing on a Blackberry. Most of the weekend was spent re-orienting myself with the city of Bangkok and settling into my home for the next 3 months. My hosts and colleagues Professors Niyada and Vithaya have been gracious hosts. A Fulbright staffer met me at my apartment to take care of some business items-so I will be able to pay the rent, etc. I also had the chance to set up my office at Chulalongkorn University. Yesterday (New Years Day) I had a wonderfully relaxing day with friends from home (Reba and Shelly) who happen to be vacationing in Asia. When I get internet access I will be able to upload pictures. Until then, sawatdee ka