Author: Rosalyn Neranartkomol M.Sc. in Gerontology from USC
6th year medical student
Origin/affiliation: Medical University of Silesia in Poland
Dr. Kanapon Phumratprapin is a geriatrician in Thailand who is also a pioneer of the first home health care service and health tech startup in Thailand. He has had international experience working as a geriatrician in Thailand and as a visiting internist at Mt. Sinai Hospital in USA.
1. Why did you decide on specializing in geriatrics?
I find that geriatrics is an up-and-coming branch of medicine that looks challenging. Thailand and Singapore are the two leading countries in Southeast Asia with a fast-growing senior population. However, in most countries where the population of seniors exceeds other population demographics, elders tend to have a healthy amount of savings before retiring whereas Thailand’s population become old before becoming rich, which pose a serious challenge for this growing subset of the population. I decided to pursue geriatrics so I can take up the challenge to fill in the care gap that is so novel that there’s no framework to go by yet in Thailand.
2. What do you envision the future of geriatrics (in Thailand) will look like 10 years from now?
As the population become frailer, there will be a need for primary care doctors to refer these complex patients to geriatricians. Due to this upcoming trend, I foresee that most families would want to have a geriatrician as part of their regular care team. The demand for geriatricians will go up as the population age and require more care.
3. How has your geriatrics training helped you in establishing your health tech start up?
My geriatrics training contributed significantly to my health tech startup, since geriatrics training is not only about clinical medicine, but it also encompasses psycho-social training. As a geriatrician we must look at every aspect of care of the patient from the main caregivers, the family dynamics, the patient’s social circle, the patient’s living arrangements, and so on. This type of training is different from other field of medicine since it is not acute medicine and mode of care is ongoing as opposed to most critical care that is set in the hospital setting. I noticed that there is a market for this health care start up because I was able to see from my training that there is a different need for geriatric patients.
4. In what way do you think geriatrics training can be improved in Thailand?
I believe that as the population age globally, medical practitioners in every field will be seeing more and more elderly patients; therefore, core medical training should reflect the changing demographics by making geriatrics training longer in duration and more in depth akin to that of pediatrics. Geriatrics rotation being just one week under internal rotation is no longer sufficient exposure for medical students. Furthermore, there should be an increase in the spectrum of training to include palliative care or end of life care since every medical doctor will be having these types of difficult conversations at some point in their career. In my opinion, these suggested changes can be applied universally, and not only to Thailand.
5. Do you notice any country/culture specific trend that makes practicing geriatrics in Thailand different than elsewhere?
I believe that infrastructures have more impact in care practices, while culture may play a role, it is not as substantial. Take for example America and Japan’s models are more similar yet they possess drastically different cultures, so their similar care structures play a bigger role. Since Thailand does not have the same infrastructure as America because we do not have the same healthcare system nor do we have an abundance of nursing homes; therefore, there are still variances in trend.
In terms of cultural differences, I do notice that Thais are not inclined to plan for old age, in comparison to Americans who are encouraged to plan for retirement and to purchase long-term care insurance and/or they might have an option of reverse mortgages if they are homeowners. Thais see this topic as a taboo; many Thai seniors will feel offended if their children were to inquire about their plans as they see any discussion of this topic akin to being cursed to die young.