On Friday last week, one of our volunteers got in the middle of a fight between two of our dogs. While trying to get them into a safer area, she got bitten on the foot. I cleaned & dressed the wound, but advised her to get it dressed properly & to get a tetanus shot, as it was some time since her last one & it's muddy in the dog center. I also said she'd need oral antibiotics. We discussed her getting rabies shots, and it was of course her decision, but it wasn't necessary, as all our dogs are fully vaccinated & we last gave them their rabies shots a few weeks ago (a fact she knew to be true, as she helped me).
She tried to go to a Thai doctor in HH, but he was closed, so she went to San Paulo. They called her to the ER (Emergency Room), but she said "No" she was happy to wait in the general area, she had time & she didn't want to pay ER fees. The waiting room was almost empty. The nurse insisted, saying it was the convenient place to do the dressings & she wouldn't be charged extra fees, so she went.
They dressed the wound, gave her a tetanus shot & tried to force her into rabies shots, which she declined. She then went to pay her bill - 5,000 bt!

She demanded to know why it was so expensive & found that they had prescribed her antibiotics at a cost of 3,000 bt (any broad spectrum antibiotic is sufficient). She demanded they change this & wanted to know what the rest of the money was to pay for. Her actual treatment (doctor, dressing, nurse, tetanus shot) came to 500 bt approx. The rest was, you guessed it, ER fees! After specifically refusing them & being told she wouldn't have to pay them.
Eventually she paid 1,700 bt for something that should have cost about 400 bt, and left, very angry.
If visiting San Paulo for outpatient procedures, please be aware of this way of padding the bills. Refuse anything you don't feel is necessary & ask for an itemised bill, in English, so you can dispute anything that seems strange.