Surgery at Manila Doctor’s Hospital

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Manila Doctor's Hospital

Manila Doctor’s Hospital

Surgery at Manila Doctor’s Hospital, Manila, Philippines. Hysterectomy. Manila has far more medical care options than anywhere else in the Philippines, by far. Some say the best hospital in Manila is the Philippine General Hospital (PGH). While it’s a public charity hospital, many of the most talented physicians in the Philippines practice there, as it’s the teaching hospital of the adjacent University of the Philippines Medical School. While PGH does accept private paying patients, the facilities and accommodations will generally be too basic and overcrowded for those who can afford hospitalization at one of the private hospitals. A notable exception is the new University Physicians Medical Center. UPMC allows UP and PGH physicians to provide outpatient services to private patients in a very modern facility. See An  costs P6,000 or less than $150.

Manila has several upscale hospitals catering to those with the money to pay for them. St. Luke’s Medical Center, Makati Medical Center are two. Asian Hospital and The Medical City are the deluxe hospitals where paying patients can get the most deluxe facilities. Many Manila physicians practice at these elite hospitals, but also at more modest hospitals for less affluent or more thrifty patients. Some dedicated doctors teach at UP, treat at PGH and accept affluent patients at one of these elite hospitals. We especially admire those who keep their ties to UP and PGH even when they could have an easier life restricting their practice to the elite hospitals.

Carol was first diagnosed with small uterine cyst and endometrial problems in 2007. By 2010 Carol’s uterine cysts had really grown and it was clear that she would have to have surgery. We decided to consult a gynecological oncologist because they can be more experienced with surgery than a general practice ob-gyn. We saw a PGH-trained Iloilo surgeon, Dr. Lora Tupas. She recommended surgery and said that it would cost between P90,000 and P100,000 performed at Iloilo’s St. Paul’s Hospital. While Dr. Tupas was well-qualified, we went to Manila for a second opinion. We saw Dr. Christine Palma at her The Medical City clinic. She basically agreed with Dr. Tupas. We decided that we’d prefer to have the surgery at a Manila hospital. Dr. Palma said that a uncomplicated hysterectomy would cost about P150,000 at St. Luke’s Hospital.

We learned that Makati Medical Center offered an all-inclusive hysterectomy package for P92,000. This seemed a good option — surgery at a top Manila hospital for the same price as surgery in Iloilo. Since the surgeon’s fee is capped under the surgical packages, many surgeons will not participate. We were referred to Dr. Jay Famador a gynecological oncologist at Makati Med. During our first visit he suggested that we have a new ultrasound at MMC. We did so and the results really alarmed us, indicating the possibility of a large malignant ovarian tumor. These results were very different from those of prior ultrasound reports. We wanted to have the surgery at Makati Med very soon. Almost simultaneously we received a recommendation of gynecological oncologist Jean Anne Toral and learned that the “semi-private room” which is included in the Makati Med hysterectomy package was really a room in which five patients shared a bathroom. If we wanted better accommodation at Makati Med we would have to switch from being a “package” patient to being a “private” patient. Dr. Famador said we should expect to pay about P200,000 as a private patient at Makati Med.  We were also disturbed by the account of an acquaintance at Makati Med.  See

We met with Dr. Toral at her clinic in a medical office building across from PGH. We both were impressed with her. She said we could have the surgery at the National Kidney and Transplant Institute or at Manila Doctor’s Hospital. We decided on Manila Doctor’s Hospital (MDH) or MaDocs, MDH is supported by the MetroBank Foundation. The objective is to provide excellent care at a price point below that of the elite hospitals. MDH is located quite near PGH and UP College of Medicine. Many UP/PGH physicians provide care to private patients at MDH. Dr. Toral told us that we would spend between P115,000 for a routine total hysterectomy and P130,000 if a malignancy was found. We scheduled the surgery for the following week.

To our great relief, Dr. Toral found no significant ovarian tumor when she operated, rather there was a very large uterine cyst (myoma), and smaller myomas. The surgery turned out to be a fairly routine total hysterectomy with bilateral salpingo-oophorectomy (“TAHBSO”) – e.g. removal of uterus and ovaries. Because of the pre-surgical ultrasound suggestion of a large, possibly malignant ovarian tumor, Dr. Toral arranged for a pathologist to perform a “frozen section” histopathology during the surgery. Dr. Toral also asked for a pre surgical CA125+HE4 ovarian cancer biomarker test. The cost of the test was P3,400. After surgery we found out that the Carol’s CA125+HE4 results were essentially negative for ovarian cancer. It’s unclear why the pre surgical ultrasound report was so far off the mark, but we’re grateful that it was.

Manila Doctor's Hospital

Manila Doctor’s Hospital – Standard Private Room – P2,500 per day

We appreciate Dr. Toral’s skill as a surgeon and her directness, modesty and compassion as a physician.  Although the surgery lasted almost four hours, Carol did not require a blood transfusion because she lost only an estimated 700cc of blood. The suturing was nicely done, unlike that of her sister who had similar surgery by another surgeon at St. Luke’s in Manila.  There have been no complications.  We can recommend her without reservation.  Her office phone number is 2-567-3908.

The total cost of Carol’s hospitalization was as follows:

P60,255.17 to the hospital. This includes six days in a private room, laboratory, medications, operating room and all other expenses.

P3,500 to the pathologist

P61,200 to Dr. Toral

P25,000 to Dr. Christinanette Songco, the anestheologist

Total : P149,955.17.  Of this, the Philippine Heath Insurance Corporation (PhilHealth) paid P11,200 to Dr. Toral, perhaps P5,000 to Dr. Songo and P10,255.17 to Manila Doctors Hospital, so PhilHeath paid a total of P26,455. reducing our out-of-pocket expense to P123,500. Since our annual PhilHealth premium is P1,200, PhilHealth is a bargain.

Of course there were other expenses. We paid our Iloilo cardiologist to do the pre-surgical cardiac clearance. There was airfare and the cost of staying in an apartment in Manila for a week after Carol was discharged so that she could have a follow-up appointment with Dr. Toral and recover enough for the flight home. Still, we feel the cost was very reasonable. The lavish Bumrungrad Hospital in Bangkok estimated over $10,000 for diagnosis and treatment. Our cost in Manila was less than a third of that. As is the custom in the Philippines, Bob stayed in Carol’s room as her “minder”. The hospital supplied a padded bench for the minder to sleep on. The cost of the private room was P2,500. This is the standard room at MDH.

Many hospital costs are linked to the daily room rate. If you have a fancy suite, many of your hospital costs will be more. If you are in a ward, they will be lower, so, while we could have afforded a suite at P4,000+, it would have raised the cost of the hospitalization much more than just the additional price of the fancier room. Anyway, our eighth floor private room was fine, air conditioned, cable TV, refrigerator and private bathroom.  Our room had a great view of the city.  We received a newspaper every morning and there was hot water and a microwave available at the nurse’s station.

Our experience with Manila Doctor’s Hospital was a good one. The hospital is very well run. No doctor’s orders were overlooked. We never had to remind the staff of anything. We were interviewed to see if we were happy with the housekeeping. The food was surprisingly good. The bill was very detailed and the charges all seemed reasonable. The upscale hospitals such as The Medical City offer better appointed facilities, but we’re doubtful that the care will be any better.

Our one beef regarding Carol’s care was inadequate post-operative pain medication. This is not the fault of the hospital. It has to do with Philippine paranoia about using opioid medications, even for surgical patients. Post-op Carol was given a NSAID “Arcoxia”. It’s similar to Celebrex or ibuprofen. Arcoxia is not approved for use in the U.S. because the manufacturer has not been able to convince the FDA that it’s effective or safe. Carol suffered due to lack of effective pain control. A few days of opioid pain killers would have been far more effective and safer than the Arcoxia.

Carol checking out of Manila Doctor's Hospital

Carol checking out of Manila Doctor’s Hospital

A friend who had surgery in Iloilo had exactly the same problem. Post-op he was given Celebrex. It was ineffective at controlling his severe pain. It was not until he got home to Miami that he received proper treatment. Our complaints fell on deaf ears. If one is concerned about post-surgical pain medications, we suggest that you get a hospital pain management specialist as part of the treatment team. Again, this is not a problem with Dr. Toral or Manila Doctor’s Hospital but is a well-documented problem with medical care in the Philippines generally. If the Philippines expects medical tourists to be satisfied with their care, this issue should be addressed.  See /philippine-pain-management/

Comments (27) Write a comment

  1. Hi Bob and Carol,

    I searched about adenomyosis and I came across your article. It was very inspiring. I just want to ask if Dr. Toral is in line also of treating adenomyosis? Thank you. Looking forward to hear from you.



    • Ghie, of course Dra. Toral will have to decide but we suggest that you make an appointment to see her. If she can’t help she will know who can through her association with UP School of Medicine. Best wishes. Bob and Carol


  2. Good morning Bob, and Carol,
    I read your article late, and even it was late, I am happy that I came across these post.
    my question right now, is How did you avail of PHILHEALTH insurance? on my last visit as a future preparation i inquired to one of the hospital which is located across the subdivision of where we have our retirement place said that they do not accept the insurance we will have when I retire, and even the current insurance I have on the time i visited the hospital, and the adjoining medical center.

    Thanks for any information you can share

    v/r Gloria


    • Gloria, I can’t imagine any Philippine hospital not accepting PhilHealth. Of course, the fancier the hospital the larger your share of the expense will be, but PhilHeath is well worth the small annual premium.


  3. thank you very much for the info all details posted here allowed us to really prepare for the expenses concerning this kind of situation. God bless.


  4. hi there. may i know the full name of dr. toral? im planning to confide with her regarding my mother’s condition. thank you


    • Jean Anne B. Toral MD
      Don Santiago Building Room 309
      1344 Taft Ave (across from PGH)
      M/Th/F 10-12
      W 10-2
      Sat 12-4


  5. Hi i have a problem, my mother need surgery and i dont know what to do because of lack of financial…its really hard…if only i have enough money, i want a good surgery for my mom…pls help us to pray for my mom…thanks…hoping that God will show me what to do…and lead our ways…coz i really loved my mom…


  6. im also her patient ..
    i have ovarian cyst.. but sadly the tumor was malignant..
    she is my doctor.. she is amazing.. i swear to god.. she is a amazing doctor 🙂


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  11. hi bob and carol,
    I Am bit relieve after reading your post..,im looking for the cost of surgery here in Aussie & i ofcourse i give credit to our more deligent and Filipino surgeon so also i look at the i happened to read you article which is too relevant in my present situation..thanks i look forward to met all those people you’ve mention..

    Thanks and more power to both of you!!


  12. I am glad that your wife’s surgery went well, inspite of poor pain management. The medical community in the philippines needs to be educated about the 5th Vital Sign which is pain. Just like temperature, pulse, blood pressure and breathing, pain control is an integral part of post op care. Nobody should go through immediate post op care with only celebrex… ouch, very ouch.
    Here in the US the hospital and the physician can be sued for pain and suffering.
    Thanks for the heads up.


  13. Bob

    I’m very happy that your wife has recover from her surgery.

    I knew on first hand about the issues and concerns of using pain killers with opiates after surgery.

    One of my wife cousin, her husband almost lost his left leg, due to a tricycle accident with a drunk driver in the National Highway. He did source to acupuncture treatment daily, to control the agonizing pain of his leg after surgery. According to him, it work well for him.

    In this part of world, including the middle east, pain-killer medicine with opiates is a no go! It is the enormous amount of paper work for a control medication and the risk of side effects are well noticeable, not the addiction.

    Another Example of side effects while using pain killers with opiates after surgery is me.

    During the 1991 Desert Storm conflict, I was wounded in my left hip, by a 7.76 caliber bullet, that ricochet from the side of my Bradley Fighting Vehicle, a firefight broke out, while dismounted during refueling operations.

    I was Medevac to Landstuhl, Germany, under a heavy dose of morphine, I did wake up 5 days later. I still can’t remember nothing, except waking up and seen my daughters smile.

    While recovering from the surgery, the Doctors prescribed me Percocet for the pain. I did develop severe skin rash, irritations all over my body and real bad hallucinations.
    All this due to the side effects. Later on, they did prescribed lots 800 Mg’s of Motrin.

    After the removal of 74 stainless steel staples, I was on pain for a whole year from my left hip all the time, the extensive Physical therapy, the discomfort of anything rubbing my scar. Every wrong jerking movement, anything causing pressure, or just bending, It felt like something was biting me in the left glutenous all the time. Basically, I had to learn how to walk, all over again.

    My two faithful companions ” The Crutches” were my inseparable partners for almost 13 months. I even quit taking those darn motrins. I settled better with “mind over matter,” Believe me or not you develop some kind of mental toughness and tolerance for the pain.

    In my opinion, the intake of any medication with Opium derivates, it is a very sensitive issue and risky business. There has to be other alternatives. Not everyone is the same, some people could withstand pain better than others.


  14. Im ilongga, about to retire, possibly to start construction on my retirement house early 2012 all because of you. Ive been an avid reader and follower of all your posts . THANK YOU. Ive always been happy to be one of your many readers, and have shared your site to countless of friends who are learning from all yours and Carols experiences. But today I cant be your silent reader. Im so pleased that Carols surgery went well. Speedy recovery to her. You have alleviated some of my fears of healthcare in PI. THANK YOU SO MUCH for all those information. I hope you dont get tired posting your experiences.. my sincere thank you for all youve done for me as I sort out whats good for me in my old age. I feel like all my decisions are largely based on your encounters of life in PI. God bless you for your talent to write and GOD bless Carol for finding you.


  15. It’s so great to see Carol! she looks wonderful. Thanks for the informative post..Do you think one day we’d have US coverage in the Phil?

    Pain control should be an issue that needs to be addressed in the Phil. When I go home for vacation, I bring a few opiates and barbs, in case i get a minor procedure. In our department, the RNs are certified to give these intravenously. In the ICUs, we are even giving Propofol ( the Michael Jackson kryptonite) per IV pump. I could not imagine post op with inadequate pain-control. It is inhumane!


    • Hi Natie,

      You’re right it’s inhumane. Our surgeon was a wonderful woman, well trained (UP/PGH) and otherwise compassionate, but she was unyielding on pain medication. Philippine physicians seem to be terrified of using opiates, even in a hospital. I told the surgeon that leaving Carol in agony was barbaric. Do they think Carol is going to become s drug addict? I’m guessing it’s easier to buy shabu on the street outside than get morphine in a hospital! The only way around this is to involve a pain management specialist in advance. Manila Doctor’s Hospital does have a pain management center which offers morphine pumps etc. Next time I’ll know what to do.



  16. Hello Bob,
    We were happy to read that Carols situation was handled so well and with such good care by both Yourself and Manila Doctors Hospital. I recently had surgery for a double (right and left) hernia here in Los Cabos. The care I received was very good. Post operative pain medicine for me was also Celebrex. UGHH

    Best Regards
    Michael & Cheril


    • Yes, it seems that both the Philippines and Mexico are awash with illegal drugs but legal medications for pain control in hospitals for patients who need them are tightly controlled. Glad your surgery went well. Bob and Carol


  17. lets face it were all gonna die do you have any plan for that ? it seems that your blog covwrs everything so i just like to get some info. thank you.


    • Yes, I’ve tried to make things as simple as possible for my wife when I die through pre-arrangements.


  18. good choice bob, “ma-doc” is a first rate hospital, my 2 brothers-in-law trained there.


  19. Hi Bob and Carol,
    I am so happy that everything went well with Carol’s health and hospitalization, etc. Take care of yourselves and don’t forget to get your yearly physical! You are in my prayers!


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