How can patients judge quality in medical tourism?

There's much discussion and hype around the medical tourism world about “quality”. Every hospital, clinic, healthcare destination and medical tourism web site claims to offer the “highest quality healthcare”, often matched with a claim of low cost treatment. Some healthcare providers invest vast sums of money in accreditation programs such as JCI in the hope that this “guarantees” quality to the patient and will assist in their marketing efforts. This is the first of three articles on quality in medical tourism written by Keith Pollard, Managing Director of Intuition Communication, the publishers of IMTJ and Treatment Abroad.

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How can a patient make an informed decision about their choice of overseas healthcare provider based on quality? (In a later article, we’ll look at what quality in medical tourism actually means).

The role of medical tourism facilitators

One option for the patient is to use the services of a medical tourism facilitator. Many patients select a healthcare provider based on the recommendation of one of the growing band of “medical tourism facilitators”. But should they trust the judgement of a facilitator or third party agency? It raises some questions:

• How many facilitation agencies have medically qualified staff who can carry out a proper assessment of the quality of care and clinical standards within a healthcare facility?

• How does the facilitation agency compare the quality of healthcare providers in different countries or even in the same country?

• Is their recommendation based on a “familiarisation visit” which essentially consists of a hospital tour and no assessment of clinical quality or facilities?

• Is their recommendation based on the nature of the financial arrangement between the facilitator and the healthcare provider?

To demonstrate the problem, let's take a typical medical tourism facilitation company as an example. It doesn’t really matter who they are, and I’m not saying whether they are good or bad at what they do. In fact, this company is probably one of the better and more respected facilitators. But it serves as an example and demonstrates the problem faced by the patient, the facilitator and by the industry.

Here are some of the words used by the company to market their services to patients:

“Access to high quality medical care at world-class hospitals......... treatment from qualified, proven physicians.....Providers to whom we refer have a history of delivering quality service in a risk managed environment...... (we) personally visit our affiliated providers on a regular basis to further ensure high quality standards”

But the difficulty for this medical tourism agency is the same as for the patient. How do they define high quality and world class? How do they measure quality service? How do they ensure quality standards? And how do they compare the quality of different healthcare providers?

The facilitation company has no medical director and no medically qualified staff. The background of their staff is typical of many facilitators; their experience is in areas such as travel, marketing, business development and sales. So how do they assess clinical standards and quality in a healthcare environment? The simple answer is that they can’t. It’s a problem faced by all facilitators. All facilitators provide cost comparisons between destinations and healthcare providers, but you’ll struggle to find one that provides comparisons on criteria such as:

• The number of operations undertaken of a specific type (on the basis that practice makes perfect... and if you need a hip replacement, you’re probably running a lower risk if you somewhere that does hundreds of these).

• Clinical outcomes for specific operations.

• Post operative complication rates

• Post operative infection rates.

• Incidence of MRSA and clostridium difficile

• Pressure ulcer incidence

• Etc, etc.....

Can patients make an informed choice?

A second option for the patient is to research the options him/herself and to select the provider on the information that he/she can locate, usually on the web.

Some may select a healthcare provider because it is “JCI accredited” or has some other form of accreditation. But for many patients, JCI accredited may mean little. Knowledge of accreditation systems amongst patients varies widely. Mamy patients have no idea what JCI accredited means, and may have never heard of JCI.

So, what does JCI accredited actually mean to a patient? JCI accreditation is not a guarantee of quality; it tells a patient little about the real quality of healthcare that they may receive or the quality of treatment outcome that they may expect. The JCI program helps hospitals to implement processes that will improve the quality of care they deliver to patients which is a good thing. but some hospitals invest in JCI accreditation as a marketing ploy (albeit expensive) to ensure that payors such as insurance companies and assistance programs will provide patients

The other problem is that there's no guarantee for patient or facilitatator that quality standards are maintained between one JCI inspection and the next.

What's the answer?

There isn't one! Patients and facilitators are having to make uninformed choices But it would be a move in the right direction if we could encourage providers of services to international patients to publish clinical and quality data. It may not be comparable, it may raise questions about validity of data but it would be a step in the right direction. Let's here less about "we've got the highest quality facilities" and see some evidence from those providing services in the medical tourism business.

Medical Tourism: Everybody's Guide to Affordable World-Class Medical Travel

Last year, more than 180,000 Americans packed their bags and headed overseas for nearly every imaginable type of medical treatment: tummy tucks in Brazil, heart valve replacements in Thailand, hip resurfacing surgeries in India, addiction recovery in Antigua, fertility diagnosis and treatments in South Africa, thalassotherapy in Hungary, or restorative dentistry in Mexico.

Currently, at least 28 countries on four continents cater to the international health traveler, with more than 2 million patients visiting hospitals and clinics each year in countries other than their own. The roster of treatments is as varied as the travelers. If the notion of complex medical procedures in far-flung lands seems intimidating to you, don't feel alone. That's why I wrote the book Patients Beyond Borders, drawing from the varied experiences of hundreds of patients who, for dozens of reasons, have beaten a well-worn path to successful treatments abroad.

It all started when my father, who was 72 at the time, announced he was heading off to Mexico for extensive dental work. I well remember my first reaction upon hearing his plans: a mixture of bewilderment and fear, then resignation, knowing that despite my protestations, he was going anyway. In spite of my concerns—some of them quite real—I'm pleased to report a happy ending. Dad and his wife, Alinda, selected a U.S.-trained dentist in Puerto Vallarta and spent around $11,000—which included two weeks noodling around the Pacific Coast. They returned tanned and smiling, Dad with new pearly whites and Alinda with an impromptu skin resurfacing. The same procedures would have cost them $24,000 in the United States.

After his treatment, when I told the story of my father's trip, most friends responded with the same shock and disbelief that I had felt initially. Then, when I explained the quality of care and the savings, more often than not, those same folks followed me out the door, asking for Dad's E-mail address. I even had an airport customs agent abandon his post and follow me to the boarding gate, seeking additional information for his son, who he had just learned required heart surgery.

Not long afterward, I developed an infected root canal and found myself following my father's example. My research led me abroad for extraction and implant work. While pleasantly surprised at the quality of care, the prices, and the all-around-good experience of the trip, I nonetheless made a number of mistakes and created unnecessary difficulties and discomforts for myself. Had I done some simple things differently, my trip would have been more successful and more economical.

In seeking additional data on medical travel, I found no reliable source of information. Everybody had something to sell or a political ax to grind. Books, magazine articles, and newspaper reports seemed more like tourists' brochures than health travel references. Thus the idea for Patients Beyond Borders was born: a well-researched guide, written in plain English, that would offer an impartial look at contemporary medical travel while helping prospective patients ask the right questions and make informed choices.

As we contemplate our options in an overpriced, overburdened U.S. healthcare environment, nearly all of us will eventually find ourselves seeking alternatives to costly treatments—either for ourselves or for our loved ones. Americans are in the midst of a global shift in healthcare service: In a few short years, big government investment, corporate partnerships, and increased media attention have spawned a new industry—medical tourism—bringing with it a host of encouraging new choices, ranging from dental care and cosmetic surgery to some of the more costly procedures, such as hip replacement and heart surgery. Those patients who take the time to become informed about our changing healthcare world will be pleasantly surprised by a smorgasbord of affordable, high-quality, American-accredited medical options abroad. Those who do not may find themselves grappling with an ungainly, prohibitively expensive healthcare system and a rising absence of choice.

There is no single type of health traveler. In researching and writing Patients Beyond Borders, I talked with wealthy women from Beverly Hills who, despite their affluence, prefer the quality of treatment and attention they receive in Brazil or South Africa to medical care California style. I met a hardworking couple from Wisconsin who, facing the prospect of refinancing their home for a $65,000 hip operation here in the United States, headed to India instead. I interviewed a Vietnam vet who wearied of long waits and red tape. He said "bon voyage" to this country's ever deteriorating healthcare system and headed overseas for treatment.

From these patients' experiences and many more like them, you'll learn when and how health travel abroad might meet your medical and financial needs. And you'll become a more informed healthcare consumer—both here and abroad.

Why is Medical Tourism a Solution for the United States, Canada, and the United Kingdom?

At this moment the healthcare crisis in the U.S can be likened to a pressure cooker that is about to blow its top. The number of uninsured or underinsured Americans is close to Fifty million, and shows little sign of diminishing. According to the U.S. Census Bureau, the elderly make up twenty-three percent of the major costs of U.S healthcare spending and each year more people are entering these age brackets as the baby boomers mature and get older.It is projected that:
The number of Americans aged 65 or over will double by 2050
The number of people age 85 or over will quadruple by 2050
By 2030 over half of U.S. adults will be over age 50
The over 65 population will nearly triple as a result of the aging Boomers.
More than six of every 10 Boomers will be managing more than one chronic condition.
Although Canada has an admirable healthcare system in many respects, many residents admit that there is a serious crisis brewing. Poor government funding has led to a notable lack of physicians, nurses, and state-of-the-art medical equipment. This, in addition to the long waiting times for many surgical procedures, has created unrest and an urgent call for healthcare reform. According to a 2007 article in the Christian Science Monitor, Britain's Department of Health reported that at any given time, nearly 900,000 Britons are waiting for admission to National Health Service hospitals, and shortages force the cancellation of more than 50,000 operations each year.In each of these cases the government has failed to adequately meet the basic healthcare needs of many of its citizens. As baby boomers age and the current healthcare system is stretched to the breaking point, expect individuals and businesses to look at new ways of regaining control of their healthcare. The medical tourism phenomenon is a natural outgrowth of these conditions – an outlet if you will, for people trapped by an unwieldy system that offers little hope for a better tomorrow. Long wait times for certain procedures is also a big factor for residents of Canada and other countries with socialized medicine, and is effectively forcing people to look for other options, including medical tourism. Wait times of a year or more are quite common in Canada and England. Contrast this with “wait times” of weeks or even days at many medical tourism destinations.

Twelve Natural Health Tips for Smart Travel

(NaturalNews) Traveling can be hard on your health. Increased stress, changing time zones and difficulty finding healthy food can all negatively impact your health. And if you travel by air, you have the added problems of exposure to airborne pathogens, fragrance chemicals, and other pollutants brought into your air space by unhealthy people. On top of that, there's the additional difficulty of bringing all your health supplements, superfoods and appliances with you (a Vita-Mix is heavy!).So how can you protect yourself from sickness and environmental stress when traveling while still providing yourself with your most important health supplements and superfoods? Being an experienced traveler myself, I'll share with you my best tips for maximizing your health when traveling on planes, trains or automobiles.
Tip #1: Boost your immune system before you goDon't dare walk into an airport, train station or other public place without protecting your immune system first. How do you accomplish that? It's simple: For at least three days before your trip, start drinking lots of vegetable juice and taking immune-boosting herbal supplements. It's even better if you're drinking fresh juices every day as a regular habit, but if you're not, at least kick in the healthful juices before you travel.On the supplements side, I like to take Kyolic garlic supplements (www.Kyolic.com), medicinal mushrooms (www.MushroomScience.com), Echinacea, goldenseal, ginger and other similar immune herbs (www.BaselineNutritionals.com). It's also important to get plenty of zinc in your diet by eating pumpkin seeds or taking high-quality zinc supplements. Taking lots of vitamin C and vitamin D3 is also helpful, but be sure to get them from high-quality supplements (I don't recommend cheap multivitamins like the Centrum brand). The best sources for high-end individual supplements are www.WellnessResources.com and www.LivingFuel.com (check out their Super Essentials fish oils with astaxanthin.
Tip #2: Bring superfood powders for instant mealsHaving superfood powders with you at all times is a great travel strategy, even if you're just traveling to a relative's house for a few days (your relatives probably aren't as health conscious as you are, right?). Don't clobber your immune system by eating the junk in their refrigerator; bring your own superfoods and amaze (or annoy) your friends and relatives with your own astonishing commitment to a truly healthful diet!Which superfood products should you bring? There are a lot of them I recommend, including Living Fuel (www.LivingFuel.com), Boku Superfood (www.BokuSuperfood.com), Healthforce Nutritionals (www.HealthForce.com), HempShake (www.Nutiva.com), Emerald Balance (www.SGNnutrition.com) and Delicious Greens (www.Greens8000.com). There's even a new product I just saw at Whole Foods called Amazing Meal (www.AmazingGrass.com). I haven't tried it yet, but I know their Amazing Grass product is high quality, and I intend on reviewing their Amazing Meal product soon.

How safe is surgery abroad?

About 100,000 Brits paid for private dental and medical work abroad last year. But how big are the risks? Your Life investigates..
A growing number of Britons are flying overseas looking for cheaper, and often faster, medical treatment. And they are not just after breast implants and tummy tucks...
The latest trend is for dental work. This is not surprising as, according to the Citizens' Advice Bureau, seven million British adults don't have access to a dentist.
The problem became worse in 2006 when new dental contracts were introduced and 1,000 dentists left the NHS.
"With high treatment costs and a shortage of NHS dentists, it's no wonder people are going abroad," says Keith Pollard, managing director of Treatment Abroad, a medical tourism information provider.
"In Hungary - the top spot for dental tourism - a root canal costs £104 compared to the average UK price of £220." According to Treatment Abroad, last year 43 per cent of medical tourists from the UK had dental treatment, 29 per cent cosmetic surgery, 18 per cent for other operations such as hip replacements, and 10 per cent for fertility treatment.
Why do it?
"People are going private because of the problems around affordable dental treatment, NHS waiting times," says Mr Pollard.
"Treatment is also cheaper abroad - even including travel and accommodation costs."
Research carried out by the official International Passenger Survey, which questions UK citizens leaving all airports and ports, shows that in 2004, 25,000 Brits travelled abroad for private health care.
In 2007, this figure had jumped to 100,000.
How risky is it?
"Of 650 people who took part in our Medical Tourist Survey 2007, 97 per cent said they would pay for surgery abroad again and 20 per cent believed they'd saved around £10,000," says Keith.
But what about the rest? "There are no statistics for the numbers of operations that go wrong," says Dr Anthony Halperin, chairman of the national charity The Patients' Association.
"As a dentist, I've done repair work on people who've had botched treatment abroad and it's not uncommon. I've also heard of people who have had other surgery, which has gone horribly wrong."
Dr Lorraine Ishak, clinical director of a leading UK cosmetic surgery group, adds: "We're increasingly seeing more patients who've had a bad experience abroad. Across the industry, 33 per cent of surgeons have seen 'much more' repair work over the past five years, due to cosmetic surgery abroad.
A total of 92 per cent of surgeons surveyed by the British Association Of Aesthetic Plastic Surgeons (BAAPS) said they're most concerned with the lack of aftercare provided."
Dr Halperin adds: "This lack of aftercare is one of the many reasons why the Patients' Association advises people to think carefully before booking treatment abroad.
You need to consider that often the first time you meet your surgeon is the day of your treatment. There may be a language barrier and minimal access in the event of an emergency.
"The British Medical Association has also highlighted the dangers of flying too soon after major surgery."
Dr Ishak, of Transform Cosmetic Surgery, adds: "We offer a 24-hour telephone support line, as well as a doctor and surgeon on call at all times. Overseas providers aren't able to offer patients this level of care. Standards are often less stringent abroad than in the UK. You need to be able to trust the facilities and your surgeon's skill and qualifications."
What if it goes wrong?
"You have no rights, only the right to legal redress - which means you would have to sue the foreign surgeon or clinic. This is complicated in the UK, let alone abroad," explains Dr Halperin.
"Guarantees often aren't worth the paper they're written on. Usually the small print states that it's void unless you have regular check-ups afterwards.
Most people don't fly back for these routine appointments. Also, no firm will insure you against something going wrong due to the high risks involved."
A spokesperson from the Department of Health adds: "We strongly advise people having surgery abroad to do their research and make sure they're clear about prices, procedures, recovery times and aftercare."
Before you pay up..
If you do want to go abroad, Dr Halperin says...
Check the clinic has a phone number and address, not just a website . Organisations should make it easy for you to contact them.
Check that the surgeon speaks good English.
Ask about recovery times and what happens if there are complications either straight after surgery or after you return to the UK.
Ask for a copy of the surgeon's and the clinic's insurance certificates in English.
Check the clinic is registered with the medical statutory body of that country. For instance, in the UK it's the General Medical Council.

SOUTH KOREA: JCI and Korean Hospital Association work together

Joint Commission International (JCI) and the Korean Hospital Association (KHA) have agreed to establish programmes focused on improving the quality and safety of health care services in South Korea.

JCI has worked with health care organizations, ministries of health, and global organizations in more than 80 countries. It focuses on improving the safety of patient care through the provision of accreditation and certification services as well as through advisory and educational services aimed at helping organizations implement practical and sustainable solutions. JCI is accredited by the International Society for Quality in Health Care (ISQua).

KHA and JCI will assist hospitals in Korea as they strive to achieve a level of quality recognized worldwide. Together JCI and the KHA will:

* Establish an ongoing series of educational programs for KHA member hospitals.
* Translate and publish the Joint Commission International Accreditation Standards for Hospitals, Third Edition, into Korean.
* Establish a help desk for KHA members to answer their questions about JCI standards, accreditation and service.
* Distribute information on JCI standards for all accreditation programs via the KHA information network.
* Develop and promote the use of patient safety solutions for the benefit of South Korean patients and health professionals.

"Working with JCI will help the Korean Hospital Association raise the profile of health care in South Korea, and bring international recognition to the quality of care in South Korean hospitals. Improving the quality of health care and patient safety in South Korea is a strategic initiative of the KHA."
says Hoon Sang Chi of the Korean Hospital Association.

More than 246 public and private health care organizations in 36 countries have been accredited by JCI. Only one hospital in South Korea has achieved JCI accreditation-Severance Hospital, Yonsei University College of Medicine, Seoul. Others are working towards JCI accreditation.

With strong government support, South Korea is on the way to become a leading medical tourism destination in Asia. The South Korean government has introduced a new category of visa for tourists who visit the country for medical reasons. The foreign medical tourist visa, M, is adopted in a bid to boost the nation's medical tourism industry as local hospitals and medical institutes asked the government to simplify the visa issuance process. The new visa is issued in two forms, C3 (M), a 90-day visa for those with short-term treatment purposes, and G1 (M), a one-year visa for those who need long-term care.

A law change allowing Korean hospitals to market services to foreigners and team up with travel agents has major Seoul medical institutions offering packages to two million gyopo, ethnic Koreans living overseas, promising them faster and more affordable service

According to a new RNCOS research report, “Emerging Medical Tourism in South Korea”, government initiatives to promote the country as a medical tourism hub will fuel the growth in the South Korean medical tourism industry. Despite the gloomy outlook for the world economy, medical tourism industry in South Korea has witnessed an impressive growth of more than 55% in 2008 over the same period last year. Due to the global recession, South Korea is now 30% cheaper to visit than it was last year.

USA: US Surgeons association offers advice on medical tourism

The number of patients seeking medical and surgical care overseas has grown in recent years, prompting the American College of Surgeons (ACS) to study the issue and to develop an official “Statement on Medical and Surgical Tourism.” The ACS statement was developed with the patient’s interests in mind, and also offers guidelines for employers, agencies and insurers.

Doctor James Unti of the ACS Nora Institute for Surgical Patient Safety says, “It is important that individuals considering health care services outside the US become informed of the potential risks and complications as well as the medical, social, cultural, and legal implications of receiving such care.”

For those who chose to seek surgical care abroad, the ACS encourages patients to:

* Seek care of the highest quality.
* Select health care institutions that have met accreditation standards established by Joint Commission International, Trent International Accreditation Scheme, or a similar internationally recognized accrediting body. They should be aware that accreditation standards are not uniform and that standards set locally can vary from place to place around the world.
* Seek care from surgeons and anaesthesiologists certified in their respective specialties through a process equivalent to that recognized by the American Board of Medical Specialities in the United States.
* Prior to travel, make specific arrangements for continuity of care and follow-up care at home.
* Obtain a complete set of medical records prior to returning home so that the details of their care are immediately available to their physicians and surgeons in the U.S.
* Understand the special risks of combining long international flights and certain vacation activities with anaesthesia and surgical procedures.
* Consider the medical, social, cultural, and legal implications of seeking medical treatment abroad prior to deciding on a venue of care.

The ACS also
* Supports their rights to select their surgeons and health care institutions without restriction.
* Encourages its Fellows to assist all patients in reaching informed decisions concerning medical care, whether at home or abroad.
* In the event of proven medical liability for injury, viable means for the recovery of damages should be in place.
* Patients should be aware that many of the means for legal recourse available to citizens in the US are not universally accessible in other countries.
* Opposes the imposition of provisions for mandatory referral of patients by insurers to health care institutions outside the US
, unless such provisions are clearly and explicitly stated in the insurance contract and accepted by the subscriber.
* Opposes the addition of provisions for mandatory referral abroad for patients with insurance contracts already in force, unless there is a fully informed consent from the patient.
* Supports the view that employers or insurers referring patients for mandatory treatment abroad should be responsible for the coordination and reimbursement of follow-up care in the US, including the management of postoperative complications, readmissions, rehabilitation, and long-term care.

The American College of Surgeons is a scientific and educational organization of surgeons with more than 74,000 members and is the largest organization of surgeons in the world.

The Cardiac Rehabilitation Clinic

With heart disease the leading cause of death in the world, Bangkok Hospital is focusing on end-to-end management of cardiac patients with its new Cardiac Rehabilitation Clinic. In the short time it has been open, the clinic has helped thousands of patients regain their health and learn how to avoid a recurrence of their condition.

Cardiac patients are often told to consult their doctors before starting any exercise regimes. Bangkok Hospital's program provides constant medical feedback, and is designed to effect the quickest possible recovery while assuring patient safety.

The clinic provides:

• An exercise-based cardiac recuperation and traning program
  
• A relaxation clinic to reduce stress
  
• Dietary counseling
  
• EECP (enhanced external counterpulsation), where pneumatic cuffs around the legs inflate to force blood back into areas of the heart that may be lacking it

Cardiac rehabilitation is suitable for:

• Patients recovering from a heart attack
  
• Patients recovering from bypass surgery, angioplasty or pacemaker placement
  
• Controlled cardiac arryhtmia and stable angina

There are separate programs for inpatients and outpatients, and individual programs may be tailored to any patient's unique situation. Both in- and out-patient programs include closely monitored, progressive physical activity to find safe levels, and focus on modifying risk factors and lifestyles. In-patients also learn about the disease process, and receive individualized dietary advice.

The Cardiac Rehabilitation Program is designed to provide complete care for cardiac patients and those at high risk of heart disease. A successful recovery from bypass surgery requires a thorough understanding of the process by the patient and the family. Recovery is directly related to the extent of damage already caused by coronary artery disease and the natural healing ability of the heart.

The cardiac rehabilitation team supports the individual and the body during the healing process and repair of the damaged tissues, and is well equipped with state-of-the-art technology and full-time cardiologists. Patient and family education is a part of cardiac rehabilitation program and helps everyone involved understand how the heart works and what can be done to improve and maintain excellent health.

Dr. Kitipan V.Arom , the director of the Bangkok Heart Hospital , feels that the growing number of clinics at the hospital is a great boon to patients. "Every condition needs to be managed differently. The doctors and staff who run our specialized centers and clinics quickly become expert at managing specific conditions, and patients have much better outcomes than at smaller facilities where generalist skills dominate in the workforce".

INDIA: Indian Medical Travel Association launches

The Indian Medical Travel Association (IMTA), an association formed recently to promote India's medical tourism industry is aggressively looking at this year promoting this high revenue-generating segment in the international markets of Middle East, Africa and Far East along with long haul markets Europe and USA. The association already has a membership of 40 hospitals, other service providers such as aruyveda, siddha and yoga clinics, wellness centres, and medical tourism agencies. It is targeting a membership of 100 in the coming months. It is also open to travel agents, tour operators and students. Most members are in India, but those who deal with it as a destination are also welcome.

As a new association, IMTA’s immediate agenda is discussing with its members the best practices that can be adopted and bringing about uniformity by charting strategies to position India as a medical tourism destination. The association is a non-profit body and aims to be a unified voice for Indian healthcare (modern medicine as well as traditional Indian medicine) and travel industries.

Pradeep Thukral, executive director, said, “The medical tourism industry has a huge potential with state-of-the-art facilities, availability of doctors, technology, English speaking nation and the hospital capacity to cater to medical tourists. The fact is that prior to choosing a hospital, international patients first decide on the country. So we must join to aggressively promote India as a preferred global healthcare destination." IMTJ asked him about the possible confusion of the use of the initials IMTA, “ We might cooperate with IMTA Singapore or Israel and if tomorrow an IMTA comes up in Iceland or Indonesia. Our objective is India focused only, unlike others.”

The IMTA aims to

• Empower all the stakeholders in the Indian medical travel industry to work together to make India the leading global healthcare destination.
  
  
• Bring together the best providers in Indian healthcare and travel industries to help create a high quality, ethical and economically sustainable medical travel industry.
  
  
• Promote and provide a forum for communication on a regular basis for exchange of views, development of industry networks, creation and distribution of knowledge, establishment of standards and work on an agenda to make India the leading global healthcare destination.
  
  
• Promote and protect the safety and well-being of patients who choose India for their healthcare needs by creating channels for communication between patients, healthcare providers, overseas insurance and corporate referral groups, consultants and physicians from around the world.
  
  
• Serve as a strong voice of the medical travel industry to Indian and overseas media and raise awareness about the high level of quality healthcare and services available in India.
  
  
• Engage with the various arms of central and state government in India to influence public policy in national interest.
  
  
• Educate members on new technologies, marketing techniques and best practices to help participants to operate more efficiently.

The original "IMTA" (the International Medical Travel Association) declined to comment on the potential for confusion –now we have two IMTA's both using IMTA on their websites and in their communications.

Kentucky woman with brain injury goes for medical treatment in China

Lorie Martin, an Auburn, Kentucky woman injured in a motorcycle accident, suffered a catastrophic brain injury and has been in intensive care and a long-term care facility since the accident. She is travelling to China for intensive therapy and rehabilitation at the First Teaching Hospital in Tianjin with the help of agency China Connection Global Healthcare.

Lorie Martin’s husband learned about China Connection Global Healthcare through friends who were familiar with another Kentuckian, Devin Dearth, who had also travelled to China. Dearth made significant improvement during his three-month stay in Tianjin following a stroke in 2008.

In the US, this kind of rehabilitation can reach $100,000 or more. The e cost will be less than $23,000 in China. While in Tianjin, Mrs. Martin will undergo intensive rehabilitation integrating modern Western techniques and traditional Chinese medicine therapies. First Teaching Hospital is a world leader in integrated therapeutic treatment for stroke and neurological conditions.

China Connection Global Healthcare is an Iowa based medical tourism agency that sends patients to a network of world-class hospitals and physicians in Tianjin and Beijing, China at costs far below those in the United States. Since 2006, CCGH has assisted hundreds of people from the US, Canada, the UK, India, Australia and Japan in finding the care they needed.

A feature length documentary about Devin Dearth’s medical care experience in China, called Dare to Triumph, is being produced by One In A Row Films.

MALAYSIA: National medical tourism figures for 2008 revealed

About 370,000 foreigners sought medical treatment in Malaysia in 2008, according to health minister Datuk Seri Liow Tiong Lai.

Over the years, the country’s medical tourism industry has registered annual growth of 30 percent.

The minister spoke at the awarding of the Joint Commission International's (JCI) hospital accreditation to the Prince Court Medical Centre (PCMC) in Kuala Lumpur.

"Being accredited, especially by an international body, would certainly help in benchmarking the quality services provided by the hospitals. The rapid uptake of accreditation activities by hospitals in Malaysia is testimony to the ministry's commitment to ensure that healthcare is provided in a safe and effective manner to all our clients, local or from overseas.

“Our own home-grown hospital accreditation body, the Malaysian Society for Quality in Health (MSQH), has been awarded this coveted international accreditation by ISQua. Thus, the standards set by both JCI and MSQH are of international stature."

Besides PCMC, the Penang Adventist Hospital and the International Eye Specialist Centre in Kuala Lumpur also have JCI accreditation.

The Institut Jantung Negara is also working towards it.

For the MSQH, 113 hospitals have been surveyed. Sixty five government and 18 private hospitals have received the accreditation. MSQH was formed by the Ministry of Health Malaysia (MOH), Association of Private Hospitals of Malaysia (APHM) and the Malaysian Medical Association (MMA).

Only 35 of APHM’s 111 member hospitals are involved in medical tourism and they are the source of Malaysia’s medical tourism figures. APHM offers a range of medical tourism packages and sets recommended fees for medical tourism hospitals

Rhe PCMC expects health tourism to contribute 30 percent of its revenue for the financial year ending March 31, 2010

Said PCMC chief executive Stuart Rowley: "Overseas patients can save up to 60 percent [in their medical cost]. We have 300 beds but only use 85.It does not make sense to use all, but we aim to do so within the next 12 months."

Dr Mubbashir Iftikhar, chief executive of Malaysian medical tourism agency Wellness Visit, noted: “Malaysia’s excellently maintained healthcare providers are certainly as good as their counterparts in Singapore and Thailand.

“Malaysia is as competitive in cost as Thailand and much superior in terms of healthcare providers, healthcare infrastructure, English-speaking staff, foreign trained specialist doctors, and strict government rulings on maintaining high standards of healthcare delivery systems. Malaysia is as competitive as Singapore in the quality of healthcare with its world-class hospitals and clinics, world-class renowned surgeons and doctors. Furthermore, Malaysia is offering services at costs less than Singapore. Singapore is no match to Malaysian costs for healthcare.”

www.msqh.com.my

www.hospitals-malaysia.org

www.princecourt.com

www.wellnessvisit.com

Angioplasty and Medical Tourism

Thousands of people are choosing medical tourism as a fast, affordable way of dealing with both necessary and elective medical treatment.

One procedure readily available to the medical tourist is angioplasty. This coronary care treatment is used in a vast selection of medical tourism destinations.

What is Angioplasty?

Angioplasty is a procedure in which a narrowed section of the coronary artery is dilated with a balloon catheter. It is less invasive and has a shorter recovery time than coronary bypass surgery. Most of the time, stents are placed in the narrowed artery during the angioplasty procedure.

The stent is a meshlike metal material, and because of this, cells lining the blood vessel grow through and around the stent to help secure it to the arterial wall.

Reclosure of the blocked area is much less likely to occur when a stent is inserted than after an angioplasty without the stent.

The Procedure

The patient is given a mild sedative, which will make the person relaxed and sleepy, but he will usually remain awake during the procedure. A catheter (a thin, flexible tube) is inserted in the groin or arm through an artery and is carefully guided up the aorta into the blocked coronary artery.

Once the catheter has reached the blocked artery, a balloon at the end of the catheter is inflated. If a stent is used, this inflation pushes the stent open. Then the balloon is deflated, leaving the stent in place, and the catheter is removed. Blood flow to the affected area of the heart should then improve.

What to Consider:

One of the greatest benefits of the angioplasty is that, unlike bypass surgery, it does not require open-heart surgery. It is far less invasive. There is less risk of immediate complications. Evidence suggests that the long-term outcomes of both angioplasty and bypass surgery are similar. This makes angioplasty an ideal procedure to consider for medical tourism. There is a wide range of world-class facilities offering coronary care in many medical destinations.

In my opinion, Singapore, India and Thailand doctors are the best in doing the angioplasty procedure.

As with any medical procedure there are risks involved.

Preparations for Angioplasty Procedure:

Your doctor will probably want to do a number of tests, including x-rays, an electrocardiogram (ECG), and blood tests. You should inform your doctor of any medications you are taking, and any allergies you may have, especially allergies associated with the contrast materials necessary to create the x-ray images of the blood vessels.

You should not eat or drink after midnight the night before the procedure. Ask your doctor to advise you regarding any medication you may be taking.

What to Expect After Treatment:

After the angioplasty procedure, you will be moved to a recovery room or to the coronary care unit. Heart rate, blood pressure and pulse will be closely monitored. The site where the catheter was inserted will be checked for bleeding.

There will be a large bandage or compression device at the groin and catheter insertion site to help prevent bleeding. If the catheter was inserted through the groin, you will be instructed to keep your leg straight.

Usually you can start walking within less than 12 hours of the procedure. The average hospital stay after an angioplasty without any complications is one to two days. You may be able to resume exercise and driving after several days.

The relatively short hospital stay and quick recovery time make the angioplasty an ideal procedure for medical tourism. The benefits of medical travel include greatly reduced waiting time and significantly lower costs, and these should be considered.

The five top medical destinations in Asia offer world-class cardiology specialists and clinics. If you are considering an angioplasty, why not look into the possibility of medical travel to Asia? You can save time, costs, and enjoy a pleasant holiday abroad while taking care of your medical needs.

Medical Tourism for Non-medical Treatment

If you are wondering how to eliminate all your health problems without taking any medicine than there are many non-medical treatments available in different countries. There are many countries, each of them specialized in eliminating a particular type of health problem by procedures not involving any medical treatment or medicines provided by doctors. Thats the reason many people go for medical tourism in different countries for non medical treatments as well.

The country most famous for non-medical treatment is India. India is a type of country which is known worldwide for its ayurveda treatments. According to indian Ayurveda, life of a human being is a mixture of mind, senses,body and soul. According to ayurveda the structural aspect of every individual is made up of five elements, namely: water, earth, air, fire, and space. The laws of the nature govern it. The main aim of ayurveda is not only just treating diseases but to promote health in general. It takes care not just dealing with the physical aspects of a body but also spiritual health too. The magic of indian ayurvedic treatment is that, it not only cure diseases but also completely eliminate its root cause so that the disease dont come again. Many diseases arrive in body due to negative thoughts, emotions and poor thinking. Indian ayurveda doctors takes the emotional, mental, and spiritual well being also and medicine is rare. Ayurveda take care to understand each person at a very subtle personal level and giving a detailed description about daily routine, diet, life-style, actions and activities to be followed. This is one of the reason that medical tourism to India is spreading like nothing.

Another reason to visit india for medical tourism is to get non-medical treatments by Yoga and meditation. Many indian Yogis never get ill or sick as they have a routine to keep themselves fit through morning yoga and meditation. People from different countries visit India to learn Yoga and meditation from Indian Gurus. There are many Yoga centers for advanced yoga training in different cities of India offering non commercial ayurvedic treatments enabling people to focus exclusively on their health. Various types of treatments are given for health problems like depression, stomach problems, weight loss, stress, high and low blood pressure, diabetes, non-sleeping, addictions, beauty therapy and more. Indian Yoga involves Yogasanas(excersies in different body styles) for each type of disease or health problem. It benifit greatly if these exercises are added along with prayers and pujas. Indian yoga also involve meditation where one has to sit alone in a room in relaxed position and by closing eyes, have to see the thoughts coming in mind. This greatly helps to reduce extra thoughts in mind which is the root cause of most of the mental health problems. So visting India for medical tourism is must if you need non-medical treatment.

Another great reason why people visit to India for medical tourism is to get their health back through Siddha medicine which is a non-medical treatment using a variety of herbs and minerals, many of which were developed in the ancient past under advanced scientific techniques, even by today's standards. Many chronic diseases, considered incurable in western medicine, can be treated successfully with Siddha medicine.

According to an article published in one of Indian newspaper, India is the country which provide the best of Western and Eastern healthcare systems. Indian Yoga, Ayurveda, and Siddha can be India’s gift to the world. Ayurveda is recognised as an official healthcare system in Hungary. Doctors in the West are increasingly prescribing Indian Systems of Medicine. More than 70 per cent of the American population prefer a natural approach to health. Americans are said to spend around USD 25 bn on non-traditional medical therapies and products. Thats the reason more and more, people from many other countries of the world are seeking out places where they can both enjoy a vacation and obtain medical treatment at a reasonable price and India is better place for medical tourism in every regard.

Medical Tourism: Quality Affordable Medical Care For The Uninsured

Most businesses acknowledge that there is nothing better than a personal testimonial from a satisfied client to boost their business. At the rate, those businesses specializing in medical tourism are receiving those rave reviews today; it is enough to inspire envy with a capital ‘E' among other industry leaders.

Without health insurance, the average household is one major medical bill away from bankruptcy, a possibility facing nearly 45 million adults in the United States today. Medical tourism representatives say they hear stories every day about the impact their business is making on the quality of people's lives both medically and financially, short and long term.

One company, Med Journeys, shared the letter below from the *son of a client for this article. The patient, rejected by the healthcare system in the U.S. decided that that the option to use medical tourism was his only alternative:

"My dad was one of the millions that lost his insurance last year and was facing a life in a wheelchair because he could not afford double knee replacement surgery. When a friend pointed him in the direction of your company, he was tired, in considerable pain, and more than a bit anxious over the thought of traveling to another country for surgery.

Understandably cautious, Dad went to great lengths to research the procedures as well as your company. He was pleased to find out that each journey is arranged through a respected, knowledgeable and trustworthy agent. He was even more pleased to find that each agent had established relationships with the most respected medical facilities in the world.

In the end, what made the entire trip possible was the amount of care and thought that went into the entire process, as well as the cost. Passport assistance, round trip airfares, all medical expenses including x-rays, anesthesia, surgery, pre & post op treatment, physical therapy, doctors, medications, hospital stay with one companion, and recovery at a beautiful guest house complete with meals was completely covered in one inclusive price!

From the moment my parent's plane touched down, they were taken care of in a manner that allowed them to focus on my Dad's health and well-being. Mom and Dad were met at the airport and taken to the hospital without any fuss or confusion. On the day of my Dad's surgery, my mother was able to relax on a beautiful hospital balcony in New Delhi. One of the world's finest orthopedic surgeons performed the surgery itself. This doctor has performed over 3500 joint replacement surgeries in his long career.

My parents returned home completely satisfied with their experience. Dad has repeatedly stated that because of your company he had complete confidence in, and indeed, experienced care in India far superior to any care he received recently in the states. He was also happy the way my Mom was treated and even encouraged to relax and sightsee while he was receiving therapy.

I am of course as delighted as my parents are. Dad still cannot get over the price of the surgery. His double knee replacement surgeries cost my Dad only 17% of the cost he would have incurred in the United States!

I would like to convey our thanks on behalf of our entire family. You have given us back our Dad." - R. L. (2009 - Reprinted with permission - Med Journeys)

Medical tourism is fast becoming a viable, alternative solution to the rising health care crisis facing the United States. Medical tourism advocates work continually to improve knowledge of the process and remove the myths surrounding the practice of medicine in foreign countries. In 2008 alone, an estimated 1.5 million people underwent surgery in exotic locations such as Thailand, Brazil, India, Costa Rica, Malaysia, and Singapore. Moreover, all the surgery performed is done at world-class hospitals by teams of surgeons and doctors educated at Princeton, Harvard, and Johns Hopkins.

Today's economic climate requires every individual to begin to think outside the box when it comes to getting quality affordable medical care. With the help of medical tourism, even those in desperate straits, may now think outside of the country when it comes to having their medical needs met and solutions to their healthcare problems resolved.

Get the Best Healthcare Cum Tourism Benefits With Medical Tourism

There are many people who avoid going on a vacation just because they are undergoing any treatment and they cannot waste their money in going on a vacation. Since everyone likes to explore new places, this seems quite disheartening that one is restraining him or herself just because of poor health. For people who cannot enjoy every brighter aspect of life just because of their poor health, medical tourism is such a service, which incorporates the finest tourism and medical benefits. In a broad sense, it can be defined as the provision of cost effective medical services in collaboration with the tourism industry; basically, this service is tailored for patients needing surgical and other kind of specialized treatments.

This service is facilitated by the corporate sector involved in medical care and tourism industry; moreover, both private and public sectors equally participate in providing people with the great medical tourism service. It refers to traveling to other countries to get specialized and cost effective medical care. People, who go for medical tourism, also experience the attractions of the destination country. Since, cost of healthcare services is very high, a patient can get cost effective but specialized treatment with it; at the same time he or she can also explore the beauty and culture of that country. It is quite true that the credit of making these services popular among global patients goes to globalization; it is global communication and unity that made it possible for every patient to have the best healthcare services in foreign countries. At present, n numbers of countries are conducting these double beneficial traveling and healthcare packages; these countries include a wide network of service providers such as airlines, hotels and resorts, traveling agents and hospitals so that a patient may get best care and services at every step.

Countries that are involved in medical tourism also offer numerous options for touring, visiting the attractions, shopping and exploring. These services are efficient enough to make one’s visit comfortable as well as memorable; in fact, a patient can also extend his or her package by paying some additional cost. Though India and South America are the most popular choices for medical tourism at present but as this industry is growing so rapidly, many other countries are also coming forward with excellent healthcare cum touring services. Since going abroad to have any specific treatment enclose a wide variety of benefits, every year more and more people are approaching these countries.

If you consider your health problems as a nightmare due to the high cost of treatments and healthcare services, then just go for medical tourism and explore the destination country with the best medical services. Definitely, it is the lure of affordable medical services that is making thousands of people move towards these countries. In fact, this lure is quite obvious, as these countries are not only rich in natural and historical beauty but are also equipped with various major hospitals. It is for sure that these healthcare centers and hospitals will never let you realize the shortage of any facility as they are well outfitted with latest technology and high-tech equipments.

The Concept of Medical Tourism

Medical tourism is the act of traveling to other nations to obtain medical, services. The concept medical tourism was initially coined by the travel agencies and the media as a catchall phrase to describe a fast growing industry where people travel to different nations to obtain medical services. Leisure aspect of traveling can be included on such a medical travel trip. It includes medical health care services (inclusive of elective procedure and complex specialized surgeries) like knee/hip replacement, heart surgery, dental procedures and different cosmetic surgery.

The idea of Medical Tourism is not a new one. The earliest recorded event of medical tourism dates back hundreds of years to when Greek pilgrims traveled from Mediterranean to the small place in the Saronic Gulf called Epidauria. This place was the sanctuary of the healing God Asklepios. Epidauria then became the original travel destination for medical tourism.

In the recent days, people would travel from all over the world to have surgery done in clinics in the United States; but, the changing political situation in the USA imposed unreasonable visa restrictions on many persons who in the past traveled with fewer restrictions (especially people from the Middle East). What emerged as a result of different factors, including the increasing cost of medical care service in the US, is a phenomenon which has insurance service providers, Third Party Administrators (TPA's) and self-insured organization evaluating a future stake in a burgeoning industry that has yet to be fully developed. This event in health care service is similar to the longstanding practice of sending manufacturing and service jobs offshore. However, many analyzers are surprised by the fact that services provided by medical professionals are now going the way of other industries. Likewise, few industry analyzers have noted that medical tourism will result to a $10 billion industry by 2009. The advantage to foreign doctors and clinics is obvious, but the future difficulty to American medicine remains unclear and a matter of contention in the American medical service community.

A combination of large numbers of factors has led to the recent increase in popularity of medical tourism the huge cost of healthcare in industrialized nations, the ease and affordability of international travel, and the advancement of technology and standards of medical service in many countries of the world.

A big draw to medical tourism is the convenience in comparison to that of other countries. Few nations that operate from a public health care systems are so taxed that it can take a long time, to get required medical care. The time duration spent for waiting for a procedure, such as a hip replacement, may be a year or more in Britain and Canada; however, in Singapore, Bangkok, Manila, Philippines or Bangalore, a patient may have their operation on the same day of their arrival. Additionally, many peoples are finding that insurance coverage either does not cover orthopedic surgery or charges unreasonable restrictions on the choice of the facility, surgeon or prosthetics to be used within the United States. Medical tourism for knee or hip replacements has came as one of the most widely accepted procedures because of the least cost and minimum difficulties concerned with traveling to and from the surgery. Colombia offers a knee replacement for about $5000 USD including all associated charges like FDA approved prosthetics and hospital stay over expenses.

Idea pushing medical traveling assumes lower health care services fess as well as the search for medical experts, quality of care, safety, and waiting times. In he nation Canada, the number of procedures in 2005 for which patients were waiting was 782,936. Again, in the same year, Canada recorded the highest level of health spending in its history.
As per the research found in an article by the University of Delaware publication, the cost of surgery in Bolivia, Argentina, India, Thailand, Colombia, Philippines can be one tenth of what it is in the United States and sometimes even less. A heart valve replacement that would cost US$200,000 or more in the U.S., for example, goes for $10,000 in the India and that also includes round trip airfare and a vacation package. Similarly, a metal free dental bridge costs $5,500 in the U.S. and $500 in India and only $200 in the Philippines, a knee replacement in Thailand with six days of physical therapy charges about one fifth of what it would be in the States, and Lasik eye surgery costs $3,700 in the U.S. is available in many other countries for only $730.

Medical tourists may come from any parts of the world and may seek necessary health care services such as cancer treatment and brain and transplant surgery as well as complementary or 'elective' services like aesthetic treatments. While the medical tourism component might be a huge draw for few Southeast Asia nation that focus on simple procedures. India is positioning itself the primary medical tourism destination for the most complex medical procedures in the world.

Medical Tourism: Seeking Affordable Healthcare Overseas

Because the cost of U.S. healthcare remains high, medical tourism could save an American patient thousands of dollars on procedures such as cosmetic or dental surgeries—as long as they are willing to travel to a foreign country where the costs are considerably lower. Foreign real estate investors can also indirectly benefit from the medical tourism industry, which appears to have a positive impact on the economies of developing destination countries.

The concept of traveling for medical care is nothing new, but the modern concept of medical tourism—traveling to foreign countries specifically for lower cost of care—has only emerged in the past 10 to 15 years, David E. Williams, cofounder and principal of MedPharma partners, and author of HealthBusinessBlog.com, said.

But “in a mainstream way it’s really only started to take off in the past year or two,” because more people are traveling around the world than they were ten years ago, and because the Internet has made long-distance communication more practical, he said.

The numbers of clients for MedRetreat, an American medical tourism services company, have nearly doubled each year since 2005, with approximately 200 clients in 2005, 350 clients in 2006 and 650 clients in 2007, Patrick Marsek, the company’s managing director, said.

Most clients are paying for health care procedures out of their pocket, specifically uninsured or under-insured American patients in need of costly medical surgeries, and clients who seek elective cosmetic or dental procedures, Marsek said.

“There’s a huge range of potential cost savings, anywhere from 50 to 80 percent depending on where [they] go and which procedures [are done],” Marsek said.

Medical tourism is most often for cosmetic surgery

It is possible for patients to pay for foreign medical expenses with money from their health savings account (HSA). As the number of people with HSAs increases, and people have to take more responsibility for their medical costs, medical tourism could grow even more.

Cosmetic and dental surgeries are the most popular procedures because “those are services that typically are not covered by insurance,” Williams said. Many patients travel to South or Central American countries such as Brazil, Argentina or Costa Rica for cosmetic procedures, where it is cost effective to travel and cosmetic surgery is advanced. For example, a full face and neck lift procedure could cost $12,000 in the U.S., while the same procedure could cost as little as $3,800 abroad, Marsek said.

In vitro fertilization procedures are also becoming popular because the cost of the procedure is high in the U.S., Williams said.

The savings for uninsured clients in need of cardiovascular or orthopedic procedures are perhaps the most dramatic because costs for those procedures are so exorbitant in the U.S. Hip replacement surgery, for example, could cost anywhere between $40,000 and $65,000 in the U.S., whereas a patient might pay between $8,000 and $18,000, which includes travel costs, to receive the procedure overseas, Marsek said.

Marsek said some of the least expensive destinations to receive hip replacement surgery are in India; however, “there’s [a different] price to be paid for going [there],” he said.

“It’s a huge culture shock for Americans to go to India,” Marsek said. “Patients should know that medical tourism is not only about receiving a high-quality procedure...it’s [also] about the total experience of when [they are] there. You have to be emotionally and psychologically prepared...as well as physically prepared.”

Quality of care

Patients might have questions about the quality of care overseas; however, one quarter of physicians in the U.S. are foreign-born, “so the concept of having a Thai...or an Indian physician is really nothing very new or very foreign to an American patient these days,” Williams said.

Furthermore, “people are also coming to realize that the U.S. health system, despite being the most expensive, is not perfect,” he said.

It’s difficult to figure out the quality of any particular overseas provider, and “if anything goes wrong you’re far away from your support network,” Williams said.

Consequently, patients should “do their homework” and work with a professional organization that has experience with overseas medical travel, Marsek said.

MedRetreat, for example, has performed extensive, on-the-ground due diligence on foreign hospitals that wish to participate in the medical tourism industry and has turned down more than half of candidate hospitals because they fell short of the company’s quality standards, Marsek said on a MedRetreat.com podcast.

Medical tourists can find high quality of care

Hospitals that participate in medical tourism usually reserve the highest quality of care and best physicians for international patients, Marsek said.

In terms of the actual procedure, “they really err on the side of caution overseas,” Marsek said.

“The absolute worst thing that could happen to a hospital overseas is to have a procedure go bad, and [for that patient to] come back to the U.S. and talk to CNN the next day,” he said. “That hospital could potentially be out of the medical tourism industry...forever.”

MedRetreat clients generally spend three times as much time in a hospital overseas than they would in the U.S. after having a similar procedure performed, Marsek said. Clients also tend to experience more hospitality—friendliness, compassion and caring—overseas.

“They’re not trying to push you out of the hospital,” Marsek said.

In a paper issued by MedPharma and MedTripinfo.com last fall, Williams and his colleague John Seus predicted that U.S. physicians, in general, will not object to medical tourism. Many U.S. physicians are familiar with foreign doctors, or are originally from foreign countries themselves, and understand the credibility of receiving care abroad, Williams said. Furthermore, physicians are probably not worried about losing business because of a shortage of physicians in the U.S. that is causing many patients to be turned away.

Thus far, the prediction seems accurate and there doesn’t seem to be any “huge outcry” by doctors against medical tourism, Williams said.

Considerations and risks of medical tourism

Quality of care abroad is not necessarily cause for concern, especially for patients who book their medical tour through a reliable company. However, other considerations about medical tourism should be taken into account.

First, patients need to decide whether or not opting for a medical tour makes sense, financially and physically. MedRetreat's website recommends “The $6,000 Rule.” A procedure that costs $6,000 in the U.S. would probably “realize a break-even scenario” if the patient elected to go abroad, because the overhead created by travel costs would cancel out the money saved for the actual procedure.

Nevertheless, some clients choose to go for the experience as well as the care, and Medretreat has “perpetual medical tourists,” Marsek said.

“Many people still choose to travel abroad to achieve complete privacy and anonymity, peaceful recuperation, and the avoidance of daily hometown distractions,” according to the MedRetreat website. The company’s clients enjoy a two- to three-week vacation in luxury accommodations following their procedure.

American patients with a medical condition should have their diagnosis performed in the U.S., Marsek said. After finding out what procedure needs to be done, they can ask the approximate cost and their physician should be able to give them “a ballpark figure,” he said. That figure can then be compared with the cost of having the same procedure performed overseas.

In addition to financial considerations, medical tourism is not physically appropriate for all patients, especially patients in need of high-risk medical procedures.

“We can’t [take patients in need of] quadruple-bypass [surgery] and facilitate those [procedures] overseas,” Marsek said.

Communication barriers are one cause of concern for medical tourists

Once a patient has traveled to a foreign country for care, he or she may face the risk of miscommunication resulting from a lack of familiarity with a foreign culture and language barriers, Williams said.

Because of all the risks involved, clients might want to have the option of canceling their procedure after they arrive in their destination country without taking a huge financial hit, Marsek said. MedRetreat promises to return the 20 percent deposit for a procedure if the client should change their mind after arriving. As a result, the financial risk to the client is only the cost of travel and cost of stay.

But none of their clients have ever felt the need to use this option, according to the MedRetreat podcast.

Refund policies vary between companies, so consumers should research multiple companies before making a decision.

Impacts on economic health

Foreign real estate investors might be interested to know that the impact on medical tourism destination economies should be “very positive,” according to Williams. Popular medical tourist destinations include developing countries such as India, the Phillipines and South and Central American countries, as well as fairly developed countries, such as Singapore and South Korea.

One important benefit of medical tourism for these countries is that the influx of international patients will create career opportunities that encourage foreign physicians to remain in their home countries as opposed to moving to the U.S. to make a living.

Furthermore, medical tourism has a positive impact “all the way down the economic ladder,” from high-educated occupations in medicine and hospital administration to the unskilled trades.

Overall, medical tourism will have a positive impact “directly by improving the health care infrastructure within a country, and indirectly because of all the new economic activity that’s generated and opportunity for growth,” Williams said.

Destination countries are realizing the value of medical tourism, and “there are [initiatives] at the government level or at the individual hospital level...to try to lure tourists from the [U.S.], Western Europe or Canada,” Williams said. As a result of the increasing supply of participating hospitals, an increasing number of medical tourism companies are emerging onto the scene to get between care providers and consumers to arrange medical tours.

As for the effects of medical tourism on U.S. health care costs, the direct impact will probably not be large, Williams said.

“At the end of the day...most procedures are not suitable for going abroad, and most patients, even if offered the opportunity, won’t take advantage of it,” he said.

Still, the secondary impact on the U.S. health care industry will be substantial; for instance, an increasing number of “mini-med plans” will begin covering medical procedures performed overseas. According to the results of a survey called Health Care Benefits: Eligibility, Coverage and Exclusions, medical tourism is already being covered by 11 percent of organizations surveyed—a surprisingly large number, Williams said.

“U.S. hospitals and physicians [will be] competing for the first time on an international basis and not just on a local or regional basis,” Williams said.

UNITED STATES: Medical tourism insurance for companies launched

Texas-based US Risk Underwriters has launched a new professional liability product for the medical tourism industry called MedTour Pro for Employers.

This and related MedTour products only cover treatment outside the US for US-based travellers, agencies and employers.

MedTour Pro for Employers is designed for US companies that provide freedom of choice to their employees, including an option to obtain medical services abroad.

The coverage is for damages caused by any actual or alleged negligent act, error or omission by the insured while providing options for medical tourism services. MedTour Pro for Employers is written by reputable insurance companies on a claims-made basis, with limits offered at US$1M, and a minimum premium of US$5,000. While MedTour for US-based medical tourism agencies offers a range of limits and a minimum premium of US$2,200.

The cover is designed to respond to employers’ needs whenever they are sued for any wrong-doing that is involved with administration of medical travel benefits.

“MedTour – Travel and Medical Complications” is a travel policy plus non-negligent trigger coverage that pays out when there is a complication without having to assess negligence. This is not available for individual purchase and can only be bought by an employer or a medical tourism agency.

The travel and medical complications package can either be automatically included in the agency fees, or offered as an option to customers. The first-known sale is to an American who went to Trinidad for cancer surgery, arranged by Mobile Surgery International (MSI).


http://www.imtjonline.com/news/united-states-medical-tourism-insurance-for-com

PHILIPPINES: Phillipines begins to market medical tourism

Official figures for 2008 revealing that less than 1,000 medical tourists, rather than the 100,000 plus that the country has regularly claimed, shocked Philippine authorities and hospitals into a rethink. Existing marketing has been all talk, little action and a total failure; so new ideas are needed quickly.

The Philippine Convention & Visitors Corporation (PCVC), a non-profit marketing division within the Department of Tourism, has appointed agency DM9 to develop a campaign to attract medical tourists. This could include road shows, videos for websites and brochures.

Another agency, Campaigns & Grey has a project from Makati Medical Centre, the country’s premier hospital, to market the hospital ahead of its 40th anniversary. The brief includes promoting Makati’s improved facilities and boosting its standing among other medical centres.

The Philippine Economic Zone Authority (PEZA) is helping develop medical tourism with incentives to health and wellness spas, and hotels; the latter being vital to places like Cebu, as there room shortages. PEZA has so far accredited two hospitals, St. Luke’s in Taguig and Cabrini in Cavite. St. Luke’s at the Fort is a 600-room, 1,000-doctor facility built at a cost of P9 billion and will open in October 2009.

St. Luke’s Medical Centre promotes itself by pointing out that the cost of a heart surgery at $10,000,is just a tenth of the $100,000 in the United States, and a third of what hospitals in Thailand, Singapore and Malaysia charge. The problem with cut-price offerings is that medical tourists are wary of prices that appear too low. The country will struggle until individual and national marketing understands why offering ultra-low prices backfires and scares potential customers away, and how other approaches are vital.

The Cebu city government here has given money to the Cebu Health and Wellness Council to help promote Cebu and its local health-and-wellness centres, hospitals and resorts as an international player in medical tourism and wellness. Hospitals, clinics, hotels

and travel operators that are partners of Cebu Health and Wellness will soon launch special packages for tourists where tourists can combine an executive medical check-up with a holiday.

Cebu Doctors University Hospital in January received 60 overseas patients, compared to an average of 10 a month in 2008. The hospital now aims for 100 foreigners a month for the rest of the year. It has rolled out a project to build suite rooms to accommodate foreigners. Most patients are Europeans in need of outpatient procedures, executive checkups, gastrointestinal procedures and heart surgery, not the Americans that everyone talks about. Cebu Doctors has new partnerships with hotels, travel operators and spas. The group sees Cebu as a top destination for spa and wellness, as an adjunct to medical services.

The Medical City has opened a satellite office in Tamuning to ease the paperwork for patients from Guam who want medical treatment at The Medical City.

All these projects are good, but the individual impact is small. What the country needs is for all those officials and politicians who have spent the last four years talking up how much they want medical tourists to come to the country, and making bloated claims on numbers, to spend money on proper marketing campaigns with selected targets, measurable results; combined with ensuring there are sufficient good quality hotels and hospitals to deliver the goods. Also, if the country wants American medical tourists, having just two JCI status hospitals is not enough.

www.themedicalcity.com

www.cebudoctorsuniversity.edu/hospital

www.makatimed.net.ph

www.stluke.com.ph

JORDAN: Economy not hurting Jordan medical tourism

Medical tourism, one of the main sectors of the national economy, has not been negatively affected by the global economic crisis, says the PHA.

Private Hospitals Association (PHA) President Fawzi Hammouri said Jordan is ranked by the World Bank as number one in the Arab world, and among the top 10 in the world, as a medical tourism destination. “ In order to maintain this ranking, we have to keep the current markets in the Arab world and find new ones in Africa, Europe and the US.”

New markets have already been opened in Chad, Nigeria, Russia, Azerbaijan and Kazakhstan, while plans are in place to open markets in Germany, the UK and the US.

The high quality and competitive cost of healthcare in Jordan have made the country an attractive destination for foreigners seeking advanced treatments that are unavailable or unaffordable in their home countries.

“The medical tourism sector annually generates over US$1billion in revenues and the number of foreign patients seeking treatment in the Kingdom stands at over 200,000 per year,” said Hammouri

The PHA encourages hospitals to get Joint Commission International accreditation. There are 61 private hospitals, 48 of which are PHA members and four have JCI status.

The PHA is working with hospitals to offer medical tourism packages to Americans and Europeans who come to the country for medical services with unprecedented packages. Hammouri explains, “ We will provide them with packages that are 25 per cent below market prices. This includes the plane ticket, accommodation and a visit to Petra to encourage tourism as well.”

Prime Minister Nader Dahabi wants the Health Care Accreditation Council (HCAC), and Ministry of Health, to enhance efforts to attract more patients, especially from Europe and the US. HCAC hospitals responded that it would help if the government made medical tourism exempt from sales tax. HCAC was established through a joint initiative between the Ministry of Health and USAID/Jordan as an independent national hospital accreditor; whereby HCAC hospital standards are accredited by an International accreditor of healthcare accreditation organisation ISqua .

www.pha-jo.com

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KOREA Are Korean hospitals ready for medical travel?

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Attracting more foreign patients has become of primary interest to the Korean medical community. Korea has advantages in high-quality medical services at relatively low prices. That is why the Korean government is allowing hospitals to market themselves to foreign patients.

Foreign patients travel to countries with different cultures and languages and entrust not only their health, but also their lives to doctors in another country. But Korean hospitals are squeezing medical tourism into existing premises. The international patient centre is often in annex, staffed by doctors and nurses who can speak foreign languages. Foreign patients experience problems communicating at Korean hospitals, which lack foreign-language signs.

There is a debate between those who want to spread the fruits of medical tourism around, and those who think that service quality can only be achieved by foreigner-only hospitals. The standard of medical care is high, but deficiencies in other service areas means there is a chance that Korea may end up losing foreign patients in the long term, despite some early successes. Reports suggest that some hospitals have not understood that while domestic patients may be content with delays and poor service, in medical tourism, the customer is king.

Last month, the Korean Medical Association conducted a survey of ten hospitals out of the 44 largest hospitals across the country, which are keen on attracting foreign patients. It showed that only four of them have assigned doctors to handle foreign patients, so nurses often have to act as translators.

The Ministry for Health, Welfare, and Family Affairs (MIHWF) and the Korea Health Industry Development Institute (KHIDI) have established a foundation to attract foreign patients; the Global Healthcare Service Association (GHSA). The GHSA will become a private corporation, help with domestic and international advertising to promote Korean healthcare, train hospital staff to deal with foreign patients, and prepare brochures on treatment fees for foreign patients.

www.kma.org/english/

www.krdkorea.com

UNITED KINGDOM: Inbound UK medical tourism

It is well documented that thousands of Britons leave the UK every year for dental and cosmetic surgery, with a minority going for medical treatment. But global medical tourism is a two way process: travel into the UK for healthcare has existed for many years, well before medical tourism became a business.In the UK, although numbers are unknown, anecdotal evidence suggests that it is concentrated on hospitals with an international reputation, almost all being in London. Some private and NHS hospitals actively seek out international patients, whether self-funded, insured or paid for by their governments. Others passively accept the business that has come to them for decades. The UK is more expensive than Asia but cheaper than the US or Middle East.

Great Ormond Street Hospital for Children trust is also looking to grow its international business both from Europe and further afield over the next few years. In the UK, HCA International owns six leading London hospitals; The Harley Street Clinic, The Lister Hospital, London Bridge Hospital, The Portland Hospital for Women and Children, The Princess Grace Hospital and The Wellington Hospital. Since the 1970’s many international patients have travelled to London for specialist patient care. The International Patient Centre (IPC) caters to the needs of patients from abroad, across all the hospitals. With offices in Kuwait, United Arab Emirates, Pakistan, Nigeria, Greece, Cyprus, Libya, Egypt, HCA offers an extensive network of access points for the medical tourist.

HCA will also look for expansion in countries where high quality specialised medical services at an affordable price are needed. Other hospitals have already taken opportunities abroad. Moorfields Eye Hospital has a clinic in Dubai; Moorfields Eye Hospital Dubai has seen over 2000 patients since opening in July 2007 in Dubai Healthcare City. Moorfields currently treats a significant number of patients in the UK from the Middle East.

www.ich.ucl.ac.uk

www.moorfields.nhs.uk

www.hcahospitals.co.uk

A Hair-Raising Experience

Hair transplant procedures have come a long way since the early 1950's. The “corn row” or “doll’s” hair look that was associated with hair transplantation has evolved into today's follicular unit procedure which, when done right, is undetectable even by a barber or hair stylist.

At the Bangkok Hair Restoration Clinic, hair transplantation is an out-patient procedure performed under twilight local anesthesia. The procedure usually lasts from four to eight hours depending on the number of grafts being transplanted and patients are discharged 15 minutes after the surgery is completed.

Modern techniques of surgical hair transplantation can restore lost hair and replace or re-shape your hairline with your own natural, growing hair, which needs no more care than the ordinary washing, styling and trimming you have always given it.

Hair transplantation is both an art and a science and involves removing permanent hair-bearing skin form the back and/or sides of the scalp (the donor area). Then, using magnification, the tissue is dissected into follicular unit grafts, each containing 1-4 hairs. These small grafts are then meticulously planted into the bald or thinning areas of the scalp (the recipient area) so as not to injure any existing follicles and at precisely the same angle as the natural hair. These very small follicular unit grafts enable the hair surgeon to create very natural, feathered hairlines, which do not have the abrupt, “pluggy look” that was commonly seen in the hair transplants of yesteryear.

While moderately effective medical treatments are offered in the form of pills and lotions, colored creams, sprays and powders that when applied to the scalp help to camouflage areas of thinning hair, and of course hairpieces and weaves, hair transplantation is the only type of hair restoration that will produce a natural appearance with the actual re-growth of real hair. A “fringe” benefit is the return of self esteem and confidence.

Economic woes hit Dubai’s health projects

The fate of a high profile international project indicates troubled times for Dubai’s healthcare building projects. Dubai’s third-largest property firm may cancel a proposed Formula 1 theme park if it fails to receive government cash or tap debt markets.

The project timeline for the proposed theme park has already been postponed. The plan was to fund the park with the sale of houses, but UAE property markets have collapsed and banks are unwilling to lend to the property sector.

Marriott International’s global expansion plans over the next five years of 30 new hotels in the Gulf region, including 17 new hotels in the UAE, nine in Saudi Arabia, three in Qatar and one in Bahrain. But construction is not going to be soon as the global economic slowdown hits, with the UAE’s hotel trade is suffering more than other Gulf countries. UAE hotels have slashed room rates in a bid to stimulate business.

The medical tourism industry in UAE is not immune to the global financial crisis either.

Indeed, Dubai’s attempt to take business from Asian medical destinations such as India by creating local brands to attract international patients maybe in jeopardy. DeveloperTatweer has apparently put some projects in its major project Dubai Healthcare City (DHCC) on hold.

The most well-known medical tourism project in the Middle East, DHCC is designed not only to attract medical tourists but also to reduce the need for residents to travel abroad to receive high quality treatment.

Although the government-owned business is keeping quiet about what it is or is not doing, details of some future projects have vanished from the DHCC website, and the sole survivor no longer gives expected completion dates.

The current debate is whether in tough times, medical tourism will accelerate in countries offering lower cost, or a lack of cash will reduce the demand for non life-threatening surgeries like cosmetic surgery, dentistry, and Lasik/laser procedures. Dubai’s problem is that by selling itself as a high-cost, high-quality destination, it loses out whichever argument is true. Healthcare tourism isn't recession proof, and new destinations will find it harder than ever to break into the market.

www.dhcc.ae/EN

CYPRUS: American expertise tapped for new medical facility

The University of Pittsburgh Medical Center (UPMC) and Leptos Group, a leading property and hotel conglomerate in Cyprus, are developing a world-class hospital that will offer a wide range of medical services to both local residents and foreign visitors in the Mediterranean island.

Under the 23-year partnership, UPMC will manage a new 100-bed hospital and the existing 36-bed Iasis Hospital in Paphos. With its global expertise in providing clinical, technological and hospital management services, UPMC will assist the new health complex in developing centres of excellence in the areas of oncology, transplantation, aesthetics, cardiology, orthopaedics and minimally invasive surgery.

The new hospital called Neapolis, which will be completed in three to four years, is an integral part of a mixed-use development project that includes a university, research centre, office park and luxury lifestyle housing, as well as retail, entertainment, cultural and leisure facilities. The project is one of the largest landscaped parks on the island.

Michael Leptos, chairman of the Leptos Group, said: “Despite the economic climate, we are confident that the new Neapolis health centre will be a success, filling the need for more health care options in Cyprus and alleviating long-wait times for many patients seeking specialised care. In addition, these facilities will be well positioned to attract patients from throughout the Middle East and Europe as medical tourism grows throughout the region."

UPMC's services in Cyprus will include on-the-ground senior management for the hospitals, staff training, equipment procurement and implementation of sophisticated information systems. UPMC expects to develop medical services that are now in short supply on the island, including comprehensive cancer services at Iasis Hospital.

UPMC already manages of two cancer centres in Ireland and it plans to develop at least 25 more cancer centres throughout Europe and the Middle East with partner General Electric Company.

In addition to the Neapolis project, UPMC's international portfolio includes management of the independent Beacon Hospital in Dublin, Ireland, and a leading transplant hospital in Palermo, Italy.

www.upmc.com

www.leptos.net/corporate.html

North India Spiritual Tour Allows You to Rediscover Harmony Through Yoga

India is where yoga was developed and practiced by the Gurus and yogis (and yoginis). Yoga, which is practiced by most Indians of all ages, has made India one of the most peaceful countries on the face of the earth. Think about it - mediation, yoga - all Indian principals of life. No matter if you’re a beginner to a highly experienced yogi or yogini, when you take a Spiritual Tour of India, you will go home with an understanding of yoga and meditation techniques taught by India’s masterful yogis themselves. By taking a spiritual journey, you can incorporate the peaceful lifestyle of India into your own life and go back home renewed, reenergized and peaceful.

The Spiritual Tours of India is not just about visiting Indian temples and other sites: this tour is about finding yourself. You’ll start out in Delhi, where you’ll have a chance to explore the old and new city of Delhi, including the 17th-century Red Fort, India Gate and the Raj Ghat, Mahatma Gandi (Father of the Nation) Memorial. Then it’s on to Rishikesh, home to the world’s oldest and largest population of Ashrams and yoga centers. For six glorious days you’ll be able to learn and practice yoga and meditation with the best yogis in the surroundings of ancient Ashrams filled with ancient, peaceful energy, or one of India’s newer yoga centers.

You’ll start each morning off with a yoga class at one of the many Ashrams or yoga centers. First you’ll visit the Omkaranda Ashram, also well known as Durga Mandi and the Swarg Ashrams, one of the oldest Ashrams in Rishikesh. While in Rishikesh, you’ll also have the opportunity to travel to the Vashist Guffa Cave along the Ganges River, where you will experience a profound meditation while in the cave. Next you’ll visit Devpryag, Karanprayag (an important city of the Hindus), and a few Karna temples. Last stop is Haridwar, one of the holiest places of Hindus in India, where you’ll visit the Sapt Rishi Ashram and the Sapt Sarovar, the holy temple of Daksha Mahadev and Sati Kund; the Maya Devi temple on the hill Bilwa Parvat; and the Maya Devi temple on hill Bilwa Parvat.

Finding peace and harmony is important for everyone in our stressful times. Yoga and meditation is the secret behind rediscovering harmony, and living a more peaceful and healthy life. Now you can learn yoga and meditation from India’s wisest yogis in the surroundings of ancient Ashrams, or India’s newer, world-class yoga centers. Classic Holiday’s Spiritual tour of India will be what you need to come back home renewed, reenergized and peaceful.