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Yo u r
G u i d e
t o
I n t e r n a t i o n a l
M e d i c i n e
Medical Tourism
ISSUE 9
El
Salvador
A Captivating Blend of
Quality, Warmth & Beauty
Pg 10
plus...
Surgical
Solutions for
Obesity and
Weight
Management
A Team Effort
Pg 32
© Copyright Medical Tourism Magazine
Brazilian
Style
Gluteal
Implants
Just a Few Hours
from Home
Pg 18
Improving
the Quality of
Healthcare
through
Accreditation
A Patient Perspective
March/April 2009
Pg 38
1
COSTA RICA
HOSPITAL CLINICA BIBLICA
www.hcbinternational.com
JORDAN
JORDAN SPECIALTY HOSPITAL
www.jordan-hospital.com
MALAYSIA
PRINCE COURT MEDICAL CENTRE SDN. BHD.
www.princecourt.com
MEXICO
CHRISTUS MUGUERZA
www.christusmuguerza.com.mx
HOSPITAL ALMATER, MEXICALI MEXICO
www.almater.com
HOSPITAL CIMA
www.hospitalcima.com.mx
HOSPITAL SAN JOSE TEC DE MONTERREY
www.hsj.com.mx
SANOVIV MEDICAL INSTITUTE, ROSARITO MEXICO
www.sanoviv.com/
SPAIN
CENTRO MEDICO TEKNON, BARCELONA
www.teknon.es
USP INSTITUTO UNIVERSITARIO DEXEUS
www.dexeus.es
SINGAPORE
MOH HOLDINGS
www.mohh.com.sg
SOUTH KOREA
SEVERENCE HOSPITAL
YONSEI UNIVERSITY HEALTH SYSTEM
www.yuhs.or.kr/en
SEOUL WOORIDUL SPINE HOSPITAL
www.wooridul.com
THAILAND
BANGKOK HOSPITAL MEDICAL CENTER
www.bgh.com.th
BUMRUNGRAD INTERNATIONAL
www.bumrungrad.com
UNITED KINGDOM
HCA INTERNATIONAL HOSPITALS
www.hcahealthcare.com.uk
United States
JACKSON MEMORIAL HOSPITAL
www.jhsmiami.org
BRAIN TUMOR CENTER, JOHN WAYNE CANCER
INSTITUTE AT SAINT JOHN’S HEALTH CENTER
www.brain-tumor.org
2
March/April 2009
Editorial
Big Brothers and Little Sisters
C
an you imagine the future of medical tourism held
in the hands of the World Health Organization?
Well yes, it may be in our cards to see Big Brother
organizations like the World Health Organization and World Trade
Organization looking at medical tourism as a trade in healthcare
services under GATT and the potential for sustainability.
In February, a group of academics met to discuss this
new growing industry and evaluate the potential effects on
public healthcare. Although the workshop was designed as an
information gathering session, the take away was clear: medical
tourism can have very positive effects on the public healthcare
systems in participating countries provided there is sufficient
planning to accommodate development in the public and private
sector as well as prevention of two tiered systems with only
“trickle down” benefits.
As we create our healthcare clusters, it is
think about the investment in the public sector
for investment in infrastructure to accommodate
patient flow and allow local patients benefits in
well.
important to
and the need
the increased
healthcare as
This is exactly the conversation that we had during the recent
“FAM Tour” to El Salvador. The Salvadorian Vice President
would like to attract Salvadorans living in the US to return to El
Salvador for healthcare. She found equally attractive the effect that
this growing demand for health services might have on the local
educational programs. Mandatory English teaching in secondary
schools would not only improve the postgraduate work force in
terms of employment opportunities, but the bilingual work force
brings in greater foreign investment and job opportunities for
floundering economies.
One of the major initiatives in El Salvador is for healthcare
providers to obtain English training programs for their medical
staff. This is the first of many efforts Little Sister Salvador is
planning for 2009. International Accreditation is also at the
top of its list, not only for its hospitals, but also its clinics like
cosmetic and dental clinics. Nowhere in Latin America is such
a national initiative taking place with such motivation.
The MTA’s organized FAM Tours provide member facilitators
the opportunities to enhance their provider networks while at the
same time providing valuable feedback to the provider countries
on how to improve their service offerings that ultimately would
be attractive to patients and enhance patient safety.
At a recent Health and Wellness Tourism Conference in
Antalya Turkey, the buzz was in the air as over a hundred health
and wellness providers gathered to learn more about this growing
industry. Turkey has a unique advantage over many destinations
due in part to the large number of internationally accredited
hospitals within the country, over 24 in total, providing the Joint
Commission International with a large percentage of its annual
revenues.
To take advantage of this opportunity, it will be critical in the
upcoming months for the various promotional groups to work
March/April 2009
3
together to create one voice for Turkish healthcare, a loud voice
talking about high quality. Another advantage for Turkey is the
opportunity to develop networks for continuity of care in the United
States. Under the support of TADAM (a Turkish American Medical
Group), Turkish Airlines and the Turkish American Chamber of
Commerce, great strides are being made to nurture the connectivity
required for such aftercare networks.
On April 16, 2009 a conference is being held in Chicago
to educate the medical community about medical tourism and
to attract insurance companies to the quality of care in Turkish
hospitals. Information about the congress can be found at www.
medicaltourisminturkey.org.
Also of interest to all of our members is the completion of the
first half of the pilot project stage of the MTA’s Medical Tourism/
Travel Facilitator Certification Program. Six of our members
have commenced the process and will look towards a successful
evaluation by the MTA’s first of three expected external surveyors.
Members achieving certification will be listed on MTA’s website at
www.medicaltourismassociation.com/certified-organizations.html.
The certification program of medical tourism facilitators is not
an evaluation of the quality of healthcare services. It is strictly an
evaluation of the “best practices” put in place, procedures and protocols
for the medical tourism services offered to patients. It provides
patients with the questions they may ask their facilitators and the
services they may be interested in receiving when travelling overseas
for healthcare. For more information about the program, please go to
www.medicaltourismassociation.com/certification.html. n
Renée-Marie Stephano is Chief Operating
Officer and a Founder of the Medical Tourism
Association, Inc., an international non-profit
organization that serves international healthcare
providers and medical travel facilitators in the
global healthcare industry. Renée-Marie is an
attorney licensed to practice law in the states
of Florida, Pennsylvania and New Jersey and
has a background in litigation and health law.
She is also Editor of the Medical Tourism Magazine, a journal
serving the global healthcare industry. It can be found online at
www.medicaltourismmag.com. Renée-Marie may be reached at
[email protected].
4
March/April 2009
The MTA Advisory Board includes
HE NASSER KHALIFA AL BUDOOR,
Assistant Undersecretary and Director - International Health Affairs, Ministry of
Health, United Arab Emirates
ROBERT K. CRONE, MD,
Former CEO of Harvard Medical International; Huron Consulting, Inc.
WILLIAM F. RUSCHHAUPT, MD,
Chairman, Global Patient Services of Cleveland Clinic, Cleveland, Ohio
JOHN F. HELFRICK,
Senior Consultant, Harvard Medical International; Boston, MA
METIN CAKMAKCI, MD
Anadolu Medical Center, Turkey
DR. JEAN-MARCEL GUILLON,
General Director, FV Hospital, Vietnam
DR. PERMYOS RUENGSAKULRACH, MD, PhD, FRCST, FCCP,
Cardiac Surgeon, Bangkok Heart Hospital; Thailand
BOBBY CHIA,
Managing Director, Bangkok Mediplex Co., Ltd., Bangkok
LEE CHIEN EARN, MD,
Senior Director, Healthcare Performance Group Ministry of Health, Singapore
JOHN A. LINTON, MD, PhD,
Director of International Health Care Center, Severance Hospital, Yonsei
University College of Medicine, Korea
MASSIMO MANZI,
Chief of Staff, Minister for Competitiveness, Government of Costa Rica, Costa Rica
DR. SANDEEPAN BHATIA, MD, MPH,
Owings Mills, Maryland
DR. UWE KLEIN,
General Manager, Europe Health, Munich, Germany
PRADEEP THUKRAL,
Group Head - International Marketing, Apollo Hospitals Group, New Delhi, India
DR. JAUME TORT,
CEO, Barcelona Centro Medico; Spain
GRANT R. MUDDLE, COO,
Global Medical Solutions LLC,Abu Dhabi, United Arab Emirates
MERI BAHAR,
Deputy General Manager, Marketing, Acibadem Healthcare Group, Istanbul, Turkey
ASHOKE CHAKRABARTTY,
Dy. General Manager - Biomedical Engineering, Indaprastha Medical
Corporation Ltd., New Delhi, India
DATUK MOHD RADZIF MODH YUNUS,
Chief Executive Officer of Institut Jantung Negara SDN BHD, Kuala Lumpur,
Malaysia
URSULA FRIEDSAM,
Managing Director, Pro Health Complete Care Service, Munich, Germany
DR. FAWZI AL-HAMMOURI,
Chairman of the Private Hospitals Association, Amman, Jordan
THOMAS HORSTER-MOLLER,
Hospitalscout.com, VIVAI AG, Germany
DR. PREM JAGYASI,
Chief Strategic Officer, Medical Tourism Association, Dubai, United Arab Emirates
DR. GIRISH JUNEJA,
Managing Director, Life Line Medical Services, Inc., Canada
MICHAEL KELLEN,
Senior Vice President Strategic Development, Assurant
WAYNE BRUCE,
Chief Executive, Ccentric Group, Australia
DR. OTTMAR SCHMIDT,
Director Marketing and PR, Welcare World Health Systems, Dubai, United Arab
Emirates
RENU GIDOOMAL,
Managing Director, Wellness Global Solutions
SEBASTIAN VIRAMONTES,
Commercial Director, Hospital San Jose Tec de Monterrey, Monterrey N.L., Mexico
KURT WORRALL-CLARE,
Advocate, Hospital Association of South Africa
DR. SHIN-HO LEE,
Executive Director for Industry Support for Korea Health Industry Development
Institute, Seoul, Korea
JULIO CESAR LOPEZ,
Sales and Provider Relations for Christus Muguerza, Col. Obispado, Monterrey,
N.L., C.P., Mexico
FATMA ABDULLA,
Chief Strategy Officer of Dubai Healthcare City; Dubai, United Arab Emirates
BRAD COOK,
International Benefits Director at Hospital Biblica Clinica; Costa Rica
KENNETH MAYS,
Hospital Marketing Director, Bumrungrad, Thailand
DR. SANJIV MALIK,
Regional Director, Max Healthcare; India
JONATHAN EDELHEIT,
President, Medical Tourism Association, Inc.; Palm Beach, Florida
RENEE-MARIE STEPHANO, Esq.,
General Counsel for Medical Tourism Association and Editor of The Medical
Tourism Magazine
CYNTHIA L. CARRION,
Assistant Secretary, Philippines Department of Tourism; Philippines
ELIZABETH BOULTBEE,
Head of International Business at HCA International Hospitals; London
STEPHEN M. WEINER, Esq.,
Chairman of the Health Law Practice of Mintz, Levin, Cohn, Ferris, Glovsky &
Popeo, P.C.; Boston, Mass.
DR. LEONID ANDROUCHKO,
Professor, International University in Geneva, Switzerland
SCOTT A. EDELSTEIN, Esq.,
Partner at Squire, Sanders & Dempsey, LLP; Washington D.C.
DR. B.K. RANA,
Deputy Director, National Accreditation Board for Hospitals and Healthcare
Providers (NABH), India
DANIEL BONK,
Executive VP ~ Central Region, Aurora Healthcare; Wisconsin
MARY ANN KEOGH HOSS,
Professor at Eastern Washington University; Washington State
March/April 2009
5
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March/April 2009
M E D I C A L TO U R I S M
EDITOR & PUBLISHER:
Renée-Marie Stephano, Esq.
ASSISTANT EDITORS:
Vivian Ho
Gabriella Vicuña
CONTRIBUTING EDITORS:
Jonathan S. Edelheit
Dr. Prem Jagyasi
Jessica Leopold
ONLINE MAGAZINE EDITORS:
Jessica Johnson
Jonathan Edelheit
REGULAR AUTHORS:
Alex Piper
Jonathan S. Edelheit
Michael Bina
David G. Vequist
Erika Valdez
Healthbase
Bill Cook
Vivian Ho
Dan Cormany
Gabriella Vicuña
CONTRIBUTING AUTHORS:
Chad Holloway
Gerardo Flore-Lima
Roberto Zelaya
Sherry Tenpenny
Hugh Slesinger
June Smailes
Nishant Bagadia
Josh Hanson
ART DIRECTOR:
Renée-Marie Stephano, Esq.
ART DEPARTMENT:
Grapixs Design
MAIN OFFICES:
10130 Northlake Blvd. Suite 214-315
West Palm Beach, Florida 33412
USA
Tel:561-791-2000
Fax: 866-756-0811
[email protected]
www.MedicalTourismMag.com
REGIONAL OFFICES:
Buenos Aires, Argentina
Dubai, United Arab Emirates
Istanbul, Turkey
Monterrey, Mexico
Munich, Germany
San Jose, Costa Rica
Seoul, Korea
Tel Aviv, Israel
Copyright © 2009 by Medical Tourism Magazine.
All rights reserved. Reproduction in whole or in part without
permission is prohibited.
March/April 2009
7
March/April 2009
Medical Tourism
AT A GLANCE
Editorials
Big Brothers and Little Sisters
3
As we create our healthcare clusters, it is important to
ask about the reinvestment in the public sector and the
need for investment in infrastructure to accommodate the
increased patient flow and allow the local patients benefits
in healthcare as well.
By Renee-Marie Stephano
Letter to the Editor
Features
Brazilian Style Gluteal Implants ~ Just a Few
Hours from Home
18
These days, firm buttocks with projection are considered
beautiful buttocks. Since the past decade, due to all types
of media, patients are becoming more educated regarding
different types of implants they can choose from in order
to improve specific parts of their body.
By Dr. Gerardo Flores Lima
Surgical Solutions for Obesity and Weight
Management ~ A Team Effort
32
Regardless of the procedure selected the most important
thing is that the surgeon is only one part of the cure, patients
must learn to control their diets and lifestyles. This is a life
altering decision and should be supported by the foundation
of a trained surgeon, psychological support and an educated
and motivated patient.
El Salvador ~ A Captivating Blend
of Quality, Warmth & Beauty
10
The key to the success of a country defining itself as a medical
tourism destination is found not only through the expertise of its
physicians, but also in the foundation and support provided by
its government. In El Salvador we found a terrific combination
of both.
BY RENEE-MARIE STEPHANO AND GABRIELLA VICUÑA
Bina Buzz
A Serious Marketing Problem
46
By Dr. Roberto Zelaya
By Michael Bina
Columns
Accreditation Corner
An Interview with Jeff Pearcy – Surgery
Facilities Resources
42
SFR was organized as a wholly owned subsidiary of the
American Association for Accreditation of Ambulatory
Surgery Facilities (AAAASF). AAAASF, the parent
organization, has been in business for twenty-eight years
providing accreditation of ambulatory surgery centers and
office based surgery centers in the United States.
Improving the Quality of Healthcare
through Accreditation: A Patient Perspective
38
The greatest concern of the majority of patients will be
how to choose the hospital where they are least likely to
suffer an adverse outcome. They will require reassurance
that the standard of clinical care, including management of
postoperative complications, is of the highest quality.
By Dr. June Smailes
8
March/April 2009
At The American Association for the Advancement of
Science, Page called scientists “great citizens,” but they
needed to become engaged in politics, in business and
the media to do more “great things.” Harnessing the full
potential of science and technology requires a much better
job of Selling of Science to policymakers, to business
leaders, and to the public. “Science,” he said, “has a serious
Marketing problem.”
Economics
Are You Providing a Top Notch Patient
Experience?
54
How do international hospitals successfully cater to the US
patient population? Surely it is essential to promote that
your hospital has the best-trained medical staff, a safe track
record of procedures, and an attractive pricing model, but
this is just the beginning.
By Alex Piper and Josh Hanson
The Effects of the World Economic
Recession On Medical Tourism
22
The world economic recession is having an effect on
medical tourism, but whether it is a positive or negative
effect depends on what country you are in and if you
are attracting medical tourists from new and emerging
countries. The most common question in the industry today
is, “How will the worldwide economic recession affect my
organization?”.
By Jonathan Edelheit
March/April 2009
Medical Tourism
AT A GLANCE
Partnering for Patients and Profit: Hospital
Developed and Owned Networks
58
As the medical tourism industry matures, hospital
partnerships will become increasingly important for a
number of reasons, ranging from simplified contracting to
improved customer service for payers and patients.
By Dr. Chad Holloway
Medical Tourism Economic Report ~
El Salvador
62
El Salvador is a land of amazing beauty and has experienced
much growth over the last ten years. During this period, the
country has adopted the US dollar as its currency (2001),
continued to move towards a free-market democracy,
engaged in a countrywide modernization, and became the
third largest economy in Central America.
Medical Tourism Consumer Conferences ~
Good Idea or a Failure?
50
By David Vequist
Investigating Medical Tourism Beneath the
Surface
66
As healthcare globalizes at a rapid scale it introduces
local complexities for a variety of players: patients and
their families, countries, hospital providers and their staff,
medical technology and pharmaceutical corporations,
accreditation agencies and regulatory bodies.
IBMS ~ Qualifying Surgeons Worldwide
An Interview with Dr. David Kalin
78
by renee-marie stephano
News & Insights
Patient Perspectives
With growth of medical tourism projected to skyrocket
in the next decade, now is the time for hotel properties to
consider their interest in serving this special type of guest.
There are many approaches and considerations that can
influence how a particular hotel may approach serving this
clientele.
The True Value
80
Medical Tourism Association Efforts to
Support Local Accreditation & Quality
Over the past year The Medical Tourism Association has
been working with many governments throughout Latin
America and other regions of the world to help them
understand the importance of increasing healthcare quality
in their country not just for medical tourists, but also for
the local patients.
The true value of health can never be measured in dollars
or consumables. As the costs from the loss of serenity,
harmony and quality of life are steadily rising in correlation
to our own self neglect and increasingly crushing and
fermented economic footprints, it is the celebration of
life’s regeneration that makes living joyful, meaningful
and fulfilling.
By Hugh Slesinger
By Dan Cormany
16
Patients have many decisions to make when traveling for
medical care. Assisting patients and their travel associates
in making informed choices about their international health
care needs is the reason the International Board of Medicine
and Surgery (IBMS) exists.
By Nishant Bagadia
The Physical Innovation of Hotels in Medical
Tourism
74
In the medical tourism industry we have seen it all in the
area of medical tourism conferences. Last year there were
40 medical tourism conferences, or shall we say “almost
40.” Almost every conference organizer around the world
is giving it a “try” at putting together a medical tourism
conference.
Alternative Health
Unconventional Medicine in a Conventional
Setting
70
Complementary and Alternative Medicine, referred to in the
US as “CAM,” is a group of diverse medical and healthcare
systems, practices, and products that have historically fallen
outside customary approaches within Western medicine.
By Dr. Sherri J. Tenpenny
March/April 2009
9
El
Salvador
~
A Captivating Blend of
Quality, Warmth & Beauty
By RENEE-MARIE STEPHANO AND GABRIELLA VICUÑA
The key to the success of a country defining itself as a medical tourism destination is found
not only through the expertise of its physicians, but also in the foundation and support
provided by its government. In El Salvador we found a terrific combination of both.
10
March/April 2009
©
Copyright Medical Tourism Magazine
Familiarization (FAM) Tour
The MTA recently joined forces with EXPORTSALUD, the
Export Chamber of Medical Services in El Salvador to host a
Familiarization (FAM) Tour in which six different U.S. based medical
tourism facilitators had the unique opportunity to visit El Salvador,
to personally meet with the physicians promoting themselves in
Medical Tourism and to visit their clinics and hospitals.
Upon our arrival, after only a short 2 ½ hour flight from
Miami, we were greeted at El Salvador’s Aeropuerto Internacional
Comalapa in San Salvador by bright smiles and a warm embrace
from a magnificent group of members from EXPORTSALUD. They
welcomed us with the excitement and affection that only family
would offer.
During our visit we stayed at the Radisson Plaza Hotel, which
features some of the city’s most breathtaking panoramic city and
mountain views. It is connected to San Salvador’s World Trade
Center as well as many international businesses. The hotel is only
ten minutes away from cinemas, entertainment and three beautiful
malls: La Gran Vía, Multiplaza and the Galería.
are also amid the most popular beaches in the country. In an effort
to promote tourism, El Salvador has placed 14 tourist recreational
centers along the Pacific Ocean Coast, Central Mountain Range and
other areas of the inviting country. Needless to say, it is a tourism
dream and awaiting the arrival of patients who can combine their
high quality healthcare needs with a little bit of paradise.
Clinic Tours
Throughout the four days of the FAM Tour, the group was
welcomed into 14 different Clínical settings with specialties ranging
from dental, plastics and ophthalmology, to bariatric & weight loss,
orthopedics and cardiology. These physicians set time aside from
their busy schedules to meet with each of the facilitators, give them
a tour of their clinics and introduce them to their staff, providing
facilitators with a first hand look at what a medical tourist would
encounter when seeking treatment in El Salvador.
Country Focus
El Salvador is located in Central America, within the septentrional
zone giving it its year round warm climate. Bordered by Guatemala,
Honduras and Nicaragua, El Salvador has a population of roughly
7 million people with a size of 8,123 square miles. Since January
1, 2001 the U.S. dollar was accepted as legal tender and is now
the official currency throughout the country, which makes it very
accessible for stable pricing for medical tourism packages.
The White House has chosen El
Hospital de Diagnóstico as the
designated hospital for the President
of the United States in case of the need
for medical treatment during his visits
to El Salvador.
Its principal exports include coffee, textiles, cotton, sugar and
seafood. Additionally, El Salvador is the only producer in the world
of Balsam, which is used for the manufacturing of pharmaceutical
and cosmetic products. Although El Salvador is the smallest country
in Central America, it consists of extensive valleys, broad plains,
volcanoes, the Sierra Madre mountain chain and the Pacific Coast,
not to mention the third largest economy in the region.
There are over twenty-five inactive volcanoes throughout the
entire country with Santa Ana as the tallest Volcano at 7,804 feet
above sea level. The intricate river system of El Salvador is divided
into ten different basins according to the climate, geography and
vegetation. Two hydroelectric dams are located in the Lempa River
supplying the country’s electric power needs. The three main lakes
in El Salvador are Ilopango, Coatepeque and lastly, Guija, which is
shared with Guatemala. All of them provide a tremendous about of
ecotourism possibilities.
El Salvador has 184 miles of alluring Pacific Ocean coastline
made up of geological structures such as vast cliffs and large rock
formations covered with rich, tropical vegetation. The Litoral
Highway connects all of El Salvador’s captivating beaches from
the West Coast to the East Coast. These beautiful beaches include
Los Cabonos, Metalio and Playa Dorada, which offer exciting
recreational activities and private beach clubs. Among others
are San Diego and Costa del Sol, where events and competitions
generally take place. El Espino, El Cuco and the Gulf of Fonseca
Lunch was graciously sponsored by the Ministry of Tourism
every afternoon during the FAM Tour. MiTur did an outstanding job
choosing the locations each day, exposing the group to tourism and
recreational areas such as the Grand Vía (for shopping and restaurants)
and Esperanto, a beautiful cliff top restaurant overlooking one of the
top surfing destinations in the world. This provided the group the
opportunity to come together, discuss their observations and share
their thoughts.
Hospital Tours
The two hospitals included in the FAM Tour were El Hospital de
Diagnóstico and El Hospital de La Mujer.
Dr. Rodrigo Brito, director of El Hospital de Diagnóstico
personally greeted the group in the hospital’s conference room, gave
an enlightening presentation and provided valuable information
about the hospital. “Diagnóstico” combines a modern hospital with a
team of over 100 distinguished physicians and offers an outstanding
Diagnostic Medical Imaging Center and a Clínical Laboratory with
cutting edge technology. Currently the nurse to patient ratio is 2 to 1
and 251 foreign patients were treated at El Hospital de Diagnóstico
in 2008.
Dr. Brito provided a tour that included Operating Rooms, the
Intensive Care Unit, the Radiology Department and the newly
renovated International Patient Suites. These beautiful suites are
equipped with flat screen TVs with complementary cable, wireless
Internet access and each suite has its own balcony offering patients
March/April 2009
11
a stunning view of San Salvador. Additionally, there are also suites
available with a connecting room for the patients’ families that
provides the perfect level of privacy for both parties. The U.S. White
House has chosen El Hospital de Diagnóstico as the designated
hospital for the President of the United States in case of the need for
medical treatment during his visits to El Salvador.
El Hospital de La Mujer was the second hospital visited. The
group was given a presentation on the services offered and later
taken on a tour of the facility which included Operating Rooms and
the Intensive Care Unit.
El Salvador Medical ~ High Expertise
El Salvador Medical is a group of talented and very well educated
physicians that have come together to offer their patients top quality
healthcare in El Salvador. Having all trained in the United States for
their pertinent specialties, they possess the knowledge and empathy
necessary to treat international patients.
Having all trained in the United States for
their pertinent specialties, they possess
the knowledge and empathy necessary to
treat international patients.
Dr. Rafael Lorenzana
Dr. Rafael Lorenzana is an American Board Certified dentistprothodontist specializing in dental implants. Dr. Lorenzana received
his Doctorate in Dental Surgery in El Salvador and then went on to
the University of Texas Health Science Center where he became
certified in Occlusion and Fixed Prosthodonics. Dr. Lorenzana
received a certificate in Prosthodontics from the Medical University
of South Carolina followed by Baylor College of Dentistry in
Dallas, Texas where he received his Doctorate in Dentistry and was
later hired as a Professor for many years.
Dr. Lorenzana is certified by the American Board of Prothodontics
and a Fellow of the American College of Prosthodontics. Along
with being a member of El Salvador Medical, Dr. Lorenzana
owns Lorenzana Dental Center, in San Salvador where he offers
his patients over 30 years of teaching experience, quality dental
material, advanced dental equipment and well trained staff which
communicates efficiently in both Spanish and English.
Herb Stevens, CEO of Health Travel Guides was one of
the facilitators that participated in the FAM Tour and became a
medical tourist himself during the tour. “While in El Salvador, I
had the opportunity to put my mouth where my money is. During
the familiarization tour, after meeting one of the top dentists in El
Salvador, Dr. Rafael Lorenzana, I actually sat in his dental chair and
had a titanium dental implant procedure. I had cracked a tooth a few
weeks before the trip and had received quotes from two dentists in
the U.S.,” he boasted. “I am very happy to report that my experience
with Dr. Lorenzana was excellent and that I saved over 60% (from
the lowest U.S. quote) on the implant. His dental clinic is world
class and I would highly recommend him to everyone,” he added.
Dr. Jaime A. Flores
Dr. Jaime Flores is an Orthopedic Surgeon specializing in
Arthroscopic Surgery and Total Joint Replacement Surgery. Dr.
Flores received his Medical Doctorate from the Universidad Nacional
de El Salvador. He then attended The State University of New York
at Buffalo as well as The University of Toronto in Ontario, Canada
to specialize in Orthopedic Surgery. Dr. Jaime Flores’ memberships
12
March/April 2009
include The American Academy of Orthopedic Surgeons, The
College of Physicians and Surgeons of Ontario, Canada as well as
La Asociasión Salvadoreña de Ortopedia y Traumatologia.
Dr. Gerardo Flores-Lima
Dr. Gerardo Flores-Lima is a Plastic Surgeon with vast
experience and an impressive educational background. Dr. FloresLima received his Medical Doctorate from the Universidad
Evangélica de El Salvador. He then completed his General Surgery
Residency at HMC in El Salvador and went on to complete a Plastic
and Reconstructive Surgery Residency at Pontifica Universidad
Católica in Argentina as well as at Clínica Raúl González in Sao
Paulo, Brazil where he specialized in Gluteal Implants.
Dr. Flores is one of only four plastic surgeons in the world who
has published articles regarding Intramuscular Gluteal Implants. Dr.
Flores-Lima completed his Fellowship Training in Plastic Surgery
at Indiana University, Purdue University of Indianapolis (IUPUI)
Medical Center in Indianapolis, Indiana. Among the services Dr.
Flores-Lima offers his international patients, he has implemented
a concierge service in his clinic which provides patients and their
families with tourism information about El Salvador and assists
them in coordinating leisure activities.
Dr. Roberto Zelaya
Dr. Roberto Zelaya specializes in Bariatric and Weight Loss
Surgery as well as Gastrointestinal Surgery & Endoscopy. Dr. Zelaya
received his Medical Doctorate from the Universidad Evangélica in
El Salvador. His training includes the Research Institute for Cancer
of the Digestive System at Louis Pasteur University in Strasbourg,
France. Dr. Zelaya then completed a fellowship at Ohio State
University Medical Center, at the Center for Minimally Invasive
Surgery in Columbus, Ohio. Dr. Zelaya also completed a fellowship
at the Hospital Clinic of Barcelona in Barcelona, Spain. Along with
being a member of El Salvador Medical, Dr. Zelaya is the owner of
Gastrointestinal Surgery and Endoscopy Clinic in San Salvador. He
offers treatments for obesity including Intragastric Balloon, Sleeve
Gastrectomy, Gastric Bypass, and Adjustable Gastric Band. Dr.
Zelaya is a member of the International Federation of Surgery for
Obesity.
López Beltran Ophthalmology Clinic
The family-owned López Beltran Ophthalmology Clinic offers
its patients over fifty years of experience in the art of visual care.
Together, Dr. José Francisco López Beltran Sr., Dr. José Francisco
López Beltran Jr., Dr. Carlos Andres Lopez Beltran and Dr. Lourdes
his country offered him and his family.” Dr. Zaldívar is currently
a member of The American Society of Plastic and Reconstructive
Surgeons as well as The American Society for Aesthetic Plastic
Surgery.
During our visit to Clínica Zaldívar, he shared the exciting new
project of opening a new State of the Art Outpatient Clinic, set to
be ready December 2009. The architect designing the clinic is Juan
Pedro Alvarez, who has a Design Studio in Los Angeles, California.
The facility offers multiple VIP entries, allowing inconspicuous
arrivals, personalized attention, and retreat from the outside world
to relax and recover in luxurious accommodations.
Working within the existing 600 square meter facility, are two
state-of the-art operating rooms with recovery areas, 2 private
recovery rooms for overnight stay, a doctor/nurse change room,
2 consultation rooms, physician’s office, a common waiting area
and 2 private waiting rooms where patients are educated about
their upcoming procedures through LED touch screen monitors,
along with staff support areas. Combined in the same space is a
medical spa where patients can receive different types of skin and
rejuvenation treatments. Backlit suspended soffits and over and
under-lit white walls dematerialize boundaries.
Amato de López offer an impressive educational foundation and
pride themselves in being the pioneers in Central America with over
ten thousand refractive surgeries. Utilizing top of the line equipment
such as Alcon, the López Beltran Ophthalmology Clinic provides
services such as Ocular Ultra Sounds, Angiography, Biometrics,
Ocular Tomography, 3D Ocular Topography, Paquimetry, Yag Laser,
Argon Laser and Digital Campimetry.
Their educational experience includes the Universidad
Autónoma de Guadalajara in México, Universidad Autónoma
de Centro America in Costa Rica, Moorfields Eye Hospital in
London, Perth in Scotland, Hospital Roosevelt in Guatemala as
well as Shands Hospital at the University of Florida in Gainesville,
Florida. Their memberships include the American Academy of
Ophthalmology, American Society of Cataract and Refractive
Surgery, Central American Society of Retina and the Salvadoran
Society of Ophthalmology.
El Hospital de Diagnóstico is also part of El Salvador Medical,
allowing the group to create complete package deals for international
patients which were shared with the group of facilitators during
their visit.
El Salvador Medical held a dinner for the FAM Tour at a beautiful
country club in San Salvador called Club Campestre. Each physician
gave a presentation on their specialty and expressed their enthusiasm
and commitment to make El Salvador a top destination of choice for
medical tourism. What was most beneficial for the facilitators was
the ability to get to know the physicians on a personal level and
further discuss business opportunities. You may learn more about
this medical group at www.elsalvadormedical.com.
Clínica Zaldívar ~ Raising the Bar in Cosmetic
Procedures
Dr. Román Zaldívar is an American Board Certified Plastic
Surgeon who completed his General Surgery Residency at Jackson
Memorial Hospital in Miami, Florida and his Plastic, Reconstructive
and Maxillofacial Residency at the University of Pittsburgh Medical
Center in Pennsylvania. Dr. Zaldívar returned to Miami to complete
a fellowship in Aesthetic Surgery and was in private practice for 5
years in Miami before returning to his native land of El Salvador to
open his privately owned Outpatient Clinic, “Clínica Zaldívar.”
We had the opportunity to interview Dr. Zaldívar in San
Francisco in September 2008 during our first annual World Medical
Tourism & Global Health Congress. Dr. Zaldívar shared that part
of the reason he returned to El Salvador was, “the quality of life
Surgical Specialties Abroad ~ Partnerships for
the Delivery of Quality
Dr. Carlos Ramos Hinds
Dr. Carlos Ramos Hinds, president of EXPORTSALUD,
founded Surgical Specialties Abroad, which consists of eight
excellent and passionate physicians. Dr. Ramos Hinds specializes in
laparoscopic surgery. He received his Medical Doctorate from the
Universidad Evangélica de El Salvador and completed his General
Surgery Residency at Hospital Nacional Zacamil, Hospital Nacional
Rosales and Hospital Regional San Juan de Dios San Miguel. Dr.
Ramos specialized in Video Laparoscopic Surgery at the Hospital
Nacional Zacamil and the Universidad Evangélica de El Salvador.
He then completed a fellowship in Video Laparoscopic Surgery at
the Louis Pasteur University in Strasbourg, France. Dr. Ramos is
extremely motivated and has certainly been a driving force in the
growth of medical tourism in El Salvador.
The all around patient experience
depends of the interaction with not only
the physician, but his or her staff as well.
Dr. Adrián Avendaño Valiente
Dr. Adrián Avendaño Valiente specializes in dental implants
and periodontics. He received his Doctorate in Dentistry from the
Universidad Salvadoreña Alberto Masferrer and specialized in
periodontics Universidad Autónoma de Nuevo León, in Monterrey,
México. Dr. Avendaño works with the latest technology and has
structured his office in a way that makes his patients feel as if
they were home. Dr. Avendaño is the President of The Salvadoran
Periodontal Association as well as an International Member of
the American Academy of Periodontology, the Salvadoran Dental
Association and the UANL Periodontal Postgraduates Association.
Dr. Julio Rodriguez
Dr. Julio Rodriguez specializes in dental implants & oral
rehabilitation. Dr. Rodriguez received his Medical Doctorate from
the Universidad Evangélica de El Salvador and completed his
Implantology and Oral Rehabilitation Residency at UCLA School
of Dentistry in Los Angeles, California.
March/April 2009
13
Dr. Augusto A. Magaña
Dr. Augusto A. Magaña specializes in Orthopedics. Dr. Magaña
received his Medical Doctorate from Universidad Salvadoreña
Alberto Masferer and completed his General Surgery Residency
in the Instituto Salvadoreño del Seguro Social. He then continued
his education at Hospital Nacional Zacamil, Hospital Ángel del
Pedregal in México and Universidad del Estudio in Milan, Italy.
Dr. Magaña’s memberships include the Asociación Salvadoreña
de Ortopedia y Traumatología and the Asociación Mexicana de
Ortopedia y Traumatología.
Dr. Mauricio Guerrero
Dr. Mauricio Guerrero a plastic surgeon who received his
Medical Doctorate from the Universidad Alberto Masferrer and
Autónoma de México. Dr. Guerrero completed his Plastics and
Reconstructive Surgery Residency at the Hospital Nacional Rosales
and the Universidad de El Salvador.
Dr. Iván Solórzano
Dr. Iván Solórzano specializes in ophthalmology and received his
Medical Doctorate from Universidad de El Salvador and completed
his Ophthalmology Residency at Hospital Nacional Zacamil, Dr.
Juan José Fernández in San Salvador. Dr. Solórzano was awarded
the Gillingham Scholarship and continued his education at Tulane
Univeristy Medical Center in New Orleans. He then completed
a fellowship in the area of glaucoma at The Kentucky Lions Eye
Center at the University of Louisville in Kentucky. Dr. Solórzano’s
memberships include the Sociedad Salvadoreña de Oftalmología
de El Salvador, Sociedad Salvadoreña de Glaucoma, Sociedad
Salvadoreña de Retina y Vítreo, the International Glaucoma Society,
the American Academy of Ophthalmology and the American
Medical Association.
Dr. Boris Ferman Sampson
Dr. Boris Ferman Sampson specializes in anesthesiology and
received his Medical Doctorate from the Universidad Evangélica
de El Salvador. He completed his General Surgery Residency
and Anesthesiology Residency at Hospital Medico Quirúrgico
del ISSS. Dr. Ferman’s memberships include the Asociación de
Médicos Anestesiólogos de El Salvador, founder and member of the
Asociación Cooperativa de Médicos Anestesiólogos, Dr. Ferman is
a member and co-founder of the first Anesthesiology Radiofrequent,
Oxygen and Ozonetherapy Equipment for pain management in El
Salvador.
Dr. Gerardo Roberto Sosa
Dr. Gerardo Roberto Sosa specializes in Anesthesiology. Dr. Sosa
received his Medical Doctorate from the Universidad Evangélica
in El Salvador. He completed his General Surgery Residency and
Anesthesiology Residency at Hospital Medico Quirúrgico del ISSS,
where he is now the coordinator of the Emergency Department.
During the dinner Surgical Specialties Abroad hosted for the
FAM Tour Surgical Specialties Abroad gave a very informative
presentation and shared one of their internal quality indicator projects
with the group. This project will benefit not only international
patients, but local patients as well because the overall standard of
care will be improved. This is truly a dynamic group of physicians
that offer their services with a touch of Salvadoran hospitality.
FAM Tour Press Conference
A press conference was held at the Radisson Plaza Hotel and
the four key speakers were the vice president Ana Vilma Albanez
de Escobar, the Minister of Tourism Ruben Rochi, the president of
EXPORTSALUD Carlos Ramos Hinds and Renée-Marie Stephano,
COO of the Medical Tourism Association. Ruben Rochi boasted,
“The excellent infrastructure of roads and highways is just another
added advantage, since patients can benefit from leisure tourism
14
March/April 2009
exploring El Salvador’s mountaintops, archeology sites and beaches
throughout their treatments.”
Government Support ~ Medical Tourism in
High Priority
Agencies such as EXPORTSALUD, EXPORTA, PROESA
and MiTur have committed to aid the healthcare industry in the
country through the establishment of protocols, promotion and even
allocating a budget for the purpose of medical tourism growth solidifying the government’s commitment in making El Salvador a
viable medical tourism destination.
The vice president of El Salvador, Ana Vilma Albanez de Escobar
welcomed the group in the Presidential House, where we also had
the opportunity to meet with EXPORTA, the government program
responsible for exporting El Salvador’s products and services
abroad and PROESA, the country’s Investment Promotion Agency.
“This enormous niche market is precisely what El Salvador seeks
to attract, taking advantage of its convenient geographic location,
American currency and excellent value in its healthcare services,
clinics and private hospitals,” stated Ana Vilma Albanez de Escobar.
Among the topics discussed was the issue of implementing English
courses into El Salvador’s education system, as this is imperative to
ensure the success in international patient treatment.
Though the physicians we encountered during our visit were
bilingual and had the opportunity to study abroad, many of the
nurses and the staff did not have the same exposure and being such
an important part of the equation, it is vital for them to have the
opportunity to receive English courses and become familiar with
medical terminology in English as well. The all around patient
experience depends on the interaction with not only the physician,
but his or her staff as well.
Accreditation ~ In the Works
One of the most challenging aspects for El Salvador to be
competitive in the global market for medical tourism is the need for
international accreditation. Although the quality of the healthcare
services is evidenced through the experience and the outcomes of
the surgeons, patients and insurance companies are looking for
international accreditation as an assurance of a certain standard for
quality.
In response to this market demand, the hospitals and clinics have
been assessing the best options for international accreditation using
accreditation schemes such as Joint Commission International,
Trent Accreditation, Accreditation Canada and Surgical Facilities
Resources, a Clinical accreditation program. The decision of
which accreditation systems or combinations of systems will be
used ultimately will come down to affordability and return on
investment.
For El Salvador, the interest in attracting American patients is
of the highest importance with Canadian and European patients
falling next in line in terms of market potential. It is estimated that
accreditation processes will commence this year. El Salvador is in
the unique position to have the cooperation of EXPORTSALUD,
USAID and BID to assist the facilities in obtaining international
accreditation for a large number of their healthcare clinics making
El Salvador the first country in Latin America to focus on their
clinics for the exportation of healthcare services.
The FAM Tour proved to be a huge success and an incomparable
networking opportunity for international healthcare providers and
medical tourism facilitators.
ExportSalud, El Salvador Medical, Lorenzana Dental Center and
Zaldívar Cosmetic Clinic are all members of the Medical Tourism
Association. n
March/April 2009
15
Medical Tourism Association
Efforts to Support Local
Accreditation & Quality
Over the past year The Medical Tourism Association has been working with many
governments throughout Latin America and other regions of the world to provide
educational programs about the importance of improving healthcare quality in their
country not only for medical tourists, but also for their local patients as well.
16
March/April 2009
standards is paramount to the delivery of high quality healthcare
services to patients and high positive patent outcomes. Governments
have an increased awareness of the economic and social benefit of
encouraging the use of international standards and accreditation in
growing their healthcare infrastructure and attracting new healthcare
projects and investors into the country. Investors are not likely to
build new healthcare facilities in regions or countries where there
is no strong underlying medical system and where the government
fails to provide for a high quality healthcare system.
Education is the key to raising awareness options regarding
international accreditation. More and more governments realize
the benefits of investing in accreditation as a national program and
the sustainability resulting from protecting the public sector in the
process. There are competing accreditation schemes, however.
We use the word “competing” because international accreditation
has become “big business,” and many of the accreditation systems
are aggressively trying to out-position the others in new regions
or countries, and establish themselves as leaders in international
accreditation.
Governments understand the
importance of these standards
and accreditation in attracting new
healthcare projects and investors.
M
edical Tourism has many valuable benefits in addition
to bringing in revenue from foreigners. Some of
the positive aspects include improving the quality
of healthcare facilities and increasing the number of international
accredited healthcare facilities. As more medical tourists travel
internationally, more investors build new hospitals, clinics and
expand existing facilities. As global competition increases, top
international hospitals compete on the medical technology side,
each trying to outdo the other with the latest and most advanced
medical technology. In the end, it can be the local patient who
benefits, having improved access to advanced medical technology
they otherwise would not have had.
As one if its tenets and missions, the Medical Tourism Association
is committed to transparency in the quality of healthcare for foreign
and local populations and assisting hospitals and governments in
understanding the importance of accreditation, both nationally and
internationally. Healthcare standards and the enforcement of those
In the end it is the local patient who
can benefit, having better access to
advanced medical technology.
What unfortunately results in a loss in this competition are
the needs of the local population and the hospitals and clinics that
do not have the financial resources for international accreditation
get pushed to the wayside. Through an integrated and systematic
approach to medical tourism, ministries of health and ministries
of tourism can work together to take advantage of the benefits of
international accreditation to raise the standards of healthcare in the
entire country, both in the public and private sectors. Reinvestment
in the public healthcare sector combined with preventative medicine
and educational health programs may be a direct result of the rewards
of medical tourism initiatives. The MTA looks forward to working
with numerous governments in their efforts in designing sustainable
and national healthcare initiatives in this regard. Educational
partnerships are available to assist in setting up healthcare clusters
and in developing programs to improve the quality of healthcare in
the regions.
As an industry it is important that we come together to protect
national populations while attracting international patients, using
opportunities of growth and investment to expand existing healthcare
systems and maintain high positive patient outcomes globally. n
For more information about educational programs offered through
the MTA, please contact [email protected].
About the Author:
Renée-Marie Stephano is Chief Operating Officer and a Founder of
the Medical Tourism Association, Inc., an international non-profit
organization that serves international healthcare providers and
medical travel facilitators in the global healthcare industry. RenéeMarie is an attorney licensed to practice law in the states of Florida,
Pennsylvania and New Jersey and has a background in litigation and
health law. She is also Editor of the Medical Tourism Magazine, a
journal serving the global healthcare industry. It can be found at
www.MedicalTourismMag.com. Renée-Marie may be reached at
[email protected].
March/April 2009
17
Brazilian Style
Gluteal
Implants
Just a Few Hours from Home
By Dr. Gerardo Flores-Lima
These days, firm buttocks with projection are considered beautiful
buttocks. Since the past decade, due to all types of media, patients are
becoming more educated regarding different types of implants they
can choose from in order to improve specific parts of their body.
18
March/April 2009
©
I
strongly believe that food connoisseurs would passionately
fall in love with any restaurant in which the décor had the
enchantment of a Japanese garden, the scent of the spices
in the air would remind one of Italy, the appetizer was made by
the most talented Spanish chef, the entrée was prepared by an
authentic French chef, and the dessert tasted like the very best
Belgian chocolate. It is very difficult to find different dishes from
the best gastronomy world wide in one particular restaurant in order
to satisfy the most demanding customers.
El Salvador, a country with barely 21,000 square kilometers of
land, gives you the opportunity, in a matter of hours or minutes, to
have the luxury of discovering spectacular beaches where you can
delightfully feel the sand between your toes; algid mountains where
you can breathe fresh air and smell exotic tropical flowers while
tasting wild berries; astonishing glowing lakes and archeological
sites that takes anyone to a different mind set.
Surgery takes about 1.5 hours;
patients are able to sit on the
implants immediately after
surgery and there is no need for
compression or special garments.
El Salvador is without a doubt the pink diamond of Central
America. Located only a couple of hours away from the United
States, El Salvador is a country that is experiencing a big bang
explosion in terms of tourism. There are many reasons that could
be attributed to this phenomenon, such as the high cultural influence
of the United States. Another reason could be dollarization. In my
opinion, the reason El Salvador is experiencing a booming tourism
industry relies in our honesty, our kindness and our tireless passion
of making visitors feel even more comfortable and cherished than
in their own countries.
The excellence in taking care of tourists’ needs and exceeding
their expectations is expanding to the medical area. El Salvador,
such as an efficient small company, is able to consolidate its efforts
and work with a select group of physicians in order to raise the bar
and offer the highest standards in medicine.
A Standard of Beauty
A cultural standard of female beauty which has changed over the
years is the presence of beautiful buttocks. If we go back in time
and have a look at the renaissance era, we can observe masterpieces
like the “Venus at the Mirror” by Peter Paul Rubens, where we can
see how the concept of beautiful buttocks has changed over time.
The most common implants world wide are breast implants. In
countries like Brazil, gluteal implants are very popular. This type of
surgery is performed as frequently and as safely as breast implants.
This is one of the countries in which I did part of my plastic surgery
training program and where I had the opportunity to work with Dr.
Raul Gonzalez, an eminence in Body Contouring and specifically in
Gluteal implants.
Anthropology
An interesting fact is that humans are the only species that have
a wide gluteus major muscle. Apes have a smaller gluteus major
muscle that works as a tree climber, and not as a muscle for walking
and standing.
History
The first gluteoplasty (Gluteal Implant Surgery) performed
was in 1969 for reconstructive purposes in a patient with gluteal
atrophy (absence of soft tissue). Ever since the first gluteoplasty,
different techniques have been performed in which the implants are
placed in different areas of the gluteus. The safest technique and the
one that gives the best long term results is the XYZ Intramuscular
Technique.
The shape and size of the implant
that a body needs, depends on
skin type, shape and size of the
patient’s buttocks.
Gluteus Maximus Muscle
The gluteus maximus muscle is the largest muscle in the body.
This muscle helps us walk and stand when we are in a sitting
position. It is measures 5 to 7 cm in thickness and has an inverted
triangular shape.
March/April 2009
19
XYZ Intramuscular Technique
This technique uses a geometrical plane with three points of
reference. These points serve as guidelines in the surgical area to
determine the depth and the lateral extension to undermine the
intramuscular major muscle pocket in order to place the implant.
Indications for this type of surgery are: Platypygia (Lack of
gluteal projection), asymmetry due to congenital or traumatic
deformities, and previous gluteal implant surgeries.
Since the patient is allowed
to sit over the implants at the
immediately following the
surgery, there is no need to sleep
upside down.
This surgery is performed under epidural anesthesia (Similar
to a C-Section type of anesthesia). The incision is hidden in the
intergluteal fold, which is the reason why it is imperceptible.
Surgery takes about 1.5 hours; patients are able to sit on the implants
immediately after surgery, there is no need for compression or
special garments.
Post Operative Care
Since the patient is allowed to sit on the implants immediately
following the surgery, there is no need to sleep upside down. The
patient is allowed to drive 12 days after the surgery and perform
physical exercise 30 days after the surgery.
Type and Volume of the Implant
The most common size of implant used is 300cc, made of
cohesive silicone gel (FDA approved since November 2006).
Implants can be round shaped or oval shaped with a smooth surface.
The shape and size of the implant that a body needs, depends on skin
type, shape and size of the patient’s buttocks.
Conclusions
Intramuscular gluteal implants are as safe and as reproducible as
breast implants; they even have a smaller rate of capsular contracture
compared to breast implants. n
About the Author
Dr. Gerardo Flores-Lima is a plastic
surgeon graduated from Pontificia
Universidad Catolica Argentina in
Buenos Aires, and Clinica Dr. Raul
Gonzalez in Sao Paolo, Brazil.
Dr. Flores-Lima also has a fellowship in
plastic surgery from Indiana University,
Purdue University of Indianapolis (IUPUI) Medical Center
in Indianapolis, Indiana. He is one of only four plastic
surgeons world wide who has published articles regarding
Intramuscular Gluteal Implants. You can reach him by email
at [email protected] and his website is www.
elsalvadorplasticsurgery.com
20
March/April 2009
A FRANCHISE OPPORTUNITY
THAT GOES BEYOND FINANCIAL REWARDS
In the vast world of Medical Tourism our Advanced
Continuum of Care provides end-to-end peace of mind.
Homewatch International, Inc. provides the benefits of a high standard of
quality care before, during and after an overseas experience. Our international
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technology-based solutions that provide secure and seamless communication,
provide fail-proof shift accountability, improve medication compliance, and
emergency alerts.
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March/April 2009
21
THE EFFECTS OF THE
WORLD ECONOMIC RECESSION
ON MEDICAL TOURISM
How Will it Affect You?
By JONATHAN EDELHEIT
The world economic recession is having an effect on medical tourism, but whether
it is a positive or negative effect depends on what country you are in and if you
are attracting medical tourists from new and emerging countries. The most
common question in the industry today is, “How will the worldwide economic
recession affect your organization?”
22
March/April 2009
T
he results can be positive or negative and those results
depend on the actions your organization takes to position
itself to successfully withstand the economic recession
and to turn the recession into a positive motivator for your
organization.
Some countries and healthcare providers that have targeted
medical tourists emerging from less developed countries like in
Africa and some countries in Latin America are seeing a slight
decline in patients because as the economic recession hits these less
developed countries, medical tourism patients may opt to sacrifice
quality for affordability. These patients are making the decision to
receive medical care in their home country in order to save money
even though the quality may not be as high. In these less developed
countries every dollar counts and these medical tourism patients are
being extremely conservative in their spending.
Many large US health insurance
companies and employers
are beginning to implement
medical tourism.
So, countries and hospitals which focus on attracting medical
tourism patients from less developed countries are currently seeing
a decline in patient flow until the economic recession turns itself
around and these less developed countries start seeing economic
growth again. In today’s marketplace, it simply is not wise for
hospitals and countries to make major marketing efforts in less
developed countries, where economic situations prohibit patients
from traveling for healthcare.
Another problem hospitals and healthcare providers are having
is the increased competition in the medical tourism marketplace
and the lack of marketing which allows them to outshine their
competitors.
Emerging Medical Tourism Patient Markets
The real opportunity in medical tourism is in attracting patients
from developed countries which are facing economic recession
such as the United States, Canada, the United Kingdom, Russia and
parts of Europe. The United States, for example, is estimated to
be the fastest growing country where medical tourists are traveling
internationally for healthcare.
A recent Deloitte Report estimated that by 2017 as many as 23
million Americans could be traveling internationally for medical care
and spending up to $80 billion dollars per year on that international
medical care. What may be even more surprising to those in the
industry is that Deloitte will be issuing a new report this Spring with
updated statistics where they will show that due to the economic
recession, current numbers underestimate the potential in the US
market and that the number of patients will be significantly greater
than previously estimated.
The reason for the massive growth from the US marketplace
is simply a factor of cost, which makes medical tourism for US
patients even more attractive because of the economic recession.
Many large US health insurance companies and employers are
beginning to implement medical tourism. The cost of healthcare in
the US is simply too high, and the economic recession has forced
both insurance companies and employers to re-evaluate how to
lower healthcare costs. One of the only ways to achieve this in the
US is through the adoption of medical tourism. So, the economic
recession has been extremely positive in convincing more insurance
companies and employers in the US to look to medical tourism and
to either implement it or consider implementing it.
Currently in the United States many of our members, who
are medical tourism facilitators, have reported that numbers have
significantly increased in Americans traveling overseas for medical
care than before the economic recession. However, there has been
a shift from truly elective procedures such as cosmetic and dental
procedures to elective procedures such as bariatric and orthopedic.
This is the perfect example of how the economic recession may
be encouraging if we can help more Americans understand and
appreciate the high quality of care they can receive internationally
at a fraction of the price.
Other growing markets are Canada and the United Kingdom.
But the problem is these numbers are not expected to grow as fast as
the United States, due to the fact that these countries have national
healthcare programs and the government pays for medical care.
Many Canadians and UK patients were traveling internationally in
order to avoid long waiting times for surgery in their home country.
Since Canada and the United Kingdom have national healthcare,
UK and Canadian patients may decide to withstand the long wait
times in order to save money. Some will decide to travel and receive
medical care, but the growth each year will not be as strong as
previous years.
The number of Americans traveling
overseas for medical care has
significantly increased since before
the economic recession began.
With the new EU program in place, UK patients are able to
travel within the EU for services and have those services reimbursed
by the National Healthcare System. This means patients will search
for surgeries within the EU. In fact, the reported number of patients
traveling from the UK is down. We will have to see how this
program affects medical tourism coming from the UK.
Medical Procedures Affected by the Economic
Recession
Because of the economic recession, we have seen a shift in the
demand for certain types of medical procedures. Many patients who
were seeking elective surgeries such as plastic or cosmetic procedures
March/April 2009
23
are now waiting because they may not have the discretionary income
to spend. Many are opting to wait and spend the money after they
see how the economic recession will affect their personal lives. Our
member hospitals and medical tourism facilitators, however, stated
that “core” medical procedures such as orthopedics, cardiology and
transplants have significantly increased, which also means more
patients are choosing to utilize medical tourism as a way to save on
overall healthcare costs.
It is amazing how many companies
spread misleading information as to the
future of medical tourism, where patients
are traveling from and where they are
traveling to, and what countries patients
will be coming from in the future.
Decreased Patient Flow in Hospitals & Clinics ~
Truly a Decrease or Lack of Marketing?
While some hospitals and clinics have stated they are seeing less
medical tourism patients, other hospitals and clinics are expressing
that they are seeing an increase in medical tourism patients. The
reality is that when the medical tourism industry first emerged very
strongly several years ago, there were only a handful of hospitals
and only about 4 or 5 countries promoting themselves as a medical
tourism destination. Today, there are hundreds of hospitals and
clinics promoting medical tourism, and over thirty different countries
promoting medical tourism. This means there is now significant
competition in the medical tourism marketplace. The decline in
patients that some hospitals are experiencing is simply not because
of a decrease in patient flow worldwide, but rather a direct effect of
the marketing efforts of their competition.
More and more we are educated about the high quality of care
available in an increasing number of countries. Some are doing
a better job at marketing and advertising their destination and the
results are starting to show. While India and Thailand enjoyed the
lion’s share of traveling patients, in the last two years many other
destinations are giving them a run for their money including Korea,
Mexico, Costa Rica, Turkey, Israel, Jordon and other countries in
Asia and Latin America.
The countries that are the most successful are those whose
hospitals and governments are working together and successful at
branding themselves as top destinations. In the meantime, hospitals
that enjoyed the benefit of being the first in the door have now sat
back to enjoy the fruits of their primary efforts and are no longer
actively marketing themselves. “Brand reputation” is the best form
of return, however the brand needs to be maintained. Any marketing
specialist will tell you that in order to keep a “brand” you must
constantly enforce it. As new players emerge in medical tourism
marketing more aggressively, these new market entrants are getting
the contracts with insurance companies, employers and medical
tourism facilitators. Due to the massive growth of this industry and
the fact that so many hospitals, clinics and doctors are promoting
themselves, industry players must constantly market themselves,
and create and maintain their “brand recognition” or they will
simply lose their market share of medical tourism patients.
One important piece of advice to all industry participants would
be to avoid misinformation and verify your facts to the best of your
ability. It is amazing how many companies spread misleading
information as to the future of medical tourism, where patients are
traveling from and where they are traveling to, and what countries
patients will be coming from in the future. In fact, some companies
exaggerate media reports to benefit their own country over others.
This is just to gain an edge and should not be taken seriously. Do
your own research and gather your own information about hospitals
and healthcare providers. No one can predict the future of medical
tourism. What we can do is look at where patients are traveling to
and from, and which countries present the best opportunity to seize
upon now. n
About the Author
24
March/April 2009
Jonathan Edelheit is President of the
Medical Tourism Association with a long
history in the healthcare industry, providing
third party administration services for
fully insured, self-funded and minimedical plans to large employers groups.
March/April 2009
25
Latin America Medical Tourism &
Health Tourism Congress
April 27th - 29th, 2009
Monterrey, Mexico
Sponsored by Medical Tourism Association
in partnership with Monterrey Healthcare City
& The Government of Nuevo León, Mexico
Conference Highlights
• Up To 400 Attendees
• US Health Insurance Companies and
Insurance Providers Invited
• Understanding Marketing Opportunities
In The US, Canada, and Europe
• Industry Players From Over 25 Countries
• Highlighting The High Quality Of Care
Available In Latin America
• The Top US Medical Tourism Facilitators
Invited
Conference to be Held in English
Translation Services Available
26
Latin America Medical Tourism & Health Tourism Congress
www.LatinAmericaMedicalTourismCongress.com
[email protected]
US: 561.792.6676
March/April 2009
April 27th - 29th, 2009
Monterrey, Mexico
LATIN AMERICA MEDICAL TOURISM & HEALTH TOURISM CONGRESS
[email protected]
US: 561.792.6676
March/April 2009
27
April 27th - 29th, 2009
Monterrey, Mexico
SPEAKERS
Dr. Enrique Ruelas Barajas
UnderSecretary, Innovation & Quality
Ministry of Health, Mexico
Dana Citron
Global Health Analyst
American International Group (AIG)
Jose Natividad Gonzalez Paras
Constitutional Governor
State of Nuevo Leon
Term 2003-2009
Dr. Jesús Horacio González Treviño
President
Monterrey Healthcare City
Director
Clìnica Vitro
Ernesto Dieck-Assad
CEO
Hospital San Jose Tec de Monterrey
Mexico
Arturo Garza
CEO
Grupo Christus Muguerza
Peter Lozier
Executive Vice President
CMN, Inc.
Massimo Manzi
Executive Director
PROMED
Council for International Promotion
Costa Rica Medicine
Jorge Woodbridge González
Minister of Competitiveness
Republic of Costa Rica
Ing. Alejandro Páez Aragón
Secretary of Economic Development
Nuevo León
Ross Pendergraft
President-Elect
Los Angeles Association of Health
Underwriters
Dr. Jorge Cortés Rodriguez
Chief Medical Officer
Hospital Clìnica Bìblica
President
Costa Rican Council
Promotion of Medical Tourism
Jeff Carter
CEO
Patients Without Borders
Dr. Chad Holloway
President
Global Health Solutions, LLC
Alex Piper
Former Buyer of Healthcare
Chrysler
Jim McCormick, MD
Founder & Owner
Premiere Medical Travel
Assistant Secretary
28
Jerry D. Turney
USNow
Brad Cook
International Department
Hospital Clìnica Bìblica
Secretary
Cecile Billiet
Founder
Spa-Med-Holiday
Dr. Carlos Ramos Hinds
President
Export Salud El Salvador
Luis Diego Osborne
President
HWCG Group
Saroja Mohanasundaram
CEO
Healthbase Online, Inc.
Thomas O’Hara
President
Surgical Trip
Wouter Hoeberechts
CEO
WorldMed Assist
[email protected]
US: 561.792.6676
March/April 2009
April 27th - 29th, 2009
Monterrey, Mexico
SPEAKERS
Mauricio Gojman
Founder & CEO
NursesNow International
Guillermo González Prieto
Strategic Development Executive
Argentina
Dr. Rafael Lorenzana
El Salvador
Lorenzana Dental Center
Jonathan Edelheit
President
Irving L. Stackpole, RRT, M.ED.
President
Stackpole & Associates, Inc.
Dr. Héctor Xavier Martínez Sánchez
Secretary of Health
Sonora
Jim Arriola
CEO & President
Sekure Healthcare
Renee-Marie Stephano, Esquire
Chief Operating Officer
Editor
Medical Tourism Magazine
Matt Leming
Swiss Re Insurance Company
Jim Krampen
Co-Founder, Principal & Executive Officer
Seven Corners
David Vequist
Center for Medical Tourism Research
Stephen M. Weiner
Chair of Health Section
Mintz, Levin, Cohn, Ferris, Glovsky
and Popeo, P.C.
Nubia Stella Martinez
Vice President for Tourism
Proexport Colombia
Kemal Canlar
United Healthcare
Kimberly Smith
Director of Development Research
Strategic Development
Assurant Health
Carlos Zavala Ruiz
Director of Business Development
Hospital Angeles Tijuana
Sherri J. Tenpenny
Executive Director & CEO
Sanoviv Medical Institute
Juan Brothers
Director for Corporate, E-Commerce, &
Leisure Sales
AeroMexico
S. Shai Gold
Managing Partner
Global-Triage, LLC
Curtis P. Page
Co-Founder
MedToGo International
Alexandra Jung
Senior Vice President
Aon’s Health & Benefits Practice
Michele Lerow
Senior Network Manager
Aetna Global Benefits
Sebastian Viramontes
Head of International Program
Hospital San José Tec de Monterrey
Dr. Héctor M. Bernal
Bariatric and Metabolic Surgeon
Hospital CIMA Chihuahua
Pramod Goel
President
PlacidWay
Edison Vallejo, M.D.
Healthcare Purchasing Manager
Bupa
Graciela Báez Ricárdez
CEO
Trust of Touristic Promotion
[email protected]
US: 561.792.6676
March/April 2009
29
April 27th - 29th, 2009
Monterrey, Mexico
CONGRESS AGENDA
30
[email protected] © Copyright Medical Tourism Magazine
March/April 2009
US: 561.792.6676
April 27th - 29th, 2009
Monterrey, Mexico
LOCATION AND REGISTRATION
2009 HOST HOTEL
The official Congress Hotel is the
Intercontinental Presidente in Monterrey, Mexico.
Attendees will receive a significantly discounted rate
of $100 USD* per night by mentioning the
“Latin America Medical Tourism Congress, Group Code: MED”.
*Available to first 100 people to make reservations
For reservations, please call the hotel directly at:
US: 888.424.6835 or Mexico: 52.81.83686000
Please make your reservations early to be sure you get
accommodations at the Official Congress Hotel.
InterContinental Hotel Group is one of the leading hotel chains in the world and offers modern style and
impeccable service, which makes it the ideal destination for the Latin America Congress. Located in the
middle of the business district of Monterrey, the hotel is also near points of interest such as the Museum of
Mexican History, the Huasteca Canyon and the Museum of Contemporary Art.
Only $549
To Register for the
please visit: www.mtcregistration.com
If you have questions, please contact us at:
[email protected]
US: 561.792.6676
© Copyright Medical Tourism Magazine [email protected]
March/April 2009
US: 561.792.6676
31
Surgical Solutions for
Obesity and Weight
Management
A Team Effort
By DR. ROBERTO ZELAYA
Regardless of the procedure selected the most important thing is that the
surgeon is only one part of the cure, patients must learn to control their diets
and lifestyles. The success of these procedures is predominantly seen within the
first two years, where considerable weight loss averages out to 60 percent. This
is a life altering decision and should be supported by the foundation of a trained
surgeon, psychological support and an educated and motivated patient.
32
March/April 2009
R
ather than for cosmetic and vanity issues, bariatric surgery
is a therapeutic weapon for weight reduction, especially
when one’s health is at risk. The largest food problem
in the world has ceased to be malnutrition. Today the problems
of overweight and obesity appear to have soared according to the
statistics of the World Health Organization (WHO), which estimates
that by 2015, the obese population will exceed 230 million adults.
The root of the cause lies in the imbalance found in diets
dominated by hyper caloric consumption of food rich in fat and
sugar, lacking vitamins, minerals and other nutrients necessary for a
balanced diet. In addition, the sedentary nature of many jobs put us
away from the cardiovascular benefits of physical activity.
This situation has led to obesity becoming a disease in America
and around the world. The Association of Nutritionists and Dietitians
of El Salvador say that due to poor nutrition around 53.9 percent
of women are overweight. The largest problem however, is when a
person loses control of food and eating habits transcend the boundary
of overweight to fall into the category of morbid obesity, a dangerous
condition that is accompanied by cardiac diseases, hypertension,
and diabetes, among other threatening life pathologies.
The World Health Organization
(WHO) estimates that by 2015, the
obese population will exceed 230
million adults.
There are surgical solutions for this problem known as bariatric
surgery. The first step is a thorough medical assessment of the
magnitude of the obesity, the presence of complications, and failure
of conventional treatments. Bariatric surgery is aimed at weight
loss and is based on three processes that involve two non-surgical
techniques such as the Intragastric balloon placement, and surgical
techniques known as Sleeve Gastrectomy, Adjustable Gastric Band
and Gastric Bypass.
Intragastric Balloon
This is one of the most popular procedures for being an outpatient
procedure and consists of introducing a silicone ball through the
mouth of the patient. Once inside the stomach it is inflated with air
or filled with liquid in order to produce the effect of fullness. The
medical indications for the Intragastric Balloon are having mild to
moderate obesity or morbid obesity with a high surgical risk. In these
cases, the Intragastric Balloon is advantageous because it helps the
patient to reduce their weight and then undergo a final procedure.
The Intragastric Balloon does not require hospitalization or general
anesthesia. It is a relatively quick procedure and placement takes
about 25 minutes. Among the disadvantages of this procedure is the
length of time the balloon can be left inside the stomach, it should
not remain more than six months because the stomach acids could
damage the coating and increase the risk of balloon perforation.
Furthermore, the success rate in weight reduction is not as high as
the rate for surgical procedures and also requires a stricter diet and
exercise. Another drawback is that in order to remove the balloon it
is necessary to remove all the liquid and then remove the balloon.
The process takes about one hour and is preferably performed under
general anesthesia for greater protection of the airways.
Surgical Options
The Sleeve Gastrectomy and the Adjustable Gastric Band along
with the Gastric Bypass have precise indications and the patient
needs to meet certain criteria in order to undergo these procedures.
Body Mass Index (BMI) must be at least 35 with co-morbidities or
BMI of 40 with or without co-morbidities (Hypertension, Diabetes,
Joint problems, high cholesterol and high triglycerides, and sleep
apnea among others).
Gastric Sleeve
This is a relatively new procedure and the stomach is cut in the
form of a tube, like a sleeve. The goal is weight loss and eliminates
the anxiety over food. This procedure consists of reducing the size
of the stomach to 85 percent of its original size. It operates under
two mechanisms:
1. Reducing the size of the stomach. This causes an early satiety
with little food intake by having a smaller stomach.
2. It removes a part of the stomach that is responsible for producing
hormones called Ghrelins. These hormones are responsible for
sending signals to the brain, which manifest into hunger.
The advantages of this surgery are that it is fast, simple and is done
laparoscopically. Fast recovery time and the rate of complications
is minimal. For the patient’s security there is no alteration in the
normal transit of food or absorption and consumption of vitamins
and minerals for life is not required. Moreover, the gastric sleeve has
the potential to become a gastric bypass in the future if the patient
fails to achieve the established weight loss. The other advantage is
that no foreign bodies are placed in the body. It has the same long
term results as the “Gold Standard” which is the Gastric Bypass.
The Intragastric Balloon does not
require hospitalization or general
anesthesia.
Gastric Bypass
The Gastric Bypass has the same indications as the Gastric
Sleeve, and has the best success rate in terms of weight loss. The
surgical technique is to cut the stomach in order to leave a small bag,
yet smaller than a gastric sleeve, where there is only space for an
average of 25 to 30 cubic centimeters of food or liquids. The Gastric
bypass works two ways. By reducing the size of the stomach the
patient eats less. The other mechanism is that we make a connection
with the small intestine and the food bypasses a part of the intestine
(the duodenum) and passes below with less absorption of fat or
carbohydrates. By diverting the passage of foods through the
duodenum, this prevents the firing mechanism of insulin resistance,
creating an added advantage for type 2 diabetic patients.
March/April 2009
33
Gastric Band
This procedure consists of a Silicone band that is placed around
the stomach. This ring is placed on the highest part of the stomach
and is connected through a small catheter to a valve under the skin
and its only mechanism is to allow less food to pass to the stomach.
It’s a quick procedure and offers a less strenuous recovery period. As
for the cons, the fact that it is an obstruction mechanism and having
a foreign body present cause infections associated with the band or
the valve. It can also cause other problems such as expansion, an
enlarged stomach in some cases due to the pressure, and discomfort
of reflux is frequent as well.
What Should You Know Before Surgery?
Surgical treatment of obesity is a major surgery. Although most
patients benefit from an improvement in their health conditions related
to obesity (such as mobility, self-image and self-esteem) after the
success of a weight-reduction surgery, this should not be the primary
motivation to undergo the procedure. The goal is to have a healthier
and longer life. This is why one should make a decision only after
doing the research and having a consultation with an experienced
physician or bariatric surgeon. A qualified surgeon should answer
your questions clearly and explain the exact details of the procedure.
It is imperative that the patient understand the recovery period and
the post-operative care required. As part of the routine assessment
of the weight reduction surgery, your physician may ask you to
consult a dietitian or nutritionist and a psychiatrist or therapist. This
will help establish a clear understanding of postoperative behavioral
changes that are essential for long-term success. It is important to
remember that there is no absolute guarantee in any kind of medical
or surgical procedure. Even in what seem simple procedures
unexpected results may vary. In terms of the surgical treatment
for obesity, the procedure is only successful when patients acquire
a commitment for life. This surgery is only a tool. Their ultimate
success depends on strict adherence of the recommended regimen
of diet and exercise, and changes in one’s lifestyle. On average
patients remain in the hospital for approximately one to four days
depending on the procedure to be performed. In general, the patient
is discharged when: • Patient is able to take sufficient fluids and nutrients by mouth to
prevent dehydration. • Patient does not have a fever.
• Patient has an adequate pain control with medication.
• Patient does not have complications.
Diet
The changes made to the gastrointestinal tract require a permanent
change in eating habits in order to ensure weight loss success. The
instructions vary according to each surgical dietary surgeon. It is
important to remember that not all surgeons perform exactly the
same surgical procedure for weight reduction and diet instructions
differ for each surgeon as well. The important thing is to adhere
strictly to the recommendations of your surgeon. The following is
an example of the dietary instructions for patients following weight
reduction surgery:
• When you begin to eat solids it is essential to chew well. You
cannot eat steak and other cuts of meat if it is not crushed, and
if it is not chewed thoroughly.
• Do not drink liquids with food that will make you feel satiated
before a meal.
• Avoid eating sugary desserts and other foods where sugar
appears as one of the first three ingredients.
• Avoid soft drinks, nutritional supplements high in calories,
milk shakes, foods high in fat and foods high in fiber.
• Avoid alcoholic beverages.
• Limit consumption of snacks between meals.
Returning to Work
The patient’s ability to resume their job after the surgical
procedure depends on their physical conditions, the type of work
and the type of weight-reduction surgery performed. Many patients
return on average in the period of one week after the procedure.
34
March/April 2009
Bases of Surgical Treatment
The best way to achieve an effective reduction of long-term
weight in patients with morbid obesity is surgery. It is not referred
to as a cosmetic procedure, by contrast, bariatric surgery is defined
as a procedure that reduces the size of the gastric reservoir, with
or without an intestinal bypass. This surgery reduces the caloric
intake and helps patients alter their eating habits enabling them to
eat slowly and in smaller quantities. It took over 30 years to find the
best surgical procedure. Prevention of secondary complications of
morbid obesity is a major objective of its management. Hence, the
surgical option it’s a rational choice based on the principle that this
is less dangerous than the disease itself.
Patient Selection
Surgical treatment should be offered to patients with morbid
obesity, well informed, motivated and with an acceptable operative
risk. The patient should be able to participate actively in the
management and long term monitoring. Some patients with mental
disorders should be excluded. Choosing surgery requires an
assessment of risks and benefits for each case.
Patients with a BMI above 40 are candidates for surgery if they
are convinced in reducing their weight, because obesity has damaged
their quality of life and understand how their life can change after
the surgical procedure. In certain patients with less obesity and
BMI between 35 and 40 may also be considered for surgery. For
example, patients with a high risk of disease have been diagnosed
with conditions such as cardiopulmonary problems, sleep apnea,
Pickwick syndrome, obesity-related cardiomyopathy, or Type 2
Diabetes.
The overall care of patients undergoing bariatric surgery require
programs that involve both the preoperative management and longterm monitoring. A thorough pre-operative evaluation is essential
for lowering risks. The patient should be clear about the risks,
complications and real benefits and long-term consequences of the
procedure. The surgeon should be prepared for the diagnosis and
management of complications and the management of morbidly
obese patients in terms of having the technology, equipment and
adequate staff. That is a management team that includes internal
medicine, dietary instructors, an exercise program, among others.
The operations and procedures that are performed more frequently
are: Intragastric Balloon, Gastric Sleeve or Sleeve Gastrectomy,
Gastric Bypass and Adjustable Gastric Band. Virtually all bariatric
surgeries can be performed by laparoscopic surgery. For safety
and effectiveness it requires not only the surgical skills but also to
have the appropriate technology. It is therefore of great importance
that the surgeon has advanced training in laparoscopic surgery.
Finally, these procedures require a surgical team familiar with these
techniques and mastering the use of instruments and equipment
used in bariatric surgery. Morbid obesity is a major health problem.
Bariatric surgery is the only alternative that maintains an effective
reduction of weight. Laparoscopic techniques, based on open surgery
are available. Performed by trained surgeons, it has excellent results.
It is important to have experience and training in bariatric surgery to
achieve these results, advanced laparoscopic skills, and a protocol
for monitoring the long-term results. n
About the Author
Dr. Roberto Zelaya specializes in bariatric
and weight loss surgery. Dr. Zelaya
received his training from Louis Pasteur
Univeristy in Strasbourg, France, Ohio
State University Medical Center, and
the Hospital Clinic of Barcelona in
Barcelona, Spain. He is the owner of
Gastrointestinal Surgery and Endoscopy
Clinic. He offers treatments for obesity
including intragastric balloon, sleeve gastrectomy, gastric
bypass, and adjustable gastric band. Dr. Zelaya is a member
of the International Federation of Surgery for Obesity (IFSO).
You may reach him by email at [email protected]
and his website http://obesitydrzelaya.com
March/April 2009
35
The Medical Tourism Association’s 2nd Annual
World Medical Tourism & Global Health Congress
•
•
Up to 100 Exhibitors and up to 2,000
Attendees
Up to 200 U.S. Healthcare and International
Insurance Companies Interested in
Out-Sourcing Surgeries Overseas.
•
Up to 5,000 One-on-One Networking
Meetings Scheduled
•
Industry Players from over 50 Countries
•
Over 3,000 “Buyers” invited from the
United States, Canada, Middle East, Europe,
Asia, Russia and other countries looking at
sending patients overseas
October 26th - 28th, 2009 Los Angeles, California
36
For More Information on the Congress Contact:
2nd Annual World Medical Tourism & Global Health Congress
www.MedicalTourismCongress.com
[email protected]
USA: 561-792-6676
March/April 2009
WORLD MEDICAL TOURISM & GLOBAL HEALTH CONGRESS
October 26th - 28th, 2009 Los Angeles, California
Dear Delegate,
Medical Tourism is one of the fastest growing healthcare industries. The world is in a healthcare crisis and
patients are starting to travel overseas in search of the best quality and the most affordable medical care.
More and more Health Insurance Companies, Employers, Claims Payors, and Health Insurance Agents are
looking at Medical Tourism as the creative solution to the healthcare crisis. A recent report on Medical
Tourism stated that by 2017, over 16 million Americans could be traveling overseas for medical care. With
that being said, people from other countries equal to or greater than that amount will also be traveling
around the world for medical care.
Last year’s 1st annual congress featured over 850 attendees from over 45 countries and over 53 exhibitors
and sponsors. Out of the 850 attendees, there were over 100 insurance companies and insurance providers,
over 400 hospitals, clinics, and governments, and over 100 facilitators. The 2nd Annual World Medical
Tourism & Global Health Congress will feature up to 2,000 attendees from over 50 countries and up to 100
exhibitors and sponsors. At this year’s Congress we have also invited “buyers” of healthcare from countries
such as Russia, China, Japan, and Africa. Many of these countries are emerging markets as more patients
travel to and from these countries for medical care.
This is the one event per year where Employers, Self Funded Health Plans, Insurance Companies, and Medical
Tourism Facilitators that are looking to outsource healthcare overseas have the opportunity to meet with
top International Hospitals and Medical Tourism Companies in one place for the ultimate networking event.
World Medical Tourism & Global Health Congress will prearrange networking meetings to assist in the
development of new relationships and valuable new contracts. While last year’s Congress featured over
3,000 one-on-one private networking sessions, the 2nd Annual Congress is anticipated to have at least 5,000
one-on-one private networking meetings.
This is the one event you cannot afford to miss!
Exhibit Hall 1 of 3 WMT & GHC 2008
Grand Ballroom WMT & GHC 2008
For More Information on the Congress Contact:
2nd Annual World Medical Tourism & Global Health Congress
www.MedicalTourismCongress.com
[email protected]
USA: 561-792-6676
March/April 2009
37
Improving the Quality
ofthrough
Healthcare
Accreditation:
A Patient Perspective
By DR. JUNE SMAILES
Medical tourism offers diverse opportunities for patients. It increases choice
and affordability of treatments. However, an increasing range of options can
be bewildering. Impressive hospital websites offer a vast range of services, in 5
star settings. The patient’s challenge is to find the hospital or clinic offering high
quality care in a low risk setting amongst these well-marketed glossy websites.
38
March/April 2009
P
atients need unbiased information to make choices. Most
will access this information via the Internet. They will be
looking for a safe provider in a convenient destination, at
an affordable price. Some will be at a vulnerable stage in their lives,
making decisions about complex surgery or treatments, possibly
planning to travel far from home.
patients about the care they can expect. A hospital that has been
successful in achieving accreditation has been inspected by an
independent accreditation body. The quality of care and the setting
of that care have been carefully assessed to ensure that risk has been
minimized.
The greatest concern of the majority of patients will be how to
choose the hospital where they are least likely to suffer an adverse
outcome. They will require reassurance that the standard of clinical
care, including management of postoperative complications, is of
the highest quality.
The greatest concern of the majority
of patients will be how to choose the
hospital where they are least likely to
suffer an adverse outcome.
There are several key factors, which determine the level of safety
in the healthcare setting. First, a hospital or clinic providing good
clinical care depends upon its entire staff embracing a culture of
delivering high quality healthcare and continual improvement in the
standard of care offered. It will also ensure that care is provided by
appropriately qualified staff that have regular training to ensure they
have the required skills to perform procedures, in an environment
where risk is minimized.
Importantly, staff will be made aware of the safest ways to
practice. There will be policies available to staff with regular
training to ensure staff have awareness of and understand these
policies. A system will be in place to know exactly how good the
care provided is. By performing regular audits to measure current
performance against best practice, a cycle of continual improvement
can be established.
In any healthcare setting some risk will always exist. Human
error can never be entirely eradicated. The wise organization
will take the opportunity to learn from mistakes or near misses.
An adverse incident provides a way to offer learning to others,
only if a mechanism exists to share knowledge rather than blame
individuals.
The Significant Event Analysis of incidents, or near misses,
facilitates team learning by involving all relevant staff in a discussion
of the causes of the event, and identifying ways to avoid a repetition.
This learning can be passed on to the whole organization resulting
in risk reduction for all patients. In a similar way, good practice can
be identified and shared.
The setting of the care will be compliant with health and safety
regulations, with a method of ensuring that regular checks take place.
Designated members of staff will be responsible for key areas, such
as infection control.
So how does a patient begin to assess whether the hospital
takes these factors seriously from the information available on the
website?
One way is to look for hospitals that have undergone an
external review of quality standards, by a credible body, which has
taken all of these factors into account. Healthcare providers are
increasingly looking towards International Accreditation to reassure
Accreditation looks at the whole organization, from management
to clinical care. The aim of accreditation in healthcare is to improve
patient services. The standards that the facility is assessed against
should be patient centred, and the survey should test thoroughly how
well the standards are adhered to in practice. Schemes such as Trent
use a survey team of active NHS Professionals, all of whom have
current knowledge of healthcare provision, to assess the application
of standards and procedures in practice. Surveyors spend most of
their time on the wards, talking to staff and patients and observing
processes in action.
Designated members of staff will be
responsible for key areas, such as
infection control.
Developmental schemes support the organization in achieving
improvements by sharing best practice and offering ongoing
mentoring support during the preparatory phase.
For the organization, accreditation provides much more than a
marketing tool. The preparation for an accreditation survey involves
all staff, clinical and non clinical, in a process of understanding how
the organization works and how, by working as a team, patient
and staff risk can be minimized. This common goal improves
communication, with cross-departmental work being necessary
to achieve the required standards. A successful survey results in
March/April 2009
39
improved staff morale, and pride in the standard of care offered.
Insurers can be assured of the risk minimization processes in place.
There are several International Accreditation schemes available
and hospitals should take time to assess fully the benefits and costs
of the various schemes. Factors to be taken into account include
the target client group, preparatory work required by the scheme
and full costs of the accreditation process. The Accreditation Body
itself should be subject to regulation. Commercial schemes should
be accredited by bodies such as ISQUA in order to ensure the
quality of their processes. Non commercial schemes such as Trent
Accreditation Scheme, which is part of the UK NHS, are subject to
rigorous NHS governance systems.
A hospital that has been successful
in achieving accreditation has
been inspected by an independent
accreditation body.
Costs vary widely, even in the not for profit sector, both for
the cost for the accreditation survey and the preparatory training
required. It is essential to be clear about the total costs to be expected
at the beginning of the process.
Ultimately, accreditation should improve patient experience
and result in fewer adverse patient outcomes. Affordability of
accreditation has deterred many good hospitals and clinics from
engaging in the process. Different healthcare settings have different
needs and will benefit from different schemes. An analysis of the
hospital or clinic’s requirements from accreditation, their target
patient group and budget followed by a detailed discussion with
accreditation bodies should result in finding the right Accreditation
Body to meet those needs.
The importance of accreditation is in the ability of the process
to alter the culture of a healthcare setting into one of continual
improvement in quality. A successful accreditation survey represents
a commitment to quality, which is recognized externally. Of
equal importance is the continued focus on the maintenance and
improvement of patient care between surveys and the engagement
of staff in the process.
Accreditation at its best should make patients safer, and develop
healthcare settings where staff can develop and thrive. n
About the Author:
Dr. June Smailes is a Board Member and Lead
Surveyor with Trent Accreditation Scheme.
Since qualifying from Sheffield University
Medical School, UK, she has practiced in the
UK and overseas, gaining first hand experience
of International Healthcare Settings. Her
interest in International Accreditation has
grown from directly observing the requirement for Standards in
Healthcare to ensure safety for the Medical Tourist.
40
March/April 2009
March/April 2009
41
Surgery
Facilities
Resources
An Interview with Jeff Pearcy
By RENEE-MARIE STEPHANO
SFR was organized as a wholly owned subsidiary of the American Association for Accreditation
of Ambulatory Surgery Facilities (AAAASF). AAAASF, the parent organization, has been
in business for twenty-eight years providing accreditation of ambulatory surgery centers and
office based surgery centers in the United States.
42
March/April 2009
S
“
urgery Facilities Resources was organized to provide
resources to surgery centers to enhance patient safety” said
Ronald Iverson, M.D., Chairman of the Board of Surgery
Facilities Resources (SFR). “To that end we developed a set of
standards for accreditation of surgery facilities around the world,” he
added. SFR representatives were panelists at the Medical Tourism
Association Congress last year, presenting on topics concerned with
patient safety in medical tourism.
AAAASF made the decision to form SFR to provide similar
accreditation processes in countries outside of the United States.
SFR benefits from the long history of experience of AAAASF.
AAAASF does not accredit facilities outside of the United States
that is the sole purview of SFR. SFR has formed a collaborative
relationship with the International Society of Aesthetic Plastic
Surgeons. Currently, any applicant who performs cosmetic surgery
must be a member of ISAPS as a condition for accreditation.
SFR has formed a collaborative
relationship with the International
Society of Aesthetic Plastic Surgeons.
In the United States AAAASF standards are recognized by
all 18 States that have mandated accreditation for office based
surgery. AAAASF is a deeming authority for Federal Medicare.
SFR anticipates working with national organizations in each of the
countries where facilities have met our rigorous standards. SFR
hopes to have recognition that our standards meet the national
requirements or are used as a model where none exists.
The SFR Accreditation Process
SFR standards cover ten essential areas of patient safety:
general environment, operating room environment, recovery room
environment, general safety, blood and medications, medical records,
quality assessment and improvement, personnel, governance, and
anesthesia. Accreditation levels are based on the type of anesthesia
that is used in the facility. SFR requires one hundred percent
compliance with all standards. SFR has established an Advisory
Committee with representation from other countries to assure that
we adapt our standards when it is necessary to accommodate specific
cultural or regional variations.
SFR has also established a secondary accreditation for surgeons
who perform their surgery in a hospital environment, but want
to have their practice accredited for follow up care and minor
procedures performed under local anesthesia.
The cornerstone of the SFR program is the global work force
of trained SFR inspectors. All SFR inspectors are physicians
who practice in a surgical specialty and it has trained inspectors
throughout Europe and South America committed to peer inspections
performed by physicians who understand local customs and culture.
Across the globe, SFR now has over one hundred inspectors.
A facility can obtain information obtain accreditation and
download the application materials at http://surgeryfacility.com/ .
Facilities are able to submit their application for accreditation. We
verify all documentation regarding licenses and certifications prior
to the inspection. We arrange for inspectors to personally inspect
the facility and review all documentation. Once a facility meets our
standards they are granted accreditation. In the second and third
year the facility performs a self-inspection to assure they continue
to meet our standards and meet any standard that has changed since
their inspection. Every third year the facility is re-inspected.
SFR is managed through the staff of AAAASF. Nine individuals
provide staff services to support the clinics in preparing their
applications and assisting with the logistics involved in setting up
the inspection. Although SFR materials are currently only available
in English, one third of the staff speaks Spanish fluently.
Medical Tourism
“SFR has no stance on medical tourism,” says SFR Executive
Vice President, Jeff Pearcy. “That may be an unusual statement to
make in this climate where patients are beginning to seek the most
cost effective care. Our only stake in the issue is to provide some
measure of equitable safety no matter where surgery is performed.”
“Safety in surgery is contingent on many independent factors,”
says Pearcy. “The education, skill, and experience of the surgeon
are paramount. Second is whether the facility itself is safe and
staffed by skilled professionals. This includes the accessibility of
equipment and medications in a life threatening emergency. Third is
whether the patient is appropriate to have the procedure performed
in the setting chosen.”
Patients traveling for surgery need to gauge this third issue very
carefully. It is important to establish how long it will be necessary to
remain in the country where the surgery was performed to be certain
that return travel is safe. The patient also needs to establish where
they can go in their home country for follow up care and who will
support them if there are complications to the surgical procedure.
SFR only addresses the second issue, the safety of the facility and
the staff in attendance.
“This singular focus on patient safety removes SFR from the
political debate about the impact of medical tourism on the economies
of countries involved,” Pearcy says. “Our stance is simple. Patients
should receive safe care in any surgical environment. A consistent
set of standards wherever surgery takes place is one of the major
building blocks of patient safety. SFR standards provide that level
of strong standards, consistently applied.”
The cornerstone of the SFR program
is the global work force of trained
SFR inspectors.
SFR has also shown a willingness to collaborate with government
entities interested in using the SFR process to increase patient safety
and to promote medical tourism in their country. “We are not naïve,”
Pearcy said, “We realize that if we keep our focus on patient safety,
our collaborative partners can then use that arms length relationship to
promote their country’s facilities as providing safe surgical alternative
in a global economy.”
The Future
Thomas Friedman has opined that the “Earth is Flat” meaning
that the web of interconnectedness is complex and reaches around the
globe. Medicine is not immune to this concept. The past concepts
of regulation and boundaries are blurred already and will continue
to blur over the coming decades. Patients will not be limited by
geographical boundaries, payer constraints, or guild restrictions on
where they can receive medical care. If they have the means, they
become a global consumer of medical care. Their major concerns
are value and safety. The marketplace dictates value. SFR can
provide one portion of safety for consumer confidence in the global
medical market. n
March/April 2009
43
about the t o u r
a Walton,
vens, Tony ttig
te
S
b
r
e
H
,
bhatla
Neil Fe
Amar Kam osford, Raj Joseph,
H
a
Lind
The trip was perfect. ExportSalud did a
wonderful job of keeping us organized, busy,
and having fun along the way. Not knowing what
to expect, I was thrilled to meet the friendliest
people who demonstrated true commitment
to offering high quality care and personalized
service to medical tourists. El Salvador’s entry
into the industry will offer competition to those
countries that already have a strong reputation.
No doubt, El Salvador will be the next hot
spot for medical tourists. The fact that the Vice
President, the Minister of the Exterior, and the
Minister of Tourism were involved in the tour
demonstrated the country’s dedication to El
Salvador becoming a leader in the region.
El Salvador
Tonya Walton – Blue Morpho Medical Travel
FAM Tour
snapshots
about the t o u r
El Salvador has tremendous potential as a very
competitive destination for medical tourism. All
of the right ingredients are there: well qualified
doctors, excellent facilities and equipment, great
inexpensive lodging and a safe and interesting
environment. Clearly, all constituents – the
medical community, the government agencies,
the hospitality and tourism industry – have
already invested a tremendous amount of time,
energy and resources in preparing the country
for medical tourism.
r. Boris
os Hinds, D Mauricio
m
a
R
s
lo
r
w: Dr. Ca
Sosa, Dr.
ht – Top Ro Dr. Gerardo Roberto o Rodriguez
ig
R
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ft
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From L
s, Dr. Juli
ig,
j Joseph,
mpson, Ra Tablas, Herb Steven Solórzano, Neil Fett
a
S
n
a
m
r
e
F
erardo
Dr. Iván
Guerrero, G ight – Bottom Row: lton, Linda Hosford,
a
R
W
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to
From Left briella Vicuña, Tonya , Dr. Adrián Avendañ
o
a
n
G
a
h
p
te
rie S
Renee-Ma
44
March/April 2009
The familiarity tour of El Salvador, sponsored
by Exportsalud and facilitated by the Medical
Tourism Association, was the perfect way to
personally get to know the country as well
the doctors, hospitals, government officials
and others facilitating medical tourism in
El Salvador. I found the people to be very
friendly, warm, welcoming and extremely
accommodating to medical tourism.
Herb Stevens, CEO of Health Travel Guides
Fettig,
inds, Neil vendaño
H
s
o
m
a
R
A
Dr. Carloslórzano, Dr. Adrián
Dr. Iván So
Amar Kam
bhatla and
Dr. Rafael
Lorenzana
ab out th e tour
My experience in El Salvador was astonishingly,
superb! It far exceeded my expectations of an
underdeveloped nation of economic downfall.
I was extremely impressed with the blatent,
growth and development of this tiny nation,
which seems to be blossoming into a profitable
territory. As a healthcare provider, I was able to
witness the competency and compassion of the
physicians that I met. El Salvador’s proximity
to the states, makes for an excellent choice for
healthcare options. I would not hesitate to return
myself, for a vacation/medical procedure. Nor
would I hesitate to refer the US public to this
little gem on the sea!
Linda Hosford, Director of Health Services,
Well Being Travel
ano,
arie Steph
M
e
e
n
e
R
ttig
ford,
Linda Hosnya Walton, Neil Fe
To
a Hosford
d Lind
s-Lima an
e
r
lo
F
o
d
r
Dr. Gera
Dr. Jaime
Flores and
Raj Joseph
March/April 2009
45
BINABUZZ
“We
have
a
Serious Marketing
By MICHAEL BINA
Problem”
Larry Page, Founder of GOOGLE
46
March/April 2009
T
he geeks are a gaga! Imagine Larry Page, the Top Geek
‘n Guru of Google saying: “We have a serious Marketing
problem.”
Google it, but you won’t find those words from Larry’s lips,
would you? Google is God for crying out loud! Omnipotent
and Omnipresent, Google is the very Top Shelf of Top of Mind
Awareness! Larry Page has a Marketing problem???
No, he doesn’t...YOU do! And Larry’s quote was directed
specifically at Scientists, but he could have been ‘talkin to me,
‘talkin to you, ‘talkin to ANYone who’s trying to sell an idea; market
a product; make some money…
At The American Association for the Advancement of Science,
Page called scientists “great citizens,” but they needed to become
engaged in politics, in business and the media to do more “great
things.” Harnessing the full potential of science and technology
requires a much better job of Selling of Science to policymakers,
to business leaders, and to the public. “Science,” he said, “has a
serious Marketing problem.”
Addressing the “Marketing Problem” for the Nicolet Bank
Business Pulse©, CEOs quantified what Page said. When asked
how effective their Marketing was at producing Sales, 40% of CEOs
said their efforts were ONLY Fair - or Poor: Serious, indeed!
PROBLEM TWO: The average tenure of a CMO/Chief
Marketing Officer is 23** months - barely time to make it from The
Job Interview-to-The Exit Interview. (CEO Tenure = 55.8 months;
CIOs = 52; CFOs = 60.)
Ideas, products, businesses and science projects are ALL
dependent on Marketing yet, 40% of CEOs have a problem?
1. CEOs are unhappy because it’s difficult to breakthrough ALL
the Clutter. (85% say they are Very, Moderately or Somewhat
Concerned about it.);
2. CEOs are unhappy about Cost. (82% are either Very, Moderately
or Somewhat Concerned about Marketing expense.);
3. CEOs are unhappy with Marketing’s inability to measure
results (76%).
Google “Marketing,” and you’ll get 768,000,000 results. There
must be one or two GOOD ideas to make a CEO a happy? How can
a Problem exist with all that good data out there?
ONE PROBLEM: CEOs in the Nicolet Bank Business Pulse© say
their Marketing is: “by Committee.” (That’s usually a DISASTER!)
A Management Team/CEO is responsible for Marketing in 77% of
the companies; 5% have a Marketing Team; 2% use their Board
of Directors; 9% say, Other...Other? There is an “Other” out
there??
Eight percent use a CMO (OATK* was the Term of Endearment
preferred by one CEO.)
23 months offers precious little time for the CMO to accomplish
anything before the HR manager gears up for another, high-profile
search for another, high-profile temp: a serious Marketing and a
serious HR Problem!
ANOTHER SERIOUS PROBLEM: Integrating Marketing with
Sales: 76% of CEOs are Very, Moderately or Somewhat Concerned
(and it’s been that way since Nicolet Bank started collecting data on
the subject of Marketing and Sales).
ASIDE TO CEOs: True Integration of Marketing and Sales
ONLY occurs inside The Human Resources Department: Since the
average tenure of a Sales Executive is about the same as a Marketing
Exec, the best opportunity for “integrating” them is either on their
way in, or on their way out! END ASIDE
As with the Marketing Strategy, the Marketing Messaging is
mostly developed in-house (58%); 9% use an advertising agency
exclusively; 33% use a hybrid of in-and-out of house suppliers.
“How well does your ad agency understand the link between
Marketing and Sales?” 52% of CEOs said, “They don’t understand
it at all.” (Odd, isn’t it, that the average ad agency tenure*** is
almost the same as the ‘average Marketing Exec and the ‘average
Sales Exec.)
Nineteen percent said their agency Fully gets it; 18% said they,
Generally Understand; 5% say they Don’t Really Seem to; 7% are
Not Sure. New York Mets CEO Casey Stengel once said: “Can’t
anyone here play this game?”
March/April 2009
47
Scientists, CEOs, CMOs all have a Marketing problem: Can’t
anyone play this game? Apparently, YES!
Addressing the Marketing Game before the Wisconsin
Technology Council, University of Wisconsin Professor Dietram
Scheufele, PhD., said this about Larry Page’s Manifesto: “An
unfortunate statement because it reinforces a concern scientists
have: that they have to ‘spin.’ On the other hand, he’s absolutely
right!”
“There are similarities between commercial marketing and
how we communicate science. We’re dealing with a public that is
not overly informed - or interested. In order to connect, we need
systematic research and strategic communication. It’s all about
understanding audiences and developing targeted messages based
on careful public opinion research.”
“Cognitive Misers,” Dr. Scheufele labled us! And marketing
to Cognitive Misers is the real Problem. How do all those Misers
out there form opinions about your ideas; your products; your
business?
“It’s unrealistic to expect people to sift through masses of
information to draw up a reasoned conclusion,” Scheufele said. “We
are mostly Cognitive Misers - drawing upon a minimum amount of
information. What is crucial is how an issue is ‘framed’ – the context
in which it is communicated and how it fits with peoples’ pre-existing
thinking. Understanding these aspects is crucial to effective science
communication.” Science – and your business, too!
The Harvard Business Review tackled The Problem a few years
ago: “Marketing is in ferment as traditional advertising declines
in efficacy. With buyers increasingly savvy, how can companies
resist relentless commodification and distinguish themselves from
rivals?”
Authors Francesca Golfetto and David Muzursky framed an
approach Scheufele might favor for Misers: Emphasizing expertise
in the business, as distinct from the quality of one’s product.
“Competence-based Marketing is especially persuasive in businessto-business relationships that involve hard-to-access goods or
follow-on services.”
The problem with Harvard, however, is that Quantifying
Competence generally takes longer than the average CMO’s tenure.
What other strategy will CEOs use to attract all us Cognitive Misers
in 2009?
54% will use Word of Mouth/Testimonials
16% will use Advertising
15% will use PR
11% will use their Website
5% don’t have a Primary Strategy
Sixty-two percent of CEOs in the Nicolet Bank Business Pulse©
are B2B Marketeers; 17% are B2C; 22% are both. CEOs say Direct
Mail (34%) is the best way; The Web (26%) is next best.
CEOs are going to use their websites Much More (31%) or
Somewhat More (35%) in 2009. Direct Mail will be Much More
(9%) or Somewhat More (32%). No other medium comes close
2those2.
Regarding the new, 2.0 Web: 12% of CEOs Fully Understand it
and how it works; 88% aren’t there yet! Those who do understand
are using, Peer-to-Peer Networking (41%), Webcasting (26%), and
Social Networking (23%).
For 2009, CEOs are planning to use More, or Somewhat More with Peer-to-Peer (+41%) and Social Networking (+30%) The Top
Two choices. CEOs like 2.0 because it’s trackable; it’s easier to reach
48
March/April 2009
specific audiences; it attracts attention and, CEOs are confident 2.0
is where their Marketing Problem will be solved.
CONCLUSION: For next year anyway, CEOs will have many
more tools and much more talent to throw at the challenge of
reaching, connecting and selling to Cognitive Misers. They can
NOW concentrate on: The Serious HR Problem of recruiting the
right person to fix The Serious Marketing Problem. n
*OATK=One Ass to Kick: Ron Weyers,, retired CEO, coined the
acronym OATK (at least we those of us who were Ron’s OATKs
believed he coined it – and believed he MEANT it). OATK was
Ron’s ‘Code for “The Person in Charge.” Ron detested work by
Committee, Groups, Teams, Boards…he didn’t like sitting around
the corporate campfire singing “Kumbaya,” either. He wanted to
know WHO’s in charge; WHO’s responsible; WHO do I talk to when
something’s screwed up! Committees could run for cover; OATKs
could not! Just another reason his companies were SO successful.
** A Spencer Stuart Survey
*** AdAge Magazine
About the Author
Like MOST people in the World,
Michael Bina fancies himself a
Cognitive Miser; he draws upon a
minimum amount of information
when writing articles for the Medical
Tourism Association. He has a
hard time sitting still for a sales
pitch much less learning anything
about it. He DOES, however, overly
concern himself about the acquisition
of knowledge regarding the field of
Marketing and Sales…and thinks he’s
pretty hip about what’s happening.
Relax...
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March/April 2009
[email protected]
49
Medical Tourism
Consumer
Conferences
Good Idea or Failure?
In the medical tourism industry there has been tremendous growth in the number
of conferences. Last year, there were in excess of 40 such events, or shall we say
“almost 40.” Almost every conference organizer around the world is giving it a
“try” at putting together a medical tourism conference.
50
March/April 2009
For those of you who have attended several conferences lately, I
think you will find that many of them have “thinned” out, meaning,
only the strong and successful ones have survived the test of time.
Can you have a conference company put on an event if they don’t
understand the content being discussed? Looking for numbers
instead of quality is a big mistake because the delegates will walk
away without satisfaction. Recently, you may have heard about a
Singapore based company that held a second Asian event that lacked
buyers and overall a “failed conference.” The company filed for
bankruptcy and left the venue with a hefty unpaid bill. Therefore as
a sponsor it makes sense to affiliate with reputable events.
One fear for speakers is whether the company will be around
tomorrow to reimburse travel expenses. It would therefore make
sense to work with organizers who have a vested interest in the
industry and a reputation to protect. If a conference organizer puts
on dozens of conferences per year, how dedicated can they be to the
development of the industry and increasing the quality of the content
at each event? With the economic recession, your selected medical
tourism conference cannot be organized by an event planner as an
afterthought, with no real dedication or long term planning.
Now some of these conference organizations that were
unsuccessful are now trying to market “consumer” shows, which
are medical tourism conferences focused on attracting the individual
consumer (not business to business). Also known as business-toconsumer events, these events have failed miserably. Several of
these organizations have cancelled events, or have failed events,
then change their names to try again so industry players don’t realize
it’s the same organizer.
M
any conference organizers have no interest in or
knowledge about the medical tourism industry and so
they promote lofty historical numbers of attendees /
delegates and “buyers” (insurance companies and medical tourism
facilitators) who have attended past conferences. However, how
many conferences have really been held regarding medical tourism
or medical travel as we see it developing today? Are these historical
numbers based on reality or a reflection of attendance at other
conferences that had nothing to do with medical tourism? Do these
conferences piggyback off of other healthcare related conferences
to achieve their high “buyer” status? As a matter of practice in
the conference industry, most conference organizers hit less than
10% of their goal and receive about 1% or less of the number of
buyers they anticipate at their medical tourism conference. Why?
Conference organizers who have no vested interest in the industry
hold conferences for the sake of holding conferences and making a
buck, not to grow the industry.
Further, people without a stake in the industry generally do not
have the ability to bring in the right players or create the appropriate
content. For this reason many of these “conferences” are nothing
more than business meetings of 40 – 80 people in attendance; many
consist of just the speakers themselves. Therefore it is important to
realize exactly what you want to gain from attending a conference
and to spend your money wisely to achieve your goals at each event
you attend. Are you looking for networking, exhibition opportunity,
developed content or a Return on Investment (ROI)?
The reasons why these conferences fail is that hospitals and
healthcare providers spend the same amount of money in exhibit
booths, airfare, hotel and marketing costs to travel to a medical
tourism consumer expo as they would spend at a business to
business medical tourism conference. At a business-to-business
(B to B) event, a hospital has the chance of networking with an
insurance carrier, employer or medical tourism facilitator who can
send them hundreds or thousands of patients per year. At a medical
tourism consumer exposition (B to C), hospitals potentially spend
time speaking with patients who may be considering multiple
destinations and providers and therefore hospitals do not maximize
their time speaking to qualified patients. In fact, the conversion rate
from inquiry to patient significantly decreases when you place the
patient in the same room with multiple competitors.
Most of the medical tourism
conferences are getting “thinned”
out, meaning only the strong and
successful ones will survive.
Moreover, patients take up a lot more time. Would a hospital
rather spend 30 minutes to one hour speaking to a potential knee
replacement patient, or spend 30 minutes to one hour talking to a
medical tourism facilitator or insurance company who can send
them thousands of patients? I don’t think you need to a calculation
to realize which is the better ROI. More importantly, the people
that should be meeting with patients are not the same people who
would be meeting with insurance companies or employers. These
March/April 2009
51
latter groups want to meet with decision makers, not public relations
or international patient department representatives.
Why is there no turn out for medical tourism consumer
directed shows?
First, you can only attract local patients. Medical Tourists who
have no health insurance aren’t going to pay the expense to fly on
an airplane, and hotel costs (thousands of potential dollars) to walk
through an exhibit hall of hospitals. These patients are trying to save
money $$$, and so they are searching on the Internet. If you can
only attract local patients, you need to do your research to find out
whether the demographics of those patients fits with your marketing
strategy. The cost of advertising on local TV and newspapers is too
expensive; therefore these shows are not marketing to a broad local
audience. So, how do potential patients hear about it? The answer
is uncertain. One such planner recently just canceled their consumer
medical tourism conference, because of a lack of interest.
With the economic recession,
your selected medical tourism
conference cannot be organized
by an event planner as an
afterthought.
Just a few months ago a foreign government tried their own
consumer medical tourism conference directed towards people of
their country origin located in the United States. Held in a large US
city with marketing directed towards the 600,000 residents of that
origin located in that city, the government spent a significant amount
of money marketing and advertising towards this specific ethnic
group. They recently reported that their Return on Investment
(ROI) was very poor and that they realized that a consumer type
show is not a viable option and would not do it again. So, it is
important to know how to wisely spend your marketing dollars
especially now that many countries and hospitals have reduced their
marketing budgets due to the economy.
Also, be very careful. Word on the street is that these so
called “medical tourism consumer conference organizers” have all
entered the facilitation business and are now trying to make money
facilitating patients and travel logistics. It is assumed that since they
aren’t making money, they are using the event to generate leads and
compete with their exhibitors.
One reason why the Medical Tourism Association assisted in the
creation of the first wholly dedicated medical tourism convention
and exposition was because of demand from our members for
there to be a medical tourism conference where the content would
continue to advance as the industry advanced. They wanted to meet
and network with actual “buyers.” Our Chief Operating Officer
created a conference company that would be dedicated to the medical
tourism industry and only put on medical tourism congresses with
advanced content, and dedicated only to the MTA’s goals of creating
a solid foundation for the medical tourism industry.
52
March/April 2009
The MTA’s annual membership meeting and complete congress
with educational learning workshops takes place on October 26th28th, in Los Angeles, with an expectation up to 2,000 attendees,
while last year’s was comprised of more than 750 attendees in San
Francisco. We now have launched smaller regional conferences
that have greater attendance than any other conference in the world.
Our first regional conference takes place in Monterrey, Mexico,
called Latin America Medical Tourism & Global Health Congress,
www.latinamericamedicaltourismcongress.com and is expected to
have up to 400 attendees. At the time of writing this article, all 20
booths were already sold out, and it is expected that between 50 to
100 corporate buyers of healthcare will be in attendance to learn and
to network.
The regional congresses are extremely affordable to put on and
therefore allowing us to offer registration fees that are sometimes
four to six times less than other conference companies. The
governments we partner with also make available a budget for us to
fly in “corporate buyers”, which simply other conference companies
do not do, because they are more concerned with maximizing their
profit than with creating good networking opportunities. Our next
regional conference is being planned for the Spring of 2010 in Asia
where we are hoping to have approximately 800 to 1,000 attendees,
and at least 150 “corporate buyers”. Besides bringing in the best
expert speakers, we really try to focus on growing the industry
through facilitating networking and the creation of solid business
relationships.
Choose your conferences wisely… n
About the Author
Jonathan Edelheit is President of the Medical Tourism
Association with a long history in the healthcare industry,
providing third party administration services for fully insured,
self-funded and mini-medical plans to large employers groups.
March/April 2009
53
Are you Providing a
Top Notch
Patient Experience?
By ALEX PIPER and JOSH HANSON
How do international hospitals successfully cater to the patient population?
Surely it is essential to promote that your hospital has the best-trained medical
staff, a safe track record of procedures, and an attractive pricing model, but this
is just the beginning.
54
March/April 2009
H
ospitals must also deliver an exceptional patient
experience in order to have meaningful success in
servicing the patient base. Ultimately your hospital
may offer the utmost in health care and still fall short in overall
evaluation by the patient. In most cases the experience may
have been lacking in some of the ancillary offerings, perhaps
seemingly simple comfort and convenience offerings that have
been overlooked or considered low on the priority scale by certain
hospitals.
neighboring states, let alone gone across the world for treatment.
The procedural/treatment experience and the non-procedural
experience (hospitality and comfort) must be evaluated as a
complete patient experience that is exceptional at every touchpoint.
Hospitals must sell the patient on the complete experience.
The patient experience is
important for attracting and
retaining the US patient base.
Of the eight (8) components that comprise the total patient
experience (Thinking, Considering, Research, Decision,
Assembling, Purchase, Experience and After Glow), only one
(Experience) is dominated by the actual medical procedure and/
or treatment that the patient is undergoing. The patient owns all
eight components and all eight contribute to the overall patient
experience. By overlooking certain opportunities to improve
on the patient experience hospitals are missing the chance to set
themselves apart from the competition and attract patients. What
opportunities are you missing with your patients? What revenue
is passing you by? Yes, revenue; because improving on the patient
experience by providing certain offerings could also create added
revenue streams. How complete and successful is the patient
experience at your facility?
First, we are going to explore the emerging trend and popularity
of defined consumer experiences in the market. We will look at
both the general consumer marketplace as well as examples in
the healthcare industry. It isn’t enough for consumer businesses
such as retail stores and service providers to simply market their
products and offer them at convenient locations. Cutting edge
companies are developing consumer experiences that deliver their
offerings in comfortable, intuitive, and focused environments.
This accomplishes key objectives for successful retailers.
Customers increase the time in the retailer’s space, increase
their purchases, make repeat visits and give positive referrals.
Three key consumer responses need to be minimized as much as
possible: stress, confusion, and product/service irrelevance. They
are detrimental to the success of your offerings. What is it that
the consumer marketplace tells us about the healthcare industry?
The more stress that is alleviated from consumer decision-making
related to their healthcare, the more parallels develop in how the
consumer makes decisions in retail and the overall consumer
marketplace. The patient experience is important for attracting
and retaining the patient base.
Hospitals need to think outside the box about how they offer
their services, experiences, and overall patient care. It is critical
that every touchpoint that a patient experiences while in your care
is positive and that it has the distinct impression that it is catered
to them. This is very important to the patient base at large. The
journey from home to the overseas healthcare provider, and back
to home, is a daunting and potentially stressful endeavor for the
patient. Sometimes this is a deal-breaker to the potential patient
who cannot fathom that this journey could possibly happen. For
example, in some cases patients have never ventured beyond
An international consumer electronic retailer recently
experimented with a store environment that focused entirely on
the woman shopper experience vs. the traditional male electronics
shopper. The environment featured colors, textures, scents,
graphics, fixtures, signage, and ultimately products that all catered
to the female shopper. The result was a 39% increase in sales
for the products and services offered in this experience-based
selling environment. Surprisingly the sales not only came from
women. The results also found that women affect over 80% of the
purchasing decisions that men make. Therefore if you markedly
improve the experience of a patient during their stay, you will
likely see this affect the greater scope of your medical tourism
business.
Hospitals need to think outside the box
about how they offer their services,
experiences, and overall patient care.
Always be aware of who is making the decision to use your
services; in the case of a patient, the spouse and family members
are equally if not more important in deciding on an overseas
hospital for their loved one. They are looking for successful
operations, safety, comfort; they are looking to minimize stress,
confusion, and product/service irrelevance. They are looking for
success in the overall patient experience, which is relevant to the
entire family unit and support structure. Neighbors, colleagues at
March/April 2009
55
work, friends and associates of the patient are also interested in
the well being of the patient, and could potentially be customers
sometime in the future; again all depending on the overall patient
experience. Word of mouth referral is huge in the patient base. In
the Deloitte report, Medical Tourism – Consumers in Search of
Value, word-of-mouth marketing is highlighted as one of the three
sources of information that a potential patient accesses during the
pre-procedure phases.
Hospitals must sell the US patient on
the complete experience.
Another example of the impact patient experiences can have
in the medical industry is demonstrated by leading healthcare
providers in the US. Throughout the US, healthcare organizations
are realizing the importance of a complete patient’s care
experience. Traditional patient care focused solely on medical
treatment and all ancillary products and services were provided
by a myriad of outside sources. This traditional approach is very
difficult to manage successfully and the gaps into which a patient’s
experience could be adversely affected are numerous. Today
healthcare providers recognize the importance of developing longterm and profitable patient relationships. To accomplish this they
are providing a portfolio of products, services, and resources that
are all offered WITHIN their organization. This offering helps to
complete the patient experience and deliver all the elements that
are so vital to the overall success of the organization.
These are just two industries that have discovered and
implemented the solution for capturing, retaining, and profiting
from a satisfied consumer/patient. This is creating substantial
returns for those organizations that embrace the concept.
Is your hospital focused on the patient experience? Is your
hospital getting repeat visits, stellar referrals, and consistent
growth? If you are not sure then you need to find out now.
The path to exceptional patient experiences:
1. Be honest about what you are providing your patients. Do you
know what the patient is looking for? What are the strengths
of your hospital in its offerings to your targeted patient base?
Is there room for improvement? Do you understand all of
the opportunities that are available today? Do you have
long term plans that provide sustainable growth and market
dominance?
2. Get unbiased analysis from a professional evaluation firm.
If you are not sure how your organization is positioned for
delivering a world-class patient experience, then find out. A
professional evaluation firm can evaluate how your medical
tourism organization is positioned in the industry and provide
the path to maximize your opportunities.
Today healthcare providers
recognize the importance of
developing long-term and profitable
patient relationships.
56
March/April 2009
3. Develop a “patient experience action plan”. Develop a
custom plan to explore and implement a world-class patient
experience for your organization. The evaluation and patient
experience firm can develop the custom plan and recommend
a process to get it done.
4. Implement the plan. When you have a plan that capitalizes on
your strengths and addresses all of your opportunities, then
implement it.
5. Sustain and Improve. Continue to get unbiased feedback from
a professional evaluation firm and plan for regular updates
to your patient experience action plan. Refresh critical
About the Authors
With over 17 years experience in Insurance,
Marketing and Employee Benefits
Management, Alex Piper possesses extensive
knowledge of the U.S. Healthcare Market
and the influence that Insurance Carriers,
U.S. Employers, Hospitals, Physicians,
Physician Groups, Healthcare Professional
Organizations and Government will have on
the next generation of global healthcare.
He is the President of OneWorld Global Healthcare
Solutions, a consulting company committed to creating
a worldwide healthcare solution. He can be reached at
[email protected] or www.
OneWorldGlobalHealthcareSolutions.com
touchpoints so new and returning patients can continue to
benefit from the world-class organization you have created.
Why is it so critical to provide a world-class patient experience?
If you don’t offer the experience then your competition will. A
world-class patient experience allows you to fully capture new
business, maximize profits, differentiate from competition, and
maintain relevance with the patient population. Ultimately patients
will choose a facility that offers safety, comfort, and a complete
experience that fulfills their needs and desires. Investing in all
aspects of your patients’ experience will establish your medical
organization as a leader in the industry and most importantly, in
the opinion of your patients. n
Josh Hanson is the principal of Touchoint.
Touchpoint has evaluated, designed, and built
complete consumer experiences throughout
the United States for organizations including
Kettering Health Network, Bellin Health,
Aurora Health Care, Avera McKennan
Hospital, Park Nicollet, BayHealth and many
more.
OneWorld Global Healthcare Solutions has formed an
alliance with Touchpoint to bring you the full spectrum of
consulting and patient experience services. Visit OneWorld’s
website (www.oneworldglobalhealthcaresolutions.com) for
more information.
March/April 2009
57
Partnering for
Patients
and Profit:
Hospital Developed and Owned Networks
By DR. CHAD HOLLOWAY
As the medical tourism industry matures, hospital partnerships will become
increasingly important for a number of reasons, ranging from simplified
contracting to improved customer service for payers and patients.
58
March/April 2009
O
ver the past 20 years, US healthcare providers learned
lessons, both positive and negative, through the formation
and dissolution of networks; that is, the affiliation of
providers into one unified organization in the pursuit of specific,
common goals. Readers should observe that, if executed correctly,
a strategic partnership of free standing hospitals to create a network
can differentiate and ultimately increase profits for all of the hospitals
belonging to the network.
PAYERS AND NETWORKS
In this article, payers are defined as self-funded groups and
insurance companies. While they differ in various ways, their
primary commonality for this discussion is that they are seeking highquality, low-cost healthcare for their members and they accomplish
this through the rental or development of networks. Payer networks
combine individual providers, groups of providers, and multi-hospital
systems into a package that the insurance company can market and
the self insured groups can access for care.
In large part, the network
and its characteristics are the
determinants of an insurance
company’s success.
Self-funded groups typically rent a network from another
company, although in some cases they may develop their own network,
and work with a vendor to provide administrative services, such as
processing claims and distributing money to providers for services
received. The companies providing the administrative services
may be third party administrators (TPAs) or insurance companies.
In either of these cases, the TPAs and insurance companies have a
fiduciary responsibility to the self-funded group to ensure that money
is distributed accurately according to the contracts with the providers,
the benefit plan, and services received. However, it is important to
remember that the money they are distributing belongs to the selffunded group’s plan and the self-funded groups, in general, are
extremely sensitive to price and access; they want to keep members
satisfied with their medical services, while using the company’s
resources as expeditiously as possible.
While self-funded groups rent networks, insurance companies
sell a number of products and services ranging from claim and benefit
administration to medical management, but their primary “product” is
their network of hospitals and physicians. In large part, the network
and its characteristics are the determinants of an insurance company’s
success. If the network lacks a key facility or group of facilities, is
perceived as being comprised of low-quality providers, is missing a
price advantage, or has access gaps in a geographic area, the groups
purchasing insurance or renting the network through the insurance
company will seek services elsewhere. For example, if a key provider
terminates its contract with an insurance company, the groups that
purchase insurance products or administrative services through that
company may not renew their contracts.
In either case, a network is extremely important in the insurance
industry. The quality of hospitals comprising a network, their cost
structure, and local perceptions are important determinants as to
whether or not the provider is included in a network. Hospitals are
likely to be “key facilities” in a network if they have some sort of
leverage, for example, if a hospital is the only one in a rural town
and the employees of the local company need their services. Or, if a
hospital belongs to a multi-hospital system that provides a significant
amount of care to a population and the hospital is included as part
of a system-wide contract with the payer, the hospital receives
some protection against contract termination because terminating
the contract would terminate the relationship with the entire multihospital system. In this situation, there is safety in numbers.
DIFFERENCES BETWEEN US AND INTERNATIONAL
FACILITIES
Readers will immediately observe the differences between a
facility in the US providing a significant amount of medical services
to the insurance company’s members and an international facility
providing medical tourism services, at this point, for a handful of
members. At the current time, from an insurer’s perspective, while
some international hospitals are important, none of them are key
facilities in the same sense that a domestic hospital is a key facility;
the volume of medical tourism patients is too low to have a material
financial impact. Any international hospital could leave an insurer’s
network, for any reason, with little or no impact on the insurer or
the hospital. As the industry matures, however, and the number of
medical tourists increases, the goal of the international facility is
to become a key provider for payers. This may occur based on the
volumes of patients treated, but more likely will be due to strategic
partnerships with other hospitals. Thus, key provider status may
be accomplished by an individual facility, but most likely will be
realized by multi-hospital groups and hospitals that, even though they
are competitors in some respects, can work in concert toward noncompetitive common goals with other hospitals. As a leader of an
international healthcare facility or international patient department,
one must take action to ensure that his or her facility or department
becomes a “key provider” for the US payers and one way to do this
is through partnerships.
PARTNERING FOR PATIENTS AND PROFIT
Although a number of facilities are owned by multi-hospital
systems, most international healthcare facilities are independent,
freestanding facilities. Individual facilities can band together with
other individual facilities, or perhaps even with multi-hospital
systems, to create powerful, provider-owned, strategic partnerships
through an independent organization that has specific goals, such
as, managing the medical tourism contracts with external parties,
including payers and medical travel facilitators. This provider
owned organization must be innovative and flexible in its problem
solving while representing and defending its constituent hospitals and
physicians.
The discussion of networks can be confusing. For clarification,
provider owned networks will be distinguished from payer networks.
Specifically, payer networks include, as stated above, individual
providers, groups of providers, and multi-hospital systems. A
provider owned network can be part of a payer network; in fact, that
is typically the primary objective. However, the difference is that in a
provider owned network, the providers organize themselves and unite
for common goals instead of being organized by a third party.
A network is extremely important
in the insurance industry.
With the partnership of several facilities, a separate and focused
organization, jointly directed by the individual hospitals, can be
created to manage some common functions, such as, creating and
coordinating a medical tourism strategic plan with the input of the
facilities, streamlining marketing efforts, realizing economies of scale,
hiring experienced and qualified staff, and contracting simultaneously
on behalf of all of the member facilities under a single signature.
First, the facilities must partner with each other. In this situation,
one organization will take the lead and invite other organizations into
discussions about a potential partnership. Some important variables
for determining whether or not to invite another organization into
discussions may include: JCI accreditation status or the potential of
a facility to obtain JCI accreditation, geographic location, medical
service mix, and current medical tourism success. In the discussions
March/April 2009
59
between and among hospitals, common goals must be identified and
could include: accessing the individual or the payer markets, reducing
marketing-related expenditures, and utilizing contractors with US
payer experience.
Second, the facilities partnering, must ensure they are equals in the
new organization. Fairness can be maintained through directorships.
For example, each hospital could have a director, such as the president
of the hospital or the director of the international patient department,
on the board of the independent organization; each director receives
one vote for each issue brought before the board by the management
of the jointly formed company.
Third, the activities must be strategically aligned. While each
facility will have a strategic plan, each hospital must cooperate through
their director to create a strategic plan for the new organization. For
example, will the newly formed organization manage only medical
tourism contracting with payers and facilitators, or, will it act as a
buyer’s group to obtain quantity discounts on medical supplies etc.?
The directors must ensure that the new organization’s goals and
strategies mesh with each hospital’s goals, especially as they relate
to shared functions.
Networks of any size will take
some time to plan, assemble,
and operate.
Next, it is important for the partner providers to own the network.
Together, the facilities can cooperate to manage price structure,
quality of care, size of the network, and geographic distribution to
ensure negotiating power. Where a third party manages relationships
with each hospital, the effective coordination of activities of the
hospitals is absent.
Finally, networks of any size will take some time to plan,
assemble, and operate. In medical tourism, the situation could be
complicated by the laws of different countries, the newness of the
industry for most facilities, and a desire to remain independent. If a
provider network is formed, it will require an investment of time and
energy in the short run, but will prove to be much more effective in
the long run.
FUNDING THE ORGANIZATION
A variety of methods could be used to fund the network, but it
is important that the partner providers share equally. Initially, the
network could be funded through a cash investment by the facilities
in the network; the more facilities in the network, the less the initial
capital expenditure per facility. However, the facilities invited to
participate must be based, not on reducing the initial cash investment
per facility, but on strategically strengthening the network and, for
medical tourism, making it more appealing to US payers. The start up
capital required depends on the final design of the organization and
the resources that it would require and the real value is recognized
once the organization is operational.
The owner facilities, after the initial start up capital, should not
need to continue funding the new company. In fact, organizations
like this should be considered revenue centers. In one example
of a provider owned network organization, the profit margin was
approximately 50% and this organization not only increased business
for the hospitals and their physicians, but also paid a dividend to the
facilities! With the right management and incentives, it will support
itself.
The new organization can obtain revenue through various
sources. One way that the new organization could make money is
through charging various access fees to payers. Charging access fees
to payers, at this early stage, is not a reality, but as the demand for
60
March/April 2009
medical tourism increases and the hospital network proves itself in the
market, this is a probability. In addition, a small percent of revenue
going to each facility as the result of the efforts of the organization
could be credited to the new company. For instance, the rates for care
for each facility should be incrementally higher because of the single
signature contracting and also because of the strategic importance
to payers of the combined hospital network. That is, with the right
mix of providers and the correct organizational structure, a premium
could be obtained from payers. A portion of the total claim (e.g., 3%)
could be retained by the organization for each claim that is paid.
ADVANTAGES FOR EXTERNAL STAKEHOLDERS
The hospitals are not the only beneficiaries; this model offers
advantages to a variety of stakeholders as well. One benefit is that
this model offers a single point of contact for payers and medical
travel facilitators wanting to initially contract or re-contract with a
group of hospitals. Through a single negotiation and contract, payers
and facilitators gain access to all of the hospitals and physicians in
the network. This simplified and unified process saves the payers,
facilitators, and hospitals time, effort, and resources. With one or two
contractors experienced at negotiating contracts with or for insurers,
the hospitals can obtain protection from the pitfalls of contracting
in the US (e.g., timely payment) and the payers can negotiate with
people who know and understand the payer contracting process.
A second benefit to payers is that quality data could be readily
available for each facility and each doctor in the network from a
single source. For example, the new organization could obtain from
each facility and then provide to relevant parties information such as,
JCI accreditation status for each hospital along with quality measures,
volumes of specific procedures, and credentialing information
about each provider. It would be proactive for the organization to
periodically obtain or update quality data for the network providers.
While payers with certain types of accreditation find delegated
credentialing to be too onerous to manage for their accreditation,
with the right policies, procedures, management, and commitment,
delegated credentialing might be an option. While it is labor intensive
to prepare for a delegated credentialing audit and subsequent re-audits
every two or three years, once the audit is passed, it can simplify the
process for both the network and the payer.
SUMMARY
As medical tourism evolves, the ability of facilities to strategically
unite and cooperate with multiple facilities to form a provider owned
and controlled network within the industry will separate those who
flourish from those who subsist. Ultimately, this is a balancing act.
The needs of the payers and the needs of the provider must be balanced
for a win-win situation; the prices and terms must be managed so
that payers can sell or rent network and the facilities can ensure the
network operates profitably. Providers in various markets, whether
local or international, must cooperate to achieve something greater
than each hospital could achieve individually. n
About the Author:
Dr. Chad Holloway is founder and
president of Global Health Solutions LLC,
an international healthcare consulting
company providing marketing, contracting,
and strategic planning services related to
medical tourism for healthcare providers and
consumers. Formerly, he was with WellPoint
Inc., the largest US health insurance
company in terms of membership, and BJC
HealthCare, a large, integrated hospital
system in St. Louis, Missouri. He has multiple academic credentials
including a master’s degree in healthcare administration from
Washington University in St Louis and a Ph.D. from the University
of Miami. He can be reached at 001-618-444-1552 or at chaddh@
accessus.net.
March/April 2009
61
Medical Tourism
Economic Report:
El Salvador
By DAVID G. VEQUIST and ERIKA VALDEZ
62
March/April 2009
E
l Salvador is a land of amazing beauty and has experienced
much growth over the last ten years. During this period,
the country has adopted the US dollar as its currency
(2001), continued to move towards a free-market democracy,
became the first to ratify the Central America-Dominican Republic
Free Trade Agreement (CAFTA) in 2006, engaged in a countrywide
modernization, and became the third largest economy in Central
America despite being the smallest country (total area of 8,123 square
miles [21,040 sq km], about the size of the state of Massachusetts)
in that region. Most U.S. cities can reach El Salvador by airline
within 2 to 7 hours, English is the second language (Spanish is the
official language of the nation), and the tourism market from the
U.S. and other western countries is robust.
According to a recent report by the Ministry of Tourism, El
Salvador received $411,135,773 USD in foreign currency in the first
half of 2008 (annualized to $822 million USD or a 22.0% growth in
earnings compared to 2007). The same report indicates that were
991,874 tourists during this same period (annualized to 1.9 million
tourists or a 25.8% growth rate compared to 2007). Also, for the
same period, the percentage distribution of tourists by region is:
Central America, 62.12%; North America, 31.64%; Europe, 2.83%;
South America, 2.30%. Within the Central American market niche,
the number of tourists from Guatemala (which it borders along with
Honduras- which is third with 103,234 arrivals or 15.0% of the
total) increased by 12.95% versus 2007. The U.S. was 2nd with
183,476 arrivals (360k when annualized) which was about 26.65%
of the total number of tourists.
Recently, the country has been
expanding capacity in the hospitality
sector and currently has 7,282 rooms
in 318 hotels throughout the country.
Recently, the country has been expanding capacity in the
hospitality sector and currently has 7,282 rooms in 318 hotels
throughout the country. It has some of the most interesting Mayan
ruins in all of Central America, over 307 km of shoreline (with
supposedly wonderful surfing!), majestic volcanoes, and beautiful
cloud forests. El Salvador has a tropical climate with only two real
seasons, the dry season (verano- from November to April), and the
wet season (invierno- from May to October). Temperatures vary
depending on the elevation in El Salvador with the coastal areas
being the warmest, averaging between 22°C and 32°C throughout
the year. El Salvador’s central international airport, Aeropuerto
Internacional Comalapa, is about 50 km southeast of San Salvador
(the capital city) and is a major Central and Latin American hub
(with direct flights to North American cities like Los Angeles, New
York and San Francisco).
The Chamber of Exporters of Health Services of El Salvador
(Exportsalud), the Export Promotion Agency of El Salvador
(Exporta), the Investment Promotion Agency (Proesa), and Ministry
of Tourism (Mitur) are pursuing medical tourism in this country.
These include savings of up to 75% over U.S. prices and many
U.S.-trained physicians in the areas of dentistry, gastroenterology,
bariatric surgery, ophthalmology, general surgery, plastic surgery,
and orthopedics, providing services such as dental implants, gastric
and weight loss surgeries, ophthalmologic care, hernia repair,
cosmetic procedures, and laparoscopic orthopedic procedures.
Economic Facts
According to the CIA Factbook, it is expected that economic
growth will decelerate in 2009 due to the global slowdown and El
Salvador’s dependence on exports to the US (its most important
trading partner, receiving 65.4% of its exports and providing 46.3%
of its imports). In addition (similar to Mexico), El Salvador leads
the region in remittances per capita from Salvadorans living abroad
(primarily from the U.S.) with inflows equivalent to nearly all export
income (in 2005, remittances reached $2.83 billion). An estimated
1.5 to two million Salvadorans reside in the United States (estimated
in 2007 as 3% of the foreign born residents), many of them illegally
(in 2007, it is estimated that only 30.1% are naturalized citizens).
The total population of El Salvador is estimated at 7,066,403 (as of
July 2008) and growing at a slightly positive rate of 1.679%.
The GDP (using the purchasing power parity model) of El
Salvador was $45.34 billion USD (using 2008 estimates) which
equals out to around $6,400 per capita (PPP). GDP was growing at
a 3.2% rate and GDP per capita was growing at a 2.3% rate back in
2008. In the most recent estimates from 2008, the services sector
makes up 64.1% of the GDP, with industry (primarily manufacturing)
making up 24.7%, and agriculture making up 11.2%. The labor
force is composed of approximately 2.958 million Salvadorans
(by industry in 2006 would be: services 58%, industry 23%, and
agriculture 19%) and the unemployment rate is 6.3% according to
2008 official rates (there is quite a bit of underemployment in El
Salvador).
According to WHO statistics, the total
expenditures on health per capita was
$387 USD and total expenditures on
health as a percentage of GDP was
7.0% (in 2006).
Healthcare Facts
The ratio of physicians per 1,000 population in El Salvador
increased in the last 5 years from .9 to 1.22 (but still low compared
to an OECD of 3.1) and now the country has at least 7,298 registered
physicians (from 2002 numbers). The ratio of nurses per 1,000
population however is .8, which is significantly lower than the
OECD average of 9.7. The number of dentists in El Salvador per
1,000 population is surprisingly high at .54 which is comparable
to Canada (which has a rate of .58). According to WHO statistics,
the total expenditures on health per capita was $387 USD and total
expenditures on health as a percentage of GDP was 7.0% (in 2006).
This ranks as 83rd in the world in health expenditure per capita
but overall El Salvador ranks 115th in the world in health system
performance.
March/April 2009
63
significant cost-sharing amount for medical care which can provide
an incentive to avoid high out-of-pocket costs.
The unique aspect of the plan was that it would reimburse
patients the same amount for each particular service, regardless of
where it is performed geographically. Therefore, a patient would
pay significantly lower out-of-pocket costs by going abroad for
treatment. The firm was planning on a health plan targeted at El
Salvadorans living in the United States. These beneficiaries would
receive a limited number of primary care visits (in the U.S.) and
could travel to El Salvador for covered major medical needs.
According to some commentators, the reason for this low
ranking is that El Salvador has something akin to two distinct health
care systems. The first is the government run system (approximately
41.8% of the total healthcare expenditures) that is designed for the
poor, employs overworked doctors, uses out of date equipment (it
was estimated in 2000 that 63% of hospitals in El Salvador are
over 30 years old), and don’t have as much time to spend with each
patient. This system was made up of 610 establishments in 2000
(30 hospitals, with a total of 4,677 hospital beds, 357 health units,
171 “health houses”, 52 Rural Nutrition Centers, and 1 clinic). The
second system is a completely private based system (using a Fee
For Service or FFS approach) that uses qualified doctors, state of
the art technology, and the doctors spend ample time with their
patients, which unfortunately, only the affluent can afford (58.2% of
healthcare expenditures, with households contributing 97% out-ofpocket). Most of these private sector clinics, general and specialty
hospitals are concentrated in the country’s capital and other large
cities. Some of the main hospitals are the Hospital de Diagnóstico,
Hospital de la Mujer, Centro Pediátrico, and Centro Ginecológico.
The main insurers in this region are SISA, Pan American Life,
ASESUISA, and Salud Total.
Doug needed a full mouth restoration
and was quoted a price of $60,000 USD
and in El Salvador he paid $19,000 USD
for the procedure, a savings of over
$30,000 USD.
El Salvador is in the process of receiving recommendations
from Joint Commission International, Trent Accreditation Scheme
and Accreditation Canada to evaluate options for international
accreditation of its hospitals and specialty clinics.
Impacts to Other Industries
An interesting aspect of the medical tourism hopes of El
Salvador was the announcement by a medical tourism firm that it
was working with a major insurer to design a low-cost health plan
(coverage might cost a family as little as $200 USD per month)
that would offer limited benefits (sometimes referred to as a “minimed” plan) where the benefit would be a specific sum of money.
Mini-med plans typically provide coverage for a limited number
of physician visits each year, a limited amount of inpatient care,
and some basic coverage for prescription drugs (the benefits are
typically capped at a maximum of about $25,000 USD annually).
Because these policies pay a relatively low amount, patients bear a
64
March/April 2009
Also, an interesting trend is El Salvador’s market in reproductive
tourism (includes IVF procedures and surrogacy options). Driving
this trend are the number of fertility specialist practicing outside the
U.S., the state-of-the-art facilities in countries like India, Mexico,
and El Salvador, the high surrogacy costs in the U.S. ($80,000 USD
or more), and the existing legal liabilities (in the U.S., there are no
legal guarantees that the surrogate will not later attempt to keep the
baby). It was reported in 2008 that surrogate pregnancies (currently
estimated to be a $1 billion USD business in India) only cost around
$25,000 USD in India (it is assumed to be similar in El Salvador),
plus there are limited legal issues and the arrangements are also
easier to manage.
Summary
El Salvador has a lot going for it when looking to grow the medical
tourism market particularly in the beauty of its location, friendly
populace, and western-trained and English-speaking providers.
However, it still has some obstacles to overcome including more
robust and mature competitors in other Latin American countries,
the disparity in its’ health system, and a reputation for violence and
crime. However, there is the possibility it could carve out chunks of
market share rapidly in areas like full mouth restoration (see below)
and reproductive tourism, among others.
Finally, medical tourism in El Salvador received a big PR
boost when a Fox News Radio Anchor/Reporter (Lori Lundin)
wrote a multi-piece blog (in 2008) off of the Fox News online site
(see http://health.blogs.foxnews.com/category/medical-tourism/)
about her experiences in the country. Lori’s husband Doug needed
a full mouth restoration and was quoted a price of $60,000 USD
by a U.S. dental surgeon. They then received quotes from several
countries and decided upon El Salvador and paid $19,000 USD for
the procedure plus a few thousand for travel expenses (a savings of
over $30,000 USD!). They describe the country and the people in a
very complimentary light and bemoan the fact that the country still
has a reputation for being unsafe. This is a great piece and is worth
its weight in gold for marketing medical tourism in this beautiful
country. n
About the Authors
David G. Vequist IV, Ph.D. is the founder and Director of the Center
for Medical Tourism Research (www.medicaltourismresearch.org)
- the very first Medical Tourism research center in the world. He
is also an Associate Professor of Management in the H-E-B School
of Business & Administration at the University of Incarnate Word
in San Antonio, Texas, USA. He is also a consultant, author and
speaker on topics such as healthcare trends and technologies. He
can be reached at [email protected].
Erika Valdez, is a student in the MBA program in the H-E-B
School of Business & Administration at the University of Incarnate
Word in San Antonio, Texas, USA. She is a promising speaker
and author in the area of economic development in developing
nations. She can be reached at [email protected].
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March/April 2009
65
Investigating
Medical Tourism
Beneath
the Surface
By NISHANT BAGADIA
As healthcare globalizes at a rapid scale it introduces local complexities for a
variety of players: patients and their families, countries, hospital providers and
their staff, medical technology and pharmaceutical corporations, accreditation
agencies and regulatory bodies. How we evaluate these trends will be critical
in predicting future growth.
66
March/April 2009
©
B
y now many are well aware of the heightened interest in
analyzing the medical tourism market. This stems from a
shared stakeholder incentive to quantify and measure the
growth of this industry. For some corporations, medical technology
companies, health insurance firms and hospital agents, an analysis
of transnational medical travel hopes to generate efficient ways to
improve their bottom-line during this global financial crisis.
Others seek to inform the economic or political agenda of the
countries participating in this process. However, the analysis thus
far precludes questions that are beneath the surface of numbers and
charts. Specifically, the social, ethical and cultural explanations
underlying the expansion of international medical travel require a
much deeper empirical study to address the more cogent adjustments
for demand-and-supplier-side participants.
In this cultural montage, the statistical trends must share their
results and forecasts with qualitative and ethnographic findings that
bring us closer to the human nature of the medical tourism process.
Thus, as anthropologists have noted, we are not only seeing
the movement of people across national boundaries that should
hold significant weight in our analysis, but the accompanying
technological, monetary and ideological movements1 are important
factors.
International health consumers are
believed to participate in “biomedical
self-shaping”.
Some authors have started to recognize the importance of the
engaging, humanizing methods that anthropologists use to reframe
the issue, and they promote the incorporation of this qualitative
research into ongoing business innovation2. As such, this article
outlines the issues that dive deeper into understanding the consumer
demand for international medical travel and reviews some empirical
evidence to inform ways in which stakeholders must welcome the
complimentary qualitative research perspectives while playing a
hand in this burgeoning market.
Problems With the Surface
The now well-attributed Deloitte Consulting survey on medical
tourism asked over 3000 people ages 18-75 various questions about
consumer healthcare. Representing an expansive demography of
U.S. nationals, survey respondents were allowed a numerical rating
on topics ranging from their perspectives and attitudes to their
expectations and desires for adequate healthcare.
At a macro-level, this study paints a picture of a segmented
patient market with self-sufficient incentives to manage their
healthcare process and increase demands for better quality care. The
findings suggest that by 2017, fifteen million innovation-seeking
consumers will transfer $400 US billion (base case scenario) of
healthcare spending from U.S. providers to hospitals overseas. This
picture enables insurance agencies, providers and other stakeholders
to paint new direction for improving and innovating domestic
healthcare3.
Kangas B (2002) “Therapeutic itineraries in a global world: Yemenis and their
search for biomedical treatment abroad.” Medical Anthrpology 21: 35-78. In context,
Kangas discusses these movements in the global process in international medical
travel and as a function of her multi-sited research.
1
Kelley T and Littman J (2005) ‘The ten faces of innovation: IDEO’s strategies for
beating the devil’s advocate & driving creativity throughout your organization’ Currency/Doubleday, New York.
2
3
Deloitte Consulting LLP (2008) ‘Medical Tourism: consumers in search of value”
The very premise for this study (and many other case studies on
medical tourism) in the U.S suggests that international travel extends a critical solution for the 46 million uninsured Americans4 and
out-of-pocket patients faced with attenuating costs for care. Treatment abroad in places like India is sometimes 10% of the cost of
domestic care (e.g. aortic valve replacement costs on average of
$100,000 in the U.S. and $12,000 in India).
But the uninsured tend to fall in a lower income bracket, with poor
advantages for tax-savings and a decreased buying power in which
potentially only universal healthcare, not an expensive trip abroad,
might ail their treatment demands5. Who then are the people taking
advantage of medical tourism and what are the myriad thoughts that
help them decide to go abroad? Are the affluent travelers and able
patients in developed countries widening the gap between domestic
and now international health access? The critical factor with these
types of ‘non-guiding’ questions is the way in which responses are
analyzed through qualitative methods instead of blanket categories
with an all-encompassing label.
Thus, before becoming the authority for directing strategies on
global healthcare, we must consider and compliment the issues that
surveys or non-qualitative research methods potentially fail to uncover. In the context of medical tourism, this requires unraveling
the stories behind the patient decision making process, the personal
moral and ethical values, and the shared experiences of a cultural
mixing of local and global care. The following section implicates
some of these issues and outlines other consumer related questions
that are important for consideration.
Beneath Consumer Demand
International health consumers are believed to participate
in “biomedical self-shaping”6, in which patients transform into
autonomous investigators of their own health and medical concerns.
This is widely accomplished in developed countries through
the advent of Internet literacy on various topics of science and
medicine, and partially through online or local support groups,
institutions and corporate stakeholders. With such an advanced and
complex channel through which patients can learn and share about
the medical experience with others, investigate their doctors and
York D (2008) ‘Medical Tourism: the trend toward outsourcing medical procedures
to foreign countries’, Journal of Continuing Education in the Health Professions,
28(2):99-102
5
Glied S & Remler D (2005), ‘The effect of Health Savings Accounts on health
insurance coverage’, Task Force on the Future of Health Insurance, New York: The
Commonwealth Fund.
6
Rose, N. and Novas, C. (2005) Biological citizenship. In A. Ong and S.J. Collier
(eds) Global Assemblages: Technology, Politics and Ethics as Anthropological Problems (Malden: Blackwell Publishing, 439_463). In context, Rose and Novas describe
biomedical self-shaping as a function of “biological citizenship”
4
March/April 2009
67
saving treatment places unintended pressure on doctors to provide
for expectations that extend beyond medical service10.
On-site investigations in
participating countries are
required to digest the economic
and health resource implications at
the local, national level.
providers, and learn about the intricacies of their medical condition7,
we can no longer assume that the incentives for health care travel
can be explained through easily defined categories and trends.
Although insights with consumers are heightened through
online interactions, we must question how much is actually known
about medical tourists. As one researcher describes, there is little
information about the consumers who seek these services; including
their motivations, personal characteristics, ways they sought services
abroad, their understanding of their condition, and their experience
in a different cultural setting8.
There is a serious disparity in
the influences for medical travel
between developed and emerging
economies.
Even more, there is a serious disparity in the influences for
medical travel between developed and emerging economies. Access
to the Internet and other online channels are not even possible, let
alone frequently utilized. For example, although U.S. medical
tourists save costs by receiving treatment in India, Yemen medical
travelers find the same treatment option tied with a hard earned,
debt inducing expense involving symbolic capital for a sick family
member that has exhausted all options for care domestically9.
The aforementioned anthropological study is just one
example revealing the differences in the consumerism process for
transnational medical care. Further research and questions are
required to develop an intimate understanding of the consumer
process. For example, how does the doctor-patient relationship
change during this global medical process? Is a knee replacement
surgery in India the same as a knee replacement surgery in the UK?
Or, how do hospitals construct “global” spaces, like international
airports and hotels, within their local culture in order to standardize
healthcare?11 It is precisely these types of qualitative ethnographic
and social science questions that will benefit the more penetrating
associations between the medical tourism process and the macrolevel comparisons of care.
Applying Complex Understanding
To recapitulate, we must contextualize ethnographic and
qualitative research in the strategy discussions for improving the trade
in global medicine. The quantitative analysis that helps us gauge and
forecast the limits of growth must share concomitant objectives with
the deeper, qualitative research in the field. On-site investigations in
participating countries are required to digest the economic and health
resource implications at the local, national level.
For example, it is critical that the promotion of foreign medical
care in India through government and private incentives do not
subsume the priorities for delivering healthcare to the millions of
rural residents with poor access to adequate care. Ten years from
now, the reflexive outlook upon global medical tourism should
not frame a world where the inequalities in proper healthcare
have irreversibly widened. Thus, the studies that will provide the
greatest enlightenment are not just the surveys and questionnaires
that engage a statistically randomized representation of medical
travelers. But, of greatest value will be those enlightening studies
that should compliment stakeholder strategies for action are those
that immerse in consumer communities, and follow the patients,
doctors, technologies, regulations, ideologies and values across the
medical cultures. n
About the Author:
Nishant Bagadia is a former consultant in customer
relationship management at Deloitte Consulting LLP USA.
He is now a graduate student at the London School of
Economics, conducting research at the BIOS Center for the
study of biomedicine, bioscience and society. His current area
of research is in the sociological and cultural relationahip of
medica care between “Western” and developing countries;
specifically, with a case study of medical tourism in India.
The Yemenis ethnographic study also illuminates the heightened
expectations that any medical traveler might have when going
overseas. Patients show vulnerability due to their inability to
understand cost and treatment comparisons, and discern the medical
risks involved. For some travelers, medical tourism agencies and
the international patient divisions at hospitals promote the fantastic
success rates and positive foreign patient testimonials. This could
form an enigmatic and ostensive perception of “care abroad”. As
result, the soon-to-be medical traveler demands for high quality life
Whittaker, A. (2008). “Pleasure and pain: Medical travel in Asia.” Global Public
Health 3(3): 271-290.
8
Health 3(3): 271-290
9
Kangas, B. (2007). “Hope from Abroad in the International Medical Travel of
Yemeni Patients.” Anthropology & Medicine 14(3): 293-305. In context, Kangas
discusses the treatment in Yemen and the emotional relationships that are important
for Yemenis receiving treatment abroad.
7
68
March/April 2009
Kangas B (2002) “Therapeutic itineraries in a global world: Yemenis and their
search for biomedical treatment abroad.” Medical Anthrpology 21: 35-78. In context,
author describes Yemenis patients going abroad to Jordan or India with knowledge of
an advanced technology or word-of-mouth procedure that saved another life.
11
Health 3(3): 271-290. Asks more detailed questions and calls for further research in
the commodity of commercialized medicine.
10
[
Korea becomes the landmark for the international patients
Healthcare in Korea provides world class healthcare service with passion for
patient care. Korean physicians, specialists and surgeons are known to be
among the best in the world of medicine. The highly advanced healthcare
facilities in Korea have cutting-edge medical technology.
Korea Healthcare is waiting for you with the excellent quality of care,
affordable prices and easy accessibility.
]
New Destination of Global Healthcare
Council for Korea Medicine Overseas Promotion(CKMP)
is composed of qualified healthcare providers in Korea and two
government affiliated organizations, Korea Health Industry Development
Institute and Korea Tourism Organization. CKMP, as the gate to the
medical tourism destination, executes a series of projects to promote
Korea’
s world-class healthcare services to the international community
with supports of Korea Ministry of Health & Welfare.
www.koreahealthtour.co.kr
March/April 2009
69
Unconventional
Medicine
in a Conventional Setting
By SHERRI TENPENNY
Complementary and Alternative Medicine, referred to in the US as “CAM,” is a
group of diverse medical and healthcare systems, practices, and products that have
historically fallen outside customary approaches within Western medicine.
70
March/April 2009
C
omplementary and Alternative Medicine, referred to in
the U.S. as “CAM,” is a group of diverse medical and
healthcare systems, practices, and products that have
historically fallen outside customary approaches within Western
medicine.
with a standard set of medications in Western medicine, but with
CAM, asthma can be effectively addressed in a multiplicity of ways,
uniquely designed for the patient.
The most commonly recognized CAM practices in the U.S. are
acupuncture, massage, vitamins, supplements and herbal remedies,
homeopathy, hypnotherapy, guided imagery, and a wide variety of
energy-healing techniques. Conventional medicine is medicine and
surgery practiced by holders of an M.D. degree or a D.O. degree (a
U.S.-trained doctor of osteopathic medicine) and by allied health
professionals, such as physical therapists, psychologists, and
registered nurses.
Practitioners of American conventional medicine were jolted to
attention in 1993, however, with Dr. David Eisenberg’s landmark
study in the New England Journal of Medicine, “Unconventional
Medicine in the United States – Prevalence, Costs, and Patterns of
Use.” Through phone surveys, Eisenberg had interviewed 1,539
adults in 1990 to inquire about their use of the most common CAM
therapies. The results were startling.
Nearly 34 percent of the respondents used at least one
unconventional treatment, and 72 percent did not relay the information
to their doctor. Extrapolated to the entire U.S. population, Americans
made an estimated 425 million visits for unconventional therapies
in 1990, exceeding trips to all U.S. primary care physicians by
more than 37 million visits. Expenditures for these practices totaled
approximately $13.7 billion, three quarters of which ($10.3 billion)
was paid out-of-pocket. This figure was comparable to the $12.8
billion spent out-of-pocket that year for all U.S. hospitalizations.
The discovery was a wakeup call for Western healthcare systems.
Eisenberg’s 1998 follow-up survey, published in The Journal
of the American Medical Association (JAMA), was even more
remarkable. Demand for CAM therapies had increased, and 42
percent of U.S. adults were using unconventional therapies, paying
629 million visits to alternative practitioners. “We estimate that
between $27 billion and $34 billion was spent out-of-pocket for
complementary and alternative medicine,” said Eisenberg.
Nearly 34 percent of the respondents
used at least one unconventional
treatment, and 72 percent did not
relay the information to their doctor.
And the rise of alternative medicine has not been isolated to the
U.S. By 2001, CAM was reported to be the second biggest growth
industry in Europe. In December 2004, The European Federation of
Complementary and Alternative Medicine (EFCAM ) was formed
to bring together organizations, patients, CAM practitioners,
researchers, and the conventional medical community to plan
political actions that would gain recognition for unconventional
therapies throughout Europe.
An Emerging Place for CAM
A difference in research standards between native traditions such
as acupuncture and herbal medicine and conventional medicine is
the primary reason Western-trained physicians have mistrusted
CAM modalities. Mostly pharmaceutically based Western medicine
is built on reproducible experiments and statistical analysis, whereas
CAM treatments are built on a different system of diagnosis and
therapies that are individualized to the patient. This is very different
from “one-size-fits-all” healthcare. For example, asthma is treated
Over the years the language of CAM has changed. “Alternative
medicine,” which implies an “either/or” approach such as using
juicing and saunas to treat cancer instead of surgery, radiation,
or chemotherapy, has given way to “complementary medicine.”
This suggests that a CAM therapy can be used in conjunction
with a conventional treatment. To CAM practitioners, however,
“complementary medicine” is unsatisfactory because it implies that
non-invasive therapies are optional and secondary in importance.
During the past decade the description of the important interplay
between CAM and conventional medicine has evolved to the point
that “integrative medicine” now rightfully explains that the best
results include a combination of conventional methodologies and
effective CAM therapies.
While few schools in the U.S. offer training and certification in
CAM therapies, an educational program for physicians is offered
through the Institute for Functional Medicine in Gig Harbor,
Washington. A new model of healthcare, “Functional medicine”
is personalized medicine. Doctors trained in Functional medicine
seek primary prevention and underlying causes. Complex, chronic
diseases can be improved by intervening at multiple levels to restore
health. Rather than promoting a new or separate body of knowledge,
Functional medicine is grounded in scientific principles and medical
school basics, including research across all disciplines.
Functional medicine physicians actively incorporate CAM
therapies into their treatment protocols. The approach has been
shown to repair dysfunctional physiology by restoring anatomic,
biochemical, and energetic relationships. It is a transformative model
that promises to become the new standard of care in medicine.
CAM in a Hospital Setting
Consumer demand for CAM is driven by a desire for treatment
options and therapies beyond what conventional medicine has to
offer. It represents the need for a different approach to getting well –
one with a greater emphasis on healing the whole person.
For many, CAM is sought out when orthodoxy has failed. In
a study of 251 cancer patients in Korea who were incorporating
CAM therapies into their programs, many did so because CAM
made them “feel hopeful,” a powerful statement of how patients
feel toward conventional care. But first-line CAM intervention is
becoming more prevalent. The expense and worrisome side effects
of conventional treatments and the desire for options beyond drugs
are driving the inclusion of CAM into the hospital setting.
March/April 2009
71
Examples of CAM practices
Whole Medical Systems: homeopathy;
naturopathy;
acupuncture;
hilot
healing;
traditional
Chinese
medicine;
Ayurveda;
anthroposophic medicine.
Mind-Body Medicine: meditation; prayer;
biofeedback; therapies that use creative outlets
such as art, music, or dance.
Biologically Based Practices: herbs; foods;
vitamins; dietary supplements.
Manipulative and Body-Based Practices:
massage; shiatsu; reflexology; Feldenkrais
therapy; yoga; manual manipulation such as
chiropractic, osteopathic, and craniosacral
therapy.
Energy Medicine: Two types:
1) Biofield therapies – Qigong, reiki, tai chi,
therapeutic touch.
2) Bioelectromagnetic-based therapies – pulsed
fields, magnets, alternating-current or directcurrent fields.
Integrating CAM practices into a hospital setting has a unique
set of challenges, however. Administrators may at first view CAM
as an untapped revenue source because consumer demand is high.
But because there are few international standards for credentialing
practitioners – and because training varies extensively throughout
the world – institutions and insurance providers have legitimate
concerns about how to evaluate a practitioner’s training and
abilities.
Many hospitals include community health and “whole person”
health in their mission statements, making CAM services seem a
natural fit. In 2007, a 44-question survey was sent to 6,347 U.S.
hospitals, with 748 responding (12 percent) and 37 of those stating
that they offered CAM services. The key reasons hospitals gave for
including CAM services were patient demand (84 percent), clinical
effectiveness (67 percent), and consistency with organizational
mission (57 percent). The greatest challenges they faced were
budgetary constraints and physician resistance. What kept them
going was patient satisfaction, reported to be 86 percent.
By 2001, CAM was reported to
be the second biggest growth
industry in Europe.
In the U.S., some of the most elite medical centers, including the
Mayo Clinic, Duke University Medical Center, Stanford Medical
Center, and the University of California-San Francisco (UCSF),
now offer acupuncture, massage, and other CAM services. All 18
hospitals recently named by U.S. News as “America’s Best Hospitals”
provide some type of CAM services. Fifteen of the 18 also belong
to the three-year-old Consortium of Academic Health Centers for
Integrative Medicine, a group of 36 U.S. teaching hospitals pushing
to blend CAM with traditional care. Major hospitals around the
world that are contemplating the addition of alternative practices
should know they are not alone.
Where CAM is not “CAM”
While Western-trained physicians struggle to understand
functional medicine, many practices considered to be “alternative”
in the West have been the prevailing modes of care elsewhere
for centuries. In Korea, for example, much of the population
regularly uses herbal medicine, and acupuncture and hospital-based
acupuncture have been available for years.
Hilot, the indigenous Filipino healing art, dates back to around
the 5th century. And in 1997 Manila passed a law promoting
alternative medicine, but so far no privately owned hospital offers
the practice, and only a handful of state-run hospitals employ
acupuncturists and hilots. The hilots are, however, legally allowed
to work in areas where registered midwives, doctors, or nurses are
not present, and the practice is gaining ground. It is a matter of time
before this native practice is part of existing hospital systems.
K.L.E.S. Hospital & Medical Research Center, in Belgaum City,
India, has a department of Holistic Medicine that incorporates the
traditional Indian medicine system into its full range of modern
medical care. Services include Ayurveda, yoga, naturopathy,
homeopathy, and guided meditation.
An Example of Fully Integrated Hospital Care
While adding massage and acupuncture to the in-patient setting
is a significant step toward an inclusive approach, a hospital in
Rosarito, Baja California, Mexico, has gone further and represents
a stellar example of a hospital that offers fully integrated medical
care.
72
March/April 2009
Sanoviv Medical Institute opened in 1999, fulfilling the vision
of its founder, Myron Wentz, PhD – also the founder of a global
network marketing supplement company, USANA Health Sciences.
The 47-bed hospital, situated on a cliff over the Pacific Ocean, has
the look and feel of a 5-star resort. All rooms are private, with an
ocean view and a balcony, and most rooms offer a private area for
a companion. Sanoviv has a medical spa, serves organic food, and
offers a wide array of educational, fitness, cooking, and meditation
classes for all guests and their companions.
Sanoviv’s mission is twofold. Prevention programs identify
and correct unrecognized nutritional deficiencies and overall
inflammation. Moreover, by combining conventional technologies
and treatments with the holistic principles of oxygenation, hydration,
alkalization, and good nutrition, Sanoviv’s medical programs are
designed to assist in the healing of all types of chronic degenerative
disease.
Personalized Medicine
Personalized medicine at Sanoviv starts the moment guests
arrive at San Diego International Airport, where a private van awaits
to transport them safely and comfortably across the border. (All
program participants are referred to as “guests” instead of “patients,”
reducing the anxiety many feel when arriving at a foreign hospital.)
The 40-minute scenic drive along the coast is a relaxing beginning
to their hospital experience.
On arrival, guests are escorted to their rooms and given organic
cotton clothing to wear throughout their stay. Each is assigned to a
healthcare team that includes a medical doctor, dentist, psychologist,
nutritionist and, for most guests, a chiropractor. Beyond their
medical training, the doctors have completed an intensive 18month certification program in Functional medicine and nutrition.
In addition, all medical professionals are fluent in English and
Spanish.
All 18 hospitals recently named
by U.S. News as “America’s Best
Hospitals” provide some type of
CAM services.
Medical treatments at the hospital include use of a wide variety
of advanced energy equipment, such as Vega technologies and the
acuscope, which can identify imbalances in acupuncture meridians,
the body’s often overlooked energy systems. Highly trained
technicians administer these therapies in an area of the hospital
referred to as the “quiet room,” a peaceful location for relaxed,
meditative healing that overlooks the ocean. Next to the quiet room
is a lovely, full-service spa. Therapies are individually prescribed
by the physicians as part of each person’s integrative medical
program.
Whether a person is healthy and wants to remain that way or
is seeking relief from chronic disease, Sanoviv’s medical programs
are tailored to the guest’s specific needs and goals. The cornerstone
program, Complete Diagnostic (CDP), is a one-week evaluation
using conventional and functional medicine tests for a full health
assessment. Tools such as the WatchPAT™, to screen for obstructive
sleep apnea, and the EndoPAT™, to non-invasively screen for
endothelial inflammation, are part of the unique assessment.
Several programs are available for prevention. For those seeking
to reduce stress and improve health, a one- or two-week detoxification
program called Rejuvenation is the perfect healthy escape. In
addition to therapeutic spa treatments, guests receive intravenous
nutrients, colon hydrotherapy sessions, and full assessments from
their Healthcare Team.
To encourage couples to safeguard their health, women can
choose the Breast Health and Wellness Program, a one-week
program that includes state-of-the-art breast thermography, while
their male companions participate in the Prostate Health and
Wellness Program.
Guests interested in getting in shape can choose between a
two- or three-week fitness and weight loss program called Lighten
Up. Designed for groups of up to eight, Lighten Up is managed
by a team of nutritionists, fitness experts, and psychologists who
conduct monthly aftercare calls to ensure success. When the
Lighten Up program is not an option for weight loss, Sanoviv offers
a five-day Lap Band Program that includes psychology, fitness, and
nutrition before the surgery to prepare the candidate and to ensure
the best possible results.
Specialized programs are available to address specific health
conditions. The six-week Cardiovascular Program – three weeks at
Sanoviv and three at home – is designed to lower blood pressure
and reduce risk factors associated with heart disease. The program
includes the use of ozone, intravenous nutrients, detoxifying spa
treatments, and a heavy metal toxicity evaluation.
To address neurodegenerative disease, Neuro Repair eliminates
heavy metal toxicities through the use of glutathione, hyperbaric
oxygen, and ozone. For all other medical conditions and degenerative
disease, Detoxification, a two- to three-week intensive program, is
the key to getting well.
Oncotherapy is a four-week cancer treatment protocol. It
combines state-of-the-art hyperthermia with metronomic dosing of
chemotherapeutic agents with nutrition, detoxifying spa treatments,
and other progressive CAM therapies.
Sanoviv also has an active research department. Through
associations with the Universidad Autonoma de Guadalajara and
the Mexican Health Department, Sanoviv has research protocols to
track outcomes.
All medical programs at Sanoviv include an extensive list of
services and consultations competitively priced and packaged to
include room and board and few additional costs. Nearly 70 percent
of U.S. guests have a large portion of their stay reimbursed by their
medical insurance.
The Future of Healthcare
As the global economy struggles to find its balance, people
around the world who are looking to improve their health will be
searching for safe, effective, value-driven holistic treatments. Using
alternative therapies in the hospital setting and understanding how
to get people well through the use of functional medicine will be the
next wave of health and healing. n
About the Author:
Dr. Sherri J. Tenpenny is the Executive
Director of Sanoviv Medical Institute in
Rosarita, Baja California, Mexico. She is
also the president and founder of OsteoMed
II, a clinic established in 1996 in Cleveland,
Ohio, that has provided integrative medical
care to patients from 38 states and 9
countries. Dr. Tenpenny is on the Advisory
Board for the Medical Tourism Association and can be reached
at [email protected]. For more information about
Sanoviv, go to www.Sanoviv.com or call 801-954-7600.
March/April 2009
73
Hotels
The Physical Innovation of
in Medical Tourism
By DAN CORMANY
With growth of medical tourism projected to skyrocket in the next decade, now is
the time for hotel properties to consider their interest in serving this special type
of guest. There are many approaches and considerations that can influence how a
particular hotel may approach serving this clientele.
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©
P
eter Greenberg, the travel editor for NBC’s Today Show,
has dubbed them “postoperative hotels” – facilities in
which their physical design has considered the special
needs of the recovering medical tourist. If services, as we considered
in the last issue, are key to a hotel’s accommodation of the medical
traveler, in some cases so are the physical layouts of the hotel
property.
This is a harder topic to consider, as so many of the considerations
of appropriate accommodations relate to the type of medical treatment
recently provided to the guest. Surely the guest who just had heart
surgery in Mumbai may have a different set of needs than the dental
patient in Costa Rica, who differs from the guest recovering from
cosmetic surgery in México. The dental patient may have little need
for specialized accommodations; the cosmetic surgery guest may
place a premium on privacy; the heart patient may require several
considerations to accommodate recuperation from such a major
procedure. No one sort of accommodation is ideal for all medical
travelers; the purpose of this article is not to describe the perfect
facility for the medical tourist, but rather to introduce some of the
many considerations a property may make to better accommodate
its medical guests.
These considerations start with the arrival to the property. The
Woodmark Hotel in Seattle pioneered the provision of a private
entrance to the hotel and an elevator serving only medical travelers,
and this can now be found at several other properties serving the
medical tourist. Such an entrance prevents any embarrassment
a bandaged or wheel-chair bound guest may feel among other
hotel guests, as well as expediting the check-in process so as not
to tax limited strength. Other hotels have offered medical guests
specialized floors which may offer a variety of support facilities
such as a concierge lounge or solarium, giving guests a pleasant
alternative to staying in their rooms while not requiring them to
walk long distances. In some cases, meals are also served in this
lounge area.
A study from the University of
California at Berkeley reports 95%
of recuperating guests with access
to outdoor and natural settings
reports therapeutic benefit from
their presence.
Serenity Aftercare Facility in Santa Monica provides medical
guests a rooftop rose garden, offering a peaceful and restful area.
A study from the University of California at Berkeley reports 95%
of recuperating guests with access to such outdoor, nature settings
report therapeutic benefit from their presence. Such facilities should
have some seating in a shaded area as those recovering from cosmetic
surgery frequently must stay out of the sun to avoid darkening of
scar tissue.
Lacking either dedicated floors or garden settings, a property
may still provide some secluded areas appealing to medical tourists
not yet ready to fully mix with the leisure travel guests, such as
cabanas or portico seating. Reducing hindrances to getting around
the property needs to be a consideration for facilities not previously
prepared to accommodate wheelchairs or other mobility assistance
equipment. In the event that elevators are not present in the hotel,
it may be necessary to use the first floor rooms for those with such
needs. While ramps are convenient for wheelchairs, for individuals
with reduced balance, stairs may be easier to navigate than ramps,
so the provision of both is recommended for small changes in
elevation.
Getting around off-property is also being addressed by some
hotels, which are operating transportation for guests to and from
medical facilities. This valuable service is also one of the more
costly additions rather commonly reported by those facilities seeking
to serve the medical traveler.
Just as important are several guest room modifications which
may be advisable depending upon the nature of the patient’s recovery.
Most of these need not be high-cost modifications, nor transform
the room into a “medical” look. Equally important, they may be
phased in over time – service to the medical tourist doesn’t require a
complete facility redo in order to meet some of their needs.
Decisions may be made regarding modifications by considering
two basic factors – the recovering medical tourist is 1) more likely to
spend a greater amount of time in the room than the average guest,
so décor and utility details may be more critical to the comfort of
their stay; and 2) more likely to have reduced amounts of energy
and perhaps some mobility limitations, so convenience factors are
especially important.
For instance, a universal remote at bedside allows guests to
open and close curtains, operate the television/DVD player, adjust
room lighting, and can provide an emergency button that calls for
help if needed. More elaborate systems can also accommodate
remote thermostat adjustment. Ambient sounds, such as the sound
of ocean waves, surf, rain, or music, have been shown to improve
sleep in post-operative individuals, and might also be included as
an audio-only television channel. When possible, carpet and drapes
are preferred to tile or window shutters, as they can reduce outside
sound from 70 to 90 percent.
The availability of wireless internet makes use of the laptop
from the bed possible, and nightstand-height electrical outlets allow
for easy connection. If only one telephone is available in the room,
it is recommended it be on the nightstand so it is accessible from
the bed.
Some facilities have added an adjustable bed; most have reported
that a separate bed for a traveling partner is a welcome arrangement.
Although unusual for hotels, a bed with a footboard allows a handle
for stability as the guest walks around the room. It also can be used
to hold the blanket or duvet to relieve pressure on the feet. A round
table removes sharp corners to prevent bruising, but it needs to have
a stable base that will support a person who leans on its edge.
If the likelihood is that the guest may have limited mobility
or require the use of a wheelchair, the furnishings need to provide
March/April 2009
75
A useful design is to create accommodations as two room suites,
giving family members a separate living/sleeping space. If such a
design is used, a method for the guest to signal to family members
in case of need is a valuable addition. Designs which place the
family’s space between the medical tourist’s room and the corridor
can reduce distracting noise. Room doors can also be staggered so
they don’t face each other in the corridor, as another way of reducing
noise.
Borrowing from the medical hotel model that has resulted in
US hospitals in Rhode Island, New York City, Yale Medical Center
running an adjacent hotel, a nurse’s office on a dedicated floor might
be an addition that permits immediate response to medical needs if
an area is serving major surgery guests. Other facilities have offered
small on-floor exercise facilities, a massage room, or a public sitting
area.
adequate maneuverable space, which may be improved by raising
desktops to allow the wheelchair to fit underneath the table apron
and between its legs. Adjustable shelf height in closets also allows
quick, easy conversion for a person in a wheelchair to use them.
(The Americans with Disabilities Act provides a detailed synopsis
of how construction can accommodate wheelchairs. While this
legislation applies only to United States properties, its specifications
can provide a handy reference for designing for mobility-impaired.
Details are at: http://www.ada.gov/stdspdf.htm).
Bathrooms can be made medical guest-friendly in several ways.
Lighting with a warm white or slightly pink cast is flattering and
improves the sometimes pallor appearance of guests fresh from a
hospital stay. A handheld shower and a seat within the shower or
tub area is a convenience if some body areas must remain dry. A
full-length mirror on the bathroom door provides service to those
in wheelchairs. Phone service in the bathroom gives the option of
calling for assistance in the event of a fall.
Yale Medical Center runs an adjacent
hotel where an entire floor is occupied
by a nurse’s office, an addition that
permits immediate response to
medical needs if an area is serving
major surgery guests.
Kohler Company has developed a “universal bathroom” that
accommodates a wide variety of physical limitations without
adopting an institutional look. Some of their suggestions include
using removable, freestanding units for each cabinet under the sink
so as to improve accessibility to both the cabinets and the sink, using
upper shelves made of tempered glass to aid those with mobility
aids to see shelf contents from below, and the use of floor to ceiling
shower curtains rather than doors, which consume floor space.
If a new facility is being constructed to serve medical tourists,
some additional considerations are suggested. A few facilities have
concealed medical gas hookups behind artwork beside the bed,
allowing their use if needed. Balconies or bay windows can greatly
enhance the room comfort by providing expansive views. Additional
electrical outlets in the guest room are helpful to accommodate
medical appliances.
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March/April 2009
Medi-spas represent the fastest
growing segment of the spa
industry, growing at a rate of 11-14
percent annually.
In addition to medical guest accommodations, some resorts
have developed facilities to permit specific medical care on
property. Sometimes referred to as “medi-spas”, and particularly
popular in Eastern Europe, these place the hotel in a position of
not only providing accommodations but facilities for a wide range
of procedures, in some cases including LASIK eye surgery, dental
procedures, and wide-ranging forms of plastic surgery. Medi-spas
represent the fastest growing segment of the spa industry, growing
at a rate of 11-14 percent annually.
Others hotels have clinics and special equipment to provide
radiology, diagnostic scans, lab services, and minor invasive
surgery, such as the Palace of the Gold Horses, in Kuala Lumpur.
These truly blur the line between hospitality and medical treatment,
requiring influxes of sophisticated equipment, and becoming, on
some properties, a part of a designated “patient care service zone”.
With growth of medical tourism projected to skyrocket in the
next decade, now is the time for hotel properties to consider their
interest in serving this special type of guest. As we’ve seen, there
are many approaches and considerations that can influence how a
particular hotel may approach serving this clientele. An excellent
and obvious starting point is for properties to consult with area
health care facilities to discover the sort of patients being sought, as
this will identify the types of recuperative needs that may need to
be addressed. With a little creativity and consideration of medical
traveler needs, room modification may be done in a value-added
way that enhances the appeal of the guest room to not only medical
travelers, but all guests. n
About the Author
Dan Cormany is a doctoral student at the
University of Nevada, Las Vegas, focusing his
studies in the Hotel College on medical tourism.
His emphasis is on hospitality’s potential roles
in serving the medical tourist. Prior to starting
these studies, he worked for 17 years as Dean
of Students at universities in Ohio, Florida and
Hawai’i, before embarking on a career change to
hospitality. His hotel work includes management
positions for Loews Hotels, Hyatt Regency, and Wynn Las Vegas. He
holds a Master of Arts in College Administration and a Master of
Science in Hotel Management.
March/April 2009
77
IBMS ~
Qualifying Surgeons Worldwide
An Interview with Dr. David Kalin
Patients have many decisions to make when traveling for medical care. Assisting
patients and their travel associates in making informed choices about their
international health care needs is the reason the International Board of Medicine
and Surgery (IBMS) exists.
A
fter personal frustrations with the cost and approach to
healthcare in the United States, I sought other options
for medical care. This experience inspired me to
organize IBMS, a professional online web registry which validates
membership with documentation of licensure, specialty certification,
hospital affiliation (if applicable),” says Kalin.
through electronic media, Internet and voice communication. Upon
evaluation, members are linked with certification of membership to
the International Board of Medicine and Surgery, whereby potential
patients from around the world may evaluate these healthcare
providers as a possible match for their particular medical needs,
thereby enabling the public to make informed decisions.
IBMS members are physicians, surgeons, dentists and other
healthcare professionals in the global healthcare community
whose qualifications have been reviewed and have established
and maintained a professional standard of patient care, as well as
Centers of Healthcare Excellence meeting those same rigorous
standards. Communication with the members of the IBMS is
“Since establishing IBMS, the IBMS Board of Advisors and I
have reviewed the qualifications of physicians and facilities in Costa
Rica, Venezuela, Israel, Thailand, South Korea, and the U.S.A.
Through extensive interviews my colleagues and I have investigated
medical and health-related opportunities and forged international
relationships,” he explains.
“
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March/April 2009
Recently, within the last several years, the Joint Commission
International has been accrediting hospitals throughout the world
to help ensure accountability and confidence in medical care,
and in order to reduce the risk for patients has raised issues of
physician selection, follow up medical care, treatment of possible
complications, and communication with the primary physician. The
International Board of Medicine and Surgery is not an accrediting
organization, but complements the Joint Commission International
and other accrediting organizations by helping to fill a void in the
global healthcare infrastructure.
Kalin further points out that the International Board of Medicine
and Surgery works closely with a U.S. multi-specialty physician
organization to promote and provide assistance and referral networks
for the medical need of those seeking pre and post medical care
through the organization’s extensive membership. It also assists to
facilitate Board Certification in the U.S.A. for purposes of insurance
reimbursement (for physicians and surgeons practicing beyond the
borders of the United States), develop and facilitate professional
medical relationships and services nationally and internationally,
create and coordinate professional meetings and journals attractive
to international membership, potentiate growth of professional
programs, and contribute to leadership and a greater professional
standing in the U.S. and international healthcare communities.
International Board of Medicine and
Surgery works closely with a U.S.
multi-specialty physician organization
to promote and provide assistance and
referral networks
Medical tourism/travel companies coordinate and facilitate
patient arrangements. This can include coordinating the
patient’s needs including medical contact, travel arrangements,
accommodations, recovery, and ancillary activities. These companies
work independently from the IBMS and help to recruit physicians,
surgeons, dentists and other healthcare professionals. The confidence
of knowing a professional medical organization has reviewed
professional qualifications of physicians, surgeons, dentists, Centers
of Healthcare Excellence, and other healthcare professionals within
the global healthcare community, and offers the coordination of pre
and post medical evaluation/treatment, allows the representative to
be able to offer additional peace of mind with regard to continuity of
the patient’s medical treatment. A medical tourism/travel company
is also entitled to attach the IBMS healthcare travel affiliation mark,
thereby enhancing the credibility of the company’s selection of
medical providers, and is promoted through linkage with www.
healthtravelservices.com, www.emedivacation.com, and www.
medivaction.com., independent affiliated global healthcare travel
sites.
Patients should consider Board membership as only one factor
in selecting a physician or surgeon, and Board membership alone
does not necessarily indicate competence or patient compatibility.
Patients ultimately have the responsibility for selecting their
physician and/or surgeons. The International Board of Medicine
and Surgery disclaims any warranty or liability with regard to any
member’s listing in the IBMS website or any other website found
through the use of this website. The Board is not an educational
institution, and membership with the Board does not confer on
any physician legal qualifications, privileges, license to practice
medicine or certification of competency. Standards of membership
are clearly distinct from those of licensure, and Board membership
does not indicate total qualification for practice privileges nor imply
exclusion of others who are not members.
Additionally, the Board does not purport in any way to interfere
with or limit the professional activities of any licensed physician
nor desire to interfere with the regular or legitimate activities
of practitioners of medicine/surgery. The Board has no intent or
function in defining requirements with regard to who shall or shall
not perform medical or surgical procedures. The Board does not
censure or review ethical problems.
Membership currently is available for 1-5 years and includes
certificate of membership, online registry with certification
mark linking to an existing website or webpage for professional
presentation, coordination of pre and post medical evaluation/
treatment, medical tourism/travel companies to facilitate and
coordinate patient arrangements, and a relationship with a U.S. multispecialty physician organization to facilitate Board Certification (in
the U.S.A.).
IBMS is actively recruiting physicians, surgeons, dentists, and
other healthcare professionals, specializing in medical tourism,
developing pre and post evaluation/treatment referral networks,
and facilitating Board Certification in the U.S.A. for purposes
of insurance reimbursement (for physicians/surgeons practicing
beyond the borders of the United States).
IBMS is a member of the Medical Tourism Association and
therefore is extends the opportunity to Medical Tourism Association
members and attendees of the World Medical Tourism & Global
Health Congress for a complimentary professional courtesy (free)
listing of physicians, surgeons, dentists by MTA’s recommendation
on our website www.ibms.us .
Professional courtesy listing (free) of Physician Name, Specialty,
Country, and Email address is offered to all physicians, surgeons,
dentists, Centers of Healthcare Excellence and/or other interested
healthcare professionals.
Professional courtesy listing (free) of non affiliated Medical
Tourism Facilitators, including Name/Company, Country, and
Email address, is also available on the IBMS website, as well as
www.healthtravelservices.com, www.emedivacation.com, and
www.medivaction.com, independent affiliated global healthcare
travel sites.
Should a hospital or clinic be interested in having distinguished
physicians, surgeons, dentists, or other healthcare professionals join
as a group, a representative of IBMS would be available to visit
the facility, make a presentation about the benefits of membership,
distribute certificates of membership, and answer any additional
questions.
Email a list (on excel spreadsheet): name, country, specialty, email
address of your physicians, surgeons, dentists, and other healthcare
professionals. Consider selecting at least 25 distinguished healthcare
providers for a minimum 2 year membership, and a representative
of IBMS will arrange to meet with these physicians, surgeons, and/
or dentists, deliver certificates of membership, explain benefits of
membership, review facilities, and discuss needs of members.
Registration online is available at www.ibms.us. Upon review,
membership will be determined, and upon acceptance, the member’s
website is linked with an IBMS certification mark, and the member
becomes entitled to services of the IBMS. n
March/April 2009
79
The
TRUE
Value
By Hugh Slesinger
The true value of health (of ourselves or our environment) can never be measured in
dollars or consumables. As the costs from the loss of serenity, harmony and quality of life
are steadily rising in correlation to our own self neglect and increasingly crushing and
fermented economic footprints, it is the celebration of life’s regeneration that makes living
joyful, meaningful and fulfilling.
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March/April 2009
©
T
he road to the capital, and the hospital where I seek care
from a kidney specialist, is ever changing. Driving east
on Highway 37 across the vast marshlands north of San
Francisco Bay, I’ve been struck by the extensive expanse of open
space where the highway meets the water’s edge. In my short span
of twenty years of driving the narrow I-80 stretch of the corridor,
I have witnessed how the nearby small rural farming towns have
exploded into tract-filled, sprawl mall paradises, by creating instant
indistinguishable freeze-dried communities. I began to wonder,
“What is the true value of the marshlands,” (not only in terms of
their economic worth or their impact on our health and quality of
life) but in terms of world health and the diverse species that have
but one globe to call home?
We must remember that waste
water dumped into wetlands and
estuaries is normally primarily
treated and secondary treated,
but virtually never tertiary treated
to chemically remove nitrates,
phosphates and the like. This
process is left up to nature alone.
As a self-indulgent and indifferent youth, nature rescued me
and offered me a source of hope and spiritual refuge. Subsequently,
as program coordinator for a local Sonoma County environmental
education non-profit, I began to notice my stamina deteriorating
and increased joint pain while hiking in the field. Blood work
revealed a possible chronic renal condition (either IgA nephropathy
or Polycystic Kidney Disease) as evidenced by multiple bi-lateral
cysts, high toxicity levels and low red blood cell scores. In 2004,
while teaching abroad in Thailand, I was forced to resign because of
my worsening condition, and began to pursue the long path toward
kidney transplantation at Kaiser of Sacramento having landed a job
in El Dorado County upon my return to the US.
During my many trips from the house I owned near the coast,
eastward toward the Sierra, I started to ponder the similarity of
meandering brackish tributaries and rivers running through out the
delta as a network of veins and arteries pumping life throughout the
entire Bay Area. I paused to reflect upon the windswept surfaces and
contemplate their ecological significance by relating to the wetlands
as “the kidneys of the planet,” carrying away waste and debris, while
filtering the heart blood of the estuary with fresh water.
The ecological niche of our increasingly rare indigenous shrubs
and forbs is that of a giant filter and sponge, by maintaining water
quality and cleansing pollutants which pass through them, attracting
a rich array of beneficial insects, fish, birds and animals. The marsh
the number
fibers create a tough mesh that resists exotic weeds by spreading
deep roots outward. Deep penetration allows the land to absorb and
hold precipitation in the watersheds while preventing flooding and
trapping soil moisture. In addition, diatoms and grasses provide
year-round sources of biomass and forage for wildlife and domestic
livestock.
If we attempt to calculate the true economic value of local habitat,
we often tend to measure it in terms of agricultural “teroire” (in this
prime growing region with its gentle Mediterranean climate.) Land
owners tend to undervalue wetlands except for the direct benefits
they might reap from them, such as farming, hunting, fishing,
trapping, camp rentals, mineral exploration and their removal.
Faced with the realization of a kidney transplant myself, I have
come to the rather obvious conclusion that the ultimate function of
a marshland is its ability to sequester, trans-locate and eliminate
toxins. We must remember that waste water dumped into wetlands
and estuaries is normally primarily treated and secondary treated,
but virtually never tertiary treated to chemically remove nitrates,
phosphates and the like. This process is left up to nature alone.
Therefore, we must not ignore the life support work that these natural
areas carry on without development. This “free service” which
nature provides must, in turn, be properly evaluated before any kind
of subsequent development is considered. Common “ecological”
sense tells us that the true value of the land is greater than all the
resources which may be extracted from it. We must consider actions
like recharge, flood conveyance and erosion in lieu of events like
Katrina.
In the summer of 2006, my brother was determined ineligible
as a living donor. I was devastated. Fortunately, my best friend
stepped up and offered to be my donor and was recently deemed
an acceptable match. Cruising back home to Sonoma County, to
commence proceedings in San Francisco, I noticed how the once
seasonal shacks located along the banks of the Petaluma River serve
as reminders of a simpler time. Those shacks are now becoming
new million dollar properties not only here, but nationwide, not
just because of their proximity to efficient twenty-first century
economies of amenities, but because of their proximity to those
swampy muck filled marshes and estuaries where one still dreams of
sitting idly, observing the increasingly precious poetic beauty of the
moment, watching the clouds and sunset, or waiting for the turning
of the tide.
The true value of health (of ourselves or our environment) can
never be measured in dollars or consumables. As the costs from
the loss of serenity, harmony and quality of life are steadily rising
in correlation to our own self neglect and increasingly crushing
and fermented economic footprints, it is the celebration of life’s
regeneration that makes living joyful, meaningful and fulfilling. n
About the Author
Hugh Slesinger is a teacher, naturalist and eco-conscious real estate
agent living in Occidental.
destination for
medical tourists
TM Ad.indd 1
www.treatmentabroad.
com
March/April 2009
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29/4/08 09:57:13
Medical Tourism
Facilitator
Certification~
Medical Travel Certification
Raising the Bar on the Quality of Services
Provided by Your Medical Tourism Company
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March/April 2009
©
What does the Medical Tourism Association’s
Medical Tourism Facilitator Certification provide to
Insurance Companies and Employers?
•
It focuses on creating a culture within the organization
focused on patient safety for medical tourists.
•
It reduces the risk of liability of the facilitator and
the provider and creating well-informed patients who
understand the medical tourism services being offered to
them.
•
The certification process is meant to protect patients and
increase patient safety when patients travel overseas.
•
It shows Facilitators that participate in the program believe
in “best practices,” patient safety, and transparency.
•
It demonstrates the right processes and procedures are
in place to reduce the likelihood of logistical errors and
unnecessary problems affiliated with traveling patients.
The certification process serves as an external review
to educate the facilitator, raising the awareness of the
importance of best practices, procedures and protocols.
•
The Certification Program focuses on protecting patient’s
privacy and providing transparency to patients in pricing,
quality and accreditation.
•
•
It increases the chances of positive outcomes.
•
It reduces the risk of liability for an insurer and employer
by working with facilitators that abide to a set of “best
practices.”
What does the Medical Tourism Facilitator Program
do for the Facilitator or International Healthcare
Provider?
•
It provides a blueprint for creating a new facilitation
company or improving the protocols of an existing
facilitation company.
What does the Program do for Patients?
It provides patients with the right questions to ask their medical
tourism facilitator or international healthcare provider with
respect to the medical tourism services they are entitled to and
the piece of mind in knowing they will receive those services.
For more information on the Medical Tourism Association’s
Facilitator Certification Program, please go to
www.medicaltourismassociation.com or
email [email protected].
Participants of the Medical Tourism
Facilitator Certification Program
Alpha Medical Tourism
www.alphamedicaltourism.com
Med Voy, Inc.
www.medvoy.com
Canadian Healthcare International
www.canadaheals.com
Patients Without Borders
www.patientswithoutborders.us
Global Surgery Network
www.GlobalSurgeryNetwork.com
Surgical Trip, LLC
www.SurgicalTrip.com
International Healthcare and Wellness
www.internationalhealthcare.com
©
March/April 2009
83
PRESS RELEASES
Costa Rica Declares Medical Tourism of Public Interest for the Country
On March 12th, in an official ceremony
at Costa Rica’s Institute of Tourism (ICT),
Government Ministers signed a decree elevating
medical tourism to a theme of national interest
for the country. The announcement was greeted
with applause by many in Costa Rica’s health
and tourism sectors who feel that the government
has to play a more active role in order for Costa
Rica to achieve its full potential as a world-class
medical tourism destination.
Roughly the size of West Virginia, Costa Rica
is just a two and a half hour flight from Miami.
This small country boasts two JCI accredited
hospitals and a public healthcare system that was
ranked ahead of the U.S. by the World Health
Organization. According to Dr. Jorge Cortes,
president of the recently formed Council for
International Promotion of Costa Rica Medicine
(PROMED), “Medical procedures in Costa Rica
cost on average a third of what they do in the U.S,
with no reduction in quality of care.”
Practically speaking, the government is now
officially committed to work with the private
sector in order to create a sustainable healthcare
cluster. To this end resources will be set aside
for international marketing campaigns; to assist
hospitals and clinics with obtaining international
accreditation, implementing uniform quality
standards, and to attract private investment.
This year the ICT estimates 20,000 people
will come to Costa Rica seeking some type of
medical care. This figure is expected to increase
to 100,000 in the next five years. n
Bill Cook
International Department Patient Coordinator
Hospital Clinica Biblica - Costa Rica
84
March/April 2009
Global Solutions, Inc. Acquires Majority Holding in e-Medsol
February 16, 2009 - Florida, USA - Global Solutions, Inc., a leader in strategic and software consulting services,
today announced that it has acquired a majority holding in e-Medsol Pvt. Ltd.
Partnering with e-Medsol, a major player in the rapidly
growing medical tourism industry, enables Global Solutions
to expand its reach into the health care sector. e-Medsol
brings to the Global Solutions group of companies, a
platform and a process to create an integrated solution for
medical tourism. This will strengthen Global Solution’s
current portfolio and broaden its value proposition into new
markets and customers.
Anuja Agrawal, COO of Global Solutions said, “We
feel e-Medsol has created an offering which is truly unique
and has the potential to provide a cohesive structure to
the medical tourism industry. We are firmly committed to
enhancing e-Medsol’s offering to create a single point of
service for any player in the medical tourism industry.”
e-Medsol will continue to operate under the same name.
Anuja Agrawal will lead the company as CEO, bringing with
her 23 years of consulting, product development, marketing
and management experience working as a senior executive
in Fortune 500 companies and running strategic consulting
and product development companies.
Dr. Benosh Haris, founder of e-Medsol, will continue
to bring his leadership and vision to the company as COO.
“Global’s strong financial backing, global infrastructure,
strategic consulting and product development expertise
will bring the stimulus needed to exponentially grow our
medical tourism offering” said Dr. Haris, “This will be a
very synergistic combination and we are extremely pleased
with the alliance”.
e-Medsol, based in Kochi, India, was recently included
in a Deloitte study on medical tourism, which details the
growth potential of the industry, and was the only offering
of its kind to be included in the study. It already has a vast
network of hospitals, health care providers and health care
facilitators across the globe. Over the next few months,
e-Medsol plans to significantly grow that number and to
add insurance companies and destination managers to
the network. e-Medsol will be launching its consolidated
platform for medical tourism in India, www.IndiaCares.com,
in the next few months. Its global platforms will be launched
shortly under the iGlobal brand. More information about
their offerings can be found on www.emedsol.biz.
About Global Solutions, Incorporated Global Solutions Inc. is a consulting and technology
firm focused on meeting the strategic and technology
goals of their customers. Since its inception in 1995,
Global Solutions has been providing quality IT services
to clients looking for cost-effective solutions and higher
returns on technology-related investments. Its customers
include several Fortune 500 companies such as EDS and
Fidelity Information Services. Its primary expertise lies
in the financial sector, providing products and services to
banking technology companies, banks and credit unions.
It also provides high-value products and services for the
construction and education sectors. Global Solutions
provides strategic as well as tactical assistance to its
customers. Its services include strategic planning, business
process improvements, CRM, business intelligence, data
and application integration technology planning, product
evaluation, product development, product implementations
and testing.
About e-MedSol Pvt. Ltd.
e-Medsol is a software and service company focused
on development of products and services for the medical
tourism industry. Since its inception in 2004, it has focused
on developing online models that can effectively connect
hospitals to health care facilitators. e-MedSol is considered
a pioneer in the medical tourism industry and has used
its domain expertise to create online tools and provide
ancillary services for networking and business automation
in the industry. e-MedSol currently has a global network
of over 50 hospitals and providers, connecting facilitators
in various parts of the world through an online B2B
marketplace. n
March/April 2009
85
L AT E S T N E W S
Turkey’s Medical Tourism Potential
Renee-Marie Stephano, COO of the Medical Tourism
Association, recently spoke at the 2nd International Health
Tourism Congress in Turkey, February 27th-March 2nd
2009. The Congress was a platform for both domestic and
foreign participants to discuss the matters on health tourism
including Turkeys need to expand its tourism activities
and improve the health tourism already in progress since
Turkey as great potential in this industry. Renee had the
opportunity to speak on Strategic Marketing Opportunities
and Turkey’s promising potential.
Turkey holds a promising position for a bright future in
medical tourism. Many improvements have been recorded in
the health aspects of the country, which has been advancing
on the road to full membership in the European Union. For
one, the number of hospitals that provide health services in
accordance with EU standards has increased rapidly. For
about 10 years now, the technological infrastructure, as
well as the comfort and quality of services of the hospitals
in Istanbul, Ankara and Izmir, have been on the same level
as their European counterparts. Moreover, the majority of
doctors and other health personnel who are experienced,
skilled and knowledgeable reside in these cities.
Turkey receives patients mainly from the United
Kingdom, the Netherlands, Belgium, Azerbaijan, Russia,
Bulgaria, Romania, Kosovo and Syria. Turkey is preferred
mostly for eye, dental, prostate and fertility operations.
When we evaluate the state of our medical tourism in terms
of contributions from Turkish citizens living in Europe,
the variety of the services provided have been very high,
as shown by annual economic earnings that have yielded
more than 100 million euros thus far.
A major strength of the medical health industry in
Turkey is that it has sufficient capacity for domestic and
foreign patients. There are many highly qualified doctors
in Turkish hospitals, which are equipped with the latest
technology and staffed by personnel who provide good and
qualified health care. Private hospitals are top-notch, while
almost all hospitals have the ISO 2001 quality management
certification. More than ten first-class hospitals have been
accredited by the JCI while others are still in the process of
accreditation. There are no waiting periods for treatment.
The elements of Turkey’s competitive advantage in
health tourism can thus be identified as follows: the high
quality of infrastructure and hardware in the hospitals;
the high experience levels of the doctors and health
service providers at par with European standards; the
price advantages in comparison with other countries; the
country’s natural and historical prosperity and its unique
geographical location as a bridge between Europe and
the Middle East; and the appropriate climatic conditions
combined with quality tourism administration and wellknown Turkish hospitality.
These factors, coupled with the desire of the almost five
million Turkish individuals living abroad to receive their
health treatments in Turkey, can be mentioned as Turkey’s
strengths in the health tourism industry.
The Turkish American Chamber of Commerce &
Industry presents a Medical Tourism Conference March
14th 2009 in Chicago, Illinois. The Sixth Annual Medical
Ball takes place the night of the 14th of March at the
Marriott Chicago Oakbrook.
The Turkish American Doctors Association of Midwest
will hold their conference on April 15th-16th 2009 in
Chicago. n
86
March/April 2009
Medical Tourism Association Participates in World Health Organization
(WHO) Workshop on Medical Tourism in Kobe, Japan
The Medical Tourism Association participated in
World Health Organization (WHO) workshop on Medical
Tourism in Kobe, Japan which took place February 24th
through the 25th.
Approximately 16 academics and experts on various
global healthcare issues were invited from around the world
to participate in the WHO Workshop on medical tourism.
The workshop was entitled “Workshop on the movement of
patients across international borders - Emerging Challenges
and opportunities for Healthcare Systems.”
The workshop was held to address the growing
phenomenon of the $60 billion dollar medical tourism
industry which is marketed by over 35 countries. One
of the main purposes was to ensure medical tourism “is
supportive of public health goals.”
Renee-Marie Stephano, Chief Operating Officer of the
Medical Tourism Association, and editor of the Medical
Tourism Magazine participated in the workshop and as one
of the leading experts in medical tourism and shared her
views of how Medical Tourism can be supportive of the local
healthcare infrastructure and how a properly implemented
national medical tourism program can improve the
underlying public healthcare system and generate revenue
and investment into the country participating in trade in
healthcare services at the same time.
The event was organized by the WHO Department
of Ethics, Equity, Trade and Human Rights, WHO
Headquarters, and the WHO Centre for Health
Development.
The Objectives of the workshop were:
(1) To present current evidence on the movement of
patients across international borders and discuss the
effect on healthcare systems of the increase in trade in
health services;
(2) To identify emerging challenges as well as good
practices, especially in the Asia-Pacific;
(3) To develop a framework to describe the implications
for health care systems of health services’ trade and
delineate appropriate research and action.
The Medical Tourism Association is the first international
non-profit association made up of the top international
hospitals, healthcare providers, medical travel facilitators,
insurance companies, and other affiliated companies
and members with the common goal of promoting the
highest level of quality of healthcare to patients in a global
environment. Our Association promotes the interests of
its healthcare provider and medical tourism facilitators
members. The Medical Tourism Association has three
tenets: Transparency, Communication and Education. n
March/April 2009
87
The Medical Tourism Association
Member Benefits
New Member Benefits for 2009
Introductory Networking Email:
Members can receive an Introduction Email that will introduce their company to new and existing members. This email will
feature information about your company, who you wish to network and work with, as well as contact information.
Video on our Website:
Members can submit a 5-8 minute video to be placed on our Medical Tourism Magazine website for viewing.Videos must be
approved by the MTA and directed at educating the industry, not just self-promotion.
Corporate Profile on the Medical Tourism Association Website:
Members can now submit their corporate profile to be listed as an additional link next to the contact information and
logo on the Medical Tourism Association website. Corporate Profile must be 1-3 paragraphs and must be approved by the
Medical Tourism Association prior to upload.
Article Published on the Online Version of the Medical Tourism Magazine:
Members can submit articles for publication for the online version of the Medical Tourism Magazine. All articles will be
reviewed and must be approved before being published. Articles should be educational.
Classified Listing in the Medical Tourism Magazine:
Members will receive a FREE Classified listing in the Medical Tourism Magazine. This will feature your company name and
website.
Listing in the Medical Tourism Association Directory:
As a member you will be listed in the Medical Tourism Association directory that will be available to everyone in the
medical tourism industry to be released October 2009 and distributed at the World Medical Tourism & Global Health
Congress in Los Angeles.
Magazine Newsletter Listing:
All new members will be introduced in our Medical Tourism Magazine Bi-Weekly newsletter.
Use of Medical Tourism Association Logo on your website:
Members can use the Medical Tourism Association logo on their own website, if linked properly back to the Medical
Tourism Association Website.
Participation in the Medical Tourism Association Committees:
All members can join any or all of the six Medical Tourism Association Committees. To read more about the
Committees please see the next page. We also will be accepting chairpersons and alternate chairpersons for these
committees. Teleconferences are held each month at various days and times to accommodate all international members.
Medical Tourism Association, Inc.
www.MedicalTourismAssociation.com
US: 561-791-2000
88
March/April 2009
Member Benefits
Committee Descriptions
After Care Committee
The Medical Tourism Association’s After Care Committee meets on a monthly basis through teleconference calls to
discuss the top issues in after care. Members of this committee meet together to discuss ways to improve aftercare,
current advancements in aftercare and patient safety, and how to provide patients with the best care after surgery and
when they return home.
Industry Direction Committee
The Medical Tourism Association’s Industry Direction Committee meets on a monthly basis through teleconference calls
to discuss the top issues affecting in the industry. Members of this committee meet together to discuss how the industry
is growing and what we can do to help promote the industry in a positive direction, creating a more solid foundation and
protecting the reputation. This committee discusses ethics and industry drivers.
Legal Committee
The Medical Tourism Association’s Legal Committee meets on a monthly basis through teleconference calls to discuss the
top issues in the legal field. Members of this committee meet together to discuss reducing the risks and liability in medical
tourism, legal forms and documents, and how to network with the right legal teams in medical tourism. The Committee is
chaired by a legal expert in medical tourism.
Quality Indicator Committee / Quality of Care Project
The Medical Tourism Association’s Quality Indicator Committee meets on a monthly basis through teleconference calls to
discuss the Quality of Care Project. This project seeks to create a single set of quality indicators that may be used
universally, a single methodology and validation method. The goal is to create indicators understandable to the consumer.
Medical Tourism Facilitator Committee
The Medical Tourism Association’s Medical Tourism Facilitator Committee meets on a monthly basis to discuss developing a
set of standards for the facilitator side of medical tourism, problems that other facilitators are facing, and help new
members who are just entering the industry. This committee will monitor the development of the certification program
and discuss improvements as the industry develops.
Membership Committee
The Medical Tourism Association’s Membership Committee meets on a monthly basis through teleconference calls to
discuss issues affecting the MTA generally and the members specifically. This committee looks to generate increased
membership for the Medical Tourism Association as well as increasing member involvement and improving member benefits.
US: 561-791-2000
March/April 2009
89
Member Benefits
Existing Member Benefits
Marketing Support and Workshops:
Whether you are just starting up your own medical tourism company or have an established business already in medical
tourism, the Medical Tourism Association can help you develop and strengthen your marketing plan by providing valuable
industry information. The Medical Tourism Association can help educate you about implementing Best Practices within your
company and provides guidance as needed throughout your membership. The Medical Tourism Association has six
committees that meet monthly on teleconference calls to discuss the top issues affecting the medical tourism industry
today. We work together to strengthen the Industry as a whole.
Increased Networking:
The contact information for all members is listed on the Medical Tourism Association website, which is easily viewed by
thousands of people searching for information on medical tourism. Prospective patients and business opportunities can
access member websites directly from our website. The Medical Tourism Association Directs all patient and media inquiries
to our active members.
Building Brand Awareness to International Insurance Companies, Employers, and Healthcare Companies:
By being a prestigious member of the Medical Tourism Association, your company is listed on our website, in our magazine,
and in emails distributed to thousands of people in the industry. By being an MTA member, you increase international brand
awareness and exposure through all outlets! The Medical Tourism Magazine goes out to thousands of people in hard copy
and the online version now has its own website. From both the MTA website and the magazine website, issues can be
downloaded and anyone can sign up for a free subscription. The Officers of the Medical Tourism Association speak at all of
the major conferences throughout the world to encourage insurance companies and employers to join the association and
to work with Medical Tourism Association Members in their implementation of medical tourism programs.
Patient Referrals:
We have potential patients contacting us by both phone and email. We refer these inquiries to our members. We also
encourage potential patients, insurance companies, and employers to work exclusively with Medical Tourism Association
Members.
Legal Information and Legal Networking regarding Medical Tourism:
As a member of the Medical Tourism Association, we can connect you with other members in the legal field. These
members are highly established lawyers and extremely knowledgeable in the field of medical tourism. They have made
themselves available to Medical Tourism Association members and are willing to assist other members with legal questions
and documents and provide special pricing to members. All Members are invited to participate in the legal committee
teleconferences held once per month.
Protecting your Reputation:
Through due diligence, our members can separate themselves from others in the industry. By being a member of the
Medical Tourism Association, you are dedicated to working with others to promote the industry in a positive direction, thus
furthering your reputation as an established and reputable organization.
Discounts at Medical Tourism Conferences throughout the World:
Members receive discounts to both the World Medical Tourism & Global Health Congress in Los Angeles and the Latin
America Medical Tourism Congress in Monterrey Mexico and any other conferences around the world throughout the year
that the MTA sponsors.
US: 561-791-2000
90
March/April 2009
Member Benefits
Media and Press Opportunities:
We have media and press that contact us by both phone and email on a daily basis. We always refer media and press to
our members and provide them with email and phone numbers to contact for articles and publications. We also encourage
media and press to work exclusively with Medical Tourism Association Members. The Medical Tourism Association has been
featured in numerous publications throughout the world, including the LA Times, Newsmax, Business Week and The New
York Times. As a member of the Medical Tourism Association your membership is held in high regard when being viewed by
members of the media, patients, insurers, and employers.
Advice on Attracting International Patients:
The Medical Tourism Association will help you attract international patients by the exposure you receive from being listed
on our website and through the Medical Tourism Magazine. We always refer potential patients to work exclusively with our
members!
MTA Certification Program Participation:
The Medical Tourism Association has launched a “pilot program” of certification of medical tourism facilitators who are
involved in the coordination of patient care for patients traveling from one country to another. This pilot program will be
open to Medical Tourism Association members for a period of six months. The certification process is a detailed process
of evaluation which may take up to 90 to 120 days to complete. Those Medical Tourism Facilitators who have applied for
certification will be listed on the website as “ In Application Process.” Successful Members will be listed on the website as
“Certified Members.”
Contact Information & Logo on the Medical Tourism Association Website:
As a member your contact information and logo are displayed under the Member Tab on the Medical Tourism Association
website.
Input on the Direction of the Association and the Medical Tourism Industry:
Members can participate in any or all of the six committees who come up with ideas for what projects the Medical
Tourism Association will participate in, as well as how members can help to create a solid foundation for the medical
tourism industry. With the help of our members the Association can grow and move forward to work together in providing
a better understanding of medical tourism and reduce liability.
Research Reports, Studies, and Information from the Medical Tourism Association:
The Medical Tourism Association will be conducting research studies and surveys.
Free Subscription to the Medical Tourism Magazine:
The Medical Tourism Magazine goes out to thousands of people and includes an online version that is featured on it’s own
website. Issues of the Medical Tourism Magazine can be downloaded for free online or anyone can sign up for a free
subscription.
Assistance in Establishing Medical Clusters:
The Medical Tourism Association with work with governments to help develop and promote medical clusters in different
countries. We will help work with the government to seek support and funding for local hospitals and clinics.
Participation in High Level Networking Events:
Participation in high level networking events such as the World Medical Tourism and Global Health Congress which will
feature up to 2,000 attendee and 100 exhibitors from all over the world.
US: 561-791-2000
March/April 2009
91
MEMBER
HOSPITALS
ACIBADEM Healthcare Group
Fahrettin Kerim Gokay cad. No: 49
Altunizade
Istanbul 34662
Turkey
Telephone: 0090 216 544 37 05
Fax: 0090 216 340 77 28
Website: www.asg.com.tr
Ajou University Medical Center
TSan 5 Wonchondong Yeongtongu
Suwon, Korea 443721
Telephone: 82-31-219-4311-2, 4010
Fax: 82-31-219-5432
Website: http://hosp.ajoumc.or.kr/eng/
Apollo Hospitals Enterprises Ltd.
21 Greams Lane off Greams Rd.
Chennai 60000-006
India
Telephone: 91-99-80118113
Fax: 91-80-41463150
Website: www.apollohospitals.com
Bangkok Hospital Medical Center
2 Soi Soonvijai 7, New Petchburi Road
Bangkok 10310
Thailand
Telephone: (+66) 320 3000
Fax: (+66) 320 3105
Website: www.bangkokhospital.com
Boomin Hospital
380-4 Deokcheon -1 - Dong
Buk-gu, Busan South Korea
Telephone: +82-51-330-3218
Fax: +82-51-330-3242
Website: www.buminhos.co.kr
Brain Tumor Center at St. John’s
Health Center
2200 Santa Monica Blvd
Santa Monica, CA, 90404
USA
Telephone: 310-582-7450
Website: www.brain-tumor.org
Bumrungrad International
33 Sukhumvit 3 (Soi Nana Nua),
Wattana,
Bangkok 10110 Thailand
Telephone: + 662 667 1000
Website: www.bumrungrad.com
CHRISTUS Muguerza
Belisario Dominguez 2005, Col. Obispado
Monterrey 64060
Mexico
Telephone: 52-81-8399-3416
Fax: 52-81-8399-3484
Website: www.christusmuguerza.com.mx
92
March/April 2009
D I R E C TOR Y
Centro Medico Teknon
c/Vilana 12
Barcelona 08008
Spain
Telephone: (34) 932906310
Website: www.teknon.es
Columbia Asia Hospitals Pvt. Ltd.
The Icon, 2nd Floor, #8, 80 Feet Road,
HAL III Stage, Indiranagar
Bangalore 560 075
India
Telephone: +91 080 4021 1000
Fax: +91 080 4021 1001
Website: www.columbiaasia.com
Fortis Healthcare
275-276 Capt Gaur Marg.
Sriniwaspuri,
New Delhi India 110 065
Telephone: 011-4229522
Fax: 011-41802121
Website: www.fortishealthcare.com
FV Hospital - Far East Medical Vietnam
Limited
6 Nguyen Luong Bang,
Saigon South (Phu My Hung)
District 7,Ho Chi Minh City
VIETNAM
Telephone: (84-8) 411-3333
Fax: (84-8) 411-3334
Website: www.fvhospital.com
International Patient Services
Telephone: (84-8) 411-3420
Email: [email protected]
International Guide: http://international.
fvhospital.com
HCA International Hospitals
79 Harley Street
London, W1G 8PZ
United Kingdom
Telephone: +44 7979770430
Fax: +44 20 7486 6132
Website: www.hcahospital.co.uk
Hospital Almater
Fco. I Madero No. 1060
Mexicali BC 21100
Mexico
Telephone: 686-523-8000
Website: www.almater.com
Hospital Cima Chihuahua
Haciendas Del Valle No. 7120 FRACC.
Plaza Las Haciendas
Chihuahua, Mexico 31217
Telephone: 01152614-439-87-16
Fax: 01152614-439-27-59
Website: www.hospitalcima.com.mx
Hospital Clinica Biblica
Calle Central y Primera
Avenidas 14y16
San Jose, Costa Rica 1037-1000
Toll Free: 1-800-503-5358
Telephone: 506-522-1414
Fax: 506-257-7307
Website: www.hcbinternational.com
Hospital San Jose Tec de Monterrey
Av. Ignacio Morones Prieto
3000 Pte. Colonia: Doctores
64710 Monterrey N.L. Mexico
Telephone: 011-52-81-13668611
Fax: 011-52-81-89838375
Website: www.hsj.com.mx
Indraprastha Apollo Hospitals
Sarita Vihar,
Delhi-Mathura Rd. New Delhi,
India 110076
Telephone: 91-11-26925858
Fax: 91-11-26925709
Website: www.apollohospitals.com
Institut Jantung Negara (National
Heart Institute)
145, Jalan Tun Razak
Kuala Lumpur 50400
Malaysia
Telephone: +603-2617-8200
Fax: +603-2698-2824
Website: www.ijn.com.my
Jackson Memorial Hospital
1500 NW 12th Avenue Suite 829
Miami, FL, 33136
USA
Telephone: 305-355-5544
Website: www.jmhi.org
Jordan Hospital
Queen Noor Street
Amman 11190
Jordan
Telephone: +962 6560 8080
Fax: +962 6560 7575
Website: www.jordan-hospital.com
Prince Court Medical Centre Sdn. Bhd
39, Jalan Kia Peng
Kuala Lumpur 50450
Malaysia
Telephone: +603 21600000
Fax: +603 21600110
Website: www.princecourt.com
Sanoviv Medical Institute
2606-A Transportation Ave
National City, CA, 91950
USA
Telephone: 801-954-7600
Website: www.Sanoviv.com
Seoul Wooridul Spine Hospital
47-4 Chungdam-dong,
Gangnam-gu Seoul 135-100
Korea
Telephone: +82-2-513-8157 / 8385
Fax: +82-2-513-8386 / 8454
Website: www.wooridul.com
Severence Hospital
Yonsei University Health System
250 Seongsanno, Seodaemun-gu
Seoul, Republic of Korea 120-752
Telephone: +82-2-2228-1482
Fax: +82-2-363-0396
Website: www.yuhs.or.kr/en/
USP Instituto Universitario
C/Sabino de Arana, 5-19
Barcelona 8028
Spain
Telephone: (34) 932274747
Website: www.dexeus.es
Wockhardt Hospitals
Associate Harvard Medical International
Wockhardt Towers, Bandra Kurla Complex,
Bandra East, Mumbai 400051
India
Telephone: 91-9980266553
Fax: 91-80 66214242
Website: www.wockhardthospitals.net
SPECIALTY, COSMETIC, & DENTAL
CLINICS
Barbados Fertility Centre Inc.
Seaston House, Hastings
Christ Church
Barbados
Telephone: 246-435-7467
Fax: 246-436-7467
Website: www.barbadosivf.org
Centro Internacional de Oncologia
6a. avenida No. 3-99 zona 10,
Guatemala, Guatemala
Telephone: (502) 59904508
Centro Integral de Cirugia Plastica
“RENOVA”
3 CALLE “a” 8-38 Zona
10 Guatemala, Guatemala 01010
Guatemala
Telephone: (502) 2329-6363
Fax: (502) 2329-6364
Website: www.renova.net.gt
Clinica Zaldivar
Prosiplastic SA de CV VIPSAL 22163
PO Box 025364
Miami, FL 33143
USA
Telephone: 50322632471
Genetics & IVF Institute
3015 Williams Drive
Fairfax, VA 22031
USA
Telephone: 703-698-7355
Fax: 703-698-0418
Website: www.clements.com
Indus Valley Ayurvedic Centre
Post Box #3, Ittigegud Post, Lalithadripura
Mysore, Karnataka 570010
India
Telephone: 0091-821-2473266,263,437
Fax: 0091-821-2473590
Website: www.ayurindus.com
La Casa Del Diente
Av. Revolucion 3780 Local 1 Col. Terremolinos
Monterrey 64858
Mexico
Telephone: +8183499466
Website: www.lacasadeldiente.com
Lorenzana Dental Center
Pasaje Sagrado Corazon 826
San Salvador, San Salvador
El Salvador
Telephone: (503) 2263-4572
Facsimile: (503) 2263-4575
Website: www.doctorlorenzana.com
Orthopedic Surgery Center of Orange
County
Gabrielle White
22 Corporate Plaza, #150
Newport Beach, CA 92660
Telephone: (949) 515-0708
Fax: (949) 515-4821
Website: www.oscoc.com
Parkside Rehabilitation Hospital
731-1 Daeyeon-dong, Man-gu
Busan, South Korea 608-812
Telephone: 82-51-629-8000
Fax: 82-51-629-8188
Website: www.parkside.co.kr
Programas de Bienestar Integral SA de CV
Ave Alfonso Reyes 143 Norte,
Colonia Regina, Monterrey 64290
Mexico
Telephone: +528183310911
Website: www.biemex.com
Seoul National University Dental
Hospital
62-1 Changgyeonggungno, Jongno-gu
Seoul, Korea 110-768
Telephone: +82-2-2072-0753
Fax: +82-2-2072-0737
Website: www.snudh.or.kr/eng/index.htm
Rehabilitation Clinic - Dr. Vorobiev
Sremskih Boraca 2E
Belgrade, 11080
Serbia
Telephone: +381 11 3167 190
Fax: +381 11 3167 190
Website: www.v-clinic.eu
The Catholic University of Korea
Yeson Voice Center
The Institute of Performing Art
Medicine
Hyung-Tae Kim, MD, PhD
638-13 Ssanbong Build. 2nd Fl.
Shinsadong, Gangnamgu
Seoul, 135-896, South Korea
Telephone:82-2-3444-0550
Fax: 82-2-3443-2621
Website: www.yesonvc.com
MEDICAL TOURISM
FACILITATORS
Advanced Medi Travel Pty Ltd
43 Cameron Crescent
Kincumber NSW 2251
Australia
Telephone: + 61 2 43684340
Fax: +61 2 43684089
Website: www.advancedmeditravel.com
Alpha Medical Tourism LTD
International Diagnostic & Treatment
Day Clinic
24 Shalva
Savyon 56548
Israel
Telephone: 972 -(0)- 3-736-2679
Fax: 972 -(0)- 3-736-2707
Website: www.alphamedicaltourism.com
Website: www.idtdc.net
Canadian Healthcare International
30 Centurian Drive, Suite 100
Markham Ontario, L3R8B8
Canada
Telephone: 905-513-3647
Fax: 905-475-8335
Website: www.canadaheals.com
ChoiceMed Pte. Ltd.
9 Tan Quee Lan Street, #02-02 TQL Suites
188098 Singapore
Telephone: (65) 6884 9375
Fax: (65) 6884 9376
Website: www.choicemed.com
Global Health Travel
Cassandra Italia
80A O’Shannassy Street
Sunbury, VIC 3429
Australia
Telephone: +613-9744-5872
Fax: +613-9740-4243
Website: www.globalhealthtravel.com.au
Health & Leisure (H&L)
9th Floor Ayala Life-FGU Center
Ayala Avenue, Makati City 1226
Philippines
Telephone: + 632 813 4527
US Number: (818) 748-8735
Fax: + 632 840 0719
Website: www.healthandleisure.net
Healthbase
Healthcare Beyond Boundaries TM
287 Auburn Street
Newton, MA 02466
USA
Telephone: 1-888-MY1-HLTH
Telephone: 1-888-691-4584 (Toll Free)
Telephone: 1-617-418-3436 (International)
Fax: 1-800-986-9230
Website: www.healthbase.com
International Healthcare & Wellness
Crater 503, Pedregal De San Angel
Mexico City 01900
Mexico
Telephone: +525552560786
Website: www.internationalhealthcare.com
Makewell Meditour Ltd
Sandeep Khemka
506-A, Kemp Plaza,
Mindspace - Malad (w),
Mumbai 400 064
India
Telephone: + 91 22 65166805
Fax: + 91 22 28773415
Website: www.make-well.com
Medical Tourism Corporation Med
Tourism Co, LLC
7000 Occidental Road
Plano, TX 75025 USA
Telephone: 1-800-661-2126
Fax: 800-661-2126
Website: www.medicaltourismco.com
MedTral New Zealand
Steve Nichols
Mercy Specialist Center
100 Mountain Road
Epsom
Auckland 1149
New Zealand
Telephone: 64-9-623-6588
Fax: 64-9-6236587
Website: www.medtral.com
MTT
9B Brookline Ct.
Princeton, New Jersey 08540
USA
Telephone: 732-735-2974
Fax: 609-751-0201
North American Surgery, Inc.
1275 West 6th Ave, Suite 300
Vancouver, Canada V6H 1A6
Telephone: (866) 496-2764
Fax: (604) 738-1734
Website: www.NorthAmericanSurgery.com
Overseas Medical Svc Canada Inc.
Aruna
Th-Hollingshead
1771-1 Ave NW
Calgary, AB T2N 0B2
Canada
Telephone: 403-283-4947
Fax: 403-283-2368
Website: www.uniquehospitals.com
Patients Without Borders, LLC
304 Newbury Street, Suite 364
Boston, MA 02115
United States of America
Telephone: 800-290-0197
Fax: 617-437-9655
Website: www.patientswithoutborders.us
Philippine Medical Tourism, Inc.
Eva Trinidad
2nd Floor, Goodwill Building,
393 Sen, Gil Puyat Ave.
Makati, Philippines 1200
Telephone: 632-897-5813
Fax: 632-898-3977
Website: www.philmedtourism.com
Premier MedEscape LLC
Joe Gasparoni
4521 P.G.A. Blvd. #377
Palm Beach Gardens, Florida 33410
USA
Telephone: 561-776-5478
Fax: 561-776-5417
Website: www.premiermedescape.com
Premium Health Solutions
Horst Bruggraber
Operngasse
2 Vienna, Austria
1010
Telephone: +43 1 51651 83
Fax: +43 1 513 44 24
Website: www.phs-austria.com
Restored Beauty Getaways
Robbie Degenaar
Suite 4/193 Guildford Road
Maylands,
Western Australia 6051
Telephone: +61 (8) 9371 7142
Fax: +461 (8) 9272 5417
Website: www.restoredbeautygetaways.com
SAI Medical Group
Deepak Sahni
S-51, J. Market,
Rajouri Garden
New Delhi, 110027 INDIA
Telephone: 91-11-45009940, 09811963845
Fax: 91-11-45009940
Website: www.mdinindia.com
Serokolo Health Tourism (Pty) Ltd
1st Floor 26 Wellington Road, Parktown
Johannesburg 2193
South Africa
Telephone: +27 11 484 6211
Fax: +27 11 484 8469
Website: www.serokolo.co.za
March/April 2009
93
MEMBER
SPA-MED-HOLIDAY
Cecile Billiet
Edificio Reforma Obelisco, St. 1106
Av Reforma 15-54, Z9
Guatemala City 01009
Guatemala
Telephone: 00 502 2332 4648 /
00 502 593 79 438
Skype: spa.med.holiday
Website: www.spa-med-holiday.com
Sphera International
Alex Lifschitz
Rua Principado de Monaco 217
Sao Paulo 01247-040
Brazil
Telephone: 55.11.3528-4545 / 9981-1358
Fax: 55.11.3528-4546
Website: www.brazilmedicaltourism.com
Surgical Trip, LLC
Thomas O’Hara
7491 North Federal Highway,
Suite C-5, #293
Boca Raton, FL 33487
Telephone: (800)513-8996
Website: www.SurgicalTrip.com
Vung Tau Tourist Sanatorium
Medicoast
Nguyen Thi Mai
165 Thuy Van St. Thang Tam Ward
Vung Tau City, Viet Nam
Telephone: 84.64.853857 or 64.510756
Fax: 84.64.852395
Website: www.medicoast.com.au
Well-Being Travel
Anne Marie Moebes
71 Audrey Avenue
Oyster Bay, NY 11771
Telephone: (516) 624-0500 X2312
Fax: (516) 624-6024
Website: www.travelsavers.com
The Wellness Travel Company Pte
Mr. JP Bos
17A Jalan Klapa
199329 Singapore
Telephone: +65-6293-8990
Fax: +65-6293-8963
Website: www.wellnesstravel.com
WorldMed Assist LLC
D I R E C TOR Y
TRAVEL AGENCIES
Millennium Travel
263 Cloverleaf Court
Ann Arbor MI 48103
USA
Telephone: 734-330-3449
Fax: 734-661-6141
Website: www.millennium-travel.com
Well-Being Travel
Anne Marie Moebes
71 Audrey Avenue
Oyster Bay, NY 11771
Telephone: (516) 624-0500 X2312
Fax: (516) 624-6024
Website: www.travelsavers.com
GOVERNMENT/
HEALTHCARE CLUSTER
Barcelona Centre Medic
Av. Diagonal 612 2o - 14
Barcelona 08021
Spain
Telephone: (34) 934140643
Fax: (34) 934140457
Website: www.bem.es
EXPORTSALUD
Centro Comercial Campestre Local # 1
Paseo General Escalon
El Salvador, San Salvador
Telephone: (503) 2263 1232
Fax: (503) 2263 1232
Website: www.exportsalud.org
Korea Health Industry Development
Institute
57-1 Noryangjin-dong, Dongjak-gu
Seoul 156-800 KOREA
Telephone: +82-2-2194-7459
Fax: +82-2-2194-7380
Website: www.khidi.or.kr
Website: www.koreahealthtour.co.kr
Monterrey Healthcare City
5 De Mayo #525 Ote. Edificio Elizondo
Paez 2 Piso
Monterrey, N.L. 64000
Mexico
Telephone: +52818320206674
Fax: +52-8183404934
Website: www.monterreyhealthcarecity.com
Wouter Hoeberechts, CEO
1230 Mountain Side Ct.
Telephone: 866-999-3848
Fax: 904-369-1044
Website: www.worldmedassist.com
94
March/April 2009
Telephone: 905-669-4333
Fax: 905-669-2221
Website: www.cmn-global.com
AMF Risk Management Solutions
300 Congress Street
Quincy, MA 02169
USA
Telephone: 617-770-0917
Website: www.amfrms.com
The Crowne Group, Inc.
1552 Boren Drive, Suite 100
Ocoee, FL 34761
USA
Telephone: 407-654-5414
Fax: 407-654-9614
Website: www.crowneinc.com
Angels Abroad
1a. calle “D” 7-33 zona 17
colonia lourdes
Guatemala, Guatemala 01017
Telephone: 502 54254103
Website: www.angelsabroad.com
Assurant Health
501 W. Michigan Street
Milwaukee, WI 53203
USA
Telephone: 414-299-6609
Fax: 414-299-6502
Website: www.assurant.com
Atlantic Health Group
1415 North Loop West
Houston, TX 77008
USA
Telephone: 713-236-8017
Fax: 713-236-8010
Website: www.atlantic-health.com
Buenos Aires Partners
Olga Cossettini 1660, Suite 309
(1107) C.A.B.A. Buenos Aires - Argentina
Tel: +1 312-212-3939
Tel: +54 11 5787 7309
Fax: +54 11 5787 7909
Website: www.buenosairespartners.com
BYZAlliance Medical Travel & Medical
Consulting
Hakkiyeten Caddesi. Unimed Center
No: 8/10 34349 Fulya - Istanbul
Turkey
Telephone: 90 212 240 82 99
Fax: 90 212 231 39 56
Website: www.byzalliance.com
Clements International
1 Thomas Circle NW, 8th Floor,
Washington, DC 20005
USA
Telephone: 202-872-0060
Fax: 202-466-9064
Website: www.clements.com
CORPORATE MEMBERS
Concord, CA 94521
USA
Telephone: +44 (0) 845 057 4039
Fax: +44 (0) 845 057 4039
Website: www.AllMedicalTourism.com
AllMedicalTourism.com
70A, Club Street,
069 443
Singapore
CMN
150 Commerce Valley Drive West, 9th
Floor
Thornhill, ON L3T 7Z3
Canada
El Salvador Medical
VIPSAL 1224 PO Box 025364
Miami, FL, 33102
USA
Telephone: 503-22634572
Website: www.elsalvadormedical.com
Elixir Medical Tours
218-220, Hankow Centre, 5/15 Hankow
Road
tsim Sha Tsui, Kowloon
Hong Kong
Telephone: 852-2311046
Fax: 852-23110058
Website: www.elixirmedicaltours.com
e-Medsol Pvt Ltd
34/1121 A, 129 BMRA
Balakrishna Menon Road
Cochin 682025
India
Telephone: 091-484-3250706,
9846170036
Website: www.emedsol.biz
Free Health, Inc.
12856 82nd Lane North
West Palm Beach, FL 33412
USA
Telephone: 561-792-4418
Fax: 561-792-4428
Website: www.freehealth.com
Global Health Choices LLC
573 Valley Road Suite 6
Wayne, New Jersey 07470
USA
Telephone: 973-406-8048
Fax: 973-696-2335
Global Health Solutions, LLC
358 West Lake Drive
Edwardsville, IL 62025
USA
Telephone: 618-444-1552
Gooch & Associates
POB 588, 224 Pond View Drive Ste G
Centreville, MD, 21617
USA
Telephone: 813-340-2277
Website: www.gooch-inc.com
Guatemala Health & Wellness
Commission at Agexport
15 Ave - 14-72, Zona 13
Guatemala City 01013
Guatemala
Telephone: 00 502 2422 3400
Fax: 00 502 2422 3434
Website: www.agexport.org.gt
Website: www.export.com.gt
HCPro, Inc.
200 Hoods Lane
P.O. Box 1168
Marblehead, MA 01945
USA
Telephone: 978-317-6478
Fax: 781-639-0085
Website: www.hcpro.com
Website: www.greeley.com
Healthcare.com
1749 NE Miami Court
Miami, FL 33132
USA
Telephone: 626-449-1624
Website: www.healthcare.com
Health Links International
11435 Drummond Court
Dallas, TX 75228
USA
Telephone: 214-564-7341 U.S.
Fax: 888-235-0208
International Fax: 425-974-7902
Website: www.healthlinksintl.com
HealthNow New York Inc.
257 West Genesee Street
Buffalo, NY 14202
USA
Telephone: 716-887-6027
Fax: 716-887-7583
Website: www.healthnowny.com
Health Tourism and Wellness Sdn. Bhd.
36-1, Jalan 25/70A, Desa Sri Hartamas
Kuala Lumpur 50480
Malaysia
Telephone: +603 2300 0980
Fax: +603 2300 2230
Website: www.medicalboutiques.com
IHG
3517 Seltzer Drive
Plano, TX 75023
USA
Telephone: 972-964-3139
Website: www.ihg.com
Institute of Clinical Research Pvt. Ltd.
D-41, 3rd Floor Defence Colony
New Delhi 110 024
INDIA
Telephone: 011 46638006
Fax: 011 41634963
Website: www.icriiindia.com
Inter-American Medical Tourism
10949 NW 59th Street
Doral, FL 33178
USA
Telephone: 305-803-0181
Website: www.
interamericanmedicaltourism.com
International Board of Medicine and
Surgery
P.O. Box 6009
Palm Harbor, FL 34684
USA
Telephone: 813-966-1431
Fax: 813-925-1932
iPatient
27679 N 68th Place
Scottsdale, AZ 85256
USA
Telephone: 480-419-5783
Fax: 480-473-5770
Website: www.IPatientInc.com
I.S.I.-Israel Scientific Instrument
32 Sham Street P.O.P. 7790
Petach-Tikva 49170
Israel
Telephone: +972-3-9232202
Fax: +972-3-9229750
Website: www.isil.co.il
Maggi Grace
Website: www.maggigrace.com
Website: www.stateoftheheart.name
Health Travel Guides
600 Townsend Street, Suite 120e
San Francisco, CA 94103
USA
Telephone: 415-412-4811
Website: www.healthtravelguides.com
MD&T Argentina
Castex 3315 2oA
Capital Federal 1425
Argentina
Telephone: (54 11) 4801-1665
Website: www.mdtargentina.com
Homewatch International, Inc.
7100E. Belleview Ave., Suite 303
Greenwood Village, CO 80111
USA
Telephone: 303-758-5111
Fax: 303-758-1724
Website: www.homewatchcaregivers.com
Medical Tourism Partners, LLC
1333A North Ave, #237
New Rochelle, NY 10804
USA
Telephone: 914-819-0839
Fax: 914-798-6678
Website: www.MedicalTourismPartners.com
Medi Globe Inc
Telephone: 314-812-2772
Fax: 314-812-2505
Website: www.mediglobeusa.com
MedNet Brazil Concierge Services
20 Orange Drive
Salinas, CA, 93901
USA
Telephone: 831-998-0130
Website: www.MedNetBrazil.com
MedTravel Costa Rica
600m South and 300m West from channel
6, La Uruca
San Jose 00506
Costa Rica
Telephone: 1 (866) 537-8821
Facsimile: 506-2291-1464
Website: www.MedTravelCR.com
MedVoy Inc.
1917 King Street
Denver Colorado 80204
USA
Telephone:720-771-6760
Facsimile: +1-866-254-0108
Website: www.medvoy.com
MOH Holdings Pte Ltd
83 Clemenceau Ave., #15-03 UE Square
Singapore 239920
Singapore
Telephone: +65-6622-0956
Fax: +65-6720-0980
Website: www.mohh.com.sg
NursesNow International
Av. Hidalgo 2609 Col. Obispado
Monterrey, Nuevo Leon 64800
Mexico
Telephone: +528181234849
Fax: +528181234851
Website: www.nni.com.mx
Passage 2 Health
Aldwych House, 81
Aldwych
London WC2B 4HN UK
Telephone: +44 (0) 7758 586 059
Website: www.passage2health.co.uk
Premiere Medical Travel Company, LLC
James McCormick MD
6303 Owensmouth Avenue, 10th Floor
Woodland Hills, CA 91367-2622
Telephone: 818-917-6189
Fax: 818-936-2101
ReachMD
95 Revere Drive Suite B
Northbrook, IL 60062
Telephone: 847-205-9075
Fax: 847-205-9091
Website: www.reachmd.com
SenditCertified
7810 Ballantyne Commons Parkway,
Third Floor
Charlotte, NC, 28277
USA
Telephone: 888-957-2999
Website: www.senditcertified.com
Seven Corners, Inc
303 Congressional Blvd.
Carmel, Indiana 46032
USA
Telephone:(317) 575-2652
Fax: (317) 575-2870
Website: www.sevencorners.com
Stackpole & Associates
1018 Beacon Street, Suite 201
Brookline, MA, 02446-4058
USA
Telephone: 617-739-5900
Website: www.stackpoleassociates.com
URAC
1220 L Street NW
Suite 400 Washington,
D.C. 20005
USA
Telephone: (202) 216-9010
Fax: (202) 216-9006
Website: www.urac.org
URUHEALTH
(Health & Tourism in Uruguay)
Dr. Marcelo Rodriguez
Av. Ricaldoni 2452
Montevideo 11600 Uruguay
Telephone: (+598) 27114444
Fax: (+598) 27114444
Website: www.uruhealth.com
US Air Ambulance
5919 Approach Road
Sarasota, FL 34238
USA
Telephone: (941) 536-2000
Fax: (888) 633-5384
Website: www.usairambulance.net
US Risk
10210 N. Central Expressway Suite 500
Dallas, TX, 75231
USA
Telephone: 214-265-2460
Website: www.usrisk.com
World Affairs Council of Conn, Inc.
66 Forest Street
Hartford, CT 06105
USA
Telephone: 860-241-6119
Fax: 860-241-2121
Website: www.ctwac.org n
March/April 2009
95
JOIN
THE MEDICAL TOURISM ASSOCIATION
[email protected]
96
March/April 2009

PDF - Medical Tourism Magazine

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