People are drawn to take the extra risk of seeking treatments abroad for many reasons, but by studying medical tourism patients, it is possible to recognize several patterns. As of 2010, the greatest number of medical tourism patients by far travel for elective procedures such as cosmetic surgery. In this case, traveling offers a significant additional benefit of “coming back a new person.” Facelifts are painful and scary to look at right after the procedure is done, and isolating oneself at home for weeks is frustrating. Of course, cost differentials abroad are another key aspect of medical tourism. Dental cosmetic surgery or other procedures fall into this category.

Another significant pattern is patients who undergo duodenal switch to treat obesity. Such patients lose one half of their body weight and have vast folds of stretched out skin and muscle. This is a growing trend in rich countries, especially the U.S., and U.S. cosmetic surgeons have little experience because it is very expensive and few patients can afford it. Often insurance covers the duodenal switch, but it will not cover reconstructive surgery. One practice that specializes in this clientele is Vitoria Physicians Group in Brazil. They conduct hundreds of such procedures per year, and costs are affordable by many middle class families. This is significant: because costs are lower, such physicians have more patients and can be more highly skilled than home country physicians.

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Another important category is ultra-high-cost surgeries for uninsured or underinsured U.S. citizens. They require very expensive heart surgeries to correct chronic conditions. They are responsible people who plan, learn about costs and cannot afford the procedures. Since the procedure (replacing a failing heart value) is chronic, they cannot just go to the emergency room. In these cases, medical tourism can fill the gap. By going to accredited hospitals and well-known surgeons, such patients can get the care they need at a price they can afford (SFGate). This category has the most potential to impact U.S. health care because it introduces competition for highly specialized U.S. surgeons. However, this category will probably be impacted by the 2010 U.S. health care reforms, if they actually materialize.

A specialist group of patients wants treatments unavailable at home. One highly discussed treatment is the Birmingham hip resurfacing procedure, which is not yet approved in most of the U.S. but is very popular in India. It enables people with defective or worn hipbones to avoid having an artificial hip because it “resurfaces” the hip socket. Physicians in India are becoming well known for their successes in this area, and at costs that are far lower than hip replacements in the U.S.

For example, Howard Grace had an ailing heart that had been getting worse for years. He was diagnosed with mitral valve prolapse and regurgitation, and the family did not have insurance. The hospital worked up a $200,000 USD estimate and would not negotiate. This was out of the question for the family, who then looked into alternatives. They ended up going to India and having the procedure done for about a tenth of that figure. However, they chose India through a personal connection, and they did not select an accredited hospital, so they had some issues, even though everything resolved in the end.

Genevieve Cairn lost 420 pounds and was mass of swaying skin. Her U.S. plastic surgeon did not want to treat her excess skin, so she was forced to investigate alternatives. She found Vitoria Physicians Group, which specializes in reconstructing formerly obese patients. Her testimonial details how she feels about her new body. Costs in Brazil are significantly lower than in the U.S., and the expertise level is high (TLC Medical Travel).

Bob Svetlik has a floor sanding business that is physically demanding. He had developed hip problems and was told by his Wisconsin physician that he would have to have his hip replaced for around $40,000. Afterwards he should expect that he would have limited movement and have it replaced again in a few years, depending on how active he was. He went to Dr. Vijay Bose at Apollo Hospitals, where he had the Birmingham Hip Resurfacing procedure for $11,000. He has no pain and can continue to run his business (Healthbase).

These examples show that medical tourism can be attractive to patients with certain types of problems and goals. If most patients are pleased with their results, and the Internet makes it easier for them to share their experiences, this will increase demand for patients (see Medhelp and DailyStrength).

In addition, high cost countries such as the U.S. will lose competitiveness in certain procedures because their surgeons will have less experience due to their high cost. Reading patient testimonials, it is obvious that, whether the patient sought cosmetic surgery or a life-saving heart procedure, they tend to see the results as life-changing, which makes them very eager to talk about their experiences among their friends and acquaintances. This will lead to an increase in demand.

Howard Grace’s story ended well, but his wife’s book (Health Business Blog) describes some of the risks and problems they encountered, so it also serves as a warning to patients. Among patients with long-term problems and frustrations, there may be a tendency to look for a “cure” and to substitute hope for detailed research. Those patients will be more likely to experience problems. Patients can diminish risks the same way they can in the U.S.: by seeking out accredited hospitals and physicians with demonstrated track records.

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