Category Archives: Travelling For Surgery Abroad / Medical Surgery Overseas

Longer UK Wait Lists Create More Medical Tourists

More medical tourists from the U.K. may be forced to go outside the country for cataract surgeries, weight loss surgery, and hip and knee operations.

Nearly all of U.K.’s health care regions have purposely made waiting lists longer by restricting the number of procedures they perform.

9 out of 10 National Health Service Trusts said they have placed limits on many procedures they perform, making longer waiting lists for these procedures.

These growing waiting lists were recently was exposed through a “freedom of information” request in the U.K.

Non-urgent rationing encourages medical travel

The NHS Trusts claim they have reduced the number of these surgeries because they need to save money. By labeling these essential treatments as “non-urgent” or “of low clinical value,” they are able to divert financial resources to more urgent care needs.

Whenever financial resources are taken away from a group of treatments, patients turn to  medical tourism to provide options in other countries.

British Health Minister Simon Burns was forced to respond to the news, stating that rationing treatment on grounds of cost was “totally unacceptable” and decisions to treat patients should be made on clinical grounds alone.

At the same time, Burns acknowledged decisions need to be made to limit or reduce certain types of treatment. This will help improve the bottom lines of budgets, re-allocate manpower or re-purpose physical space.

The NHS must find £20 billion (about US$30 billion) worth of efficiency savings by 2015 while it is still staggering from a failed central computer project that has ended up costing over £12 billion (almost $19 billion).

Canada makes wait times public

In Canada, the province of Ontario maintains a website that publicly lists the wait times not only for surgery but also for diagnostic imaging or emergency room care. Wait list information is searchable by procedure, hospital name or location.

The Ontario list is remarkably similar to that of the U.K. – listing procedures more in demand in aging populations.

Currently, reducing wait times for hip and knee replacements, cataract surgery, radiation oncology and cardiac services are a priority for the Ontario Ministry of Health and Long-Term Care, reducing the need for medical travel.

But weight loss surgery in Ontario has a wait list of 3 years, and is not included in the public list – apparently not an immediate concern of the Ontario government. Weight loss surgery travel by Canadians will continue.

Bed shortages

A different shortage, of patient beds, is the justification for another practice in the U.K. that was also recently made known.

UK doctors are putting tens of thousands of elderly hospital patients to death prematurely because they are difficult to manage or to free up beds, contends Professor Patrick Pullicino, a consultant neurologist and professor of clinical neurosciences.

Denying care to elderly

Speaking to the Royal Society of Medicine in London, he described a “death pathway,” known as the Liverpool Care Pathway (LCP), as a treatment protocol approved by the NHS and National Institute for Health and Clinical Excellence.

LCP, a method of looking after terminally ill patients, is used in hospitals across the U.K., and may include withdrawal of treatment including all nourishment and water. On average, LCP leads to death within 3 days.

Similar protocols exist in the U.S., Canada and other countries, for withdrawing treatment from terminally ill patients who are often in hospice and have very little time left to live. Nourishment and all medical treatment are withdrawn, and high levels of pain medication, often morphine, is given.

Pullicino said doctors had turned the use of this controversial ‘death pathway,’ meant for use when doctors believe when death is imminent, into the equivalent of euthanasia of the elderly. He claims it has become an assisted death pathway rather than a care pathway.

There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP.

source: http://www.mtqua.org / Medical Travel Quality Alliance / by Julie Munro / July 22nd, 2012

Omanis prefer India for medical tourism

Muscat:

India is fast turning into a favourite destination for Omani tourists, especially for those seeking advanced medicare.
There has been a steep rise in the number of visas being issued to India-bound Omanis in the recent past.

From January 1 to June 30 this year, the number of medical visas issued to Omanis has jumped three times and that of other kinds of visas went up 30 per cent when compared to the same period last year, the official data shows.

“There was a tremendous increase in the number of all kinds of visas issued to Omanis during the first half 2012. The statistics reveal that India is turning into a prime destination for Omanis who opt for advanced treatment and also want to have a glimpse of the rich Indian cultural heritage,- a senior official from the Indian embassy told Times of Oman.

According to the data, Tamil Nadu, Andhra Pradesh, Kerala, Maharashtra and New Delhi are the top five destinations -”in descending order-” where Omanis visited for medical treatment during the last six months.

“The rise in the number of medical visas shows that India is turning into a medicare hub. India has state-of-the-art medical facilities, experienced medics, affordable and quality nursing facilities, cheap medicines, and traditional healthcare centres. This has led to a rush in medical tourism,- the official added.

The Indian’ Embassy in Muscat issues medical, tourism, business and student visas for Omanis.

Omanis travels to India to seek treatment for cardiovascular, gastroenterology, orthopaedic, oncology, ophthalmology and dental ailments.

“After their return from India, many Omanis say that due to cultural similarities and historical ties, they feel they are at home,- the official added.

“I took my wife for allergy treatment to Kerala a few weeks ago. She received the best available treatment and now she is fine. The facilities are world-class and treatment quite cheap,- Fahad Al Kharousi, an oil company employee, told Times of Oman.

“The processing of official papers for going to India for medical purposes is much easier compared to any other country. Moreover, the facilities we get there are the best,- Fahad said, adding that his friend recommended him to travel to India.

Meanwhile, a private agency engaged in medical tourism says that visa enquiries for treatment in India are very high.

“More and more Omanis want to visit India as it is an affordable and trusted destination for medicare. Many persons whom we gave the Indian option are quite happy after their return. The medical facilities in India are the best,- Hassan Mohsin Al Lawati, chairman of Al Furdha Services, said.

During the last six months, Al Furdha Services has assisted more than 50 Omanis for treatment in India.

Recently, there were media reports that the government of India is planning to provide “visa on arrival- facilities to the GCC nationals as part of a major drive to attract tourists from the Gulf region.

According to reports, Sultan Ahmed, Indian Minister of State for Tourism, said in Dubai, the government is planning to extend it to more countries, particularly the GCC nations from where Asia’s third largest economy is drawing steadily increasing inbound traffic.

India is already providing visa on arrival facility to 17 nationalities.

“As the minister said, if India begins to offer visa on arrival for the GCC nationals, then it will be a boon for India. More people means more revenue. Hope, this plan is implemented soon,- Shaji Sebastin, an Indian expatriate, said.

source: http://www.timesofoman.com / Home> News / by Rejimon K  / July 17th, 2012

7/24 health service for foreigners

Ankara – Anatolia News Agency

Health consulting in English, German, Arabic, and Russian is available on the Turkish Health Ministry’s 24-hour foreign call center service.

Dursun Aydın, the head of the ministry’s health tourism department, said the health consulting service had been providing service 24 hours a day, 7 days a week in four languages at 444 4 728 since the beginning of the year.

English, German, Arabic, and Russian translators work at the call center, Aydın said. “In our country in the summer season, there is a drastic rise in the number of tourists. With this phone line, we serve tourists who have health problems.”

Within the scope of the Health Ministry’s “tourist health” project, foreign patients have been provided with health services at hospitals in Antalya, Muğla and Aydın. “Foreigners can use paid ground and air ambulances, while Turks use these services free of charge,” Aydın said.

July/13/2012

source: http://www.hurriyetdailynews.com / Homepage> Life> Health / Ankara – Anatolian News Agency / July 13th, 2012

Hot spot in medical tourism

Dimitri K (full name withheld at request) flew all the way from Ukraine to Dubai for a complicated reconstructive dental surgery.

After the doctors in his home town left his teeth in what he calls ‘a horrible state’, Dimitri decided to come to Dubai because “a friend once mentioned in passing that there are a lot of good dental clinics in Dubai. I don’t know much about the cost, but I am happy with the outcome,” said Dimitri. A businessman by profession, Dimitri is not new to the UAE. He knows all the tourist hot spots in the country.

When Khaleej Times asked him if he would consider the UAE the next big potential hub for medical tourism, he said: “Yes, maybe.”

Taking advantage of the several cost-saving opportunities that exist beyond our immediate neighbourhood is what medical tourism is to most people.

Government authorities, private firms, and experts have come forward to suggest that the UAE might just be the next big cost effective medical tourism destination. According to figures provided by the Dubai Health Care City (DHCC), the city welcomed more than 9.3 million visitors and tourists in 2011 and is projected to grow at an annual 7.2 per cent through 2015.  Health tourism in the city is expected to generate Dh6.1 billion by the end of 2012.

Ayesha Abdullah, Managing Director of DHCC, said: “At DHCC, we have recorded a sharp growth in medical tourism over the past three years.  We received over 502,000 patients in 2011 including 15 per cent medical tourists, as compared to 10 per cent of a total of 412,000 patients in 2010. We believe that there is potential for further growth.”

Meanwhile, the Director-General of Dubai Health Authority (DHA,) Qadhi Saeed Al Murooshid, said that they have been working on this in the background for a while, building up on other initiatives linked to medical tourism, such as the clinical services capacity plan.  “The revenues from Medical Tourism are estimated at $30 billion. We believe that medical tourism is a space that involves and impacts various sectors within Dubai. Its growth would lead to a positive impact on the economy as well as be a driver for trade and investment in healthcare, tourism and hospitality services,” 
said Al Murooshid.

Currently, Dubai has over 4,750 doctors/physicians speaking over 40 languages. Experts in the medical field believe that the emirate is ready for medical tourism.

Cost of medical tourism

“The UAE, and particularly Dubai, offers quality healthcare solutions that largely measure up against cost-competitive destinations such as Thailand and India.

The figures show that a cardiac bypass costing around $130,000 in the US can be had for $44,000 in the UAE,” said Abdullah. Adding to which, Laila Al Jassmi, CEO of Health Policy and Strategy Sector at the DHA, said: “The costs here are definitely cheaper than the US for comparable quality of services. However, many people believe that medical tourism means lower cost which isn’t necessarily true. Price of services is an important component but not the only component in making the choice for the medical tourism destination,” said Al Jassmi.

She added that people travel abroad for different reasons for different types of services.

In Dubai itself, there are various facilities that offer the same services at different prices and their services are targeted at different market segments.

Also, we do not intend to compete with ‘low cost’ destinations for medical tourism.

Popular treatments

“In the past we have noticed that medical travellers have come to Dubai for cosmetic procedures, dental treatment and even hip-replacements. Today, Dubai has strategically positioned itself as a leading provider of top-quality care in diverse areas with a focus on niche services,” added Abdullah. In the long term, DHCC seeks to provide high-end tertiary care.

“In line with our mission to respond to emerging healthcare needs, we plan to add centres for oncology, genetic disorders and diabetes in an effort to expand the medical tourism segment. We are also in the process of closing gaps in services by adding facilities such as rehab, paediatrics and integrated medicine,” she added.

Adding to this, DHA officials said that there are various opinions on this from health professionals considering their areas of expertise.  “The specialties that Dubai is well suited to medical tourists include a host of medical, cosmetic and dental procedures along with wellness treatments and health check ups.

Dubai gets tourists from over 120 different nationalities and a number of them are utilising healthcare services in Dubai for various reasons.

There is a considerable growth in the demand for these services by tourists from the GCC, North and East Africa, Central Asia as well as for certain health and wellness services by tourists from Europe and South Asia,” said Al Jassmi.Scope for Alternative treatments Over the last few years we have seen a growing trend in patients choosing Complementary and Alternative Medicine (CAM).  “To date, DHCC is home to 12 CAM medical centres, more than 50 CAM-licensed professionals who offer treatment in 14 areas including homeopathy, Ayurveda, traditional Chinese medicine, Unani medicine, osteopathy, therapeutic massage, naturopathy, guided imagery, Thai Chi, Pilates, chiropractic, and yoga,” said Abdullah.

Al Jassmi assured that DHA would look into the growth of alternative medicines very seriously. “The growth of alternative treatments in the region is definitely something that we’ll look at and consider seriously.

There are many successes in this space in parts of Europe and South Asia and some of these services are going to be promoted to the extent they tie up with Dubai’s Medical Tourism Strategy,” she added.

dhanusha@kahleejtimes.com

source: http://www.KhaleejTimes.com / Home> Health / by Dhanusha Gokulan / July 04th, 2012

Lebanon’s love affair with plastic embellishment

Beirut:

Summer seems to bring out some of the stereotypes most closely associated with Lebanon: street fighting, beach parties, fresh cosmetic surgery scars.

In this latter category, surgeons are saying the demand among Lebanese is higher than ever, but a huge client base, Gulf and Arab tourists, are shying away this year, due to the recent string of security incidents, and warnings issued from their embassies.

At the Hazmieh International Medical Center, general manager, medical director and facial cosmetic surgeon Dr. Elias Chammas says demand among Lebanese has risen consistently since the center opened in 1998.

Rhinoplasty remains the most popular  surgery performed on men and women

Rhinoplasty, or the nose job, has remained the firm No. 1 favorite, performed on girls from the age of 16, and followed, he says, by breast augmentation, liposuction and eyelid lifts. Less common, but still conducted, are hymenoplasty and anterior vaginal wall repair surgery, usually carried out, Chammas says, “if you have delivered four or five babies, you have a wider vagina and the husband or boyfriend is not happy with it.”

The only new trend that he can discern is the increase in male customers.

“At the beginning we had very few men coming in; now they account for around 30 percent of surgeries,” he says, adding that the most common procedures are hair transplants, rhinoplasty, liposuction, face lifts and breast reductions, this last surgery being performed at the center once or twice every month.

Penis enlargement surgery is less common, with one procedure performed every three or four months.

But this summer, patient numbers have fallen drastically.

“When it is stable, we have a lot of patients coming from the Gulf, around 40-45 percent,” Chammas says. “When the situation is bad, people don’t come.”

“This is the first time in 13 years when countries are actually telling their citizens not to come; usually they just tell them to be careful.”

In May, the United Arab Emirates, Kuwait, Qatar and Bahrain urged their citizens to consider leaving Lebanon, after deadly clashes in the northern city of Tripoli left 11 dead, although some of the warnings were later downgraded.

The Lebanese diaspora, while not quite as cautious as the Gulf medical tourists, are still not coming in the same numbers, Chammas adds.

Dr. Antoine Abi Abboud, who has an office at the Beirut Beauty Clinic in Zalka, and who routinely travels to the Gulf to work, agrees with Chammas’ assessment.

Last year around 35 percent of his patients were from the Gulf and Iraq, but now, “It doesn’t look so good, this is normally the most popular time of year for these clients. They are not coming these days due to the circumstances.”

Lebanon has traditionally been a favored cosmetic surgery destination among regional medical tourists due to the reputation of the country’s doctors, mostly trained in the United States, and the price of surgeries here.

Whereas a nose job could cost about $10,000 in Australia, here the price is around $2,500, Abi Abboud says.

Like Chammas, Abi Abboud has also seen a rise in male patients, with hair transplants and rhinoplasty again the most common procedures, and breast reductions increasingly popular.

While perhaps surprisingly, given its reputation, Lebanon fails to grace the rankings for highest rates of cosmetic surgery procedures per capita – Hungary and South Korea topped a 2010 survey – it is thought that this country has the highest number of plastic surgeons per head.

The background to this, some believe, lies with the Civil War and the need at that time for plastic surgeons capable of dealing with physical disfigurements.

But there are concerns the industry has spun out of control, due to a lack of enforced regulation. While there are only around 80 members of the Lebanese Society of Plastic Reconstructive and Aesthetic Surgery, which self-regulates, there are another 300 operating outside this syndicate.

All of the cosmetic surgeons at the Hazmieh center are members of the LSPRAS, Chammas says. “If you are related to this syndicate, it means you are good,” he says. “Otherwise, they could chuck you out.”

Recently there has been an increase in doctors of other branches of medicine – physiotherapists or pharmacists, for example – who buy up ad time on TV, promoting their clinic, and then they “bring a plastic surgeon in who they pay maybe $1,000 and then they charge the patient maybe $4,000,” Chammas says.

“You have a physiotherapist giving a lecture about face-lifts on TV. They are not qualified to do that.”

“There should be more control on who should do what,” Chammas adds, but he says he cannot pinpoint where the blame should lie.

The industry has come under increasing scrutiny recently, on charges that the proliferation of cosmetic surgery in Lebanon is creating an unrealistic standard of beauty, and contributing to the objectification of women, but Chammas denies that too many people are getting plastic surgery.

“Everybody is saying that, but I don’t understand the problem,” he says. Comparing cosmetic procedures to wearing makeup, Chammas believes it hypocritical to criticize the industry unless one is prepared to “have a bath and then walk in the streets like that. Don’t put makeup on, don’t put eye shadow on, don’t pluck your eyebrows.”

“You want to look at ease with yourself, [and] you either do it by wearing makeup, or clothing, or, if there is a physical deformity in the face, you come and correct it with plastic surgery. It’s the same.”

In the U.S., which has the highest overall number of cosmetic procedures in the world, every patient seeking treatment must first undergo a psychiatric screening.

For Chammas, such a process is unfeasible in Lebanon.

“We cannot do that. If you tell the patient that he has to see a psychiatrist, you will never see him again. The attitude toward psychiatry in the States is completely different … in Lebanon if you tell someone they have to see a psychiatrist they would say, ‘What? You think I’m crazy?’ So we don’t do that.”

It is up to each surgeon to act as the psychiatrist here, he says.

“If the woman is asking to humiliate herself, we’re not going to do that,” Chammas says. “Or she brings me a photo of an artist and she wants the same nose. We can’t do that.”

For Abi Abboud, he will refer certain patients for psychiatry, as he has done in the past with male patients seeking breast augmentation as part of a sex change process.

“If I can see that the person is asking for things I do not want to do, then I send them to a psychiatrist. Then if I receive an OK, I will do it.”

For Myra Saad, an art therapist who works with body image and self-esteem issues, and who is this summer running a series of workshops on the issue, it would be a positive step for every cosmetic surgery procedure to be preceded by a psychiatric assessment.

“Each surgeon has his own ethics, but as a counselor, I think it should be required,” she says.

Of patients who keep going back for multiple surgeries, a phenomenon both surgeons defend, Saad says that while this may not be a symptom of body dysmorphia, it may indicate issues relating to self-esteem and identity.

“It’s so obvious that a lot of plastic surgery is about business, not about health,” she says.

She also thinks that the cosmetic surgery trend in Lebanon can be seen, in a way, as a rejection of local heritage, and an attempt to emulate Western norms of beauty.

“Media promotes this idea of what beauty is … beauty is no longer subjective,” she says.

The root problem, she believes, should be targeted at a young age, with “more media literacy classes, and empowerment and self-development workshops which teach confidence in the way you are.”

source: http://www.dailystar.com.lb / The Daily Star, Lebanon / Home> News> Lifestyle / by Olivia Alabaster / June 30th, 2012