Roberto Gawianski Plenitas

I was recently reading about Iceland and how it's not uncommon in that country for people to dramatically change career paths once, twice, or even five times in their lives. Instead of viewing an individual's lack of experience in a given field as a negative, a potential employer looks at what an individual has learned in a different field and sees it as an opportunity to bring some new thinking to their business.

While a long way away from Iceland, Roberto Gawianski made a bit of an Icelandic-career move in 2003 when, after spending years as an economist, he started Plenitas, an Argentina-based medical travel company.

I recently spoke to Gawianski and learned how his non-healthcare background helped him shape a company that operates a bit differently than others.

Medical Travel Today (MTT): Please tell us a bit about your background and why you started Plenitas.

Roberto Gawianski (RG):  We started Plenitas at the end of 2003. We specialize in elective surgeries such as plastic surgery, bariatrics, cosmetic dentistry, in vitro fertilization, and egg donations.

Prior to starting Plenitas I worked as an economist and businessman. I developed the business plan for Plenitas after the devaluation of the peso in Argentina. For ten years the peso was 1:1 with the dollar. Then in 2002 it suddenly went 1:3. So for the first time Argentina had the opportunity to compete on a worldwide scale with its medical services.

I spent a good bit of time thinking about how I could exploit this new exchange rate and make the most of the high-level care offered through the Argentine medical system.

In 2003 there were very few Web sites promoting the industry.  There were a few companies in South Africa actively promoting themselves and some others, but I didn't like the business model they were using -- the one based on a commission structure.

I put my economist hat on and developed the model for Plenitas. The way we operate is by negotiating directly with the clinics and hospitals where we send our patients. There's no commission structure at all.

MTT: So let me get this straight. In 2003 you started showing up at hospitals with no health care background and started telling them how you wanted to structure the deal for this then-new concept of medical tourism. How did that go?

RG:  At first, very badly. And you're right, I not only had to overcome the fact that I wasn’t part of the health care world, but I also had to sell them on the idea that people were going to travel abroad for care. It wasn't easy.

People really didn't even understand the concept of the industry. But I stuck with it and here we are.

Since 2003 we've arranged care for more than 3,000 international patients. I believe that's one of the largest volumes in the industry. It's also why clinics and surgeons are willing to work with us.

MTT: When you negotiate with facilities, are you negotiating on a case-by-case basis or is there a term to the agreement?

RG: Typically we negotiate a three-year term for our fee structure.  

MTT: Where are most of your patients traveling for care?

RG: Up until recently it's been mostly to Argentina. But now we're also sending patients to the Dominican Republic and Egypt. We are now expanding to new destinations. Most of  our patients come from the United States. After that they come from  Canada, the United Kingdom, and Spain.

MTT: Tell me about the Plenitas Partnership Program for Medical Tourism Facilitators.

RG: Well, the truth is that every facilitator converts a very low percentage of the leads or prospects they receive.  At the end of the day, everyone ends up with a lot of leads they can't convert in sales. This is true for everyone in the industry. Our position is to take the leads that others can't convert, and if we can convert them, we offer the organization that provided them with a 10% commission.

Partnering companies, of which we now have five, get access to an area of our Web site where they can upload leads. They also get access to our customer relationship management software. They're able to see exactly what happens to all the leads they provide…which ones convert, which don't, how we've reached out to the customer, and so on.

If a lead converts, they can see the schedule and fees and determine exactly what's due them. We're willing to take a lower margin to get the business and they're willing to take 10 percent of something rather than 100 percent of nothing. It's a win-win.

In this program we are also prepared to do the reverse. We send some of them the leads we couldn’t convert and follow the same terms.

MTT: How are you currently doing outreach to both potential partners and referred patients?

RG: We're currently conducting an email campaign to medical travel facilitators to solicit partners.

As far as the consumers go, a lot depends on how the lead came to us and how the consumer reached the facilitator in the first place.

In many, or even most cases, the consumer doesn't remember where they completed a form online. When they first start shopping, they go everywhere. So making the first contact is perhaps easier than one might think.

We usually initiate contact with a prospective patient through a phone call.  We have a team of representatives who make those calls. Actually, right now we're looking to add more representatives to help with closing sales in our target market. Our goal is to create a team of independent agents and representatives in different cities in North America and Western Europe, and, eventually, Australia.  Those representatives should live in the city where prospects come from.

MTT: In working with so many leads from other companies, have you developed a theory as to why so many leads aren't converted?

RG: Many of the people who first come to a facilitator's Web site are in the very early stages of decision-making. Most of them are simply gathering information.  In those cases, the consumer isn't even really a prospect yet.

Another challenge is that sometimes the patient isn't willing to travel to the part of the world where you have partner facilities. Price is another reason. If you've got someone willing to travel they're often looking to travel where they can get the best care and the best price. And, of course, if you don't offer the procedure they need, you're not going to get the customer.

Through our partnership program, consumers get access to more locations and more procedures, and the facilitator gets a cut for really very little effort.

About Roberto Gawianski
Roberto Gawianski is a 56-year-old economist who has always been an entrepreneur. At the age of 21, he created a wallpaper factory from scratch, which is currently the largest in South America. He was responsible for the expansion of a Home Decoration business chain in Argentina, which went from having four branches to fourteen over a four-year-period. He was also vice president of an Argentine textile factory chamber. In 2000, Roberto created the first Barter Company in Argentina, and then left his position there to start Plenitas in 2003. At that time, Plenitas was a very original idea, when only a few companies were promoting medical tourism. It has an original business model in the medical tourism industry, which is substantially different to standard models, and it is already expanding operations worldwide. Roberto is also a member of Vistage, a global CEO organization. He can be reached at rg@plenitas.com

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INDUSTRY NEWS

Global Solutions, Inc. Acquires Major Holding in e-Medsol

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, says, "We feel e-Medsol has created an offering that 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.

Benosh Haris, M.D., 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," says 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 and health care providers and 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 platform will be launched shortly under the iGlobal brand. More information about their offerings can be found on www.emedsol.biz.

Nation's Original Luxury "Healthtel" Provides Perfect Complement to World-Class Mayo Clinic

Rochester, Minn. — Known as one of the top medical facilities in the world, the Mayo Clinic fuels health tourism with more than 500,000 outpatients checking in each year, from New York City to Los Angeles to the Middle East.  Because 80 percent of Mayo outpatients are looking for a four to five night stay, and affluent visitors are seeking privacy and luxury, the International was born.

Since opening in April 2006, the International has had an influx of returning guests with overwhelming reactions to Rochester’s first and only AAA Four-Diamond hotel.  Affluent travelers have included former heads of state, CEOs and rock stars.  The success led the property to construct six new suites in April 2007 and then double its size in 2008 with the construction of a second floor.     

The International evolved from Rochester’s historic property, The Kahler Grand Hotel.  The VIP hotel , also referred to as a "healthtel", bridges world-class hospitality with world-renowned medical services provided by the adjacent Mayo Clinic, connected via skywalk and underground pedestrian subway.  Room rates for the International range from $450 to $3,000 a night.

24/7 First-Class Service for First-Class Guests            
Arabic royalty, foreign dignitaries and all discerning travelers enjoy a “no check-in” policy and personal concierge available seven days a week while staying at the International.  Their favorite comfort food is waiting for them in their room - one of six executive king rooms, eight executive suites, six grand suites, and one presidential suite.  The Lounge, a 24-hour exclusive retreat for guests, serves a European-style breakfast with foods flown in from all over the world, as well as afternoon high tea and an evening reception with hors d' oeuvres, canapés, petit fours and fine wines and liqueurs. 

Some of the Mayo-centric amenities include Ask MayoTM Buttons on in-room phones with 24-hour access to medical experts.  Days before visiting Rochester, guests receive a personal phone call from the International inquiring about special needs so requests are met as soon as they arrive.  Not only will the International personally escort guests to their appointments, they'll be at their service upon return.

East meets west as award-winning chefs have designed their own unique menu for Middle Eastern travelers.  But food and beverage is not limited to a standard menu as culinary experts are on hand around the clock to cook cuisine tailored to guests' appetites, or their favorite doctor-recommended snacks.  Guests of the Presidential Suite can request chefs to personally cook them dinner in the full kitchen equipped with a refrigerator, sink, stove and oven, microwave and dishes. 

Three 42” plasma LCD TVs with satellite feeds to over 200 international channels are featured in the Lounge so worldly travelers won't have too worry about missing their favorite shows.  Looking for international headlines, guests can also choose from 360 global newspapers as it's personally delivered at request. 

Lounge featuring European-style breakfast, afternoon tea and evening receptions.

If guests have business to do while away, a private meeting room is accessible with international calling, speakerphones, teleconferencing capabilities and Mayo Clinic computer support.  Personalized stationary is waiting at in-room desks, as the suite becomes the guests’ short-term home.  And all guestrooms are furnished with executive desks and office equipment, including Cable and WiFi Internet access, printer, scanner, fax, copier and a personal storage safe, not to mention the over-sized European-style furniture.  

The International features mahogany trim, gold fixtures and marble floors, fine linens, European-style baths and whirlpool saunas, and digital temperature controls.  Refrigerators, oversized flat screen LCD TVs, DVD, CD, MP3 players, and cordless and wired telephones with direct phone and fax numbers provide some of the finishing touches for a home away from home experience.
   
"The privacy and luxury of the International came from guest demands," says Fairchild.  "Guests of the Mayo Clinic and other visitors to Rochester were looking for the kinds of accommodations reserved for the most exclusive travelers.  It doesn't matter that they are not in New York, Paris or Tokyo, these guests want an experience equal to the finest hotels in the world, which is what we are delivering."

A hotel truly “international” for worldly guests has been designed in an unexpected place, Rochester, Minn.  Combined with personalized features and services, and first-class medical care at the Mayo Clinic, sophisticated travelers and patients have a top choice for health and wellness travel—The International Hotel.  For more information, contact Robin Mindt at 414-224-9424 or robin@ebadvertising.com.  

The International Hotel, owned by Sunstone Hotel Investors, Inc., and operated by Sunstone Hotel Properties, a division of Interstate Hotels & Resorts, delivers luxury facilities, services and amenities for guests from around the world.  Located at the top floor of the Kahler Grand Hotel, the AAA Four-Diamond International was designed keeping travelers visiting the Mayo Clinic in mind.  One of five properties surrounding the Mayo Clinic, the International Hotel completes the Sunstone Hotel Properties portfolio in Rochester, which provides for every preference and travel occasion.  Visit www.InternationalHotelMN.com for more information.

University of Pittsburgh Medical Center to Manage New Health Center in Cyprus

Pittsburgh, Pa./Nicosia, Cyprus (PRWEB) February 27, 2009 -- The University of Pittsburgh Medical Center (UPMC) and Paphos Plantations Ltd. (PPL) - a member of the Leptos Group - announced today that they are collaborating to develop a world-class health care center in Paphos, Cyprus, designed to offer a wide range of medical services to both local residents and foreign visitors to this Mediterranean island.

Under the agreement, UPMC will manage a new 100-bed hospital and the existing 36-bed Iasis Hospital in Paphos. With its global expertise in providing clinical, technological, and hospital management services, UPMC will assist the new health complex in developing centers of excellence in such areas as oncology, transplantation, aesthetics, cardiology, orthopedics, and minimally invasive surgery.
"By working with the Leptos Group, one of the largest and best-regarded real estate development companies in Cyprus, UPMC can extend its excellent, patient-focused healthcare to another part of the world," says Jeffrey A. Romoff, UPMC president and chief executive officer. "Patients in Cyprus and throughout the region will benefit from our global health enterprise as it engages the best physicians, nurses, and scientists worldwide."

The new hospital, named Neapolis, to be completed in three to four years, will be an integral part of PPL's mixed-use development. The project is expected to include a university, research center, office park, and luxury lifestyle housing, as well as retail, entertainment, cultural, and leisure facilities, in one of the largest landscaped parks on the island. The 23-year partnership with UPMC will be the first health care venture for PPL.

"With its long track record of success in managing international health care projects and its reputation as a health care leader and innovator, UPMC is a natural partner for us in this ambitious undertaking," says Michael Leptos, chairman of the Leptos Group. Leptos has more than 45 years of experience in real estate and tourism. "Despite the economic climate, we are confident that the new Neapolis health center will be a success, filling the need for more health care options in Cyprus and alleviating long wait times for many patients seeking specialized care. In addition, these facilities will be well-positioned to attract patients from throughout the Middle East and Europe as medical tourism grows throughout the region."

UPMC's services in Cyprus will include on-the-ground senior management for the hospitals, staff training, equipment procurement, and implementation of sophisticated information systems. UPMC expects to develop medical services that are now in short supply on the island, including comprehensive cancer services at Iasis Hospital. "With our management of two cancer centers in Ireland and our recently announced plans to develop at least 25 more cancer centers throughout Europe and the Middle East with our partner, General Electric Company, patients in Cyprus can expect to benefit from our extensive network of treatment and research capabilities," says Charles Bogosta, president of UPMC's International and Commercial Services Division.

The new health center is expected to serve both public patients and those with private insurance. To help meet the demand for medical services, the government of Cyprus is moving forward with health insurance legislation that would further open the market to private hospitals.

In addition to the Neapolis project, UPMC's international portfolio includes management of the independent Beacon Hospital in Dublin, Ireland, two cancer centers in Ireland, and a leading transplant hospital in Palermo, Italy. UPMC also provides emergency medical services and training in Qatar and is deploying electronic medical record technology at Newcastle upon Tyne Hospitals in the United Kingdom. By leveraging its medical, technological and management expertise, UPMC expects to generate revenue that it can reinvest in its healthcare and research mission at home and abroad.

Bumrungrad International Hospital Wins 1st Place as "Best Website for International Medical Travel"

Bangkok, Thailand (PRWEB) February 24, 2009 — Bumrungrad International won 1st Place as "Best Website for International Medical Travel" at the 2008 Consumer Health World Awards event in Washington, D.C..

Bumrungrad.com is a hospital website serving international audiences, Thais, and expatriates. The Award organizers said the site "makes it easy for prospective patients to find the information they are interested in, provide an efficient way to make inquiries and request appointments, and provide information to help international medical travelers understand how to get care at Bumrungrad."

JWT Connect, Bangkok, helped the hospital redesign its home page, focusing on audience segmentation and content architecture, earlier this year.

The award adds to a list of honors achieved by Bumrungrad in 2008, including: "Thailand's Most Innovative Company" by Chulalongkorn University's School of Business; top medical tourism destination (Tourism Authority of Thailand); top Thai company for quality of products and services (Asian Wall Street Journal); and excellence in information technology (Association of Medical Directors of Information Systems).

"Global Medical Tourism Report" Released by bharatbook.com

Global Medical Tourism Report provides information about the worldwide importance of medical tourism. The wealthy citizens of developing countries have frequently traveled to the United States and Western Europe to seek the expertise and gain access to advanced technology available at leading medical centers. Recently, a trend categorized as 'medical tourism' has emerged, wherein citizens of highly-developed countries choose to bypass care offered in their own communities and travel to developed areas of the world to receive a wide variety of medical services in order to save money.

Medical tourism is fundamentally different from the traditional model of international ”medical travel,” where patients generally journey from less-developed nations to major medical centers in highly-developed countries for medical treatment that is unavailable in their own communities. See www.bharatbook.com/Market-Research-Reports/Global-Medical-Touris.

This report focuses on the medical tourism trend that will have an increasing impact on the health care landscape in industrialized and developing countries around the world. The term ”medical tourism” does not accurately reflect the reality of the patient's situation or the advanced medical care provided in these destinations. Nevertheless, it provides an unambiguous way of differentiating the recent phenomenon of medical tourism from the traditional model of international medical travel. This phenomenon is driven by marketplace forces and occurs outside of the purview and control of the organized health care system. Medical tourism presents important concerns and challenges as well as potential opportunities. This analysis will examine the international locales that are experiencing a dramatic increase in medical tourism, with particular emphasis on Asia, Eastern Europe, and Latin America.

For more information please visit : www.bharatbook.com/Market-Research/Healthcare.html

Or contact:

Bharat Book Bureau
Tel: +91 22 27578668
Fax: +91 22 27579131
Email: info@bharatbook.com
Website: www.bharatbook.com

Satori World Medical Contracts with Employee Benefits Firm McGregor & Associates

Satori World Medical Contracts with Employee Benefits Firm McGregor & Associates to Bring its Innovative Global Healthcare Benefit Program to Thousands of U.S. Employers and Employees

San Diego, CA (PRWEB) March 2, 2009 -- Satori World Medical, a new global health care company in the emerging multi-billion dollar medical tourism industry, announced that it has executed an agreement with McGregor & Associates, Inc., an employee benefits consulting firm specializing in servicing public sector employers, to offer Satori's innovative payer-supported, employer-sponsored and consumer-choice global health care network to thousands of McGregor & Associates' contracted employers and employees, as well as its own staff.

"The costs of healthcare in the U.S. are higher than in any other country in the world, placing an enormous burden on today's U.S. companies that fund their employees' healthcare, in addition to the employees themselves who have become responsible for more and more of their own medical expenses," stated president of McGregor & Associates, George McGregor, M.B.A., C.P.A. McGregor is also general manager of the Southern California Schools Voluntary Employees' Benefits Association (VEBA), administrator of the California Public Employers Employees Health Care Coalition, and administrator of the SDCS-SDEA, a Joint Retiree Medical Benefits Trust.

He continued, "As an organization committed to its customers and their employees, ensuring that the quality they get through international hospitals is equal to or better than the care they could receive in the U.S. was the number one decision criteria upon selecting Satori World Medical. Satori World Medical has the most sophisticated quality assurance process of all of the competitors that I reviewed that operate in this space."

Through its global network of board-certified doctors and Joint Commission International (JCI)- accredited, state-of-the-art hospitals, Satori World Medical provides a comprehensive, high quality and integrated medical benefit program that reduces the costs of selected surgical procedures over 50 percent. The savings generated are shared with all stakeholders, while a portion of the savings for the first time is deposited for an employee in a tax-advantaged Health Reimbursement Account (HRA). With Satori World Medical's innovative Health & Shared Wealth Program™, everyone benefits.
Other key benefits to U.S. employers are as follows.

Ability to compete better globally: Global healthcare models result in major economic benefits for U.S. companies because the costs of their employees' healthcare are greatly reduced. U.S. companies have access to the same quality healthcare at a much lower expense, and as a result companies can be more profitable and competitive globally.

Improved employee retention and satisfaction: An organization's financial strength is built and reinforced by reducing costs and investing in the financial security and well-being of its workforce. Therefore, companies that offer a global health care benefit option to their employees can greatly strengthen the overall morale and productivity of their workforce. This is a new medical benefit at no cost to the employer or employee.

Seamless integration with any existing medical plan: A global health care benefit program can be seamlessly added to an employer's existing employee benefit program and without any startup or ongoing expenses for the employer. This medical benefit is in addition to the medical plan that is currently in place.

Single bill for employee claims: When considering the implementation of a global health care benefit program, one common concern among employers is whether or not significant internal resources and staff to administer patient claims and billing are involved. Satori World Medical meets this challenge by handling the entire billing process for the employer, in which a single bill in U.S. dollars is provided for all services rendered, thus reducing company claims processing costs and with no foreign currency exchange fluctuations.

Steven Lash, president & CEO of Satori World Medical, concluded, "We are extremely excited about our partnership with McGregor & Associates because we believe our program will allow them to significantly improve the quality of their participating employers' benefit administration processes, as well as their own, resulting in improved value and reduced costs across the board. McGregor & Associates understands the importance of providing quality improvement solutions that increase employee and customer satisfaction, competitiveness, and financial performance."

The World Medical Markets Fact Book 2008

The need to understand world medical markets, and be able to answer quickly those questions that arise daily, is essential. Therefore an authoritative, current and comprehensive market intelligence source is an invaluable aid for every executive. And that source is The World Medical Markets Fact Book 2008 (published May 2008).

The 332-page Fact Book 2008 brings together a range of often difficult to source information in one single, convenient publication. Keep it near you at all times, or consider an electronic version to share with colleagues for the search and retrieval of specific information.

EASY ACCESS TO THE LATEST AVAILABLE DATA ON:

• World market:
  The worldwide medical device market covering key market areas such as demographics, mortality data, health services/resources and medical market values. International comparisons provide unique rankings and key indicators are forecast to 2013.
• Regional analysis:
  Major world regions providing regional analysis, rankings and forecasts for the Americas, Asia/Pacific, Middle East/Africa, Central and Eastern Europe, and Western Europe.
• National market data:
  Detailed national market profiles of 67 countries worldwide from Argentina and Austria to Venezuela and Vietnam.
• Company analysis:
  The performance of the world’s 80 largest medical device and equipment manufacturers is provided in comparative tables.

ANSWERS KEY BUSINESS QUESTIONS SUCH AS...

• Which country spends most on medical devices in terms of per capita GDP?
• Which medical markets are growing the fastest?
• How does the Brazilian market compare with Mexico and Argentina in terms of total health expenditure?
• What demographic development is affecting the market in Latvia and Estonia?
• What will the per capita spend on medical devices be in 2013 in South Korea and Thailand?

Orthopedics: Global Industry Guide Now Available
Datamonitor

The Orthopedics: Global Industry Guide is an essential resource for top-level data and analysis covering the orthopedics industry. It includes detailed data on market size and segmentation, textual analysis of the key trends and competitive landscape, and profiles of the leading companies. This incisive report provides expert analysis on a global, regional, and country basis.

Scope of the Report:

• Contains an executive summary and data on value, volume, and segmentation
• Provides textual analysis of the industry's prospects, competitive landscape, and profiles of the leading companies
• Incorporates in-depth five forces competitive environment analysis and scorecards
• Covers the global, European, and Asia-Pacific markets as well as individual chapters on five major markets (France, Germany, Japan, the United Kingdom, and the United States)
• Includes a five-year forecast of the industry

Highlights:

• The global orthopedics market grew by 8.1 percent in 2007 to reach a value of $16.2B.
• In 2012, the global orthopedics market is forecast to have a value of $22.9B, an increase of 41.7 percent since 2007.
• Spine implant sales account for 31.1 percent of the global orthopedics markets value.

The Americas account for 71.3 percent of the global orthopedics markets value.

Why you should buy this report:

• Spot future trends and developments
• Inform your business decisions
• Add weight to presentations and marketing materials
• Save time carrying out entry-level research

For more information, click here.

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PERSPECTIVES: Travel Law: A Duty To Inform Travelers Of
Health Risks Abroad
Martin B. Lessans, Esquire-Lessans, Praley and McCormick, P.A.
Member of the Maryland Bar

Originally published in a customer newsletter published by PassportHealth, a nationwide provider of medical travel services. Republished with permission.

In recent years travel has been the fastest growing and one of the largest industries in the world. With this explosive growth has come a change in the status of the travel agent in relation to the consumer. The contemporary agent is now held to a higher degree of responsibility in dealing with the consumer client. The courts have increasingly imposed upon travel agents the duty to convey needed and relevant information to consumers.

Modern travel agents and professionals in the travel business – including corporate travel managers and tour operators – are frequently viewed as information specialists. They are relied upon to provide accurate information about the destination, including any negative points that could have an adverse affect on the traveler.

There is a well-established duty of all agents to act in the best interest of their clients by revealing any information that travelers should know. Travel agents hold themselves out as experts and are trusted and relied upon by consumers. Thus the travel specialists must be aggressive in their search for all relevant information that consumers need in order to make informed decisions. Characterizing the duty of modern travel agents as passive in nature and requiring such agents to reveal only what they happen to know at any given point in time rewards ignorance.

Litigation has defined the responsibility of the travel agent. One traveler sued his travel agent for damages arising from rapid altitude changes in a tour to La Paz, Bolivia, (a destination some 10,000 feet above sea level).  At such a high altitude, oxygen-scarce air can have a propensity to cause hypoxia resulting in cerebral hemorrhage. In holding the travel agent responsible, the court held that information dealing with health hazards must be aggressively sought out and a failure to do so constitutes negligence.  In other cases, tour operators have been held liable for failure to warn travelers of the risks and dangers associated with terrorism and crime in various developing countries.

Today there are several sources of relevant information available to the professional travel agent. U.S. State Department’s Travel Advisories warn of crime and terrorism in various destinations. The Centers for Disease Control (CDC) publishes reports of the outbreak of disease and the recommended vaccines for travel to various parts of the world. The destination country may be suffering from a typhoid epidemic or some other outbreak of contagious disease. One recent court decision held: “travel agents should be under an obligation to inform consumers of the need for vaccinations to ward off diseases in international locales.  Such information is readily available from the CDC…” and other sources such as Passport Health, the local experts in travel medicine and health for consumers.

Until 1995 there was no vaccine for the Hepatitis A, a virus which is usually transmitted by poor sanitation in food handling. This illness can result in death in the young and elderly. Others can suffer weeks of pain and flu-like symptoms with months for recovery.   Although it is recommended by health professionals that everyone --especially travelers -- be vaccinated against the Hepatitis A virus, many countries still have a high incidence of reported cases. Even some locales in the United States have experienced severe outbreaks, such as Spokane, Wash., and Long Island, N.Y..

It is clear from case law that any travel professional has the duty to inform their travelers of Hepatitis A and other potential health risks. This responsibility can be met most easily by referring travelers to Passport Health representatives, whose exclusive mission is to keep abreast of health and safety risks abroad and administer the most up-to-date vaccines and advice.

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DESTINATION: Tunisia

Situated on Africa's Mediterranean coastline, Tunisia has long been a popular tourist destination for many Europeans who enjoy the beautiful countryside and unique architecture.* In recent years Tunisia has experienced  an upsurge in a new kind of visitor: the medical tourist.

The country’s 80 clinics and 8,000+ doctors have been attracting people from England, Italy, Spain, Portugal, Switzerland, and a host of other European countries. Like most medical travelers, Tunisia's visitors are looking for an affordable and timely health care option. But unlike India, Thailand, or Singapore, Tunisia delivers the value and quality without the need for extensive travel.

According to Treatment Abroad, most foreign patients come to Tunisia for specialized care in cardiology, orthopedics, ophthalmology, gynecology or urology. Cosmetic procedures also make up a significant portion of the medical travel base, as does  dental care.

Europeans no doubt find comfort in the fact that many of the country's surgeons are European- or U.S.-trained. Many of the private clinics have state-of-the-art equipment and all cosmetic and plastic surgeons are regulated by the nation's Ministry of Health.

In addition, the country is largely multi-lingual with English, French, and the official language of Arabic spoken in all the major health facilities.

Cost is of course another reason Tunisia is gaining ground as a medical destination.
A typical cosmetic procedure offers savings in the range of 40 to 60 percent (including the cost of accommodations) when compared to Western countries.

	Rhinoplasty (nose reshaping)	Breast augmentation	Upper and lower eyelids	Facelift
UK private hospital	£3,000 to £4,000	£3,500 to £5,000	£2,900 to  £3,700	£4,300 to £6,000
UK cosmetic surgery clinic	£3,100 to£3,300	£3,600 to £4,600	£1,950 to£3,700	£4,000 to £5,700
Tunisia	£1,500	£1,780	£1,400	£2,350

Source: Treatment Abroad

Plus, they come for the luxury. It's quite typical for a Tunisian clinic to partner with a luxury resort or hotel for part of a patient's care program. The country's mild Mediterranean climate makes a seaside recovery feasible year round. In advance of surgery, patients can take advantage of the country's golf courses, water sports, pristine beaches, and spas, many of which offer the ancient practice of thalassotherapy (treatments involving sea water purported to help with everything from stress and skin conditions to joint pain and circulation). While not yet supported by scientific evidence, thalassotherapy is an ancient practice that offers a glimpse (albeit a sometimes mud- and seaweed-laden glimpse) into the countries therapeutic history.

* You can count George Lucas among Tunisia's fans. He personally chose it as the location for several parts of his classic film Star Wars.

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MEDICAL SPOTLIGHT: Varicose Vein Removal

Varicose veins are a prevalent and painful condition. Varicose veins are caused when the valve of a deeper large vein in the leg begins to leak blood back into smaller veins near the surface of the leg, often due to a faulty valve. The smaller veins become stretched and painful swelling can occur. This swelling can be debilitating because standing and walking increases the pressure in the veins in the legs.

When prescribed exercises or compression stockings fail to bring relief, two types of treatment are typically prescribed: surgery or laser removal.

Surgery options include stripping the vein, ambulatory phlebectomy, or endoscopic vein surgery.

Stripping is usually done under general anesthesia with the goal of removing the leaking. The vein is tied off using a small wire inserted into the vein through an incision at the groin. The wire is inserted through the length of the vein. The vein is then stripped out through a second incision. This option may require an overnight stay and a full recovery can take up to two weeks. 

Ambulatory phlebectomy removes varicose veins on the surface of the legs. Performed under local anesthesia, it involves making tiny incisions through which the varicose veins are removed. Because veins are very collapsible, even large veins may be removed through the tiny incisions used in this technique. No stitches are required. The patient is able to walk following the procedure.

Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers. Performed under general anesthesia, endoscopic vein surgery, involves creating a small incision near the vein. The doctor then inserts a tiny camera at the end of a thin tube to move through the vein. A surgical device at the end of the camera is used to close the vein. A full recovery may take a month or more.

The least invasive option for addressing varicose veins is laser vein removal.
Performed under local anesthesia the surgeon, guided by ultrasound, uses a needle to insert a wire through an incision in the main problematic vein. The wire then guides the placement of a catheter and small laser through the entire vein. The surgeon activates the laser and pulls it back out of the vein. The laser collapses the vein walls, which effectively stops the blood from leaking back into the smaller leg veins. After an observation period of up to six hours patients can usually walk out of the doctor's office.

In most cases laser vein removal is considered cosmetic and is not covered by insurance.

COST FOR VARICOSE VEIN SURGERY

U.S. Inpatient Price	U.S. Outpatient Price	Average of 3 Lowest Foreign Prices Including Travel Cost
$7,993	$2,685	$1,576

Source: Mattoo A. and Rathindran R.
"Does Health Insurance Trade Impede Trade in Healthcare Services"
World Bank Policy Research Working Paper 3667,  July 2005

Is there a topic you'd like to see covered in our MEDICAL SPOTLIGHT? Please let us know. Send your thoughts to ahaar@cpronline.com

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UPCOMING EVENTS

Thailand Convention & Exhibition Bureau to Sponsor the 2009 World Medical Health Tourism Conference in Phuket

Thailand Convention & Exhibition Bureau (TCEB) is set to sponsor the World Medical Health Tourism Conference: A New Way Forward, which will be held in Phuket, Thailand, September 2009.

TCEB’s participation and sponsorship in this internationally diverse networking event will aim to promote Thailand on an international scale as a medical tourism destination and a preferred venue for international meeting, incentive, convention, and exhibition (MICE) events.

The whole of Phuket Island is getting behind the conference, which will cater to more than 1,200 delegates. Local supporters range from local community groups, tourism operators, and many of the major hoteliers and resort owners, namely Woraburi Phuket Resort, Millennium Resort Patong, The Moevenpick Resort, Karon Beach Resort of Kata Group, Aquamarine Resort, Cape Panwa Hotel, and Andaman Seaview Hotel group.

Phuket, dubbed as the medical tourism hub in Asia, is the ideal location to hold the conference because of its infrastructure, capacity to host a massive number of international guests, and the availability of cutting-edge technology and internationally trained medical experts manning their world-class medical facilities.

Sometime within the next month the floor plan or layout for exhibitors at the venue, Hilton Phuket Arcadia Resort & Spa, will be published online and application forms will be available for the exhibitors to download from the Web site. Many pre-conference and post-conference activities have been planned for the conference, which early estimates expect to bring a windfall to Phuket of about $10 million over the two-week period. Interested parties are advised to visit the conference website: www.sosmedicaltourism.com for more information.

Alternatively, for more information call + (66)76-289-800, to request a printable registration brochure by email sosmedical@sosmedicaltourism.com or sosmedical@ymail.com

Date Set for Healthcare Travel Exhibition & Congress in Dubai: October 27-29, 2009
With the healthcare travel industry poised to play an important part in Dubai's growth strategy, the Institute for International Research (IIR) Middle East, the organizers of the first medical tourism conference in the United Arab Emirates (UAE), which concluded in Dubai, recently have reported high levels of interest from a potentially huge international market.

"Research unveiled at the event indicated a global market of around two million medical travelers a year and an industry constrained by hospital capacity and lack of consumer familiarity with medical travel," says Sietske Meerloo, marketing manager at IIR Middle East and organizer of Healthcare Travel Exhibition & Congress.

IIR Middle East is also the organizer of the Arab Health Exhibition and Congress, the region's premier event for Middle East healthcare that takes place in Dubai 27-29, October, 2009.

“Large numbers of hospitals and clinics around the world are attempting to tailor their health services to cater to medical tourists," Meerloo added. "Several major insurance companies offer a travel component in their policies, and governments are looking closely at policies to take account of the trend."

The health care event was officially opened by Haidar Al Yousuf, M.D., transition director at the Dubai Health Authority, who highlighted the importance the Authority is placing on the future of medical tourism. 

"As we look to develop our domestic health strategy, we also want to develop a joint strategy with our colleagues in the Department of Tourism & Commerce Marketing (DTCM), for the future of health tourism in Dubai," says Dr. Al Yousuf. "The health care sector in Dubai will become an increasingly attractive place for international health care investors, providers, services, facilities, and other health care professionals."

PlanetHospital, a California-based leader in medical tourism, used the event as a platform to announce the official opening of its Jeddah Saudi Arabia office to serve inbound and outbound medical tourists from the Arabian Gulf region.

"The Gulf has the potential to drive growth in medical tourism," says Mohammed Alarifi, managing director for the new operation.  "It is not only a destination from where patients seek medical care abroad but is also becoming a medical tourism destination itself thanks to major hospital developments throughout the region."

The American Hospital Dubai also had high visibility at the event. There was "a lot of exchange of experience among colleagues from around the world," says Naser Saleh, director of marketing and sales. “On the conference side, the sessions were very informative."

Gary Miller, CEO of Health Travel TV, says the event had been important for them. "We have a unique product, and we’re the only broadcast media here dedicated to this area. I’m coming back to Arab Health in January."

Organized in association with the International Medical Travel Association, the Healthcare Travel Exhibition and Congress was supported by the UAE Ministry of Health and the Health Authority of Abu Dhabi. Platinum sponsors were Singapore Medicine. Gold sponsors were the American Hospital Dubai and Dubai Health Authority.

For details about Arab Health events, please visit: www.arabhealthonline.com