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If you knew a medical procedure you needed couldbe done at the same quality but half the price internationally, would you jump on a plane to have it done?
It is estimated that around 15,000 Australians are heading overseas for nip tuck holidays every year, spending a total of $300 million on medical procedures — some of them life saving.
It’s called medical tourism, and it’s having a significant impact on global healthcare, including in Australia, where our health system is straining under the weight of an ageing population and long waiting lists for elective surgery.
Thailand is leading the world as a medical tourism destination, earning a staggering $4.31 billion in revenue from the industry in 2013. Of the 26.5 million people who visited Thailand in 2013, 2.5 million came purely for medical reasons. That number has been growing at an average of 15 per cent a year over the past decade.
“It’s changing the landscape in terms of price; in any facet of our life people want value for money,” says Sydney based plastic surgeon, Dr Joseph Rizk.
“Medical tourism has been around forever when people would travel for procedures not available in their country. Now people are going to underdeveloped countries for things that are offered in Australia because it’s cheaper,” he says.
Calli, from Subiaco in WA, recovers in a five star Bangkok hotel.
So what are the risks involved when travelling to a foreign country for medical treatment? And why is the Australian Medical Association and Society of Plastic Surgeons staunchly against it?
“The biggest risk I think is the post operative care. You might get two to four weeks of care overseas but in Australia you would see your plastic surgeon at least four to six times over the following 12 months,” says Dr Rizk.
However Bangkok is changing this image dodgy backyard jobs and unqualified surgeons by offering a select group of world class hospitals, state of the art technology and internationally trained physicians.
And then there’s the value. A trip to the dentist for a filling in Australia will set you back around $150, in Thailand it’s $30. Breast implants will cost at least $8000 at home, compared to around $3000-$4000 in Thailand. It is this reality that is changing the medical landscape, as Australians and travellers worldwide are lured by cheaper costs, no wait lists and technology often better than what they’d find at home.
The hospitals — what they’re really like
The two biggest hospitals targeting medical tourists are Bumungrad International Hospital and Bangkok Hospital, both located in the country’s largest city.
Bumungrad International Hospital treated more than one million patients in 2013. Forty per cent of these were international patients, including around 8500 Australians.
The country’s move into medical tourism started as a survival strategy in 1998, after Thailand was hard hit by the Asian financial crises. It has transformed the way they deliver healthcare.
The 9/11 attacks were a big turning point, as Middle Eastern patients who once travelled to the US for surgery found it harder to get a visa, so they turned to Thailand.
Bumungrad hospital went from treating 10,000 Middle Eastern patients each year pre 9/11 to more than 120,000 today.
Walking into the hospital today, you’ll feel like you’ve stepped into a five-star hotel rather than a hospital ward. Lounge areas offer free (non alcoholic) drinks, check-in desks look more like civilised bank tellers, in-house travel agents organise visa extensions and a whole wing is dedicated to interpreters offering translator services for its international patients.
Then there’s the hospital rooms. The top of the line rooms are like small apartments with a living room, bathroom and kitchen all tastefully decorated, offering Wi-Fi, and room for partners or family to stay.
Yes, this is actually a hospital room.
All the comforts of home and room for visitors.
Bumungrad has invested heavily in technology, there’s even a pharmacy robot that dishes out medication into pre made packs to reduce the chance of human error.
Bangkok Hospital tells a similar story. It treated 800,000 patients in 2013, of which 200,000 were medical travellers, including around 2600 Aussies.
People travel here for more than cosmetic surgery. Chronically ill patients are hoping an operation in Thailand could save their life.
An entire wing is dedicated to sports injuries, where Australian soccer players, AFL stars. and boxers have been treated.
Attached to a shopping mall, it is anything but clinical. Ironically, both hospitals even have a McDonalds to cater for their international visitors.
Cancer patients are choosing Thai hospitals for their revolutionary equipment.
The anti-gravity treadmill treats our injured sports stars.
Then there’s the patient nurse ratio. In Australia the patient to nurse ratio is 8:1, in Thailand it’s 4:1. “The only time the nurse didn’t come was when their buzzer had broken,” said Jackie, a 31 year old professional from the Hunter Valley in NSW who travelled to Thailand for a breast lift, construction and augmentation.
Costs — why is it so much cheaper?
Thailand’s medical procedures are around 30 to 40 per cent cheaper than we’d pay in Australia and up to 50 to 70 per cent less than in the US. While there’s no difference in the cost of medical technology and drugs, it’s the difference in labour costs that make it so competitive.
A nurse can expect to be paid around $17,000 in Thailand compared to $70,000 in Australia. Doctors earn around $50,000 in Thailand compared to $150,000 plus at home. Malpractice premiums are far less too. Doctors may pay around $1000 in Thailand, compared to the US where annual premiums have sky rocketed to $100,000. Then there’s the competition that keeps prices low, as the market battles for the international tourist dollar.
Surgery costs: Australia v Thailand
Breast implants: Australia — $8,000-$12,000, Thailand — $3,000-$4,000
Facelift: Australia — $9,000-$10,000, Thailand — $4,000-$5,500
Tummy tuck: Australia — $7,000-8,000, Thailand — $5,000-$5,200
Dental implant Australia — $3,500-$7,500, Thailand -$2,300
Knee/hip replacement in Australia — $20,000, Thailand — $12,000 -14,000
Fees in Thailand do not include airfares or hotel accommodation (needed for recovery once patients are discharged).
This Thai plastic surgeon’s client base is 95 per cent Aussie.
Medi Makeovers is an Australian company that organises packages for women and men seeking cosmetic and medical procedures overseas. After eight years in business they send an average of 50 clients per month to Thailand.
“Initially there was a high fear factor for cosmetic surgery, but that has now changed. Now we’re looking to change general surgery perceptions too,” says Medi Makeovers director Daniela Pratico, who has seen an increasing number of travellers heading overseas for cardio, orthopedics and cancer treatments.
Organising complete packages from airport transfers, to hotel bookings, doctor consultations and after-care, in eight years Medi Makeovers has only had three people return due to complications.
Business is so good that at the five star Grand Central Terminal 21 hotel in Bangkok, their business makes up 10 per cent of all corporate bookings.
Internationally trained dentists at DDS Clinic in Bangkok target medical tourists.
Why are Australians choosing Thailand?
Every patient news.com.au spoke to had a different story for why they are sitting in a five star Bangkok hotel waiting for surgery or recovering from a procedure.
“It’s like the Athlete’s Foot of the boob,” said Michelle, a 33 year old media professional from the Hunter Valley in NSW who had breast implants, teeth whitening and fillings.
Michelle says her experience in the Bangkok medical system was better than anything she had at home. From the doctor patient interaction to the compassion and care of the nurses, the biggest difference was the after-care. She spent three days in hospital and eight days in a five-star hotel after her procedure. She compares this to a friend at home who paid $12,000 for breast implants and was discharged from hospital the same day.Michelle post breast implants and dental work.
Then there’s 30-year-old Calli from Subiaco in Western Australia, who flew over for rhinoplasty and breast implants. After having her nose fractured twice when she was 19, she booked her surgeries 12 months ago after hearing about it from a couple of friends.
“There’s a get ‘em in, get ‘em out attitude in Australia,” she says. “After one night I wouldn’t have even be able to lift a glass to have a drink of water,” she added, relieved she had longer to recover in a Thai hospital.
From breast implants to whole body transformations, patients range in age from early 20s to 60s.
The end result was worth all the pain for Calli.
Tracy, a 51-year-old Australian mother, googled “cosmetic surgery in Thailand” and two hours later it was a done deal. Recovering from an arm, face and neck lift, as well as a tummy tuck and liposuction she paid $20,000 after being quoted more than $80,000 at home.
“It’s been a confidence lift, I did it to make myself feel better,” she said. Two surgeries and seven days in hospital, she said the support has been unbelievable. “They are more interested in what your expectations are here compared to Australia.”
Getting insurance for having medical procedures that are performed overseas has been a long battle between the Australian Medical Association, health funds and patients.
This year health fund NIB was the first to offer a 12 month guarantee on cheap offshore dental and cosmetic surgery under a revolutionary service aiming to cash in on the booming medical tourism industry.
“nib Options is about helping Australians choose from a borderless network of surgical excellence as well as providing safety assurance. says NIB spokesman Matthew Neat.
Launched in March, the service does not provide health insurance cover for cosmetic and dental surgery, instead it will organise travel, accommodation and treatment packages for patients who wish to travel to Thailand.
Michelle can’t stop smiling after having her teeth whitened for a quarter of the cost in Thailand.
Patients who take the nibOptions package will be guaranteed 12 months after care and if they suffer a complication can have it assessed and dealt with at no extra expense.
“Our Australian and overseas packages include an ‘after care’ promise to assure customers nib Options will be there to help them through a of process of any further follow-up treatment and care, for up to 12 months after the surgery, should they need it,” says Neat.
“To date we have received very strong interest, with 50 per cent of inquiries being for cosmetic surgery and 50 per cent for major dental treatment. We are launching a more aggressive marketing and marketing campaign in the next few months,” he said.
Do your research and set realistic expectations.
“I always advise patients to find out if their surgeon is a member of a society of the international community of plastic surgeons,” says Dr Rizk.
“Have they spoken to the surgeon or to a third party? What type of equipment are they using, what implants, sutures and brands, — make sure they are TGA approved or equivalent.”
“What is the plan should you get a post operative complication, and do they know somebody that’s been there?” he says.
And don’t be fooled by cosmetic surgery packages sold as a holiday.
“I’m alarmed when its advertised as a holiday, when they use the word tourism. Laying by the pool in the sun drinking cocktails is terrible for surgery, it makes you more prone to dehydration, DVTs and swelling,” says Dr Rizk.
Medical tourism is only set to increase as emerging economies, spiralling costs and wait lists demand a change in the way we deliver healthcare.
“In the educated patient” [negative outcomes] are rare,” says Dr Rizk.
And the group of Australian women in Bangkok couldn’t agree more.
“I’d go back to the hospital just for the service, it was like a hotel,” said Jackie.
“It was the best experience of my life.”
This reporter travelled as a guest of Medi Makeovers and the Thai Consulate.
Originally published as The truth about Thailand’s hospitals