[lit-ideas] Hospitals in India

 (javascript:print();) Okay, this is the piece I was  remembering.  The first 
part talks primarily about Thailand, but the latter  part addresses the 
hospitals in India. Btw, the pediatric cardiologist who  did the procedure on 
my 
daughter's ASD (everyone here wanted to do open-heart  surgery cutting her from 
neck to pelvis; I researched and researched  until I found this guy -- he 
developed a device by which a patch is  threaded up through an artery from the 
groin into the "hole" in the heart,  the patch is opened scissor-like, detached 
from the catheter, and the  patient is very very still for a few weeks as the 
heart tissue grows around the  patch.  A permanent solution to the ASD.  
Hospital stay of 2 days  instead of 6 - 8 wks. in intensive care) was from 
India -- 
he taught Docs at  Cardinal Glennon's Children's Hospital how to perform and 
monitor the  results of the procedure and he has since moved to Wisconsin where 
he is  doing the same thing.   Any reactions?
 
Julie Krueger (javascript:history.back();) 
_http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998.shtml_ 
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Vacation, Adventure And  Surgery?

Sept. 4, 2005   
____________________________________
 (CBS) This summer, millions headed out to foreign lands for  vacation, 
adventure, tourism, or just a beautiful beach. 

But how about  hip surgery or a multiple bypass or a facelift? 

A growing number of  tourists are doing just that, combining holidays with 
health care, and that's  because a growing number of countries are offering 
first-rate medical care at  Third-World prices. Many of these medical tourists 
can't afford health care at  home (the 40 million uninsured Americans, for 
example). Others are going for  procedures not covered by their insurance: 
cosmetic 
surgery or infertility  treatment, for example. 

And as Correspondent Bob Simon reported  last spring, the hospitals in these 
faraway countries are glad to have these  medical tourists. In fact, they are 
courting their business, trying to get more  people to outsource their own 
health care.   
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 Thailand is an exotic vacation spot known for its Buddhas, its beaches, its  
brothels, and the bustle of Bangkok. 

But for people needing medical  care, itâs known increasingly for Bumrungrad 
Hospital, a luxurious place that  claims to have more foreign patients than 
any other hospital in the world. Itâs  like a United Nations of patients 
here, 
and theyâre cared for by more than 500  doctors, most with international 
training. 

The hospital has  state-of-the-art technology, and hereâs the clincher: the 
price. Treatment here  costs about one-eighth what it does in the United 
States. It's the No. 1  international hospital in the world. 

"Itâs sort of Ground Zero. I  havenât heard anybody yet whoâs told us 
that 
they take more than 350,000  international patients a year," says Curt 
Schroeder, CEO of Bumrungrad."Itâs sort of Ground Zero. I  havenât heard 
anybody yet 
whoâs told us that they take more than 350,000  international patients a 
year," says Curt Schroeder, CEO of Bumrungrad.<PGBR>One  patient is Byron 
Bonnewell, who lives 12 

"They told me I was gonna die," says Bonnewell, who didn't have  insurance. 

He estimates he would have had to pay over $100,000 out of  his own pocket 
for the operation he needed, a complicated quintuple bypass. And  he says he 
actually decided not to do it: "I guess I figured I'd rather die with  a little 
bit of money in my pocket than live poor." 

But Bonnewell says  his health was deteriorating quickly, when he read about 
Bumrungrad Hospital: "I  was in my doctor's office one day having some tests 
done, and there was a copy  of Business Week magazine there. And there was an 
article in Business Week  magazine about Bumrungrad Hospital. And I came home 
and went on the Internet and  made an appointment, and away I went to 
Thailand." 

He made that  appointment after he learned that the bypass would cost him 
about $12,000. He  chose his cardiologist, Dr. Chad Wanishawad, after reading 
on 
the hospitalâs Web  site that he used to practice at the National Institutes 
of Health in Maryland.  

"Every doctor that I saw there has practiced in the United States," says  
Bonnewell. 

But three days after walking into the hospital, he was on the  operating 
table. Two weeks later, he was home. 

How does he feel?  "Wonderful. I wish Iâd found them sooner," says Bonnewell. 
"Because I went  through a year â I was in bad shape. I couldnât walk 
across 
the room."  

How was the nursing? How was the treatment? 

"I found it so  strange in Thailand, because they were all registered nurses. 
Being in a  hospital in the United States, we see all kinds of orderlies, all 
kinds of  aides, maybe one RN on duty on the whole floor of the hospital," 
says Bonnewell.  "In Thailand, I bet I had eight RNs just on my section of the 
floor alone.  First-class care." 

Thatâs what the hospital prides itself on: its  first-class medical care, 
which it can offer so cheaply because everything is  cheaper here, particularly 
labor and malpractice insurance. You can get just  about any kind of treatment, 
from chemotherapy to plastic surgery. 
<PGBR>Kim  Atwater from Bend, Ore., was on vacation in Thailand when she 
decided to combine  sightseeing with a bit of an eye

Was she nervous about having an  operation done in Thailand? 

"Yes, yes, I was somewhat hesitant about  having any type of operation in a 
foreign country, and it turned out to be, I  mean, it was beyond my 
expectations," says Atwater. 

And it was not  beyond her budget: $1,500, and that included a private room. 

How would  she describe the difference between this place and an American 
hospital? "It's  much nicer than any that Iâve ever stayed in the United 
States," 
says Atwater.  

The rooms look more like hotel rooms than hospital rooms, and thatâs no  
accident. The idea was to make the whole hospital look like a hotel and a  
five-star hotel at that. There are boutiques and restaurants to suit every 
taste  and 
nationality 

"Part of the concept was to create an environment when  people came in they 
didnât feel like theyâre in a hospital," says Schroeder.  "Because nobody 
really wants to go to a hospital." 

Bonnewell says he's  going back this fall for another checkup. He'll have to 
take a 22-hour flight,  but thereâs even an upside to that. 

"We do have a very unique  relationship with Thai Airways," says Schroeder. 
"So you can buy a ticket. You  can use frequent flier mileage to get your 
checkup." 

Whatever it takes  to get your business. 

"And this is not the only hospital trying to  outsource healthcare, is it?" 
asks Simon. 

"My goodness, no. I, we  certainly have not gone unnoticed," says Schroeder. 
"There are hospitals  throughout Asia. There are hospitals throughout Asia, 
throughout India."  "My goodness, no. I, we  certainly have not gone 
unnoticed," 
says Schroeder. "There are hospitals  tfamiliar images of the country 
(teeming, dusty  streets, and poverty) you can add gleaming new, private 
hospitals. 

The  hospital boom in India was fueled by Indiaâs growing middle-class who 
demanded  access to quality health care. Now, the country known for exporting 
doctors is  trying hard to import patients. 

The most important player is the Apollo  Group, the largest hospital group in 
India, and the third largest in the world.  

Why is it so important to get foreign patients here? 

"It makes  sense to establish India as sort of a world destination for health 
care," says  Anjali Kapoor Bissell, director of Apolloâs International 
Patient Office.  

But why should foreigners come here? Well, itâs even cheaper than  Thailand 
for most procedures, with prices about 10 percent what they would be in  the 
United States. 

Anne Bell works at the British High Commission in New  Delhi. She just had a 
baby and says sheâs glad she was here, and not in England:  "Thereâs been 
no 
pressure to go home after the delivery. Weâve been welcomed to  stay as long 
as we want. Theyâre looking after the baby. Theyâre looking after  me, 
giving 
me enough time to get settled and get confident enough to go back  home. Often 
in the UK, you might be out of the hospital within five hours if  youâve had 
a normal delivery." 

And in the UK, she wouldnât have had a  private room and a private bath. Not 
to mention massages, and yoga, too. And the  doctors? Indian doctors are known 
worldwide, they speak English, and theyâre  often the very same doctors you 
may have had in Europe or America, where many of  them practiced before 
returning to India. 

"Do you find that many Indian  doctors are coming back now because of 
hospitals such as this one?" asks Simon.  

"Yes, a large number are coming back," says Bissell. "Because they have  
something to come back to." 

Dr. Praveen Khilnani, a pediatric intensive  care specialist, worked at 
several American Hospitals, including Mass General.  Dr. Vikas Kohli is a 
pediatric 
cardiologist who worked at hospitals in New York  and Miami. 

Both need sophisticated equipment to care for their patients,  something 
India didnât have before the birth of private hospitals like Apollo.  They 
both 
wanted to come back to India despite the fact that medical care costs  much 
less 
here, partly because doctors make much less. 

"How much less do  you make here than in the United States?" asks Simon. 

"Maybe a tenth or  a twentieth of what we were making the U.S.," says 
Khilnani. 

They wanted  to come back, they say, because they felt their expertise was 
needed here in  India much more than in America. 

"There are probably 1,500 to 2,000  pediatric cardiologists in the U.S. I 
would be one of them," says Kohli. "In  India, there were just four of us. I 
was 
very passionate about working for  Indian kids." 

Since there are so many Indians who require the kind of  care that only they 
can offer, why is there such a strong drive to attract  foreign patients? 

"Who doesnât mind extra money flowing in?" says Kohli.  

Stephanie Sedlmayr didnât want to spend the tens of thousands of dollars  it 
would take to get the hip surgery she needed. And she didnât have insurance,  
either. So with her daughter by her side, she flew from Vero Beach, Fla., to 
the  Apollo Hospital in Chennai. Sheâd never been to India before, but she 
already  knew quite a bit about Indian doctors 

"My doctor, actually, in Vero  Beach, she's an Indian doctor. So, why not go 
where they come from?" asks  Sedlmayr, who says her friends questioned her 
decision. "Hardly anybody said,  'Oh, great idea.'" 

But she didnât just come here to save money; she came  for an operation she 
couldnât get at home. Itâs called hip resurfacing, and it  has changed 
peopleâ
s lives. 

It hasnât been approved yet by the FDA, but  in India, Dr. Vijay Bose has 
performed over 300 of them. He showed 60  Minutes
the difference between a hip resurfacing and hip replacement,  which is the 
standard operation performed in the United States. He says his  patients 
usually recover faster because his procedure is far less radical and  doesnât 
involve cutting the thighbone. 

Instead, Bose fits a metal cap  over the end, which fits into a metal socket 
in the hip. The result, he says, is  that patients end up with enough mobility 
to do virtually anything. 

"So  my patients, you know, play football, basketball, whatever you want. Not 
a  problem," says Bose. 

Until the FDA approves it, the only way to have  this operation in the United 
States is by getting into a clinical trial. But be  warned: It isnât cheap. 

How much does it cost in the States? 

"I  believe it costs something from $28,000 to $32,000 U.S. dollars," says 
Bose.  

And in India, Sedlmayr says it costs $5,800: "Private nurse after  surgery. 
And, feeling always that they were just totally attentive. If you rang  the 
bell next to your bed, whoop, somebody was there immediately." 

Sound  too good to be true? Don't forget: Itâs at least a 20-hour trip, there 
is  malaria in parts of India, patients have complained of intestinal 
disorders --  and if something goes wrong, you could end up suing for 
malpractice in 
an Indian  court. 

And one could only wish you the best of luck. But Sedlmayr feels  sheâs 
already had more luck than she had any right to expect. By the time  60 Minutes 
left India, she was into the tourism part of her  treatment, convalescing at a 
seaside resort an hourâs drive from the hospital.  

"Is this standard, that when somebody gets surgery at the hospital to  come 
to a resort like this afterwards?" asks Simon. 

"Yeah, they suggest  it. They recommend it," says Sedlmayr. "[It cost] $140 
day for myself and my  daughter, including an enormous fabulous breakfast that 
they serve until 10:30."  

"I think a lot of people seeing you sitting here and what's usually  called 
post op, and hearing your tales of what the operation was like, are going  to 
start thinking about India," says Simon. 

"Yeah, and combining surgery  and paradise," says Sedlmayr. 


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