Documente Academic
Documente Profesional
Documente Cultură
July 2008
July 2008
Editorial
July 2008
KAREN TIMMONS,
President & CEO of Joint Commission International
JEAN-MARCEL GUILLON,
General Director, FV Hospital, Vietnam
WILLIAM F. RUSCHHAUPT,
MD, Chairman, Global Patient Services of Cleveland Clinic, Cleveland, Ohio
BOBBY CHIA,
Managing Director, Bangkok Mediplex Co., Ltd., Bangkok,Thailand
JOHN F. HELFRICK,
Senior Consultant, Harvard Medical International; Boston, MA
JOHN A. LINTON,
MD, PhD, Director of International Health Care Center, Severance Hospital,
Yonsei University College of Medicine, Korea
PRADEEP THUKRAL,
Head of International Marketing at Wockhardt Hospitals Group; Mumbai, India
MASSIMO MANZI,
Chief of Staff, Minister for Competitiveness, Government of Costa Rica
GRANT R. MUDDLE,
Sr. VP of Operations, Apollo Hospitals, Bangalore, India
ASHOKE CHAKRABARTTY,
Dy. General Manager - Biomedical Engineering, Indaprastha Medical
Corporation Ltd., New Delhi, India
MERI BAHAR,
Deputy General Manager, Marketing, Acibadem Healthcare Group, Istanbul, Turkey
DATUK MOHD RADZIF MODH YUNUS,
Chief Executive Officer of Institut Jantung Negara SDN BHD, Kuala Lumpur,
Malaysia
URSULA FRIEDSAM,
Managing Director, Pro Health Complete Care Service, Munich, Germany
DR. FAWZI AL-HAMMOURI,
Chairman of the Private Hospitals Association, Amman, Jordan
DR. PREM JAGYASI,
Chief Strategic Officer, Medical Tourism Association, Dubai,
United Arab Emirates
DR. GIRISH JUNEJA,
Managing Director, Life Line Medical Services, Inc., Canada
MICHAEL KELLEN,
Senior Vice President Strategic Development, Assurant
WAYNE BRUCE,
Chief Executive, Ccentric Group, Australia
DR. OTTMAR SCHMIDT,
Director Marketing and PR, Welcare World Health Systems, Dubai,
United Arab Emirates
RENU GIDOOMAL,
Managing Director, Wellness Global Solutions
SEBASTIAN VIRAMONTES,
Commercial Director, Hospital San Jose Tec de Monterrey,
Monterrey N.L., Mexico
JOHN F. P. BRIDGES,
PhD, Assistant Professor at Johns Hopkins Bloomberg School of Public Health;
Baltimore, Maryland
ELIZABETH BOULTBEE,
Head of International Business at HCA International Hospitals; London, U.K.
DR. B.K. RANA,
Deputy Director, National Accreditation Board for Hospitals and Healthcare
Providers (NABH), India
July 2008
KURT WORRALL-CLARE,
Advocate, Hospital Association of South Africa
DR. SHIN-HO LEE,
Executive Director for Industry Support for Korea Health Industry Development
Institute, Seoul, Korea
July 2008
Medical Tourism
AT A GLANCE
EDITORIALS
New AMA Guidelines on Medical Tourism
FEATURES
Philippine Quality Healthcare: Excellence is the
Standard
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Exceeding Expectations:
Health and Wellness in the
Philippines
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Medical Tourism
AT A GLANCE
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Makati Meds BMT Unit, like the rest of the Cancer Center, is
equipped with the latest machines using progressive technologies
and run by doctors and nurses who are all board-certified and
specially trained.
By Dr. Francis F. Lopez
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An Unparalleled Legacy
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COLUMNS
JCI CORNER
JCI Standards Address Physician Competencies
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BINA BUZZ
aBuzz about the Congress
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Eye Republic
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After weighing pros and cons, its good to know that there are
world-class eye care facilities, offering inexpensive, modern
treatment in the Philippines. When costs may be reduced by half
and a nice vacation in a desirable destination gets thrown into
the deal, Philippine medical tourism is considered for corrective
eye surgery.
By Dr. Manolette Roque
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ECONOMICS
Marketing to the U.S. Do you really know how?
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Medical Tourism
AT A GLANCE
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ALTERNATIVE HEALTH
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Oh my aching body
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60
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50
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By Cathy S. Babao-Guballa
July 2008
MEDICAL TOURISM
CONTRIBUTING EDITORS:
Jonathan S. Edelheit
Dr. Prem Jagyasi
Jessica A. Leopold
Gabriella Vicua
REGULAR AUTHORS:
Michael Moody
Alex Piper
Jonathan S. Edelheit
Sandra Landsman, Ph D, CHt
Karen H. Timmons
Linda D. Bentley
Dianne J. Bourque
Michael Bina
Lourdes Gasparoni
David G. Vequist
CONTRIBUTING AUTHORS:
ART DIRECTOR:
Rene-Marie Stephano
ART DEPARTMENT:
e-Medsol
MAIN OFFICES:
REGIONAL OFFICES:
July 2008
July 2008
MEDICAL TOURISM
Global Health or Global Healthcare
These are terms we should really stay away from. If you search
Google, or receive Google Alerts, you will see that Global
Health and Global Healthcare mainly focus on other issues. For
example, Global Healthcare refers to physician and nurse staffing
internationally, recruitment, staffing and replacement of healthcare
providers internationally and international regulation of healthcare
products. A search of Global Health reveals page after page of
information about issues affecting the health of patients worldwide.
You will find data on HIV/Aids, malaria, natural epidemics such as
global warming, childs health, womens health, infectious diseases,
and even hunger issues.
Bill Gates, the founder of Microsoft, has a non profit organization
called the Bill & Melinda Gates Foundation dedicated to Global
Health/Healthcare issues. It is one of the most famous Global
Health organizations and there website is www.gatesfoundation.
org/GlobalHealth . After you review their website, I am sure you
will agree that Global Health and Global Healthcare clearly are
not medical tourism and have nothing to do with the industry or
terminology.
Medical Travel
Medical Travel has many different definitions.
The first
definition, for which it is commonly known, is doctors and nurses
traveling to other countries on volunteer or missionary work in
developing countries.
Some define Medical Travel as the industry of mobility medical
equipment for those patients that are disabled. Medical Travel
includes electronic wheelchairs and scooters.
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JCI CORNER
JCI Standards
Address Physician
Competencies
By Karen Timmons
Karen Timmons is President and CEO of Joint CommissionInternational.
Our standards require that they continually look for any data suggesting a physician has a high number of
undesirable outcomes such as a large number of patients with surgical complications, returns to the surgical
suite, or post-operative infections, and determine the cause of these problems immediately.
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But the reality is that the medical traveler may have a more
difficult time getting this type of information and find it harder to
determine if he has chosen or been assigned a competent physician.
Thats why it is important that the medical traveler choose a JCIaccredited hospital. It is one of the best tools he has to reduce his
risk of having an unqualified doctor perform his surgery.
There will always be risks in medical care, but many hospitals
around the world are working hard to reduce risk and improve
care. Finding these hospitals is the medical travelers best
bet. For more information on JCI-accredited hospitals: visit:
www.jointcommissioninternational.org
The good old U.S.A. is the epitome of capitalism, and thats good for the Medical Tourism Industry.
There are no artificial barriers to marketing your facility, organization, products and services to the
U.S. market; no government restrictions, no monopolies and no trade barriers. The only hurdles
for providers in the industry are surmountable, if you know how to get over them that is. Lets look
at a few of the hurdles.
A sound, disciplined,
well thought out
strategy is essential
in order to spend
an organizations
marketing dollars
wisely.
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people who travel, and people who want to
live life to the fullest. When you think about
it, its very, very difficult to penetrate this
market. Its very complex and diversified in
both geography and profile.
Knowing the
budgeting process
and the gatekeepers
of the budgets are
one of the key pieces
of knowledge to
aid organizations
in marketing to
businesses
in the U.S.
Which leads us to the third hurdle.
Do you know the profile of your target
market; the socio-economic factors that
helps you to define who they are? The
common indicators of household income,
geographic location, age, gender and
financial obligations (mortgage, auto loans,
credit card obligations, etc.) only begin to
scope the consumer market. Likewise, the
common indicators of revenue, headquarters
location, office locations, number of
employees, healthcare insurance carrier,
healthcare benefits enrollment percentages,
executive management, board of directors
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American Hospital Management Company appoints Gregory Ciottone, MD as Chief Medical Officer
merican Hospital Management announced the continue with these appointments while on staff with
appointment of Gregory Ciottone, MD to the position AHMC.
of Chief Medical Officer of American Hospital
I am extremely pleased to welcome Dr. Ciottone
Management Company.
to American Hospital Management Company as Dr.
Ciottone brings significant academic and practical
Dr. Ciottone brings over 15 years experience
experience to our medical facilities and physicians.
in academic, clinical and international medicine
We look forward to working with Dr. Ciottone and
to American Hospital Management Company. Dr.
to continually strengthen and support the physicians,
Ciottone is a Board-Certified Emergency Physician
nurses and other professionals in the communities we
and is an Assistant Professor of Medicine at Harvard
serve while accomplishing our mission in meeting
Medical School, where he currently is the Chair of
healthcare needs locally, stated Randall D. Arlett,
the Disaster Medicine Section. He has served as
President and Managing Director of American Hospital
Director of the Division of International Disaster
Management Co.
and Emergency Medicine and Medical Director for
I am very excited to begin work as the Chief
Emergency Management at Beth Israel Deaconess
Medical Center, where he works clinically in the Medical Officer for American Hospital Management
Department of Emergency Medicine. In addition, Dr. Company. AHMC has firmly positioned itself
Ciottone holds a Visiting Professorship in Disaster as the world leader in hospital management and
Medicine at Vrije Universiteit Brussel in Belgium and administration by creating world class medical centers
the Universita del Piemonte Orientale in Italy, and has that maintain quality as their number one goal. Under
served as the Medical Director for the Office of Security AHMC management, these institutions have flourished
and Investigations, United States Citizenship and by linking the hospital with the community through
Immigration Service, U.S. Department of Homeland local partnerships. It is an honor for me to now join
Security, Washington D.C. Recently, Dr. Ciottone this winning team and I look forward to continuing the
established the Operational Medicine Institute at tradition of excellence AHMC has become known for,
Harvard Medical Faculty Physicians, of which he has stated Gregory Ciottone, MD, Chief Medical Officer
assumed the position of Director. Dr. Ciottone will of American Hospital Management Co.
About The American Hospital Management Company
American Hospital Management Company (AHMC),
a member of the Family Hospital Group of Companies,
is a Longmont, Colorado USA based diversified
international healthcare system whose focus is on
the administration, management, and development
of international hospitals and healthcare systems.
Founded in 1998, AHMC has grown into the leading
international hospital management and administration
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The Age
Whether they are Filipinos, who are returning home from work overseas or are migrants coming home for muchawaited family reunions and tropical vacations, they continue to look for the healing touch of the hilot.
WHAT IS HILOT?
Hilot is the age-old indigenous Filipino healing practice
associated with elderly healers. It is relatively complex way of
healing complete with philosophy, health concept and healing
methodologies. The Hilot Master or manghihilot could identify
body illnesses or areas of energy imbalance in the body through many
unconventional methods like pulse reading, hot and cold analysis,
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BRIEF BACKGROUND
The practice of Hilot is a part of the Filipino way of life.
Traditionally, prior to the popularity of modern medical doctors, the
manghihilot was the health care giver of the community. Like all
traditions, it has seen its share of being pushed to the background at
the arrival of new methods, new medicines and new technology.
Lately, in the worldwide resurgence of alternative forms of
medicine and the research and study of the old ways of healing,
Hilot is re-established as the Filipino Healing Art based on scientificuniversal and natural laws.
CONCEPT OF HILOT
Man is considered healthy or at-ease if his faculties (mind,
emotion and body) are in harmony with the Universal Law. This
harmony sets the phase for the balance and precise combination of
the Elements of the body (earth, water, fire and air). The unique
combination of the four Elements varies according to mans existing
patterns and programs that are called genes. Furthermore, the unique
combinations are also dependent on mans lifestyle, culture and
environment. This combination has its own individual limitations,
and once limitations are violated, imbalances happen. The imbalance
is called dis-ease.
Imbalances of elements of the body could be corrected by the
introduction of changes through; biochemical, neuro-electrical,
electro-magnetic and bio mechanical means.
MAKING OF A HILOT
The training of Hilot Practitioners or the manghihilot involves
learning the concepts and philosophy of traditional healing,
instilling an individual valuing process and its relevance to Hilot
Healing and understanding the body functions. The education of the
Dr. Bibiano Fajardo is an albularyo and a general practitioner of Hilot. Dr. Fajardo has a vast experience in the practice of hilot
spanning 40 years. The ATHAG is located at the 2nd floor Jacinta bldg., EDSA Guadalupe Nuevo, Makati City, Philippines.
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Makati City in Metro Manila hosts the Philippines premier business hub. It is one of Asias sterling
examples of self-engineering to provide urban capitals with livable environments, stimulating cultural
fare, contemporary leisure and shopping enclaves for enhanced lifestyles.
Makati Meds BMT Unit, like the rest of the Cancer Center, is
equipped with the latest machines using progressive technologies and
run by doctors and nurses who are all board-certified and specially
trained. Many of the doctors have received further specialization
and certification in foreign universities and hospitals. Aside from
clinical staff, nurses also keep abreast of treatment procedures and
patient care through continuous education and constant training.
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The countrys world-class physicians and its medical facilities using modern technology are good banners
for its medical tourism program. Yet, add to this the Philippine brand of health care one that is summed
up as tender loving care, one is led to conclude that there are more than enough compelling incentives
to seek medical attention in the country through the medical tourism program.
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These credentialing and privileging mechanisms ensure the
continuing technical proficiency of and adherence to ethical
standards by medical doctors, and thus, promotes the quality and
safety of patient care.
Externally and internally-driven Quality Improvement (QI)
programs prompt the improvement of the design, documentation,
implementation and monitoring of hospital processes and their
efficiency. QI programs are initiated by external regulatory agencies
like the PHIC and through institutional collaboration with the
Philippine Society for Quality in Healthcare (PSQua).
Within the medical organizations, the conduct of peer audits,
sentinel event monitoring, the tracking of Hospital Quality Indicators
and launch of Quality Circles are ways by which self-improvement
are undertaken.
Among noteworthy developments as a result of tracking of
Hospital Quality Indicators include the finding, from a sampling of
Philippine hospitals, which infection rates are in the lower range
or levels, per the International Nosocomial Infection Control
Consortium (INICC).
From an INICC low of 1.7 to a high of 12.8, the sample
Philippine hospital scored a low of 1.9 in the monitor for Foley
catheter-associated infection. From an INICC low of 7.8 to a high
of 18.5, the studied hospital manifested a low 8.9 in blood stream
infection. In ventilator-associated infection, with a low of 10.0 and
a high of 52.7, the count for the model hospital was 13.2.
Presented side by side with the finding that death from infection
is listed in the Top Three causes of deaths, these remarkable scores
of sampled Philippine hospitals are undoubtedly excellent indicators
of patient care and safety.
Patients are not left out in the process of achieving quality
health care. As vital partners for growth and quality management,
Patient Education Programs are carried out, empowering patients
to demand quality service and safety. Feedback mechanisms
through e-newsletters and web-based forums are new venues for
active engagement of patients in the care process. Other forms used
in Patient Rights Programs are individual counseling and group
sessions.
The surge of managed care in the Philippines, with a count of
18 Health Maintenance Organizations (HMOs) since 1981, has also
figured in the quest for quality health care. Awareness of hospitals
of length-of-stay issues from HMOs and the Philhealth has upped
the bar for efficiency in processes. It has also affected hospital
compliance with documentary requirements for speedy claims
processing.
All told, the current Philippine scene for the achievement,
maintenance and continuous upgrading of quality health care is set.
The recognition of the value of maintaining high marks in health care
delivery and safety, with the onset of medical tourism, is providing a
fresh drive for increased efficiency through focused and innovative
schemes that address medical tourism requirements.
With quality health care and patient safety as vital elements
for a growing medical tourism industry, the distinguished Filipino
medical doctors and heads of institutions have nothing less than the
best reasons to continue raising the bar in their respective fields.
Dr. Bengzon, who led his organization, The Medical City, to
obtain the highly-coveted JCI accreditation is a multi-faceted leader.
He is described as a brilliant doctor, savvy manager, dedicated
educator, courageous public servant and visionary leader. He is
constantly driven by the quest for excellence and the passion for
service.
A practicing neurologist, Dr. Bengzon completed his residency
in Neuropsychiatry at the Philippine General Hospital and further
honed his specialist expertise in several renowned medical training
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system, specifically using dentritic cells and fusing it with known tumor
antigens to create a tumor vaccine or as a direct injection into the prostate
cancer. Dr. Dator is often invited as lecturer in international meetings
The bio-data of the Dr. Samuel Bernal, The Medical City Consultant,
veritably reads like a list of advanced course offerings. With a passion for
knowledge not only in the medical field but also in other related disciplines,
Dr. Bernal is Board Certified in Internal Medicine and is a Diplomate of the
American Board of Internal Medicine. He completed his training as Fellow
in Internal Medicine at the Harvard Medical School, as Fellow in Medicine
at the Peter Brent Brigham Hospital in Boston. He completed his Doctor
of Jurisprudence degree at the Loyola University Law School and now
specializes in Regulatory Law and Medical Malpractice. He completed
his M.B.A. degree in a business program for company presidents at the
Pepperdine University in Malibu, California.
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Taking Excellence to
Heart
By Eric Michael Santos
Dr. Jorge Garcia is the man behind the excellent cardiovascular surgery success rates of the Asian Hospital
and Medical Center. The track record of the man and the hospital speaks for itself.
hen it comes to heart surgery, Dr. Jorge Garcia knows that the
harmony of details is what creates the symphony in every successful
surgery. Thats why one of the best cardiovascular surgeons in the
world took an active role in designing the Asian Hospital Medical
Center (AHMC) in the Philippines.
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left ventricle. With each heartbeat, this scar can thin and bulge out,
eventually forming a dangerous aneurysm. These changes, along
with other damage to the heart, may result in heart failure. Initially,
the heart is able to cope with having to pump harder; but over time,
the extra work load causes the left ventricle to enlarge and lose its
ability to pump effectively. Reconstructive surgery restores the left
ventricle to a more normal shape thereby enhancing its pumping
capability, explains Dr. Garcia.
MAZE
Dr. Garcia utilizes a cutting-edge technique called the Maze
procedure to surgically treat atrial fibrillation, the irregular beating
of the heart caused by faulty conduction of electrical impulses. In
the Maze procedure, an energy source (radio frequency, microwave
or cryothermy) is used to scar heart tissue in order to block
abnormal electrical impulses and restore the hearts optimal impulse
conduction.
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MEDICAL TOURISM
Other innovative procedures performed by Dr. Garcias team at
AHMC include thoracic aneurysm repair and implantation of the
left ventricular assist device (the bridge to transplantation) in
critically ill patients who have no other recourse but to undergo a
heart transplant.
Sources
http://www.hsc.dlsu.edu.ph/cm/index.htm
http://www.cebudoctorsuniversity.edu/colleges/medicine/admission.html
http://travel.state.gov/travel/cis_pa_tw/cis/cis_999.html
Requirements to become a nurse
Must have a high school diploma or the equivalent
Must complete science and math coursework in high schools
Must be able to express themselves in English
Sources
http://www.hsc.dlsu.edu.ph/cnm/BSN.htm
http://www.ceu.edu.ph/schools_and_colleges/nursing_academic.asp
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Picture yourself walking down the beach, with sparkling sands massaging your feet and the sun prompting a dose
of sweat, as your leg and arm muscles get their fix of desirable motion. All of this, as your senses take in a spellbinding view of forests and mountains and the fresh whiff of sea air.
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Do you have
Errors & Omissions - Liability Insurance
when Dealing With Patients?
(615) 444-8859
Copyright Medical Tourism Magazine
July 2008
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MEDICAL TOURISM
In the Philippines it seems as if they are trying to build a sustainable international Medical Tourism culture. It
seems that the Philippines has many opportunities to take advantage of the estimated, over $40 billion dollar
Medical Tourism industry. For this country, 700,000 medical tourists and US $2 billion annually seems very
achievable in the very near future.
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Economic Facts
The countrys economy has been helped by growth of Private
Services (which include healthcare services) which were up 8.9%
in 2007. The Filipino government reports that the country has
capitalized on the growing trend in medical tourism in 2007, and
overall the performance of the Medical & Health Services sub sector
increased sharply (around 8% and up from 2.4% in the previous
period). They attribute this recent trend to the rising cost of health
care in developed countries, coupled with improving medical
technology and human resources in the Philippines. In 2005, the
countrys health and wellness tourism was estimated to be at about
1.26% of total GDP or $68.5 billion Filipino Pesos (approximately
$1.65 billion US dollars in 2008).
Summary
In the Philippines, it seems as if they are trying to build a
sustainable international Medical Tourism culture. The government
encourages private hospitals to give at least a 10% share of the medical
facilities and treatment to patients that are unable to pay. In addition,
the PMTP is involved in the creation of international medical zones
(IMZs) to encourage economic development in Medical Tourism.
Other trends to watch are the .5 to 3 million Filipino-American
retirees who may choose to settle in the Philippines sometime in
the years 2010 to 2020. It seems that the Philippines has many
opportunities to take advantage of the estimated, over $40 billion
dollar Medical Tourism industry. For this country, 700,000 medical
tourists and US $2 billion annually seems very achievable in the
very near future.
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Based on data from 30-day post-operative survival rates recorded by St. Lukes Heart Institute Cardiovascular Disease Information System
(CVDIS), US National Medicare experience, latest Morbidity and Mortality Statistics on Coronary Bypass Surgery and Angioplasty, and The
Best Hospitals for Heart and Heart Surgery 2005-2006.
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An Unparalleled Legacy
By The Beverly Hills Medical Group
Beverly Hills Advanced Surgery Institute (BHASI)s legacy found continuity in the other half of the world, in the
wake of the creation of the Philippine Medical Tourism Program, the countrys stepping stone to the development
of a medical tourism infrastructure that is distinctly its own and at par with world standards.
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A Stable of Firsts
The integrity of services is undiluted, she adds, such that BHMG
facilities meets the US gold standard for multi-specialty ambulatory
surgery centers. The center provides a variety of outpatient surgical
procedures in the areas of regenerative medicine, cosmetic surgery,
plastic and reconstructive surgery, cosmetic laser and dermatology,
general and vascular surgery, gastroenterology, gynecology surgery,
otolaryngology, podiatry, orthopedic and sports medicine, pain and
cancer pain management, and urology and mens health. Its cancer
pain management program is one of the few venues in the Philippines
where cancer sufferers can receive much welcome relief.
A Response Unparalleled
In the eight months it has been operational, the volume of clients flocking to the BHMG has been unparalleled primarily due to
its comprehensive website. The costs of surgery, says Rebujio
counting expenses spent to recover in one of the most beautiful
tropical settings in the worldare a fraction of US prices. We
have brought the same technology and quality to the Philippines at
a fraction of the cost, Rebujio says.
If plans call for surgery sandwiched in between trips to the beach
or rounds of golf, BHMG is happy to oblige. We work with worldclass concierge agencies from all over the world, one of which is
Philippine Medical Tourism, Inc. (PMTI), that provide travel needs
from A-Z.. Nothing less can be expected from BHMGthe only
company able to infuse the Philippine medical tourism industry, a
serious contender in the Asian arena, with a dose of world-class
expertise.
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Exceeding Expectations
Living in todays stressful and fast-paced modern world, health has apparently taken the back seat in favor of
meeting work deadlines, catching up with payment of bills, keeping up with glitzy and power lifestyle trends.
Checklists to take care of business unfortunately have overlooked to a certain degree vital health-related
concerns. The increasing back-to-basics awareness and the keen realization of the sensitivity of the human
body to abuse are, however, changing attitudes toward wellness and the pursuit of health care.
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for different character needs. Over at the Peninsula Spa, the setting
is aligned for rejuvenation. A refreshing dip in the pool, an hour
of relaxing Thai massage or a detoxifying sauna bath are all made
available with special touches for the client.
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With huge, mainland China at the northeastern side of the Philippine archipelago, it is not surprising to
find significant Chinese influences in Philippine culture. Trade between the Chinese and Filipinos has been
chronicled since the ninth to 12th centuries. Today, some ten percent of the Philippines entire population is of
Filipino-Chinese descent.
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Boasting 7,107 sun-drenched islands, diverse flora and fauna, rich marine life, the worlds best beaches, crafts
and arts, easy access to sea and mountains, and abundance of fresh fruits and vegetables, the Philippines is
one of the most desired tourist destinations in the world. At the center of the Philippine archipelago is Cebu an island, a province and a city.
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Tourism in Cebu
Cebu is the business, educational, medical, transport and
tourism center in Central and Southern Philippines. Facilities
and infrastructures are well-placed, resorts and hotels enjoy high
occupancy rates, Foreign Direct Investors (FDIs) number by
the hundreds, and multi-million dollar investments are poured in
yearly. Foreign visitors have continually set record highs - eager to
experience the resorts and dive spots, the mix of rural-cosmopolitan
lifestyle, and even enroll in the English as a Second Language, or
ESL schools that populate in this province.
It is very strategically located at the heart of the Philippines, the
Central Visayas Region, which was declared by Philippine President
Gloria Macapagal-Arroyo as the Supra Region for Tourism in
the country. In her speech during the opening of the Philippine
International Tourism Fair (PITF) last year, the President hailed
Cebu as the "tourism mecca" of the Philippines. Stakeholders know
that, in due time, Cebu has what it takes to be a well-known worldclass destination being a strategic gateway accounting for 50% of
foreign arrivals in the country, and a vibrant, self-sufficient economy
that remains largely immune to any adverse political upheavals in
the nations capital.
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Eye Republic
By Dr. Manolette Roque
People are very particular about their eyes, which are poetically referred to as windows to the souls.
These organs are so sensitive that even the smallest bits of intrusions can cause immense discomfort.
Word-of-mouth
EYE REPUBLIC introduced multi platform, multi center laser
and non-laser vision correction in the Philippines in 2003. People
from all over the Philippines, the U.S. and over 30 countries
worldwide come to us for treatment. But no matter how good we
are at it, if the procedure isnt right for you, you can trust us to tell
you.
We have built upon a word-of-mouth clientle desiring the
flexibility that we offer while providing a single high standard of
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eye care for all. Clients satisfied with our services serve as our
ambassadors spreading goodwill all over.
We work on a pay it forward dictum, believing and
understanding that providing excellent service to each of our clients
generates an exponential increase in referral.
In good time, health care providers, consolidators, travel
agencies, and government institutions, began to take notice of our
patient-centric services and successful results. By linking up with
fellow stakeholders, such as the Philippine Medical Tourism Inc.
(PMTI), a company that provides convenient packaged services
designed for the individual who is seeking cost-effective medical
and wellness programs outside his country of residence, our network
has expanded exponentially.
Multiplatform, multicenter
By aligning ourselves with other major stakeholders in eye care
service and delivery, our practice currently offers laser refractive
surgery using four different platforms: VISX STAR S4 with IR and
WaveScan CustomVue System, Carl Zeiss Meditec MEL 80, Bausch
& Lomb Technolas 217 Z100 Zyoptix System, and CustomVis
PULZAR Z1, located in different centers of excellence.
Our clients are very pleased to know that they have options with
respect to platforms and locations. Having access to the popular
platforms used in the US, Europe and Australia, provides our global
clientle with the unmatched flexibility to take charge of their
refractive journey.
After weighing pros and cons, its good to know that there
are world-class eye care facilities, offering inexpensive, modern
treatment in the Philippines. When costs may be reduced by half
and a nice vacation in a desirable destination gets thrown into the
deal, Philippine medical tourism is considered for corrective eye
surgery.
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MEDICAL TOURISM
In a comfortably furnished room at The Medical City in Pasig City, Metro Manila, Inaki Ugarte, looks out
the window and smiles. I was diagnosed with liver cancer in 2004. By the time I was ready to have a liver
transplant, they found out that it had already spread to my lungs, he says. The doctors gave me about 3 to
4 months to live.
hey told him that over a year ago. Today, the 65-year old
businessman is enjoying an extended lease on life, thanks to the
very promising field of Regenerative Medicine.
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Regenerative Medicine is
an innovative program that
involves the engineering of
living cells, tissues and organs
to preserve and enhance organ
function and improve
quality of life.
Copyright Medical Tourism Magazine
July 2008
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MEDICAL TOURISM
The Farm at San Benito, a multi-award winning health resort in the Philippines, is one such case of
taking an idea far to prove a point. Here, the point is that the ones appreciation of oneself holistically
brings about and sustains the gift of wellness.
ake an idea, and take that idea to the hilt, one is certain to find
great chances of remarkable successes.
The Farm at San Benito, a multi-award winning health resort
in the Philippines, is one such case of taking an idea far to prove a
point. Here, the point is that ones appreciation of oneself holistically
brings about and sustains the gift of wellness.
The Farm, which traces its roots to organic farming in Lipa,
Batangas province, came about as the world witnessed a stronger
surge of return-to-nature initiatives.
In the assessment of The Farm owners, the nature of man is not
one-dimensional, limited to his physical being. The physical aspect
is only part of his totality which includes the other facets of his
being the spiritual, mental and emotional.
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From this concept, The Farm laid out its holistic approach to
healing, with programs addressing health issues at various levels.
And setting the programs amid the backdrop of poetry-inspiring
natural environment, The Farm was well on its way to inviting its
clients to benefit from this concept -- to the max.
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MEDICAL TOURISM
The Concierge
By Lourdes Gasparoni
When I first meet a Medical Tourist at the airport, my goal is to make them feel comfortable and
assure them that I am familiar with what they are doing. I want them to know that I will be there for
them throughout their entire trip.
When the plane first touches down, many questions may pass
through ones mind: Will I be safe?; Will they understand
me?; How will I get around the country?; Will they accept my
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Whether it is recommending a
restaurant or a tour, assisting with
translation or transportation, a
concierge who is familiar with the
Medical Tourists specific needs can
make a difference.
Salas adds that he has learned through his experience, that there
can be big challenges faced by the Medical Tourist, but they are
not insurmountable. Its as simple as seeing the relief in their eyes
when they see me waiting with a sign with their name on it when
they pass through customs. Also, they appreciate the help I provide
them when checking in and getting settled at their hotel.
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MEDICAL TOURISM
By Jonathan Edelheit
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July 2008
in the US. I was the first person to implement Medical Tourism into
both fully insured and self funded health plans years ago, creating an
affordable solution for my client to waive deductibles, coinsurance
and reimburse travel expenses for the insured and a companion.
This is the current trend for implementing medical tourism.
What is the real difference in how I implemented Medical
Tourism and the mistakes many organizations are making today?
First, make sure you really think this through, do your research
and engage in due diligence. There are three ways to implement
a Medical Tourism Program. First, simply put, is to implement it
successfully and professionally. The second way is to implement
it improperly and simply no insured or employee ever makes the
choice to go overseas. The third option, is implementing it with the
wrong company, and encounter high risk of liability for an employer
or insurance company. I have seen many companies implement it
correctly and others do it wrong by simply picking horrible partners
to communicate to employees, to the insured and to coordinate
care overseas. Every aspect of a Medical Tourism program must
be carefully planned in advance in order to achieve successful
outcomes. Proper planning equals positive outcomes.
Industry
4 . Choosing a Hospital
How are you selecting hospitals? Are you taking recommendations
from third parties or choosing based upon the most impressive
websites? Or, have you done your own research and due
diligence and perhaps even visited the hospital personally?
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MEDICAL TOURISM
a patient may directly impact the overall patient experience. Then
you would like to know whether the doctors and nurses also pass
the language and understand the customs of foreign patients. Why
is this so important? What if the patient is in pain and needs to
communicate to the nurse or doctor about the pain or some other
important need, and the nurse or doctor doesnt understand them?
The language issue is probably one of the most important aspects of
a successful medical tourism program, so make sure you choose the
right hospital that has these processes in place.
Privacy
Does the hospital have privacy regulations in place to protect the
privacy of the patient in accordance with the privacy laws in their
home country? Remember if you are based in the US you are very
familiar with HIPAA, you will quickly notice that no other country
has the privacy laws as stringent as those found in the US and many
hospitals have no idea what HIPAA is, how they should comply,
or if they could even put the administrative procedures in place to
comply. Each country has their own definition of privacy and how
they deal with medical information. Are you aware of the hospitals
privacy procedures?
5. Aftercare
Where the patient will recover after surgery and what happens
when the patient returns home is directly related to a positive patient
experience. Does the hospital have an aftercare program in place?
Has aftercare in the home country been pre-arranged? How long is
the recovery time?
For recovery directly after the surgery, each hospital has their
own policies, so you need to be aware of country specific practices. For example in most hospitals in India, patients recover in the
hospital, specifically because the costs of hotels are too expensive.
Decent hotels can cost $400+ per night, which are unaffordable for
many patients and the price of the extended hospital stay is usually
included within the hospital package. But in other regions, such as
Latin America, after the appropriate recovery time in the hospital
the patient is moved to a hotel or recovery resort where they will
continue rehabilitation before they return to their home country.
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The costs for the hotel or recovery resort are normally not included
within the hospital package price for the surgery. So, then you need
to ask the question of what hotel or recovery resort are they recovering in and what procedures are in place? Does the recovery resort or
hotel have nurses and rehabilitation services available?
Once you deal with aftercare within the country of surgery, one
of the most important aspects of the patient experience is follow-up
care when the patient gets back to their home country. In reality,
this issue needs to be resolved before the patient ever steps onto
a plane. Prior to an overseas journey, the patient or a third party
should get involved to assure their local, domestic provider understands where the patient is traveling to, what procedure they are
getting, and clears the patient for travel. It would be best to have
the physician agree to treat the patient upon his return. If this is not
in place, patients should not be traveling overseas! Also, this is not
something that can be coordinated when the patient is in the foreign
country for their surgery or just before their return, it is a necessary
detail to be resolved prior to departure from their home country.
6. Communicating to Employees
One of the most overlooked aspects of any successful medical
tourism program is how will you communicate the program to your
employees and their dependents? Most organizations have absolutely no idea, and to not think this through before implementing a
medical tourism program can be a waste of time. Simply put, you
cant hand an employee a brochure showing a pretty picture of a
hospital and expect that now they will be convinced there is high
quality of care available overseas and that they will jump at the opportunity. You must educate the employee or their dependent about
the quality of care overseas.
Ethnic Insured?
One of the major aspects that most employers or insurance
companies do not think about is an ethnic insured patient. This
refers to an insured or employee who is from another country or
a descendant of another country, meaning their parents or grand
parents are from another country. Currently under most insurance
plans this type of employees or insureds are forced to get care in the
country they live in, when in reality they would rather go for care
to their home country and recover with extended family. This
segment of employees or insureds does not need convincing of the
quality of care available in their home country. This is one of the
biggest opportunities in Medical Tourism. A Filipino, Mexican,
Indian, Colombian, Costa Rican, Vietnamese, or Salvadoran (for
example) employee or insured would jump at the opportunity to
go to their home country and, if they had an incentive such as
waiving deductible, coinsurance and travel, they would not hesitate
to travel overseas.
Conclusion
Dont just rely on third party. As an employer or insurance
company, you have a duty to educate yourself, understand the issues
and come up with solutions and answers.
Your employees or insured are assuming you have done the due
diligence for them, and that if you are recommending a hospital,
you have done your research on the hospital and on the actual doctors as well. Dont disappoint them. They are looking to you to put
together the whole package, and a package that they as the end user
can use without complications or problems. A successful medical
tourism program is easy to implement, but needs proper planning
and strategic analysis.
Jonathan Edelheit is President of the
Medical Tourism Association with a
long history in the healthcare industry,
providing third party administration services
for fully insured, self-funded and minimedical plans to large employers groups.
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MEDICAL TOURISM
TRAVEL INSURANCE
By Dr. Michael Moreton
These three patients were all fit young people with no previous medical illnesses who had no reason to believe
that they would need hospital care during their vacation. That is the whole point about insurance - it is there
to help you when the unexpected happens.
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July 2008
bike and ride around the back roads in Thailand. A truck that he
was following too closely suddenly pressed his brakes. Robert flew
through the air and landed on his face in the road.
Fortunately he was transported into the city quickly and
brought to the Bangkok Hospital Medical Center, a tertiary care JCI
Accredited facility and admitted to the Neurological Intensive Care
unit, as he was unconscious.
His family was contacted and consent for treatment obtained.
They were not aware if Robert had any Health Insurance and were
reluctant to guarantee payment for the care. In spite of this he
received excellent care and is now on his way to full recovery after
multiple surgeries for his facial fractures and skin grafting to other
wounds. He was obliged to take out a considerable bank loan to
cover his care.
Melanie Albert was working as a volunteer in a childrens care
home in Cambodia. After eating a very spicy dinner one evening
she started to have abdominal pain. Thinking it was indigestion she
ignored the pain initially but by the following morning realized that
this might be something more serious than an upset stomach. She
had not obtained any insurance when she left home and naively
thought that her patents policy would cover her medical expenses
while out of the country. After been seen in the clinic she was flown
to Bangkok and admitted to the Bangkok Hospital Medical Center.
A diagnosis of Appendicitis was made and she had an operation on
the same day. Her family came out to be with her and was able to
have funds transferred to cover the cost of her care.
She was particularly fortunate as she had been able to get to
Bangkok on a commercial flight. If she had needed to have a special
air-ambulance the cost would have been enormous. One of the
features that is always included in Travel Insurance is Evacuation
Insurance, that covers the cost of you being transported to a good
medical center close to your accident or where you were taken ill.
July 2008
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MEDICAL TOURISM
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MEDICAL TOURISM
Medical Tourism is a
Search for Value, not Low Prices
By James McCormick, MD
From my perspective, I saw synchronous business expansion, reports of increasing traffic and a future that
holds healthy, steady growth. Significant capital investments in facilities and capacity were evident at all the
facilities. Those who plan and execute their business models and imperatives skillfully will have an opportunity
to earn a healthy return going forward.
fter returning from a trip through Asia these past few weeks, I
can happily report that the future for medical tourism and travel looks
very promising. My thanks go out to all the providers and facilitators/
concierges who were extremely gracious with their time. We were
able to visit active facilities and ones undergoing new construction.
Government officials, executive leadership in private institutions,
and leading facilitators all expressed convincing arguments for a
favorable future. From my perspective, I saw synchronous business
expansion, reports of increasing traffic and a future that holds
healthy, steady growth. Significant capital investments in facilities
and capacity were evident at all the facilities. Those who plan and
execute their business models and imperatives skillfully will have
an opportunity to earn a healthy return going forward.
All the facilities offer clear value propositions (high quality
care and customer services for lower prices) to clients now and
are improving such services for the future. As both a physician
and an MBA student, I wondered about a focus on pricing and cost
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July 2008
procedures. This may not be the best marketing story. I wholly and
actively support this industry, but these scenarios of an Internet flight
of fancy can be a high-risk proposition for everyone involved. These
relationships can result in bad experiences, adverse public relations
releases and generally negative media reports. These cases can be
very difficult to unwind the public relations damage, resulting in
restrained growth, and more costly media rebuttals for each case
that surface. No doubt, prevention is more effective and less costly
than the cure. In healthcare, bad experiences and outcomes can be
overly magnified. Constituencies who do not support this industry
take advantage of such outcomes in media releases. They maximize
the effect of incorrect assumptions about poor quality, misguided
attitudes of fear and pre-existing negative bias. The effects of such
releases on the mindset of the tentative healthcare traveler can be
difficult and costly to reverse.
The consumers psychological state should be moved carefully
and methodically from an existing state of concern, fear and
hesitancy: to positions of acceptance, enthusiasm and hopeful
anticipation. I believe that this mechanism can fully accelerate the
growth rate of traveling US patients.
Solutions are complex and require a careful analysis of many
factors. Assumption about US patients and about international
providers can lead to both parties not fully understanding the
customer base and marketing approaches. The market is vital and
provides an essential service that will grow. Engaged discussion,
understanding cultural gaps in viewpoints, and continued dialogue
will only continue to grow a brighter sustainable future.
Dr McCormick is originally from New York and now lives in Los Angeles. He is a practicing Emergency Medicine physician in Los
Angeles. He has remained Board Certified for the last 10 years. Prior to that, he served for over 20 years in pre-hospital emergency
services, both ground and air based operations. He graduated from medical school at the State University of New York Downstate in 1993.
His residency in Emergency Medicine at the prestigious LAC+USC Medical Center was completed in 1997. Dr McCormick is a founding
member and co-inventor of the NuMask IntraOral Mask, a breakthrough medical device for ventilating patients. His next direction is a
more strategic solution to the US healthcare challenges with the launch of a medical tourism business called Premier Medical Travel
this fall. He is convinced that combining his MD and MBA will help to unleash the tremendous benefits this industry has to offer: our
patients, our payers, our country and our future generations. He may be reached at jjmccormi@earthlink.net.
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MEDICAL TOURISM
BINA BUZZ
Conventional Thinking? Leave your heart elsewhere! After reviewing the agenda for The First World Medical
Tourism and Global Health Congress in San Francisco in September 2008, I said to myself, Selfdo you
know the way to San Jose (or thereabouts)?
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MEDICAL TOURISM
OH MY
ACHING BODY
By Sandra Landsman, Ph D, CHt
No body, but no body, has the flu or feels like they have the flu for months or years on end. That is what it feels
like to be one of the 6 to 10 million Americans who suffer from the chronic pain of Fibromyalgia. And who
knows how many others suffer the same around the world. They range in age from about 30 to their 60s and
are predominately women. In the past this has often granted them a pat on the head from their physician and
a trip to the psychiatrists office because there has been no clear cause. Fibromyalgia is called a syndrome
rather than an illness due to the fact that the multiple and varied symptoms lack the clear markers of a disease
such as changes in organ function or blood.
Sleep deprivation. With all the time that is spent in bed, how can
anyone still have trouble falling asleep? Sleep is elusive. After hours
of tossing and turning, having just barely gone to sleep, people with
fibromyalgia may wake up several times during the night or early
in the morning feeling as if they havent slept at all. No wonder
exhaustion is the word of the day. Deep restorative sleep is needed
for the muscles to rebuild during the night. For some of the victims
of this insidious malady, employment is no longer an option. Often
these are women that are Type A personalities, who have had top of
the ladder positions. Oh yes, often the high stress and well paying
positions have long since faded from their agenda like a washed out
pair of jeans. These people are not malingerers! They are just stuck
in the muck and mire of their own debilitating, exhausting pain.
Fibromyalgia Symptoms
Memory has been fading over the years as the anxiety has been
ever increasing. They feel as though they are sitting on teeter-totter
or see-saw and no matter what they do, they can not bring the board
into balance. Their entire life is out of balance.
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Fibromyalgia Diagnosis
The American College of Rheumatology
has maintained that prior to making a
diagnosis of Fibromyalgia there has to have
been muscle pain for at least 3 months.
There is a simple, but crude test that is made
to determine if you are one of these souls.
There are 18 individual tender sites on the
body that cluster around the neck and back.
A positive diagnosis is made if pressure is
applied to an individual and they respond to
11 of those 18 painful spots. Then you will
be considered positive for fibromyalgia.
Fibro Fog is the term that is often used
when they cant remember something
that is simple or obvious that they should
know. Fibromyalgia patient fears that their
brains and value left as the water went
down the bathtub drain. Lets also add heart
palpitations to the mix.
Headaches come in a variety of sizes
and consequences from mild, which come
and go, to monster migraine headaches
that have their own arsenal of medication.
Then of course, there is the neck pain that
is a whole new epidemic unto itself. Often it
contributes to the headaches, but who knows
which came first?
Vertigo or dizziness can be added to top
things off, as if things were not bad enough.
Now terrified to drive, even if they had
the energy to get up and go, this energy is
drowned in a flood of awful fearful thoughts
about hurting oneself or others in a car
wreck. The projection can come fast and
furiously with images about vehicles piling
up and hurting others all over town. The
mental exhaustion takes its toll and these
individuals surrender to the bed or couch for
another day of being a prisoner in their own
home.
And the list goes on with motion
sickness as another symptom. This can
make for impossible traveling. Here is a
little item that the divers and boaters use
for motion sickness that is available most
any where in the world; it is an inexpensive
over the counter tablet, Meclizine with the
brand name of Bonine. So traveling locally
or globally is in the realm of comfort and
possibility. It works wonders.
Intestinal Disturbances have a couple
of more ugly items that will usually find
themselves on the list. These can be bouts
of diarrhea followed by constipation,
flatulence or even leaky bowels. By the time
these symptoms are done, your body is on to
another set of symptoms perhaps in another
location entirely.
Fibromyalgia Research
The issue of chronic pain and depression
are taken very seriously by Pedro Montoya,
PhD, and his research team in Spain.
They are gravely concerned regarding
the negative effects and the influence on
brain processing of physical and sensory
information an illness such as fibromyalgia
may have over time. Another research group
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Taking an entirely different tack,
we have R. Paul St. Armand, MD, a
practicing physician and endocrinologist by
profession. He is one of the few men and his
three daughters who all carry fibromyalgia
syndrome. He proposes that fibromyalgia,
chronic fatigue syndrome, systemic
candidiasis are all one and the same things,
energy deficient syndromes, and may
have a hereditary cause.
These conditions all result as phosphates
build up within the cells in the body. There is
a failure of the phosphate ions to be excreted
from the urine so they then become trapped
in the bloodstream, and eventually get
stored in the bones, tendons and muscles.
When the build-up is great enough, it will
interfere with the energy production within
each of our cells. This is where everything
gets very, very complicated. The phosphate
ion is needed to help to convert the calcium
that comes from storage and all of this take
fluid. There is a portion of the kidneys that
just doesnt pump properly. As that happens,
over time the excess fluid will be stored in
many areas throughout the body which over
time causes pain. Specifically, this is the
very pain that is experienced at the surface
of the body and at the 18 pressure points.
Dr. St. Armands protocol for cleansing,
balancing, and restoring individuals is to
divest themselves of all salicylates, aspirin,
mint and various other herbs while going on
a regimen of Guiafenesin to help flush out
the body.
Fibromyalgia Treatment
So now that we know what is under the
medical spotlight, what do we do about it?
Can we drug it into submission? Well, we
can not do that exactly. There are a range of
anti-depressant, sleep and pain medications,
muscle relaxants anti-seizure medications
that have been prescribed often off-label for
this malady. This means it was given with
the hope and blessing that it would help
people with fibromyalgia. Of course lots of
aspirin and Tylenol also have been taken for
help.
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SPEAKERS
Joseph M. Heyman, MD
Chair-elect, Board of Trustees
Mike Kellen
Senior Vice President, Strategic
Development
Assurant Health
Robert Germain
Vishal Bali
CEO
Wockhardt Hospitals, India
Grant Muddle
Sandra G. Morris
Proctor & Gamble
Arturo Garza
CEO,
Christus Muguerza,
Monterrey, Mexico
William F. Ruschhaupt, MD
Chairman, Global Patient Services
Cleveland Clinic, Ohio
Curtis Schroeder
CEO
Bumrungrad
James Lee
Wooridul Spine Hospital,
Korea
Frank Lasee
Wisconsin State
Representative
Robert Crone
Former CEO,
Harvard Medical International;
Managing Director,
Huron Consulting Group
John Blalock
Guardian Life Insurance
Company Of America
Steve Green
Director
Trent Accreditation
Kemal Canlar
Senior Sales Executive
United Healthcare, USA
Sharon Kleefield
Harvard Medical School
Dan Bonk
Executive VP, Central Region
Aurora Healthcare,
Wisconsin
Jay Savan
Towers Perrin
Alex Piper
Former Buyer of Healthcare
Chrysler (Formerly
DaimlerChrysler)
Peter Hayes
Hannaford Brothers
Ilyas Benvenyste
Acibadem Hospital
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July 2008
Brad Cook
Medical
Medical Tourism
Tourism Association
Association
www.MedicalTourismAssociation.co
www.MedicalTravelAuthority.comm
Info@MedicalTourismAssociation.co
Info@MedicalTravelAuthority.comm Copyright Medical Tourism Magazine
SPEAKERS
Edward Watson, MD
CEO
MedTral, New Zealand
Jonathan Edelheit
President
Medical Tourism Association
Christi de Moraes, BA
Founder
MedNetBrazil Services, Inc.
Fred Hagigi
Professor
UCLA School of Public
Health
Alexandra Jung
Aon Consulting
Shin-Ho Lee
Ph.D. Executive Director for
Industry Support
Elizabeth Boultbee
Head of International Business
Stuart Rowley
CEO
Prince Court Medical
Center, Malaysia
Christine Leyden
VP & GM of Client Services,
Chief Accreditation Officer
URAC
Michael Kent
Senior Regional Director
Great West
Jim McCormick, MD
Board Certified Emergency
Medicine
Robert Frary
Symetra Financial
Leann Reynolds
Homewatch International, Inc.
Margaret Ball
Founder
Health Links International
David G. Vequist
Professor
Professor J D Frame
International Society of
Aesthetic Plastic Surgery
Charles Cutler, MD
Chief Medical Officer for Aetna
July 2008
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www.MedicalTourismCongress.com
July 2008
73
JOIN
THE MEDICAL TOURISM ASSOCIATION
info@MedicalTourismAssociation.com
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July 2008