Medical Tourism.

A GROWING TREND IN THE AMERICAS

IMAGINE BEING ABLE TO COMBINE A VACATION IN historic Boston, a ski trip to the Rocky Mountains or a relaxing week in Miami Beach with medical treatment by an experienced physician, hospital or other health care provider. That's the medical tourism concept -- a fast-growing approach to health care throughout the Americas.

Many U.S. destinations are beginning to recognize the potential of combining internationally oriented health care services with a special vacation package that highlights nearby attractions. In addition, non-U.S. destinations, such as Mexico and Costa Rica, have begun marketing to North American travelers, offering them access to types of medical care that are not yet available in the United States, along with a "get-away" vacation.

The medical tourism approach is especially appealing for Latin American patients who come to the United States for an annual checkup, a second opinion or relatively minor diagnostic or treatment services. In addition, many patients appreciate taking a few days to several weeks to unwind and heal from a surgical procedure before heading for home.

In the age of the Internet, it's relatively easy for sophisticated medical travelers to find just the right combination of medical services and a vacation destination. A number of international patient intermediaries, for instance, have sprung up to play a "matchmaking" role between patients and health care providers.

Typically, these patient intermediary services offer to:

* Locate the most appropriate medical services in the United States.

* Negotiate to obtain competitive pricing for all aspects of care.

* Oversee the patient's stay while in the United States.

* Coordinate all travel plans from the home country to the United States and back.

* Arrange for amenities such as interpreters, ethnic meals, and places of worship to be made available to patients and family members.

* Ensure that a full report is sent to the patient's primary physician back home.

Many of these services are also provided directly to patients by a number of hospitals who have established international centers or who have staff dedicated to coordinating care for visiting patients.

Many regions in the Unites States are building closer ties with Latin America, including Massachusetts, South Florida, Texas and California. In turn, many Latin American nations are recognizing the importance of strengthening their health care ties with the United States.

For example, the California HealthCare Foundation in 1998 began a collaboration with Fundacion Mexicana para Ia Salud (Mexican Health Foundation), the Academy for International Health Studies, and Healthcare Redesign International. One of the goals of this multi-phase project is addressing health insurance issues for Mexican and U.S. citizens on both sides of the border.

In Central America, nations like Costa Rica are marketing their plastic surgery, dentistry, and certain surgical procedures to U.S. residents. "A U.S. citizen looking for medical services can dedicate a certain amount to a complete medical check-up, a program of major dental work or a vacation in Costa Rica and get all three for the price of one," reads one on-line brochure.

One popular medical tourism destination for Latin Americans is Boston, the capital of Massachusetts and one of the most historic U.S. cities, with many sites dating back to the colonial period. Among the famous attractions are Bunker Hill, site of an important Revolutionary War battle; Boston Commons, a parade ground for Colonial and British soldiers, and Old North Church, where Paul Revere began his famous ride, warning Bostonians that "the British are coming."

Today, Boston is also the home of famed medical schools, and some of the most sophisticated hospitals and health care facilities in the United States.

Serving international patients is the goal of some of the member institutions of Boston Health Care International, an alliance that includes teaching institutions for Harvard and Tufts University medical schools.

Each year, hundreds of international patients visit Boston, seeking everything from regular checkups to the most advanced medical and surgical procedures. Some are referred by Latin American physicians, while others are taking charge of their own care. Participating medical institutions include Beth Israel Deaconess Medical Center, Children's Hospital, Massachusetts Eye & Ear Infirmary, Medical Center of Boston International, New England Baptist Hospital and New England Medical Center.

In South Florida, one of the most popular U.S. destinations for health care -- as well as for business or leisure travelers, local hospitals and physicians see thousands of Latin American patients every year.

Dr. Aizik Wolf, a neurosurgeon affiliated with HealthSouth Doctors' Hospital in Coral Gables, has been treating domestic and international patients -- both adults and children -- since 1986 for brain tumors, epilepsy, vascular lesions and all forms of neurological problems.

"About 35 percent of my practice is from South America, Puerto Rico and other Caribbean countries," says Dr. Wolf, who travels abroad regularly, educating neurosurgeons and neurologists. "For many Latin patients, the first stop in the United States in Miami is now the last stop necessary for medical services."

At HealthSouth Doctors' Hospital, Dr. Wolf uses a non-invasive gamma knife to treat many types of brain conditions without surgery. "We have done more than 2,000 cases here, making us the third busiest center in the nation," he says. "For our patients, the gamma knife is an outpatient procedure and general anesthetic isn't needed. Most patients are up and about the next day."

Dr. Wolf has seen an increase in medical tourism to South Florida in recent years. "Many of my patients come to Miami on business trips, in addition to receiving treatment," he says. "With children, families like to visit places like Disney World after their surgery."

HealthSouth Doctors' Hospital is a 281-bed acute care facility delivering the highest standards of medical care. The hospital enjoys a reputation for excellence in patient care with medical specialties in orthopedics/sports medicine, women's wellness center, urodynamics center, the neurosciences, technologically advanced operating suites and state-of-the-art radiologic imaging services. In addition, HealthSouth Doctors' Hospital is committed to a mutually supportive relationship with a dedicated and highly qualified medical staff and other health professionals to provide personalized, compassionate health care.

Promoting services to international patients is the goal of The Miami Medical Alliance, also known as Salud Miami and Saude Miami. Nine South Florida hospitals are involved in this partnership, including Mount Sinai Medical Center, Cedars Medical Center, Miami Heart Institute, Aventura Hospital and Medical Center, Baptist Hospital of Miami, Mercy Hospital, South Miami Hospital, Miami Children's Hospital and the University of Miami/ Jackson Memorial Medical Center.

Members of the Miami Medical Alliance have joined together with are hotels, airlines, travel agents and the medical community to offer medical care and comprehensive physical exams.