In yesterday’s interview with Dr. Miguel Alfaro of Costa Rica, he candidly noted that the number of plastic surgery patients coming to Costa Rica from outside the country is down by perhaps 15-20 percent in 2008. This should surprise no one, given the state of the economy in the United States. In fact, Costa Rican plastic and cosmetic surgeons are probably weathering the economic slowdown better than are their higher priced counterparts in the U.S. The American Society of Plastic Surgeons estimates that business is down more than 50 percent, according to CNN, as reported by the Business and Media Institute.

The market for cosmetic procedures in Costa Rica, Mexico and other medical travel destinations has held up better than the U.S. market primarily because of the large price differential and because more Americans than ever before are aware that plastic surgery abroad is a relative bargain. Plastic surgery and dentistry travel (or both, combined) remain among the top choices of BridgeHealth International clients in 2008. People who might have opted for procedures costing $10,000 to $30,000 or more at home are instead getting the same work done abroad for perhaps $3,000 to $10,000.

The CNN report linked below looks only at the sharp decline in cosmetic surgery in the U.S. We thank Dr. Alfaro for his estimate regarding patients in Costa Rica. The video is better viewed on their site due to the format of the file.

Plastic Surgery’s Nip: CNN

Syndicated columnist Froma Harrop of The Providence Journal in Rhode Island writes about the “good and bad” of medical tourism in a piece that has appeared in newspapers from coast to coast over the past few days (including in The Seattle Times: Medicine through the back door.) Harrop fancies herself something of a pioneer as a medical tourist, having had Lasik ™ eye surgery in Toronto in 2000, paying about a quarter of what she would have in the United States, saving $3,000. She says that, at the time, “Canadian doctors had more experience with Lasik surgery than most of their American colleagues.”

I took 10 minutes to surf about the web and see what I could find out about traveling to Canada for eeye surgery now, in 2008. Disconcertingly, even in that small amount of time I could tell that it is very difficult to cut through the data smog I wrote about the other day. There is not a lot of concrete, objective information about getting Lasik in Canada that is immediately visible. Almost certainly, the cost difference between the U.S. and Canada has narrowed. A Canadian dollar was wotth only about 70 cents in U.S. money in 2000; today the currencies exchange at approximately 1:1.

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As of this morning, a Google search for “medical tourism” returns 1.8 million results. If a reader spent one minute on each page, for eight hours a day, it would take more than a decade to get to the end … and by that time there will probably be some more millions of results.

One of the mantras of medical tourism, as far as advice to people who are thinking about going overseas for healthcare, is “Do Your Homework.” Everyone says it. If you think I’m exaggerating — another Google search, this time for “medical tourism” and “Do Your Homework,” turns up 2,400 references. That’s a lot better than 1.8 million but it’s still a lot to go through for what is liable to be very much the same thing, over and over again, with the possibility that you aren’t going to find what you really want at all.

In the research biz, we call this data smog, a term probably coined and certainly popularized by David Shenk in 1997. As an author, I have learned to live with data smog. Once upon a time, people wrote books about particular subjects because not enough information was available about them. More often in the Internet age, books are written because too much information is available and someone hits on the good idea of winnowing it down. When I wrote Beauty from Afar in 2005-06, medical tourism was somewhere in between those two things and the book’s narrative was shaped accordingly. There are a lot of things in it that hardly anyone knew about, and also a lot about how to find medical information online. Today, there are books such as those in Joe Woodman’s Patients Beyond Borders series, which are more directory-like and represent more of an effort to bring good information out of the smog.

Part of what medical travel companies such as BridgeHealth International consciously do, part of what they bring to the table for consumers, is that they are soldiers in the war on data smog. They travel, accumulate good information, choose hospitals, facilities, surgeons and doctors on behalf of prospective patients; who in turn travel, undergo medical procedures, give valuable feedback on their own experiences.

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Andres Oppenheimer, a popular and sometimes controversial columnist for the Miami Herald, has generated a buzz on the newspaper’s website with his personal account of the healthcare he received in Mexico, where he was hospitalized for three weeks after a potentially life-threatening emergency. Oppenheimer was stricken during dinner and damaged his esophagus when he became ill. He had a rare medical condition called Boerhaave Syndrome, which, left unattended, can be fatal. He writes:

By the time the ambulance arrived at the nearest hospital — the Angeles Mocel hospital — they had convened a first-class team of physicians who were awaiting me. It didn’t take long for Dr. Jorge Salas, the lung doctor who presided over the team, to rule out a heart attack and enlist thoracic surgeon Dr. Patricio Santillan for an operation to remove the more than four pints of gastric fluid in my chest. After a six-hour operation, I spent two weeks in intensive care and another week in a single-bed room until I was released — with all tests showing excellent results — on June 28. Doctors tell me that I should be back to normal in a matter of weeks.

The full article is here:

To your health: You can care for it abroad

Oppenheimer is quick to point out that he is something of a VIP, and perhaps got better care than would the average tourist. “Medical tourism experts warn that there are both good hospitals and lousy hospitals in Mexico,” he adds. “You can land in a bad one, and you are history (plus you can forget about suing anybody for malpractice).”

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