Costa Rica was among the first well-known destinations for modern medical travel, dating back to the 1970s and early 1980s when some pioneering plastic surgeons and dentists first began serving international clients. Among them was Dr. Miguel Alfaro, who, like many Costa Rican surgeons, came to medical school in the United States and was trained in general and plastic surgery at the University of Colorado; the University of Missouri and the University of Michigan. He returned to Costa Rica in 1976 and worked for years for the country’s public health care system, while building his private practice in plastic surgery on the side. Most recently, Alfaro has been chairman of the Department of Surgery at Hospital San Juan de Dios in San José, Costa Rica.

Among other professional associations, Dr. Alfaro belongs to the International College of Surgeons; the Costa Rican Plastic Surgery Association; and the Plastic Surgery Association for Iberoamerica. He is a Fellow of the International College of Surgeons, a member of the American College of Surgeons and a Founding partner of the Costa Rican Association of Mastology.

Alfaro prides himself on being a conservative plastic surgeon and has built his international reputation in plastic surgery on excellent results as well as a safety record that is second to none.

“I have very good results,” he said in a recent interview with The Bridge. “I have done thousands of operations and I am very conservative … I mean, if I see a change in technique going on, I will wait a few years, frankly. I want to be sure it is safe, see what complications are encountered by others.”

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The Motley Fool’s reason for existing is “to educate, amuse and enrich.” The website has been dispatch breezy and sometimes irreverent financial advice to millions since about 1996. (It looked pretty different back then, too.) Late last week, Fool came out with its take on medical tourism:

Medical Vacations: The Retiree Health-Care Solution?

Despite the question mark, the Fool’s verdict was pretty one-sided.

The debate over U.S. health-care reform rages on. But why wait for someone else to dictate your future? You have many options — if you’re willing to take a vacation. If recovering from a medical procedure while lying on a palm-swept beach, relaxing by the hotel pool, or shopping for terrific bargains sounds good, then medical vacations may be exactly the right solution for you.

In other words — go for it. At The Bridge — and at BridgeHealth International — most folks cringe a little when life-saving or enhancing medical care is discussed in terms of being part of a vacation, but we’ll forgive Fool’s lightheartedness as long as patients recognize it for what it is.

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Dr. Andrew Weil, MD, is a prolific author, perhaps best known for establishing and popularizing the field of integrative medicine, which combines conventional medical treatments and alternative treatments for which there is some high-quality scientific evidence of their safety and effectiveness. His web site, DrWeil.com, is among the most visited medical sites on the Internet. The “Ask Dr. Weil” column, from the site, is a cottage industry unto itself; “Dr. Weil has raised dispensing health advice to an art form,” says reviewer Erica Jorgensen at Amazon of his bestseller Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being.

But I didn’t know until yesterday that Dr. Weil had ever had anything to say about medical tourism. I really should have known better. In an “Ask Dr. Weil” column from last fall, he confronts the issues involved in medical travel head-on, concluding:

Keep an eye on the growing trend of medical tourism. I predict it will become more prominent in coming years.

This, in response to a writer who said he was “appalled” that a friend was going to India for heart surgery.

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Relaaaaaaax. It’s not a true story. It’s not based on a true story. It’s a work of complete fiction by the master — perhaps the inventor — of the medical thriller genre, Robin Cook. “Foreign Body,” published Aug. 5, is bound to find an audience; Cook, 68, has written a string of bestsellers dating back to the 1970s. “Coma,” the original medical thriller, came out in 1977. It was the “gripping story of patients who check into a hospital for “minor” surgery-and never wake up again.” We’ve had variations on the theme ever since from Cook, a medical doctor. Books. Movies. TV Miniseries. Robin Cook is an industry.

That his latest book comes wrapped with a medical travel and tourism theme shouldn’t be surprising. Cook has always mined the latest headlines for his stories: Organ donation, genetic engineering, fertility treatment, in vitro fertilization and managed care have been a few of the topics that have previously provoked his flights of fancy. His last book, “Critical,” was a tale woven from some of America’s worst fears, and facts, about its own medical system — one in which business issues take precedence over quality of healthcare.

Medical tourism is a natural for Cook. That it has become big enough to attract his attention is testimony more to its popularity, success and safety than it is to its drawbacks and dangers, however. Medical tourism generally, and Indian medical tourism specifically, will continue to thrive, though I wouldn’t choose to read “Foreign Body” to pass the time while on a plane to Delhi for hip surgery any more than, once upon a time, I would have read “Jaws” while relaxing on a small sailing vessel off the shore of Cape Cod.

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