Medical tourists opting for sea Bangkok - Arabstoday When a friend returned from holiday recently looking remarkably refreshed, I couldn't help but wonder whether her newfound radiance was simply the result of relaxation, or if she hadn't had a sly fix of Botox. I would never ask, of course. Just as she would never freely admit it. Travelling abroad for a cosmetic or medical treatment is attractive precisely because of the privacy it offers and - depending on the destination and procedure - the chance to holiday at the same time. Whether it be rhinoplasty, a new set of teeth or remedy for a serious illness, waking up at a five-star hotel on a beach somewhere beats scurrying to the local grocery store, fearful of bumping into the office gossip. "Sometimes patients' faces can be fairly badly bandaged up and they don't really want to go out in public," says John Sutherland, CEO of Dreamscape Journeys, a specialist company that offers tours in the emerging medical tourism destination of Hua Hin, Thailand. Sutherland's firm works with Bangkok Hospital, which attracts 38 per cent of its patients from abroad. Of these, about 55 per cent are from the Middle East. In April last year, the Thai hospital opened an outpost in the coastal resort of Hua Hin, a two-hour drive from the capital. Once frequented by royals and wealthy Thais, it is home to some of Asia's top resorts and golf courses, offering visitors sun and leisure activities and, even more importantly, a sense of privacy that would be impossible in tourism hot spots such as Phuket. Many of Sutherland's clients are groups of friends who mix "bits and bobs" of cosmetic surgery with the opportunity to travel, he says. "The reason I started [working] in Hua Hin was because I spoke to a lot of women, 40s plus, who felt they would be more comfortable going somewhere in a group but they didn't want to sit around a hotel room somewhere in a city, recovering. "They really don't have to go and do anything [post surgery]. They can just sit by the pool [in Hua Hin] or walk on the beach, and they're never bothered." Dreamscape Journeys offers tailor-made "lifetime experiences" that might include travel by private jet to Hua Hin, a luxury villa, a personal chef and concierge service, post-surgery health and wellness programmes at the nearby Chiva Som and Six Senses resorts, and shopping trips to Bangkok. "Many Middle East clients also treat it as a shopping trip but my programme is appealing to people who want to spend time at a relaxing beachfront destination while recuperating," Sutherland says. Personal introductions to senior hospital staff and consultations with surgeons can also be arranged. "The surgeons used for cosmetic surgery are well known; some have spent most of their careers practicing in countries such as the USA. They have performed thousands of breast implant operations and facial reconstructions." Medical tourism has emerged as the cost of private healthcare in first-world countries, including the US, UK, Canada and Australia, has skyrocketed, making both cosmetic and more vital medical procedures in India, Thailand, South Africa and South America more attractive. In Thailand, for example, facelifts and breast enhancements normally cost around US$4,000 (Dh14,700), half the price of what they would cost in the US. "While we target cosmetic surgery patients, coronary artery bypass operations can cost as much as $88,000 (Dh323,300) in the US but in Thailand they are quoted at around $23,000 (Dh84,500)," Sutherland says. "Hip replacements in the US are around $33,000 (Dh121,000) but in Thailand they cost $13,000 (Dh47,800), so there's a great incentive for people to travel." Medical tourism was once considered a risky business but the scrutiny of international organisations such as Joint Commission International, a US-based organisation offering accreditation in healthcare quality and patient safety, and with hospitals and clinics being marketed centrally by national tourism boards, standards of care have become more transparent. Agencies such as Dreamscape Journeys are only too aware of the importance of patient perception and also encourage their clients to act responsibly. "During my research and discussions with doctors, I discovered that most infections or problems, if they ever arise, happen within two to three days of surgery but almost all showed up within 10 days," Sutherland explains. "I'm interested in clients who want to come for a minimum of 10 days and not rush, in because it's cheaper to receive treatment in Thailand and then rush off again." If medical tourism has traditionally been associated with elective procedures, namely cheap cosmetic surgery, times are changing. Medical tourists from GCC countries have kick-started a trend of their own. Rather than seeking cheaper healthcare in developing nations, it is common practice for monied Gulf nationals to travel to wealthy health centres to seek expertise and specialist hospitals. Countries such as the US, UK and Germany benefit most thanks to their established reputation for high standards of care and leading treatments for medical conditions prevalent in the region such as type two diabetes, hypertension and cardiovascular problems. Frankfurt is home to 15 world-class hospitals including one at a leading research university in Germany - Frankfurt's University Hospital. It boasts a cluster of top-tier outpatient clinics where services are offered to tourists at the same price as they are to German nationals, thanks to the country's universal healthcare system. According to Dr Weipert of the German healthcare travel agency, Med2Heal, a heart bypass in Germany costs approximately €25,000 (Dh132,300) and a hip replacement is €18,000 (Dh95,300). A direct flight to Frankfurt is around six hours from the UAE, roughly half the time it takes to fly to New York. Dr Ulrich Mondorf - who worked at the Frankfurt University hospital before setting up his own private medical centre - has teamed up with Villa Kennedy, a five-star Rocco Forte hotel complete with spacious suites and its own spa offering organic and Ayurvedic treatments, that's a two-minute walk from his clinic, as well as a team of personal trainers and dieticians. The doctor aims to offer his foreign patients a range of services geared towards relaxation and a healthy lifestyle, all sold with the luxury tag. Dr Mondorf's clinic works with Med2Heal, which can coordinate some or all of the bookings that a patient and their family (and entourage) might require, including flights, car services, accommodation, clinic appointments, interpreters and recreational activities. Dr Mondorf's clients include those prepared to travel just for a check up, albeit a rather rigorous one. "The client or patient we are looking for is actually somebody who is healthy, who wants to stay healthy, who wants to know what can I do to maintain my health," Dr Mondorf says. "We have a lot of laboratories here. We have all the facilities and all the possibilities here, even to find out extreme rare diseases ... and we get this information in a very short time." You might call it the Mercedes-Benz of checkups and it doesn't come cheap. The one-day "Premium Check-up" booked through Med2Heal starts from €2,405 (Dh11,620) and consists of the following: a clinical examination (physical, orthopaedic and basic neurological examinations); laboratory tests; examination of the stomach and pelvic organs as well as the thyroid (colour ultrasound of the liver, gall bladder, spleen, kidneys, stomach, intestines, pancreas, bladder, abdominal artery, vena cava, thyroid, prostate for men, uterus and ovaries for women); cardio-respiratory diagnostics for stroke prevention; screening for skin cancer; lung diagnostics; and, a final consultation with the doctor, who gives the patient a detailed written report. Depending on the test results, additional modules in urology, gynaecology, gastroenterology, neurology may be recommended. Eyes, ears, nose and throat checks also cost extra. Then there are Med2Heal's "Complete Check-Up Packages" for longer stays that include luxury accommodation, limousine transfers, language services for non-English speakers, a medical spa component, personal training, nutritional advice, first-class sightseeing trips and follow-up care after the patient has returned to their home country. With treatment at Dr Mondorf's clinic, these start from €6,148 (Dh29,659) for three days, €10,520 (Dh50,749) for five days and €15,065 (Dh72,674) for 10 days but can be tailored to the individual. Patients often describe the process as an "eye opener", Dr Mondorf says. He claims that check-ups have identified serious conditions that might otherwise have been discovered too late. "Many of my patients are very glad they did the health check-up and learned that they have to change their lifestyle to prevent any serious diseases." Public relations and marketing manager for the Villa Kennedy, Siria Nielsen, says the hotel's medical tourists are often frequent business travellers who appreciate having a package tailored around their schedule. "The aim is to make them feel very much taken care of in a discreet way," Nielsen says. The concept follows a strong trend for elective screening in the United States, the idea being to prevent illness and disease before they start. "We have a lot of companies here in Germany [that] send their top managers yearly or every second year for a check-up," said Dr Mondorf. He also has regular clients from Saudi Arabia and Kuwait, who sometimes bring their entire families along. "We do not only see the Sheikhs. We also see ordinary people," he says.