Category: Medical travel/medical tourism

Hello Kampala, New York calling

published date
March 4th, 2008 by

I’m traveling to Kampala, Uganda next week to take part in a meeting on HIV prevention so I’m interested in what’s going on there, so I was fascinated by today’s article in New York Newsday (Via Internet, NY doc helps deaf Ugandan man hear):

Through the power of Internet technology, medical experts in New York have switched on an inner-ear device, allowing a man in Uganda to hear for the first time in two years.

Activating the device from halfway around the world is a first, and highlights a trailblazing way in which the growing realm of telemedicine – conducting medical procedures from remote locations – can enhance the lives of people in struggling nations.

David Nuwagaba, 23, of Kampala, Uganda, had to drop out of college after becoming deaf from the toxic effects of tuberculosis medication. But when Dr. J. Thomas Roland, co-director of NYU Medical Center’s cochlear implant center, learned of his plight, he knew he could help.

Roland, who often volunteers in Uganda, was able to implant a cochlear implant at the hospital in Kampala. But after the implant the next step is to activate each of 22 electrodes, and that requires a different specialist. In this case Dr. William Shapiro, chief of audiology at NYU Medical Center, was able to perform the activation remotely and now Nuwagaba is doing well.

As exciting as this case is, it’s really just a first step. Both physicians volunteered their time and the device manufacturer donated the implant. The typical all-in cost is about $40,000, so you won’t see this scene being repeated in Uganda every day.

Still, it may not be too long before robotic surgery techniques allow surgeons hundreds or thousands of miles away to perform operations. That should lower costs and broaden access and add another dimension to medical tourism. Imagine doctors in India operating on a patient in New York!

Medical tourism webinar: Implications for the medical device industry

published date
February 18th, 2008 by

On Tuesday, February 26, 2008 from 2-3 pm EST, my colleague John Seus and I will be leading a webinar entitled Medical Tourism- Risk and Opportunity Assessment for the Medical Device Industry. If you’d like to attend, register here.

In the fall we issued a white paper about medical tourism, including background on the industry, a set of predictions, and the implications of medical tourism for various parts of the US health care industry. On this call we’ll look at how those predictions are panning out (so far our track record is pretty good) and will dig into some issues of particular interest to the medical device industry.

Germs on the brain –and the bathroom door handle

published date
February 15th, 2008 by

I’ve got germs on my mind today. Specifically I had an appointment with the travel clinic at the Beth Israel Deaconess Medical Center in Boston to prepare for an upcoming business trip to Uganda. Along with the challenging logistics of getting there, there are a few issues to worry about, like malaria, Yellow Fever, hepatitis, typhoid and meningitis. I was impressed with the nurse I met at the clinic. She went through the preparations and recommendations with me, and tactfully brought in the Chief of the BI Infectious Disease division for some friendly persuasion when she sensed (correctly) my resistance to a particular recommendation.

After reading about disease transmission and precautions for Uganda I was well prepped for the front-page Wall Street Journal article (Restroom Decor: Germy Doorknobs Inspire Inventors), which talks about strategies patrons employ to avoid touching their clean hands to the bathroom door knob on the way out. Some use paper towels, some a “pinky pull,” and others wash up again once they leave. Then there are handles that can be operated with an elbow, automatic door openers, foot pedals, and sprayers that disinfect the handle on a regular basis (without dripping, of course.)

The article quoted some statistics I’ve seen before, from a Soap and Detergent Association and American Society for Microbiology study that showed 34 percent of men and 12 percent of women don’t wash their hands after using the bathroom. But it reminded me of another figure that the Associated Press published recently, which indicated that compliance with handwashing in the hospital is about 40 percent. (I don’t know where that figure came from and of course it could be bogus.) If it’s true, that means 60 percent aren’t washing, which is worse than the general public’s bathroom habits.

I know that the numbers aren’t really comparable, but it does make you wonder.

Will US patients accept foreign doctors? They already do

published date
February 13th, 2008 by

Whenever I discuss plans for a medical tourism business with friends and colleagues, I am always cautioned that Americans are leery of dealing with foreigners for medical care. Getting over that barrier will be a big hurdle for any business, they say (while usually adding that they themselves realize that many non-US physicians are equally or better trained than their US counterparts).

On the other hand Americans are already treated by foreign doctors all the time. Primary care physicians are increasingly drawn from the ranks of foreign physicians, according to a government report release this week, as reported by Newsday:

Fewer American doctors are focusing on primary care, but the decline is being covered by physicians from other countries. The [Government] Accountability Office said Tuesday that as of 2006 there were 22,146 American doctors in residency programs in the United States specializing in primary care.

That was down from 23,801 in 1995, the research arm of Congress told the Senate Health, Education, Labor and Pensions Committee.

Overall growth in the number of primary-care physicians “has been totally due to the number of international medical students training in America,” [Senator Bernie] Sanders said. “We are increasingly dependent on international medical school graduates to meet our needs. Currently, one in four new physicians in the U.S. is an international medical graduate.”

In its report on primary-care providers, GAO said the number of international medical graduates training in primary care had grown from 13,025 in 1995 to 15,565 in 2006.

Rather than complaining about foreign physicians or merely tolerating them, we’d better start making life in the US more attractive for them. With anti-immigrant sentiment growing and better opportunities back home, foreign physicians may return to their home countries or may not bother coming to the US in the first place. Throw medical tourism and telemedicine into the mix and we may see some interesting shifts in care patterns.