This study directly compared a minimally invasive dual-incision muscle-sparing surgical technique with a standard posterolateral approach in total hip arthroplasty to assess for early complications, clinical success, and alignment. Total hip arthroplasties using a minimally invasive, muscle-sparing, dual-incision approach were performed on 21 hips (20 patients). This cohort was compared to a contemporaneously performed group of 21 hips (20 patients) using a standard posterolateral approach. Five complications were reported for the dual-incision group versus one complication for the posterolateral group. Postoperative radiographic alignment of the prosthesis was closer to optimal for the posterolateral group. The dual-incision group had longer operating times and a significant increase in complications. The authors have discontinued the use of this technique based on the results of this study.

Excellent article. At WorlMed Assist, we couldn’t agree more. The reference to Medical Tourism and Medical tourism companies is made in this article several times and correctly so. Some of these companies engage in the selling of organs. WorldMed Assist specifically does not: we have helped many people obtain organ transplant surgeries, but in all cases the recipient had to provide a family member and the organ donor. To read more about our ethical guidelines, please see:  To read more about one of our past patients, please see:

Organ transplant tourism is not a fad nor a fashion, but a serious 21st century problem for health service providers and governments. In this article I try to identify the basic ethical and political issues.

“The core of the debate is how best to put an end to such abuses.” The abuses Dr Gabriel Danovitch, writing in Nephrology Dialysis Transplantation, is referring to is the commercialising of organs from live donors. Organ transplant tourism is the common term used to describe people who travel abroad, usually to poor countries, to have organ transplant operations. The organs come from live donors who sell their organs, such as kidneys, not because they act from altruistic motivation, but because they are poor, vulnerable or simply easy to coerce.

Organ transplant tourism is not a fad nor a fashion but the result of two factors. The first is that life saving transplantation of organs is a successful procedure. In the Bulletin of the World Health Organization, December 2007, Dr Yosuke Shimazono writes that in 2005 around a total of 93,000 kidney, liver and heart transplants were carried our globally. The second factor is that this success has also created a problem with the supply side. For example, the NHS website, UK Transplant, illustrates the point with these simple words: “Today more than 9,000 people in the UK need an organ transplant But less than 3,000 transplants are carried out each year.” Shimazono confirms the scale of the problem when he writes, “The shortage of organs is virtually a universal problem.”

The term Organ transplant tourism is itself disputed. In a paid for article by Prof. Leigh Turner, in the June 2008 edition of the British Medical Journal, he objects to the use of the term in both the media and academic circles. But semantics and style apart, Shimazono, in 2007, gives the following definition of the term: ““Transplant tourism” involves not only the purchase and sales of organs, but also other elements relating to the commercialization of organ transplantation.” The Declaration of Istanbul (2008) (pdf) (via Transplantation Society), proposed, in April-May 2008, the following definition, “Travel for transplantation becomes transplant tourism if it involves organ trafficking and/or transplant commercialism or if the resources (organs, professionals, and transplant centres) devoted to providing transplants to patients from outside a country undermine the country’s ability to provide transplant services for its own population.” (see the Declaration itself for a fuller description).

There is a difference between organ transplant tourism and health service providers outsourcing medical services abroad. For example, the British NHS has a programme to outsource certain medical procedures in the rest of Europe. And in the abstract of a paid for paper, Dr K. A Bramstedt et al (Pubmed), in Ethics Corner American Journal of Transplantation (July 2007), write about the various insurance programmes in the US who encourage policy holders to travel abroad. The organ transplant tourism that is repugnant and objectionable is the one that exploits living donors directly, and in many cases the patients.

The circumstances of obtaining organs from live donors and the consequences of organ transplant tourism are the main concerns of international health organisations, such as the WHO, governments, NGOs and professional groups.

Live organ donors are usually people from countries without a regulatory framework to protect donors from, as Shimazono describes the situation, coercion, exploitation and physical harm. Danovitch writes, “Potential living donors who may be educationally, socially or economically vulnerable” And a Lancet commentary (pdf) (via Transplantation Society) describes live donors as possibly being: illiterate and impoverished individuals, undocumented immigrants, prisoners, and political or economic refugees. But what does this really mean?.

Shimazono, refers to a study were 71% of the Indian donors were below the poverty line. What is more revealing about this study is that from the 305 donors, 71% were female and 96% of all the donors sold a kidney to “pay off” debt.

Ironically, if exploiting live organ donors seems bad, the consequences of organ transplant tourism are much worse. For donors, the list of consequences is nearly endless, the money they might have made from selling an organ would soon disappear. In a study of Egyptian donors, 78% of the group spent their money within five months (Shimazono). But the more serious consequences for donors, are deterioration of health, psychological effects, discrimination, inability to do labour intensive jobs, and lack of follow up health care.

Recipients (organ transplant tourists) of organs from live donors are themselves not immune from consequences of the transplant. Like donors, organ transplant tourists can be the victims of fraud and more seriously sometimes die from the procedure. Dr Michael D. Horowitz et al, writes in Medscape Journal of Medicine, that transplant tourists may also find it difficult to “identify well trained physicians and modern hospitals.”

After an operation abroad, who does the recipient consult should a problem develop? In a Canadian study, Dr Leigh Turner, writing in Canadian Family Physician, 2007, says that family doctors back home might have to deal with the problems. As for the success rate of the procedure Shimazono says that some studies show that results are considerably lower than international standards, while other studies show results “comparable with local results.” Giving specific examples, Shimazono says that there is a, “heightened frequency of medical complications, including the transmission of HIV and the hepatitis B and C viruses”

Organ transplant tourism would not be a global medical issue if it did not involve some serious ethical problems. Maybe the most relevant of these problems is the implication organ transplant tourism has on the medical profession itself.

Danovitch describes how the Declaration of Helskinki (1964)(pdf)(Wikipedia) can be applied in the context of the Declaration of Istanbul. For example, responsibility for human subjects should always rest with the medically qualified person even if consent is given by the patient, “consent does not free the physicians from responsibility.” The Lancet commentary is more forceful, “The success of transplantation as a life-saving treatment does not require-nor justify-victimising the world’s poor people as the source of organs for the rich.”

It is not surprising, therefore, that Organ transplant tourism, is a serious concern for the medical profession. Coercion, commercialisation of organs and lack of follow up treatment does not exactly meet the criteria of what an honest medical health carer ought to be associated with. That organ transplant tourists can just pay their way to the front of the queue only confounds the ethical issues.

It would be rather odd to write an article on the theme of tourism, even if we have to stretch the meaning of the word here, and not mention money and countries. For practical reasons, the money aspect is not that relevant because this changes with time. But how does one calculate a market value for an industry that can easily be described as murky? Horowitz, gives some figures, for example, some studies suggest annual revenues from global medical tourism (Wikipedia) (and not just organ transplantation tourism) to be US$60 billion, but other studies dispute this and project a figure of US$40 billion by 2010. Shimazono calculates renal “transplant packages” to range between US$70, 000 to US$160, 000.

Given that Organ Transplantation Tourism depends on poor people giving up their organs it is not difficult to imagine the origin and destination of this trade. David Spurgeon (quoting Professor Daar, Canada: BMJ) identifies the Philippines, Iraq, China, India, South Africa, Turkey and Eastern Europe as destinations for transplant tourists. However, the Lancet commentary reports that the representatives of the Declaration of Istanbul have “played major roles in the promulgation” of laws and regulations affecting transplantation tourism in China, Pakistan and the Philippines. Although the Australian website on 12 August 2008, had a story with the headlines: Australia urged to ban China’s ’transplant tourism’. Shimazono quoting an Organs Watch report, identifies the following major countries as “organ importing countries” (origin of tourists): Australia, Canada, Israel, Japan, Oman, Saudi Arabia and the USA.

The Declaration of Istanbul is a major step forward in curbing organ transplant tourism by apply pressure on the relevant authorities and governments. Some advocate going the commercial route and let market forces decide. Of course, market forces with the right sort of regulations and safeguards.

The Iran model is often quoted as an example of a successful organ transplantation programme for a country where the donor is paid from an official fund. Donors and recipients are managed by this programme with the result that there were no waiting lists. This model is supposed to maintain the equitable nature of organ transplantation and still reward the family of the deceased. Details of the model are described by Ahad J. Ghods et al, in a paper, Iranian Model of Paid and Regulated Living-Unrelated Kidney Donation, published in 2006, in the Clinical Journal American Society of Nephrology.

The Committee on Environment, Public Health and Food Safety of the European Parliament, (March 2008) have urged the Commission to introduce an European donor cards and regulations to fight organ transplant tourism. Another solution aimed at addressing the shortage of organs is to modify genetically animals to provide the necessary organs. However, Prof. Robert Winston, Imperial College, in 2007 failed to persuade the Department for Environment, Food and Rural Affairs (UK) to start research on modifying pigs. In the same article, the (UK) reported that Prof. Winston moved his research to the USA. Prof Winston was also reported as saying that it was ethical to eat pigs as food, but not ethical to provide us with life saving organs.

No doubt organ transplant tourism is a serious ethical and philosophical issue in bioethics. It is also an issue that cannot be solved by a single lobby or group with vested interests. Nor is organ transplant tourism a problem for the medical profession alone to solve or politicians to fudge. What is clear, however, is that this is a twenty first century problem. But despite the various efforts to deal with this problem the situation is still, to use Shimazono words, “provisional and tentative.”

1 Sep 2008 In: Articles, Surgery Info

Please see below for an interesting study reported by Reuters.

We welcome research into the clinical outcomes of newer types of joint replacement surgeries. The outcome is not surprising though: since it takes experience to achieve the desired result, newer surgeries, all else being equal, will on average have poorer outcome data especially when you are talking about complex surgeries such as hip resurfacing or unicondylar knee replacement. The good news is that the solution is readily at hand: as a medical tourism company we get people in touch with some of the top hip and knee surgeons in the world. The results that our patients have from these experienced doctors are excellent.

Newer joint replacments need more revisions-study
09.01.08, 10:36 AM ET

United Kingdom - EMBARGOED FOR RELEASE 0001 GMT, SEPT 2 LONDON, Sept 2 (Reuters) - New techniques used for hip and knee replacements appear to need reworking at a higher rate than older methods, British researchers said on Tuesday.

About one in 75 people needed to have their hip and knee replacements redone in the three years following the original procedure, according to the study published in the journal PLoS Medicine.

That figure is low but the revision rates were higher for people who had new surgical techniques called hip resurfacing and unicondylar knee replacements, a finding the researchers said raises concern about the procedures.

On the basis of our data, consideration should be given to using hip resurfacing only in male patients and unicondylar knee replacement in elderly patients, Jan van der Meulen of the London School of Hygiene and Tropical Medicine and colleagues wrote.

The researchers analyzed nearly 170,000 procedures carried out between 2003 and 2006 about half of all such surgeries performed in England in this period and found an overall revision rate of 1.4 percent, or about one in 75 people.

Yet hip resurfacing a newer technique in which doctors replace just the surface of the femur instead of the whole joint had a revision rate of 2.6 percent, the study found.

Unicondylar knee replacement when doctors only replace one side of the knee joint had a revision rate of 2.8 percent, van der Meulen said.

The results are in line with findings from other countries showing higher revision rates for the new procedures, which offer benefits because recovery time can be shorter as only part of the joint is replaced, he added in a telephone interview.

That is an observation that is seen around the world, he said. Our registry is the largest in the world, which allows us to look at the most recent results.

Hip and knee replacements are some of the most frequently performed surgeries, and medical device makers like Britains Smith & Nephew and U.S.-based Stryker Corp (nyse: SYK - news - people ) have looked to new techniques to profit from an aging population.

The researcher did not look at brands or what types of products had the lowest revision rates, though that is something they hope to do in the future, van der Meulen added. (Reporting by Michael Kahn; editing by Sharon Lindores)

Please see article below that just came out in the Washington Post. Our Medical Tourism process supports what is recommended in this article, and then some. Unfortunately the statement made by assistant professor Bridges is also true: there are a lot of vultures out there. That makes the need for an ethical medical tourism company all the greater. There is a need to accredit medical tourism companies, something we have been advocating since the early days of the industry.


Doing Your Homework

Tuesday, July 8, 2008; Page HE05

Prospective medical tourists should first zero in on a surgeon, finding out when the doctor started practicing, where she went to school and how many surgeries she has performed, said Jonathan Edelheit, president of the Medical Tourism Association.

They should also ask for referrals so they can talk to other American patients who have used that doctor. Only then should a prospective patient decide on a hospital, Edelheit said.


Next move? Ask the hospital if the doctor has had any complaints or sanctions, or has committed medical malpractice. Most, if theyre working hard to keep business robust, will tell you, he added.

Unfortunately, finding good surgeons is mostly a matter of hit-or-miss poking around on the Internet and making overseas calls. Edelheit says thats why his organization is building a portal where prospective patients can go online and research overseas doctors.

Once youve chosen a surgeon, its time to dig in on the hospital. Is it accredited? If so, by what body? How stringent is that body? Karen Timmons, president of the Joint Commission International, which accredits 147 overseas hospitals, said that if youve never heard of the body that accredits the hospital, check to see if that body has been accredited by the International Society for Quality in Health Care.

Another option for prospective patients is a facilitator, a small firm that offers to hold ones hand through a medical tourism experience, from helping choose a hospital to booking a flight.

Renee-Marie Stephano, chief operating officer and general counsel for the Medical Tourism Association, said its beneficial to have such a facilitator on your side if things go badly.

John F.P. Bridges, an assistant professor of health economics at Johns Hopkins School of Public Health, disagrees.

Be very, very careful, because theres a whole heap of vultures on the Internet trying to scam, he warned. If you are interested in going overseas [for health care], deal with the hospitals directly.

Edelheit says that if you want to use a facilitator, you should find out how long the company has been in business, if it has someone with medical credentials on staff and if it has a relationship with the hospital, which would be a plus. Finally, he said, you should always pay the hospital directly.

The American Medical Association recently adopted guiding principles on medical tourism aimed at the employers, insurance companies and other parties that facilitate medical care abroad. http:// They can be seen at

Suz Redfearn

Call For Organ Trafficking Ban

6 Jul 2008 In: Articles

Interesting article that we fully subscribe to. The medical tourism ethics of worldmedassist ( go much further than this declaration, but this is a step in the right direction. 

Experts from 78 countries around the world have signed a declaration calling for a total ban on organ trafficking and transplant tourism.

The 152 transplant specialists, including representatives from the UK, US, France, India and China, agreed on the proposal at a summit in Istanbul, Turkey.

Although the Istanbul Declaration has no legal authority, it is expected to be highly influential.

Shady deals mainly involving the sale of kidneys are believed to be soaring in number because of an international shortage of suitable transplant organs.

Organ trafficking is said to account for around 10% of the nearly 70,000 kidney transplants performed worldwide each year. Some estimates put the annual number of trafficked kidneys as high as 15,000.

China, India, Pakistan, Egypt, Brazil, the Philippines, Moldova, and Romania are among the worlds leading providers of trafficked organs. All apart from Romania had participants at the Istanbul summit.

Like drug trafficking, the trade involves exploitation and big money. Organ brokers reportedly charge between £50,000 and £100,000 to organise a transplant for a wealthy patient. Donors, who are frequently impoverished and ill-educated, may receive as little as £500 in return for losing one of their kidneys.

Transplant tourism, the flip-side to trafficking, involves patients travelling abroad to obtain transplant organs that are not available in their home country.

Published in the latest issue of The Lancet medical journal, the Istanbul Declaration says: Organ trafficking and transplant tourism violate the principles of equity, justice and respect for human dignity and should be prohibited.

The Declaration urges governments to outlaw advertising and other practises that might promote or encourage the organ trade. In addition to a large number of other proposals, it asks governments to do all they can to increase the supply of legitimate transplant organs within their own borders.

Very interesting report from a credible source that goes into the current state of medical tourism in Asia as well as its potential for the next 4 years. 

Delhi, India, June 25, 2008 RNCOS has recently added a new Market Research Report titled, Asian Medical Tourism Analysis (2008-2012)” to its report gallery. The report provides an insight into the Asian medical tourism market. The past, present and future potential of the five biggest Asian markets - India, Thailand, Singapore, Malaysia and Philippines - have been analyzed, and both statistics and trends regarding market size, tourist arrivals, infrastructure, accreditations, cost and success and risk factors have been thoroughly discussed in the report.

Asia represents the most potential medical tourism market in the world. In 2007, the region generated revenues worth US$ 3.4 Billion, accounting for nearly 12.7% of the global market. The report draw the fact that the ageing population, particularly in the developed world, is increasing rapidly, putting an extra demand on an already overburdened health infrastructure, thus creating huge opportunities in the Asian medical tourism market.

The report also acknowledges the fact that the five Asian markets covered have vast differences in terms of cost, infrastructure, human resources, patient perceptions, competencies and level of government support. Thus, it provides valuable information to clients looking to venture into these markets and helps them to devise strategies while going for an investment/partnership in these markets.

For the purpose of this report, the Asian medical tourism market has been defined as the aggregate of medical tourism markets in Thailand, Singapore, India, Malaysia and Philippines.

Key Findings

- More than 2.9 Million patients visited Thailand, India, Singapore, Malaysia and the Philippines for medical tourism in 2007.

- Thailand’s low cost and scenic beaches have enabled it to become the largest medical tourism market in Asia; however, an unstable political environment and occurrence of another epidemic such as bird flu can restrain its growth.

- Healthcare costs are considerably high in Singapore as compared to other Asian destinations. The country, however, boasts of an infrastructure and resources that in some cases are even better than those in the west.
- India, with its low cost advantage and emergence of several private players, represents the fastest growing market. The country’s questionable sanitary perceptions in the west are, however, a major roadblock for growth.

- Malaysia and Philippines, both relatively new players in the medical tourism market, are expected to grow strongly in the next five years.

- A number of employers and health insurance firms in developed countries have now started looking at medical tourism to reduce their surging healthcare expenditure.

- The Asian medical tourism market is expected to grow at a CAGR of 17.6% between 2007 and 2012.

Key Issues & Facts Analyzed

- Evaluation of past, current and future market trends.
- Market study by segment and country.
- Discussion about the major drivers of the Asian medical tourism market.
- Analysis of the opportunities created by the market.
- Analysis of the major challenges faced by the market.
- Competitive landscape of the market.

Key Players Analyzed

This section provides the overview and key facts of prominent players in the Asian medical tourism markets, such as Apollo, Bumrungrad, Raffles, Parkway Health and St. Luke’s Medical Center.

Research Methodology Used

Information Sources
Information has been sourced from books, newspapers, trade journals, and white papers, industry portals, government agencies, trade associations, monitoring industry news and developments, and through access to more than 3000 paid databases.

Analysis Methods
The analysis methods include ratio analysis, historical trend analysis, and linear regression analysis using software tools, judgmental forecasting, and cause and effect analysis.

About RNCOS:

RNCOS, incorporated in the year 2002, is an industry research firm. It has a team of industry experts who analyze data collected from credible sources. They provide industry insights and analysis that helps corporations to take timely and accurate business decision in todays globally competitive environment.

Interesting study comparing gastric bypass (RNY) and lap band surgeries. Click on the following for more information about gastric bypass in Mexico or India or lap band in Mexico 

LAP-BAND(R) System is less invasive, less risky than laparoscopic gastric bypass, according to a five-year study comparing the two most common weight-loss surgery procedures for the seriously overweight presented at this years American Society for Bariatric Surgery meeting by Emma Patterson, M.D., the senior investigator of the study and Director of Oregon Weight Loss Surgery, LLC (Portland, OR).

This was one of the first comparative studies of LAP-BAND and laparoscopic gastric bypass patients conducted by a single institution, said Dr. Patterson. It is significant to note that at the five-year mark there is no difference in the weight-loss results between the LAP-BAND and laparoscopic gastric bypass patients, yet the gastric bypass has a much greater risk of operative complications. The study is an extension of a three-year study conducted by Legacy Health System published two years ago.

The study concludes:

- LAP-BAND patients have shorter operative time, less blood loss and shorter hospital stay compared with laparoscopic gastric bypass patients

- LAP-BAND is less invasive with less perioperative risk to the patient

- LAP-BAND patients have decreased complication rates

Additional results of the study indicate that patients undergoing laparoscopic gastric bypass had statistically significant greater weight loss up to 4 years, but at 5 years, there was no statistical difference in percent excess weight loss between laparoscopic gastric bypass and LAP-BAND.

The study also concluded that laparoscopic gastric bypass patients had significantly more major complications than LAP-BAND patients (10% vs. 5%, respectively). This observation was substantially different from the finding in the 3-year report, where no significant difference in major complications appeared between laparoscopic gastric bypass and LAP-BAND patients.

As morbid obesity continues to be a global health problem, bariatric surgery remains the only viable, consistent form of weight loss for this patient population. With the LAP-BAND System, there is now a safer, less invasive and more acceptable surgical option for patients suffering from the emotional and physical impact of being seriously overweight, added Dr. Patterson.


The study compared a consecutive series of patients who underwent LAP-BAND (406) and LRYGB (492) for morbid obesity over a five-year period in a single institution. Most patients were able to choose between the LAP-BAND and laparoscopic gastric bypass procedures unless they were determined to be high risk (higher age, sex, male, super-super-obesity ((BMI greater than or equal to 60 kg/m2)), and presence of significant cardiopulmonary disease). All patients age, sex, BMI, complications, mortality and excess weight loss (EWL) were examined. The LAP-BAND group had a higher mean preoperative BMI, and the LAP-BAND group had more patients with BMI greater than or equal to 60 kg/m2 (14 vs. 9%; P < 0.05).

All patients underwent pre-operative evaluations by a psychologist, nutritionist, sleep study and laboratory evaluation at the Legacy Good Samaritan Obesity Institute. Prior to surgery, patients were instructed to maintain a low-fat, low carbohydrate diet and encouraged to lose at least 5% of their initial body weight.

Postoperatively, LAP-BAND patients were seen at three and six weeks, monthly for the first six months, bi-monthly for the next six months, every three months for the second year, and then yearly thereafter. LRYGB patients were seen at three weeks after surgery, then every three months during the first year, every six months during the second year, and yearly thereafter.

By Robert Lupo, Santa Rosa, CA

I was in the middle of a construction job when my hip finally said, “No more!”  I couldn’t get up the stairs.  I told the guy I was working for I’d have to give up—he could wait for me to have hip surgery, or he’d have to find someone else to finish the job. 

I’d already had x-rays and knew I couldn’t afford the $60,000 I’d been quoted by my doctor.  I checked out other hospitals throughout California, but couldn’t get anything close to what I could afford.

A friend knew someone who had hip surgery in India.  At first I thought surgery in India was a joke, but then someone else mentioned India to me, so I started checking more closely.  I checked a few options in Mexico and the Philippines but found India offered the best price, and I was satisfied that the quality would be very high. 

I knew I couldn’t set this up on my own—I can barely send e-mails, let alone do much computer research.  I came across a medical tourism company to make all my arrangements, but found they wanted to book me a frilly vacation along with the surgery.  I’m self employed, so getting over there, getting my hip replaced, recovering and getting back to work was my top priority.  I then found WorldMed Assist, and they agreed:  let’s get my hip fixed and get me back to work.  I liked them right off the bat because they really understood what I wanted. 

I checked WorldMed Assist out through the Better Business Bureau, and was satisfied they could take care of me.  They got back to me right away with a couple of options in India, and I chose Wockhardt Hospital in Bangalore.  Three weeks after I made my decision to go, I was on a plane to India.  WorldMed Assist put everything together really quickly, soup to nuts.

I was a little nervous, but mostly about flying.  I’ve been all over the U.S. on my motorcycle, but I’d never been on an airplane, and a 20 hour flight wasn’t something I looked forward to.  I’m a big guy—260 pounds—and squeezing into a seat was not something I’d like to repeat. Now that it is done, I’ve pretty much forgotten all about it. What helped is that WorldMed Assist warned me about this so I was prepared.

The rest of the experience was great.  I was picked up at the airport and driven right to the hospital—which was very modern and clean.  They put me through a bunch of tests right away, then set up my surgery for the following day.  Everything that WorldMed Assist told me was exactly as advertised.

I started physical therapy right after I got out of ICU.  I did even more exercises than they prescribed.  In fact, when they’d come to check on me, they’d have to look all over the hospital for me because I just couldn’t sit still.  Everyone was super polite.  I know now that surgery anywhere is no joke, including in India …my experience was great!

My total charge for travel, surgery—plus I had them do a colonoscopy I’d been putting off—was $10,000.  That’s one sixth what I’d have paid here.  Would I do it again?  I hope I don’t have to, but absolutely yes.

 By Jerry Mead, Pekin, IN 

“India??  Are you kidding?”  That was the common response to my plan to have both my hips replaced in India. 

By the end of 2007, it was very apparent that I need a bilateral hip replacement to resolve my two-year onset of osteoarthritis.  My career in carpentry was over, and all attempts at financing for the surgery in the States were without success.  I was quoted a price for hip replacement at $30,000 per hip, and that’s just the surgeon’s fee.

I heard a program on National Public Radio about people getting surgery abroad at a much reduced price.  They mentioned World Med Assist, located in California, headed up by Wouter Hoeberechts.  After exhausting all possibilities here, I contacted WorldMed Assist and asked what was available to me. 

There are several countries from which I could choose, but I’d wanted to go to India since I was 16 and first began to meditate.  I hadn’t planned to go as a patient, but God has mysterious ways.  WorldMed Assist gave me a choice of a hospital in New Delhi or Bangalore.  Both were accredited through Harvard Medical, had several surgeons trained and certified in America or Europe, and use the latest in prostheses, techniques and technology.  I chose Wockhardt Specialty Hospitals in Bangalore, which caters to local clientele as well as international guests.

World Med Assist scheduled my surgery and transportation to and from Bangalore.  I left Louisville on April 2, and with the 10-hour time change, arrived in Bangalore on April 4.  At each of the four airports, I was greeted by an assistant and wheelchair to get me to my next gate.  A driver from the hospital met me in Bangalore to take me to the hospital, where I was admitted into a very nice private room with my own computer and television, shower and restroom. 

The next day, I was given a battery of tests:  x-rays, MRIs, CT scans, echocardiogram, blood work and urinalysis, along with a detailed health screen:  All very thorough and complete.  I then met my surgeon and his team.  Everything is done as a team:  anesthesiologists, surgeon, post op staff, dietitians, and rehab therapists.  Everyone was extremely warm, comforting and welcoming.

Then off to surgery on my right hip.  After three days in ICU, I had surgery on my left hip April 10, followed by another three more days in ICU.  WorldMed Assist stayed in touch with my medical team and relayed information home about my progress until I was transferred to my private room. 

My nursing care was excellent:  Not once did I have to wait longer than a minute after pushing the call button for someone to check on me.

My rehab began as soon as the drain tubes and catheter were removed.  Because of my post-op pain, they decided to reduce rehab until my pain settled down a bit.  Everyone, without exception, showed a personal interest in every aspect of my recovery. 

Unlike in the U.S., my dressings were changed by doctors, not nurses.  My surgeon and members of his team saw me every other day. 

It’s important when traveling abroad for treatment to remember that you are a visitor in someone else’s home.  Don’t go with the attitude that you are the big American with tons of demands.  I didn’t ask for a thing, and I got everything.  I mean that.  I was treated so well and with such kindness, I could not have asked for more. 

I returned home on April 28th after 24 days.  I was given copies of all my x-rays and CT scans as well as a total report of all my treatment there.My cost of traveling there and back, spending 24 days in a very nice private room and having both hips replaced plus an additional CT scan ($300) was about $18,750.  Quite a difference from what it costs in the U.S.  I would recommend it to anyone. 

One note:  You have to wire your money ahead of time, unlike our system of treatment first, pay later.  So it is a bit of a leap of faith.  But do your homework, go through a reputable medical facilitator like World Med Assist and read all the reviews and reports on the hospital and surgeon you select for surgery.  I had wonderful results and now am looking forward to the rest of my life. 

My experience in Bangalore was heartwarming and rebuilding.  I will never forget those kind and wonderful people and will return someday to express my gratitude.

For more information, please visit the following links:

medical tourism

Hip replacement India

Orthopedic surgery abroad

Medical Tourism testimonials

Stacey Owen, Southport, FL


I’ve had a weight problem all my life.  For the last two years, I’ve been thinking seriously about bariatric surgery—nothing else has ever worked long-term.  I checked out several options lap band, and gastric bypass [RNY].but for me, they weren’t right.  A friend of my mother-in-law thought I should check out duodenal switch surgery.  When I studied the data of all the weight loss surgeries about keeping weight off, I decided this was the way to go. 

The surgery here would have cost $30,000 to $35,000. I knew I’d have to go out of the countryto Mexico, Brazil or Spain.  My initial research led me to medical tourism company WorldMed Assist, where I learned I could have the duodenal switch in Mexico—my first choice—done at the brand new Hospital Angeles in Tijuana for $16,000 with a surgeon who had a great reputation and a lot of experience. 

I continued researching other options on my own, and discovered I could set up surgery on my own at a clinic in Tijuana for less money, so I booked it with a $500 deposit and bought airline tickets for my husband and me.  What a mistake that turned out to be!

Seven days before I was to fly there, I read a posting on the internet that scared me from one of that doctor’s patients.  I talked to the surgeon, who tried to calm my fears, but it just didn’t feel right.  I called WorldMed Assist, and told Wouter that if he could arrange the surgery with Dr. Ungson at Hospital Angeles using the plane tickets I’d already purchased, I’d sign on.  This was the choice I really wanted in the first place—I’d already done all the research on both the hospital and the surgeon and was completely confident, but saving money led me to book my own surgery.   

WorldMed Assist pulled through.  In 24 hours, they were able to get me qualified and scheduled for surgery with the doctor I’d originally selected and using my existing plane tickets.   They made it seem like it was their pleasure to finagle everything in such a time squeeze. 

The hospital was great—hospitals here are like a much older version of Hospital Angeles.  I was amazed at how completely spotless everything was.  When the patient next door to me checked out, two ladies scrubbed every square inch of her room—even the walls!  My doctors were fantastic, and WorldMed Assist stayed in close touch to make sure everything was up to my expectations.

I highly recommend using a medical tourism company, and WorldMed Assist came through from beginning to end.  Don’t try to do book everything yourselfI’m now out the $500 deposit to the other clinic because I had no intermediary working on my behalf.

About this blog

This Medical Tourism Blog is part of the WorldMedAssist Network. Please visit the site or call 866-999-3848 to see how they enable you to access high quality, low cost health care abroad.