Aussies are boarding the medical tourism bandwagon in growing numbers and writer Priscilla Crighton finds out that combining your next holiday with surgery could make a great deal of sense.

Australians, like many other westerners, are facing huge dilemmas as the cost of keeping healthy is causing blood pressures to rise. The costs of medical procedures in Australia are ever-increasing, while health insurance premiums seem to be constantly costing us more each month. The public health system provides little relief as long waiting lists mean elective surgeries could take years, while some procedures are just not offered at all.

While many suffer silently, coughing up the thousands of dollars to be treated or waiting by the phone to hear from a public hospital, others are taking to the skies in revolt, travelling to countries like India and Thailand for a medical tourism getaway. It is here, Aussies are going under the knife for cut-price procedures and combining their trips with five-star boutique holiday experiences. In fact, according to tourism experts, surgery is said to be the 7^th ‘S' of tourism - complementing sun, sea, sand, sex, safari and spirituality. 

It's a win-win for both patients and the developing countries that are making it all happen, according to CQUniversity medical tourism researcher and economics lecturer Anita Medhekar.

"Medical tourism is international economics in action. It is an economic activity that involves trade in services from two distinct sectors of the economy: medicine and tourism. It's a growing phenomenon that is expected to be worth $4 billion in Asia and $2 billion in India by next year. While it's worth a lot of money for these developing countries, it also means a lot of savings for people in the UK, US and Australia, who are seeking affordable, quality medical procedures without having to wait."

Top hospitals in Thailand and India - the world's leaders in medical tourism - are offering surgeries and medical treatments at between a third and a tenth of the costs charged in countries like Australia. With prices like these it's hard not to doubt the quality of treatment and the credentials of the medical staff, but according to Medhekar global health authorities are ensuring high standards are maintained.

"Patients can be assured of quality if they choose hospitals that are accredited through the Joint Commission International (JCI) - a not-for-profit organisation focused on improving the safety of patient care globally since 1998. By choosing facilities recognised by JCI, patients can be assured of the very best in medical care. These JCI approved hospitals in India and Thailand match some of the best medical facilities in the world, and their staff are second to none."

Medhekar added that many of the doctors employed at these facilities are trained in western countries and are all English speaking.

Contrary to popular belief, medical tourism isn't all about liposuction, facelifts and boob jobs - at least not in 2011. Medical tourism providers are offering a suite of medical surgeries and procedures from cosmetic and dental to major, invasive surgery including bone marrow and liver transplants and orthopaedic and heart surgery. While it could cost up to $250,000 for a bone marrow transplant in the US, Indian medical tourism provider, Travel India Company is promoting its reduced fees online at under $70,000. A hip replacement could cost up to $19,000 in Australia (before Medicare rebates), while Health Line is quoting an average cost of $4300 in India. Lasik eye surgery used for vision correction could cost about $4000 each eye in Australia (with no Medicare rebate offered), but will only set you back $1100 each eye at Bangkok Hospital in Thailand.

Depending on the severity of the medical procedures, some Aussies are packaging these services with a complete holiday, spending a few days in hospital and the rest of the time sightseeing; and according to Medhekar countries like India and Thailand are capitalising on this market.

"In some cases, what we are seeing is high rise, state-of-the-art hospitals combining with five-star accommodation. The first few floors are for diagnosis, surgery and medical suites, and the remainder is similar to any top-end resort. What countries like India and Thailand are offering is a new kind of patient experience - a balance of western medicine and eastern hospitality."

Hospitals are tailoring their facilities to cater to this influx of western patients - coffee shops, book stores, food chains ... and that's just in the hospital lobby. And it seems as though hospital food has also never tasted so good, as the culinary spread on offer caters to different cultures and tastes. Hospitals are also organising sightseeing for patients - you can book optional excursions like you do at a tropical resort or a P&O cruise.

With the spike in interest in medical tourism around the globe, medical travel agencies are gaining in popularity. US-based medical travel agency Healthbase Online Inc promotes itself as a leader in medical tourism and is able to connect patients with a list of internationally accredited hospitals in 18 countries around the world. According CEO Saroja Mohanasundaram they not only offer patients choice, but a complete travel package.

"Healthbase provides a complete door-to-door arrangement of medical travel logistics starting from sharing their medical records to booking medical appointments, booking travel, accommodation, ground transportation, local tours, as well as assistance in obtaining the necessary travel documentation and financing."

Mohanasundaram said India is one of the top destinations they work with.

"The main advantage of having surgery in India for western patients is the cost - over 70% savings in many cases - with the same level of quality that is available here."

According to Medhekar the medical tourism industry in India is booming with no plateau yet in sight.

"We are beginning to see whole medical cities emerge, complete with research centres and five-star hotels. It is quite unbelievable," explained Medhekar, who has seen first-hand the medical tourism industry on the ground in capital cities of India. Located in the heart of New Delhi, Moolchand Medcity is becoming Asia's largest single site multidisciplinary hospital campus. Its architecture encompasses six speciality hospitals and offers a portfolio of services all under one roof. Adding to Moolchand's uniqueness, a patient concierge service makes multiple doctors' meetings hassle free for international patients.

"It is quite amazing to see. Surrounded by some of the world's biggest slums [in India], these hospitals designed specifically for the international patient market are pristine, clean, accredited with state-of-the-art medical technology and are highly respected globally."

While this level of opulence and service is normally reserved for the rich and famous, it's middle class Australians who are getting their passports stamped as medical tourists. Anna (not her real name) from Rockhampton in Central Queensland travelled to Thailand last December for gallbladder surgery. She had already been planning a trip to Thailand and decided to look into getting the procedure done at the same time. After a week of shopping and sightseeing with family, Anna checked in to have her troubling gallstones removed.

"I came to know about my gallstone problem a few weeks before my trip, so I looked into combining the trip with the surgery. It looked fine so I went ahead."

Anna said the alternative was to have the surgery done through the public health system.

"My GP told me that I could be waiting six to nine months to have the surgery done through the private hospital here and would have to pay a fortune; or could be waiting six years through the public hospital. It would have cost me $5000 to have the operation here, while it only cost me $2000 to have the surgery through the hospital in Thailand."

Anna was treated through an after hours special clinic at the Ramathibodi Hospital in Bangkok.

"I was extremely happy with the quality of medical staff and facilities. The surgeon was very experienced and had worked in Australia, America and Japan recently. He was friendly and generous with his time, while the nursing staff were also friendly and able to provide good information about my treatment and caretaking after the operation."

One of the glitches with medical holidays is that it may not be practical to enjoy sightseeing after surgery, especially if that's the doctor's advice. By venturing out of a sterile hospital environment you may be exposed to bacteria which could reduce your recovery time. India is renowned for very hot summers and water-borne diseases can become a problem during the monsoon season. According to Medhekar, this is a problem for those who undergo quite invasive surgery, but others might be quite willing to take the risk for the chance to experience the eastern culture. And it seems many are doing just that.

"While many head for the local tourist attractions, others take the opportunity to participate in spiritual and yoga/ashram retreats in beautiful and peaceful natural environments," she explained.

For Anna, and many other Australians, travelling overseas for medical procedures has become an affordable and quick solution to some concerning health issues. It is a decision that shouldn't be made lightly, but is definitely one that people like Anna would make again.

"If the cost was right and I had the time to do it, I would definitely go abroad for surgery again."

And it's comments like this that are contributing to the soaring economy of medical tourism, making the world our global hospital.