Sunday, April 17, 2011

Medical Tourism

I aimed to avoid the Indian medical system. You can run halfway around the globe to avoid your demons, but they will always come and find you. At first, I reluctantly sought care for some of my pesky health issues. Now I find myself seeking out the care because it's just so damn good, so convenient, and so cheap. Today, medical tourism in India is a $310M industry. In 2 short years, the Indian government predicts it will be a $2B industry. Put another way, you know there are issues with healthcare in the States, when your doctor in the US actually advises you to see specialists while living in a developing country. I thought she was crazy, but actually she was right. India has come to the rescue for the US system's inadequacies.

I was referred to the Rainbow Clinic, less than 5 minutes away from our home. As I pull up to the clinic I see young girls less than 5 years old carrying enormous stacks of firewood and/or babies and men piling bricks to be carried on their heads.




Once inside, I pay Rs 300 ($6) to see a specialist. Did I mention what it took to get an appointment? Just a call the day before (no automated phone tree, no waiting on hold) - the hours are so convenient that I can come after work or on the weekends. Why, pray tell, are all of my doctors in the States working part-time so that they can spend time with their kids? As a result, I receive no continuity of care and have to take off time from work just to see them. My health suffers because whoever is on call has no clue about my medical history and doesn't have time to listen. Shouldn't doctors in the US make themselves available to suit my busy schedule when I'm working 60 hours a week and sacrificing time with my own kid? Which system abides by the Hippocratic Oath?


Now, the Rainbow Clinic may not be much aesthetically, but it has opened up my eyes to the stark problems of the American health system.



In its advertising, the Rainbow Clinic cites a study which named it one of the 4 best OB/GYN/pediatrics clinics in India. Inside, there is a fascinating medical hierarchy reflected in the dress of the staff: Ayah-mahs wear the typical uniform-blue saris (and bring the doctors tea), receptionists wear an aqua one with pretty purple trim. The medical assistants wear green scrubs. Interns and medical residents wear salwar kameezes. The doctors and specialists wear stunning silk saris with gold trim.

Cons
First I'll take you through minor inconveniences of the Indian system, because should you visit India, you'll heed these first. Note that a $2B industry can easily fix the most pressing issues listed below:
  • No rubber gloves (though hands are sanitized) when blood is drawn
  • No bandaids either
  • Ambulances should be avoided, because if you are in critical condition, you will likely expire on the way to the hospital in crazy Indian traffic
  • No trashy magazines provided (I really don't miss them)
  • No toilet paper, and possibly no soap in the bathrooms
  • No emotional fluffiness provided (having a miscarriage? plan to be in the same labor and delivery ward as mothers-to-be and their omnipresent mothers-in-law as they welcome a new life into a country already populated by 1.2B people)
  • No ultrasounds telling you the sex of your baby (that is against the law) and thank goodness because the birthrate of girls is falling annually here (927 girls to every 1,000 boys born in 2001; in 2011 it's 914 girls to every 1,000 boys)
  • You may hear the words "I told you so" by your doctor or "You clearly don't need to work. I advise you to get your priorities in order and quit your job so I can treat you." As long as you can shrug these comments off as proof that your doctors are human (and fallible); they will diagnose you and treat you with more care, attention, and access to cutting edge medicines than they will make available to you in the States
Pros
  • Stellar care - quite simply, smarter doctors who make themselves accessible to you. I kid you not, my specialist gave me her phone number. I called her on a Sunday, she picked up, and answered my question
  • No waiting, no bullshit
  • Tea! The best you ever tasted, always accessible, any time, any place (no matter what condition you have, it's always sweeter with tea)
  • 45 minutes with a specialist costs $6
  • Prescription drugs will cost you another $6 - there's no waiting for them, and you don't even need a prescription (why should the rest of us wait hours at Walgreens to protect that .00001% of the population who may abuse prescription drugs?)
  • Tests that cost you thousands of dollars in the States will cost you $100 and a ride across town. But don't worry about traffic, because the clinics are open on the weekends!
  • Access to your own medical records - you take them with you! No more time on the phone, signing waivers for scans of your own god damned body that you paid thousands of dollars for
  • Next day appointments when it's convenient for you
  • No hassling with insurance companies, because you paid cash!
Now it's true that many people in India can't afford this care, but the good news is many more can today than in previous generations. I think I'll go to the doctor every day between now and the time I return to the States so I can avoid ever going again when I get home.