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Chapter Excerpts

Patients Beyond Borders

Dear Reader: On this page, we’ll post excerpts from Patients Beyond Borders: Second Edition—either an informative chunk from one of the eight chapters in the book, or a peek at one of the 37 destinations featured in Part Two. Check back for new posts, or go to Amazon and click the “Search Inside” link.

Foreword to the Second Edition


By Steven Tucker, MD, FACP;
Former President, International Medical Travel Association

Little more than a year has passed since the First Edition of Patients Beyond Borders was printed. In that brief time, medical "tourism"— better termed medical travel—has continued to grow and to transform the way we all perceive—and receive—medical care. As an American physician practicing oncology in Singapore since 2006, I've been fortunate to have witnessed this medical revolution from the front lines.

Prior to my journey to Asia, I worked as a clinical oncologist specializing in prostate cancer in Los Angeles. Around the year 2000, I started treating more and more traveling patients, not just from across the US, but from all around the world. Patients would come to LA from as near as San Francisco, St. Louis, or Boston and as far away as London, Berlin, and Delhi. Honestly, it never struck me as unusual that, in today's increasingly international climate, patients were willing to travel for high-quality medical care. However, I was shocked when I learned they also wanted to visit me monthly—even weekly—for chemotherapy if needed. Often the cost of travel exceeded the cost of the medications. Nonetheless, I always tried to get these patients involved with doctors in their hometown or home country with whom I could work as a team.

Some patients were leery of the team approach at first, but with adequate planning, evaluations before and after travel, electronic records, email, Skype, and digital imaging, it soon became common for me to see my patients quarterly and let them work closely with their local physicians the rest of the time. Over a few years I built a reliable network of specialists who could care for my cancer patients across the world. I learned that I could obtain any medicine, procedure, or test for my patients anywhere on the globe if I armed them with a well-reasoned letter or rationale. And I discovered that my patients could go to centers of excellence closer to them than LA; we just needed to network with the right people.

Fast-forward to 2006, when I was offered a chance to develop a US-style cancer center in Singapore. I was approached for the task because my peers knew that 30 percent of my practice came from outside the US and another 40 percent from outside California. Healthcare leaders in Singapore could see that the cracks in the US healthcare system might grow wider, and they saw medical travel as a potential safeguard against spiraling costs. My experience in global networking made me an ideal candidate for the post.

It was only after settling into my position that I realized I had been facilitating medical travel for years! In Los Angeles, 70 percent of my patients came from outside of California. In Singapore, 70 percent of my patients come from outside of Singapore, many seeking high-quality care not available in developing countries. In LA, I often worked with a Spanish translator. In Singapore, I work with a Chinese translator. In Singapore, I see a large number of new Asian patients, but I also see my followup US patients along with Australians and Europeans who were already traveling to Singapore for healthcare before I arrived. The reality is that I did not turn patients into medical travelers; they had done that for themselves years before.

The US and the rest of the world are now filled with medical travelers, but the phenomenon, in fact, is not new. For thousands of years, people have been willing to travel great distances to obtain the best healthcare at any price. The industry can cite as many historic pilgrimages to ancient physicians, such as Hippocrates and Galen, as it can modern journeys to hospitals in India, Thailand, or the US. Seeking the best in medicine for our families is no different from seeking education or employment. What is different today is that with so many centers of healthcare excellence, the disparity in cost is glaringly obvious—and patients are learning they can do something about it. The huge numbers of Asian patients who travel to obtain high-quality care are being joined in the waiting room by a small, but increasingly Westernized, crowd seeking not only high quality but also lower costs.

With this Second Edition of Patients Beyond Borders, Josef Woodman and his team will again help tens of thousands of patients safely cross borders for medical care. As the globalization of healthcare services and delivery matures, it's my deepest personal and professional desire that we all come together to offer the highest quality of care to more and more patients. For our children as much as for our parents, I envision a world filled with expanding healthcare choices, even greater safety, and financial transparency for medical services.

By Steven Tucker, MD, FACP;
Former President, International Medical Travel Association


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