Operation Vacation

Experts' Takes

The American Heart Association has no official position or warnings regarding medical travel, spokeswoman Cathy Lewis said. Same for the American College of Cardiology. Asked to comment, the American Medical Association offered a prepared statement that patients should be "confident in the qualifications" of health-care professionals and "the safety standards of the hospital or clinic." Patients going abroad for care should be sure they have a plan for proper follow-up after coming home, the AMA adds.

The American Society of Plastic Surgeons is much less sanguine.

"Cosmetic surgery is still surgery. Surgery is serious and not the place to look for bargains," says surgeon Richard A. D'Amico, president-elect of the society. "It's difficult enough to verify physicians' training and the standards of the facilities here in the States. In a foreign country it might be nearly impossible."

Patients should also know that they are more prone to blood clots after surgery, and "the last thing you should do after surgery is [take] a long plane ride," D'Amico said. Finally, "if a patient has complications and needs a plastic surgeon here to clean up a mess and save them, they're undertaking additional costs with a new surgeon. It's false economics."

Shaw says he found comfort in knowing that Bumrungrad is accredited by the Joint Commission International, an Illinois-based nonprofit group that has accredited 4,500 hospitals in the United States and 135 overseas.

Details about the training of Bumrungrad's more than 900 physicians are on its Web site ( http://www.bumrungrad.com). More than 200 of the hospital's doctors, it says, have trained overseas, mostly in the United States, England and Australia. Some are U.S.-board-certified in various specialties.

Shaw says he called Bumrungrad and asked to speak to their best cardiologist experienced in angioplasty and stents. His call was transferred to Sureerat Panyarachun, who trained in Melbourne and noted that she had performed 1,500 similar surgeries. He had a doctor.

In Bangkok, one day after his arrival, Shaw registers at the hospital. At Shaw's presurgical consultation, Dr. Sureerat, as she prefers to be called, reviews the 3-D pictures of his heart that were taken in Dallas and e-mailed to Thailand. She answers his questions and orders tests. It's exactly what you'd expect in the States, only the surgeon sees him within moments of his arrival and spends more than an hour talking with him, seemingly in no rush.

Shaw goes off for basic tests before his surgery, scheduled for the next morning. In a nearby area, a 72-year-old Arizona man who came to Thailand for vacation is awaiting an appointment. While in Bangkok, he heard about the hospital. He dropped in to arrange a long-overdue physical and got one the same day. The verdict: Time to get his cataracts removed. He was so happy with the outcome and price -- $300 -- that he has carved out more time on this trip for a facelift. No way he'll let his name be printed. "My buddies back home would laugh me off the face of the Earth."

Apparently he believes they'll chalk up his new younger look to rest and relaxation.

A Helping Hand

Julie Munro, 59, is a pioneer in an emerging profession: medical concierge, or medical travel planner. A Scottsdale, Ariz., resident who spends most of her time in Bangkok these days, Munro is a combination travel agent, health consultant and hand holder. American patients considering a medical procedure in Thailand or Singapore find her by word of mouth or on the Web ( http://www.cosmeticsurgerytravel.com). She and her staff recommend doctors, book travel, lend cellphones and accompany patients to appointments and surgeries.

"It's naive to think you can walk into a foreign environment and all will be well," Munro says. "You want the best surgeon, even if it costs a little more than one down the street. If it's plastic surgery, you should go for the equivalent of a Beverly Hills surgeon but still at a Bronx price."