Medical tourism seen as 'big business' for RP

MANILA, Philippines –  Boob jobs can bring back overseas Filipinos.

It seems a far-fetched claim to make, but if you listen to the Department of Tourism’s Betty Nelle, she has a compelling argument for how the country’s plastic surgeons will help reverse the tide of overseas Filipino workers: Medical tourism.

Last year, the country received at least $200 million from foreigners coming to the country specifically to use Filipino doctors, dentists and cosmetic surgeons. By 2015, they want to increase 2009’s 100,000 to one million — which would represent at least $2 billion to the economy.

“If medical tourism is really to succeed it would be one way of bringing back a lot of our medical practitioners who have gone abroad,” the DOT product research and development director says.

“Medical tourism really contributes a lot to the economy... it’s big business.”

The essential ingredients

The country has all the right ingredients to be a good medical tourism destination, she says.

It is cheaper than many other destinations, people are fluent in English, there are well-trained doctors, modern facilities, Filipino nurses and doctors are renowned for their nurturing manner, and there is very little waiting time at medical facilities.

The Philippines also has the cheapest hotel room rates throughout Asia, medical check-ups are the second cheapest (behind India), and it has some of the cheapest rates for cosmetic surgery.

Many of the tourists, who come primarily from the United States, Japan, Korea and the Middle East, come for cosmetic surgery.

“I think we’re rather good at it,” Nelle says.

Middle Eastern tourists are particularly lucrative, on account of the way they travel.

“When they come here they really spend a lot, because they come with their families, they stay in hotels, they travel a lot, they do a lot of shopping,” she says.

Most tourists divide into two categories: those who come from other countries because their own do not have adequate health facilities, and those who come simply because it is cheaper.

For example, residents of Micronesian states such as Guam and Nauru choose the Philippines for essential medical treatment because they must go overseas and choose somewhere close by and affordable.

But even Westerners are seeking refuge in the country’s medical care.

“In the United States the cost of insurance is becoming very prohibitive so a lot of them say that even without insurance it’s cheaper to come to Asia and have your medical treatment here than it is to buy insurance in the US,” Nelle says.

Residents from countries with public health systems will also choose to pay lower private health costs in the Philippines than sit on public waiting lists.

Good for the whole country?

Nelle says the DOT has put a lot of work into developing the industry since 2005. They attend medical congresses to liaise with medical tourism operators and surgeons, and have five staff dedicated to medical tourism, who are able to field queries and aid medical tourists.

“We... work closely with the tour operators that sell medical tourism packages, beauty packages, dental (packages).”

The operators make sure all of a patient’s arrangements are taken care of. They arrange transport from the moment the patient arrives at the airport, book accommodation, take care of needs of anyone accompanying the patient, and book other tourist activities planned before or after any procedures.

Concerns have previously been voiced that foreigners will take over the hospital beds needed by the country’s own sick, but Nelle dismisses this.

“We will never turn away our own countrymen.”

Accredited hospitals have given the DOT an assurance of this, but any enforcement depends on self-regulation.

Universal beauty

Cosmetic surgeon Joel Nicdao has had his own practice for nine years, and currently has a 20 percent foreign patient base. His surgery is even located in a hotel, where his patients stay.

“You start local just like everybody else,” he says.

Six years ago he had his first foreign patient, an American woman living in the Okinawa naval base in Japan but whose husband worked in the Philippines. Her husband, a decade younger than her, had wanted her to get the “full works” and interviewed six surgeons before deciding on Nicdao.

The extensive remodeling included breast augmentation, tummy tuck, vaginoplasty, thigh lift, butt augmentation, facelift, and work on her eyes and nose.

“From that single patient to today, I’m now the most popular plastic surgeon in the Okinawa base, it’s like a household name,” Nicdao says.

Americans are his main international clients, followed by Koreans, British, Brazilians and Australians.

“(Americans) have the mentality to get plastic surgery.”

While the desire for plastic surgery is the same for all ethnicities - to look younger and sexier — there are nuances, Nicdao says.

Asians often want eye folds and bigger breasts and hips, whereas typically prematurely ageing Caucasians request facelifts or eye work — “Even in your 30s, the wrinkles are coming.”

Thin skin and a love of the sun are to blame, he says.

The Philippines is a good place for foreigners seeking plastic surgery because it is as cheap as Thailand — the other main destination — but English is a national language here.

“The communication is very important... the slightest miscommunication can mean a different-looking eye, a different-looking nose.”

Filipinos are educated the “American way” and would be very similar to the surgeons of Beverly Hills, except for some missing bells and whistles such as automatic reclining beds.

“There is very little need for high-tech gadgets in plastic surgery, so the surgeon’s really only as good as his hands,” Nicdao says.

It is cheaper to have plastic surgery in the Philippines, even factoring in the cost of plane tickets. For example, breast augmentation in the Philippines is between $3,500 and $8,000 compared with $5,500 to $18,000 in America.

Nicdao communicates with patients via e-mail, sending photos and discussing options so “before they fly out they have a pretty good idea of what will be done to them.”

Just like going to the parlor

Nicdao works with a travel agency, which organizes other tourist activities for patients who want it - and most do, he says. The hotel even has another location in Boracay, where some opt to recover.

Nicdao was recently invited to join a “wellness center” in Boracay, where he would work weekends.

The center would also have a cosmetic dentist and stem cell specialist, so patients could get all their beauty work done at the same place, “while touristing.”

He expects the venture to be a success, if the current trend is anything to go by.

“(We are getting) a lot (more patients). I don’t know if it’s just because of my price, but I don’t think so.”

“It’s just part of life now, just like the parlor is a part of life. Now women take it a step higher, they also go to the plastic surgeon.”

And it’s not just women — Nicdao has seen a three-fold leap in male clients in just five years, with three males for every 10 female patients.

Male embrace of plastic surgery is a telling sign of its accepted status, he says.

But Nicdao still thinks there is more the government could be doing to promote the Philippines as a medical tourism destination.

“We should be doing better than Thailand, the only reason is the same (reason why) our economy is not doing well.”

Issues for the country such as corruption and the Muslim separatists mean the government is preoccupied with issues other than promoting the country.

“Our resources are directed elsewhere instead of being directed to tourism,” Nicdao says.