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COVER STORYhealthBy April Frawley BirdwellLong-distanceHealth travel is booming. While some patients seek expertise in distant locales(including programs at UF) others are opting to leave the states for cheaper care.They arrived at the UFProton Therapy Center every morningby 8. By 8:25, Alex Barnes, then 4, wassedated, strapped onto a table whiledoctors and technicians prepared toblast his brain tumor with a precisebeam of radiation.By 10, the little boy from Englandwas awake, happy and ready to go tothe beach or the zoo or wherever elsehis mother and grandparents plannedfor the day.“He came away from that treatmentthinking he had a giant vacation,” saysAlex’s mother, Rosalie Barnes, whobrought her son from their home inLeicester, England for 12 weeks lastSeptember so he could undergo protontherapy treatment in Jacksonville. “Itwas winter, the weather was beautiful. We sampled all the delights ofJacksonville, and my son thinks of it as a great experience.”Alex suffers from a rare type of cancer called anaplastic ependymoma.Diagnosed in 2007, he underwent surgery to remove the tumor and had 14months of chemotherapy before coming to the United States for protontherapy. The tumor came back after his chemo ended, and because of hisage and the sensitive location of his cancer, normal radiation wasn’t anoption for him. So his parents did what they felt they had to do, theyraised $150,000 — in three days — and brought their boy to the UnitedStates for proton therapy, a treatment not available in their country.Although UF and the Shands HealthCare system don’t explicitlymarket to international patients, or even to Americans living in distantstates, certain highly specialized programs in Gainesville and Jacksonvillehave become hot spots for patients from across the country and globe. Asone of only six proton therapy centers in the country, UF’s ProtonTherapy Institute is among them. (For more on a few of these programs, seepage 18)For most of the patients who travel to Florida for care, the sunshine andpalm trees are just a pleasant bonus. The real draw is the expertise.POST07 / 08 • 0916 POSTVisit us online @ http://news.health.ufl.edu for the latest news and HSC events.
Atummy tuck and apina coladaBut there is another breed of health traveler out there, the kindmost people think of when they hear the phrases “medicaltourism” or “dental vacation.”Nearly 750,000 Americans traveled to other countries forhealth care in 2007, according to a Deloitte Health Solutionssurvey. The company’s estimates show that as many as 6 millionpeople may be following suit by 2010. Why? It’s simple.Undergoing dental surgery or obtaining a facelift in Costa Ricaor Mexico is cheaper than in the United States, and patients get avacation to boot.Imagine reclining on a lounge chair on a tropical isle, margaritain hand, ocean at your feet, while the sun glistens off your bargainbasement dental implants. For some patients, the trip might gojust like this. But for others, it doesn’t, and a botched procedure ina foreign country can lead to a plethora of problems down the road.Patients who face complications after returning home mayhave to spend thousands more to fix the problem and couldstruggle to find a U.S. surgeon willing to help because ofliability concerns, says Kfir Ben-David, M.D., a UF assistantprofessor and director of the bariatric surgery program in theCollege of Medicine. Even when a surgeon does agree to takethe case, finding out what devices or procedures were usedposes a challenge.Samuel Low, D.D.S., M.S., M.Ed., an associate dean andprofessor of periodontology, remembers a patient who came tohim after having dental implants — one of the most expensivedental procedures — placed in his mouth at a clinic in Mexico.The bone around the tooth implants had been destroyed. WhenLow tried to call to find out what materials had been used, theclinic’s phone was disconnected.“He literally almost doubled the cost, plus the trauma, as if wehad placed them in the first place. It doesn’t mean there are notgreat dentists (and physicians) outside of these borders. But whena dentist within these borders does that, we can take action.”Because of their concerns for patients headed oversees for care,the American Dental Association released guidelines to helppatients make decisions about international care before hoppinga plane, said Low, one of the ADA’s 17 trustees.For Ben-David, the main concern about people seeking cheapsurgery overseas is the lack of follow-up care in the monthsafterward, which he says puts patients at risk for complications.“I think the patients should really think about whether theyare saving money. One of the things they have to look at is theseare long-term effects,” he said. “Is it really worth it to save moneyand not have someone to take care of you afterward?”Patients can find great doctors overseas, but there are stillrisks. A language barrier could cause communications problems,and patients will have no legal recourse if the procedure goesawry. Ultimately, the decision on where to receive care is apatient’s choice.“I think the better informed the patients are about theprocedures and the surgeon who is going to do it, the better offthey are going to be,” says Brent Seagle, M.D., chief of plasticsurgery in the UF College of Medicine.Visit us online @ http://news.health.ufl.edu for the latest news and HSC events. 07 / 08 • 09continuedon Page1817POST
Page 1: 07/08•09noplaceLIKEPAGE 16THERE
Page 4 and 5: ADMINISTRATIONLooking back, steppin
Page 7 and 8: EDUCATIONPHOTO BY FOOTSTONE PHOTOGR
Page 9 and 10: EDUCATIONHow UF has become a hot sp
Page 11 and 12: AROUND THE HSCOpen up and …read a
Page 13 and 14: Got soap?Got soap?RESEARCHSoap-snif
Page 15: RESEARCHWaiting-list worriesLive ki
Page 19 and 20: of its medical facilities and sunny
Page 21 and 22: RESEARCH DAYPHOTO BY SARAH KIEWELTh
Page 23 and 24: Sweet DISCOVERYUF makes gene therap
Page 25 and 26: An affair to rememberJACKSONVILLETh
Page 27 and 28: AWARDSCollege of Nursing10 Years: C
Page 29 and 30: DISTINCTIONSJACKSONVILLEROBERT A. P
Page 31 and 32: PROFILEBy Jessica Metzger‘Sunny

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