Medical Tourism- A Health Journey

We define Medical Tourism as “Health Journey”. After all, people suffering from medical conditions are traditionally discouraged to travel as it involves discomfort and many risks but sometimes patient’s conditions are so acute that patient or the caretakers decide to take this leap for survival or better health conditions than status quo.

Lead My World’s Health Management Model

LMW is positioned on higher grounds of this profession. We develop medical coaching and certification programs for universities, we train doctors and collaborate with teaching hospitals and healthcare facilities. Our executive management is comprised of medical doctors. We have established collaborative relations with the hospitals of specialization in critical disciplines. We have instituted a strong patient referral program for those patients seeking alternative treatments and with the progressive hospitals to treat such patients. Our medical professional expertise and working at the grassroots level gives us leverage over people who use Medical Tourism strictly as a business. To us, it’s about the value of life and a relentless pursuit of wellness.

HEALTH JOURNEY- MT BACKGROUND

Medical tourism is as old a phenomenon as human being started traveling out of their enclaves to discover certain tree roots and herbs for treatment and traveled across continents for it. Their journey was not necessitated by economics but the unavailability of medicine and the healers. Medical Tourism- while introduced as an alternative is becoming a mainstream Healthcare management field. According to Dr. J. Bhagwati of Columbia University, Americans have saved up to 75 Billion dollars in one year by taking advantage of MT Healthcare. Revenue attributed to MT for the year 2014 is at 65 Billion dollars according to a report published by “Frost & Sullivan Research”, and growing at the rate of 20%. Johns Hopkins and Mayo Clinics have now setup,  their offshoots overseas for the purpose of savings of HC cost. We believe that China is one of the most advanced countries in the world, both technologically and in physician care with an added benefit of new innovations and holistic approach to Medical Tourism.            

WHY PEOPLE TRAVEL FOR MEDICAL TREATMENT

It is not easy to leave the comfort of your home and familiar environment in a situation when you do not even feel good but it’s a journey some of us must take- Leaving home involves financial, physical and psychological hardships but none of them are greater than the risk of not getting well. While information is readily available at our fingertips the renowned hospitals have also gotten closer in distance with global traveling trends. Traveling for wellness and health are no different from traveling for leisure. As a matter of fact, it has now become “business as usual” for some. Following are a few reasons attributed to Medical Tourism;

Advanced medical technology (AMT): Hospitals in developed countries are generally equipped with state of the art technology which is not readily available in developing country’s hospitals. The technological know-how also gives an edge to the hospitals in the industrialized nations.

Advanced medical research and inventions: Industrialized nations invest into research and development, inventions and experiments to improve on healthcare experience. As a result, they are far ahead of other countries in implementing such procedures. Cost effective Stem Cell research and organ implants are some of the prime examples of such privileges which attract patients from other parts of the world developing and industrialized alike, to countries like China.
Legalities of medical procedures: An American interventional radiologist Dr. Charles Dotter experimented with a procedure to deliver a stent through a catheter to treat peripheral arterial disease in 1964. The experiment was successful Dr. Charles Dotter and Dr. Andreas Gruentzig experimented with the same procedure and found it not only successful but also a better option for reconditioning of the body after a surgical procedure. The procedures were not legalized yet and the medical doctors had to be creative about their practices in the beginning. Dr. Peter Dr. Richard Myler of Emory University Hospital mentioned once that he had to travel to Latin America to perform angioplasty procedure which after getting a legal approval revolutionized cardiac care. Not all countries allow some medical procedures because of lack of scientific data, bureaucracy or cultural taboos; as a result, patients end up traveling to the countries not restricting healthcare procedures most suitable for the patients from abroad.
Economics of Healthcare: Some countries like China have lower healthcare cost than the others. China is a prime example of it. This makes destinations like China attractive and financially viable for the insurance companies. Patient and the family is rewarded with expenses paid residence and other allowances to get the treatment done abroad rather than in the USA or some European countries.
Patient & caretaker’s choice: It does not come as a surprise that the elite class of developing countries has the option to travel to the developed countries for medical treatment. This gives them the sense of empowerment that their wealth is working for them and that they can exercise the right to choose whatever they like. This market segment is small but with a bigger spending sources on their wellness. According to a report issued by Center for Disease Control and Prevention, Atlanta CDC approximately 1.2 Million Americans travel overseas for medical treatment each year. Some of the obvious reasons are;

·         Medical treatments are far less expensive overseas than in the USA

·         Insurance companies have started giving incentives to the families and caretakers of the patients whereas they feel like they on vacation rather than being stuck with no options.

·         Some experimental drugs and procedures prohibited in the USA are already administered and institutionalized abroad. Medical professionals are not gun-shy of taking the risk and the societies are not litigation oriented as much as the Americans are. Most common procedures that people are coming to China for are;

o    Stem cell therapy

o    Organ implantation

o    Cosmetic surgery

o    Dental work

o    Heart surgery

o    Alternative cancer treatment

o    Orthopedic and sports medicine

o    Holistic and traditional medicine treatment for chronic diseases

RISKS OF MEDICAL TOURISM & RISK MANAGEMENT BY LMW

Anytime we come out of our comfort zone we involve risk due to our activities. Following a list of MT risks and how Lead My World addresses them:

·         Linguistic and cultural difference: It is a major risk to take especially when you are dealing with a life situation. LMW’s doctors and MT staff are all bilingual and professionally trained on cross-cultural sensitivity.

·         General and Medical hygiene standards: Western countries practice high standards of hygiene & preventative care, developing nations are not as sensitive about it in some cases. LMW only uses hospitals which are government approved and practice, WHO, CDC, HEPA, OSHA and other global standards of operations. We thoroughly examine and inspect facilities before putting them on our recommendation list.

·         Counterfeit medications: It is not uncommon to find counterfeit medications in developing countries like India but Chinese laws are very strict in this regards. Our association with the Health Ministry approved facilities guarantees the authenticity and safety of drugs.

·         Proper recovery time after surgery: some people like to go home right after a successful procedure is completed. We recommend that proper time is allotted for rest and leisure to avoid potential risks such as blood clot due to flying. We believe that post-operative care is as important as the procedure itself.

CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) GUIDELINE FOR MEDICAL TOURISM

What You Can Do

·         If you are planning to travel to another country for medical care, see a travel medicine practitioner at least 4–6 weeks before the trip to discuss general information for healthy travel and specific risks related to the procedure and travel before and after the procedure.

·         Check for the qualifications of the health care providers who will be doing the procedure and the credentials of the facility where the procedure will be done. The Joint Commission International (US-based) certifies health care facilities according to specific standards.

·         Make sure that you have a written agreement with the health care facility or the group arranging the trip, defining what treatments, supplies, and care are covered by the costs of the trip.

·         Determine what legal actions you can take if anything goes wrong with the procedure.

·         If you go to a country where you do not speak the language, determine ahead of time how you will communicate with your doctor and other people who are caring for you.

·         Obtain copies of your medical records that include the lab and other studies done related to the condition for which you are obtaining the care and any allergies you may have.

·         Prepare copies of all your prescriptions and a list of all the medicines you take, including their brand names, their generic names, manufacturers, and dosages. Arrange for follow-up care with your local health care provider before you leave.

·         Before planning “vacation” activities, such as sunbathing, drinking alcohol, swimming, or taking long tours, find out if those activities are permitted after surgery.

·         Get copies of all your medical records before you return home.

Lead My World has stringent rules to enlist a hospital offering Medical Tourism. In China, we not only assist clients to locate and qualify a healthcare facility but our medical staff monitors the hospitals as it relates to services. Dr. Dong Zhe and Dr. Khayyam Masood are heading this division of LMW. For any questions, please contact: Najam@Leadmyworld.com    

Nutritional psychiatry: Your brain on food

Posted By Eva Selhub MD On November 16, 2015 @ 9:00 am In Back Pain, Complementary and alternative medicine, Healthy Eating, Mental Health 

Think about it. Your brain is always “on.” It takes care of your thoughts and movements, your breathing and heartbeat, your senses — it works hard 24/7, even while you’re asleep. This means your brain requires a constant supply of fuel. That “fuel” comes from the foods you eat — and what’s in that fuel makes all the difference. Put simply, what you eat directly affects the structure and function of your brain and, ultimately, your mood.

Like an expensive car, your brain functions best when it gets only premium fuel. Eating high-quality foods that contain lots of vitamins, minerals, and antioxidants nourishes the brain and protects it from oxidative stress — the “waste” (free radicals) produced when the body uses oxygen, which can damage cells.

Unfortunately, just like an expensive car, your brain can be damaged if you ingest anything other than premium fuel. If substances from “low-premium” fuel (such as what you get from processed or refined foods) get to the brain, it has little ability to get rid of them. Diets high in refined sugars, for example, are harmful to the brain. In addition to worsening your body’s regulation of insulin, they also promote inflammation and oxidative stress. Multiple studies have found a correlation between a diet high in refined sugars and impaired brain function — and even a worsening of symptoms of mood disorders, such as depression.

It makes sense. If your brain is deprived of good-quality nutrition, or if free radicals or damaging inflammatory cells are circulating within the brain’s enclosed space, further contributing to brain tissue injury, consequences are to be expected. What’s interesting is that for many years, the medical field did not fully acknowledge the connection between mood and food.

Today, fortunately, the burgeoning field of nutritional psychiatry is finding there are many consequences and correlations between not only what you eat, how you feel, and how you ultimately behave, but also the kinds of bacteria that live in your gut.

How the foods you eat affect how you feel

Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibit pain. Since about 95% of your serotonin is produced in your gastrointestinal tract, and your gastrointestinal tract is lined with a hundred million nerve cells, or neurons, it makes sense that the inner workings of your digestive system don’t just help you digest food, but also guide your emotions. What’s more, the function of these neurons — and the production of neurotransmitters like serotonin — is highly influenced by the billions of “good” bacteria that make up your intestinal microbiome. These bacteria play an essential role in your health. They protect the lining of your intestines and ensure they provide a strong barrier against toxins and “bad” bacteria; they limit inflammation; they improve how well you absorb nutrients from your food; and they activate neural pathways that travel directly between the gut and the brain.

Studies have shown that when people take probiotics (supplements containing the good bacteria), their anxiety levels, perception of stress, and mental outlook improve, compared with people who did not take probiotics. Other studies have compared “traditional” diets, like the Mediterranean diet and the traditional Japanese diet, to a typical “Western” diet and have shown that the risk of depression is 25% to 35% lower in those who eat a traditional diet. Scientists account for this difference because these traditional diets tend to be high in vegetables, fruits, unprocessed grains, and fish and seafood, and to contain only modest amounts of lean meats and dairy. They are also void of processed and refined foods and sugars, which are staples of the “Western” dietary pattern. In addition, many of these unprocessed foods are fermented, and therefore act as natural probiotics. Fermentation uses bacteria and yeast to convert sugar in food to carbon dioxide, alcohol, and lactic acid. It is used to protect food from spoiling and can add a pleasant taste and texture.

This may sound implausible to you, but the notion that good bacteria not only influence what your gut digests and absorbs, but that they also affect the degree of inflammation throughout your body, as well as your mood and energy level, is gaining traction among researchers. The results so far have been quite amazing.

What does this mean for you?

Start paying attention to how eating different foods makes you feel — not just in the moment, but the next day. Try eating a “clean” diet for two to three weeks — that means cutting out all processed foods and sugar. Add fermented foods like kimchi, miso, sauerkraut, pickles, or kombucha. You also might want to try going dairy-free — and some people even feel that they feel better when their diets are grain-free. See how you feel. Then slowly introduce foods back into your diet, one by one, and see how you feel.

When my patients “go clean,” they cannot believe how much better they feel both physically and emotionally, and how much worse they then feel when they reintroduce the foods that are known to enhance inflammation. Give it a try!

Related Information: Healthy Eating: A guide to the new nutrition

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Article printed from Harvard Health Blog: http://www.health.harvard.edu/blog

URL to article: http://www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626

MD Degree Program in China- A New Reality                                                                      By: Najam Hasan

A Chinese Dream

President  Xi Jinping  said in his address to the nation that he wants to rejuvenate the Chinese nation to allow it to take its rightful place in the world by improvements of his people’s livelihoods through better education and healthcare services, more stable employment, a cleaner environment, the elimination of corruption and a stronger military.

A reality

Six hundred thousand (600,000) medical students are trained each year in Chinese medical universities but only one hundred thousand (100,000) actually become doctors, according to Professor Li Ling of the National Development Research Institute at Beijing University. In 49 listed medical universities in China more than 10,000 international students got admission to become medical doctors last year, the majority of them from South East and Central Asia. The financial contribution of these students is not significant to the Chinese economy, as these students are rather unprofitable when compared to what EU or North American students are prepared to pay for medical education. The other reason is, most Chinese universities are offering MBBS undergraduate degrees which is in line with the European medical education standards but not that of North America.

American medical education, on the other hand, is divided into two parts; 4 years of pre-med education with an undergraduate degree in human biology and 4 years of clinical training resulting in a graduate degree of Doctor of Medicine , MD. The United States Medical Licensing Exam (USMLE) is a pre-requisite to enter into an American residency for both domestic and foreign trained doctors planning to work in the United States. USMLE has also become a benchmark in other regions of the world as a medical doctor's professional qualification for employment. The USA faces a probable shortage of 90,000 medical doctor in this decade, cited by Dr. Darrell G. Kirch MD, president of the Association of American Medical Colleges (AAMC). American healthcare providers prefer graduates with an MD degree and a US medical license for residency. This presents a unique opportunity to a nation that has had a message from its leader to lead in educational fields as a national pride and priority.

Number of applications in USA for 10 desired med school for 2014

Medical school (state)	Applicants (fall 2014)
Drexel University (PA)	14,648
Lake Erie College of Osteopathic Medicine (PA)	13,536
Georgetown University (DC)	13,016
Temple University (PA)	11,286
George Washington University (DC)	10,981
Thomas Jefferson University (Kimmel) (PA)	10,204
Tufts University (MA)	9,882
Boston University	9,713
New York Medical College	9,412
Western University of Health Sciences (CA)	8,656

*An average of 11,133 students applied at each above mentioned university. Available seats for enrollment in all cases were less than 10% of the applications received.

An average of 290 students were enrolled in 165 medical schools in 2014 but an average of 109 students graduated, totaling 18,078 for the year 2014.

*Source: Association of American Medical Colleges

Statistical data of Medical school enrollment vs. graduation

Year	2010	2011	2012	2013	2014
Enrollment	42,721	43,919	45,266	45,224	48,014
Graduated	16,836	17,362	17,344	18,154	18,078

The following is a glance at the top 25 American medical schools, their tuition fees and enrollment per year.

Enrollment in the schools of medicine with the number of seats and tuition fee  

Ranking	Medical School	Tuition fee	Enrollment
#1	Harvard University  Boston, MA	$54,200 (full-time)	726
#2	Stanford University  Stanford, CA	$50,715 (full-time)	473
#3Tie	Johns Hopkins University  Baltimore, MD	$47,250 (full-time)	461
#3Tie	University of California— San Francisco  San Francisco, CA	$32,106 (in-state, full-time); $44,351 (out-of-state, full-time)	664
#5	University of Pennsylvania (Perelman)  Philadelphia, PA	$50,444 (full-time)	655
#6	Washington University in St. Louis  St. Louis, MO	$56,212 (full-time)	474
#7	Yale University  New Haven, CT	$53,540 (full-time)	415
#8Tie	Columbia University  New York, NY	$53,544 (full-time)	648
#8Tie	Duke University  Durham, NC	$51,888 (full-time)	430
#10Tie	University of Chicago (Pritzker)  Chicago, IL	$47,673 (full-time)	356
#10Tie	University of Michigan— Ann Arbor  Ann Arbor, MI	$31,154 (in-state, full-time); $48,862 (out-of-state, full-time)	727
#10Tie	University of Washington  Seattle, WA	$31,992 (in-state, full-time); $60,978 (out-of-state, full-time)	938
#13	University of California— Los Angeles (Geffen)  Los Angeles, CA	$31,134 (in-state, full-time); $43,379 (out-of-state, full-time)	749
#14Tie	New York University  New York, NY	$47,650 (full-time)	650
#14Tie	Vanderbilt University  Nashville, TN	$45,350 (full-time)	429
#16	University of Pittsburgh  Pittsburgh, PA	$48,792 (in-state, full-time); $50,014 (out-of-state, full-time)	601
#17	University of California— San Diego  La Jolla, CA	$31,134 (in-state, full-time); $43,379 (out-of-state, full-time)	502
#18	Cornell University (Weill)  New York, NY	$49,500 (full-time)	406
#19	Northwestern University (Feinberg)  Chicago, IL	$51,882 (full-time)	687
#20	Icahn School of Medicine at Mount Sinai  New York, NY	$44,604 (full-time)	556
#21	Baylor College of Medicine  Houston, TX	$19,650 (full-time)	738
#22	University of North Carolina— Chapel Hill  Chapel Hill, NC	$18,887 (in-state, full-time); $45,766 (out-of-state, full-time)	827
#23	Emory University  Atlanta, GA	$49,500 (full-time)	560
#24	Case Western Reserve University  Cleveland, OH	$55,370 (full-time)	864
#25	University of Texas Southwestern Medical Center  Dallas, TX	$17,163 (in-state, full-time); $30,263 (out-of-state, full-time)	953
	Source: US NEWS Medical school rankings.

An American Dilemma 

After earning a 4 years Bachelor's of Science in human biology, some students do not pass the MCAT exam, a prerequisite for admission into med-school. Even with passing the MCAT exam, most aspiring pre-med undergraduates do not get admission to med- school due  to very tough competition for a limited number of seats, as shown above. These students end up changing their career path, while a very small number seeks to study in the Caribbean Islands. The Caribbean Islands have very limited resources, few teaching hospitals, and have acquired a reputation of low academic training standards. This gives an opportunity to reputable Chinese medical schools to step up and seize the opportunity.

Doctor of Medicine (MD) Program in China   

China is a power to be reckoned with. A journey that started with the manufacturing of low end consumer goods has now embarked on missions in space and the development of important innovations. Xi Jinping's Top 5 priorities for the country include, "better education and healthcare services ". This is Chinese reality, not a dream. A graduate degree in medicine in clinical science is an inevitable response to this calling to compete in the healthcare field, so China can improve its own health care sector and play its role of an emerging superpower. An MD degree program coupled with USMLE training has the potential of thousands of American medical students being recruited each year. For all we know, this could be the next best thing China has to offer the world since green tea.

Program Development

The transfer of technology is what has made it possible for China to build the infrastructure for the largest network of bullet trains in the world. Duplicating and implementing an American MD degree curriculum is essential in setting a benchmark for excellence in health care education. Universities like MIT, Harvard and Yale are already hosting cohort programs with Chinese universities in business and technology. Collaboration in the medical field will be a natural fit and will help America and China to set the standards of education on an equal footing. This cooperation is essential and desperately needed by both countries. Matching a Chinese MD program with the American counterparts will make Chinese medical doctors more marketable to the US health care sector and will attract many American students to study in China. It is a win-win scenario. The American students are capable of paying higher tuition fees compared to other foreign students  while incurring a lower financial cost than at home.

Lead My World's role in the development of this academic program 

It is an undertaking for sure and a lot needs to be done to overhaul Chinese higher education system with fundamental changes in the culture of Chinese academia. Lead My World's educators and executives have  been actively engaged in Chinese education sector for over a decade. Lead My World (LMW) is a higher education pathway organization managing Medical Education and coaching programs at the International School of Capital Medical University, .Beijing, China and other institutions.  LMW management has developed academic curriculum in English language for Chinese schools, authored and contributes in MBBS coaching , USMLE training and the development of an MD degree program for Chinese medical universities. Lead My World has the necessary relations and partners both in the USA and Peoples Republic of China to launch and execute Public Health Degree programs with medical schools and HC training institutes . For information or comments  please contact the author, Najam Hasan.

 najam@leadmyworld.com or Najam@ccmu.edu.cn