Joint Replacement

SEBRING — About 30 percent of Newsom Eye & Laser Center’s business comes from medical tourists like a security company owner and his wife from the Virgin Islands.

When they were ready for cataract surgery, both came to Highlands County.

“January through April is our busy season. We’re going to be doing a high volume of patients. It peaks in March, but in April it’s still high,” said Dr. Hunter Newsom, an optical surgeon who just built a three-story clinic north of Sebring. He also has ophthalmology offices in Tampa. “In the summertime, money is tight. We send home staff early,”

Many of his winter patients are the same people who vacation in Highlands County. They are predominantly from Indiana, Ohio and Michigan, and most return north in the spring.

SB 178, sponsored by Health Policy Chair Aaron Bean, R-Fernandina Beach, would direct Enterprise Florida to advertise the state as a destination for health services.

That would include a marketing plan to promote the services and expertise of Florida providers.

Bean, whose committee unanimously approved the bill, said medical tourism could become an economic engine.

Medical tourism isn’t well defined. For some doctors, it’s winter visitors. For HRMC, it’s patients who have permanent addresses in other states. But it’s clear that medical tourism is already here, Newsom said.

Adam Kless agreed: “Highlands County certainly sees its share of medical tourism due to our seasonal population.

“We see a sharp increase in elective procedures in the winter months,” said Kless, chief nursing officer at Highlands Regional Medical Center. “Recently, we added a program that allows individuals with high-deductible insurance plans or no insurance an affordable option to pay cash for an elective procedure at a discounted rate.

“The addition of this new program, called MD Save, has resulted in even more people choosing to come to Highlands Regional for their surgery from greater distances,” Kless said. “Our MD Save program, in conjunction with our strong seasonal population, has made Sebring and Highlands Regional a surgical destination.”

HRMC tracks medical tourism by the permanent address of the patient, insurance data, and location of the patient’s primary care physician. “Over the course of the year, approximately 7 percent of our surgical volume is related to medical tourism,” Kless said.

Dr. Juan C. Alvarez specializes in joint replacement, computer-navigated and robotic surgery at Florida Joint & Spine Institute.

“Florida is ideally suited for medical tourism,” Alvarez said. “I have been performing joint replacement surgery in Highlands County for the past 11 years. Over that time, I have had more and more out-of-town patients and international patients.”

Florida Hospital Heartland “brought in the MAKO robot so I can more precisely perform partial knee replacements,” Alvarez said. “This robot-assisted technology gets my patients back on their feet faster because the smaller incisions preserve healthy bone and tissue. Florida Hospital is the only place in the Heartland with this advanced technology.”

Because Highlands County is in the middle of the state, Alvarez said, “It is easily accessed from south Florida, where I get a lot (of) joint replacement patients.” Orlando and Tampa airports are just a few hours away, and that allows out-of-state and international patients to drive in easily.

Alvarez got a boost two years ago when he was asked by the producer of “Un Nuevo Dia” – Spanish TV’s version of “Good Morning America” – if the Sebring doctor would talk about robotic partial knee replacements.

“I agreed,” Alvarez said. “And it was only after the show that I realized it was televised live nationwide as well as in 23 countries.”

His office started getting appointments from patients from around the U.S., as well as from the Caribbean and South America.

“The producer of the show contacted me a month later and told me their viewers wanted more information,” Alvarez said. He was asked to return for another show.

Alvarez talked about anterior total hip replacements. That show caught the attention of a Chinese orthopaedic organizing committee.

“This allowed me to expand my educational scope to Asia,” Alvarez said. “The World Congress of Orthopedics and technology, which is based in China, asked me to be one of their speakers at their 2014 meeting in China.” In 2015, he was asked to return.

His medical mission work has also attracted Latin America patients to have their orthopedic care in Central Florida. “In the past two years, I’ve been involved with both Faith in Practice and OperationWalk. Both of these charitable organizations offer free hip and knee replacements to needy patients in Third World countries. I traveled to Guatemala to perform hip replacements in May 2015. I am returning to Guatemala in January 2016 and also May 2016.

“As a result of my missionary work and Guatemala, I have also been invited to lecture at their university on joint replacement surgery,” Alvarez said. “I have just recently returned from Havana, Cuba, where I was lecturing and also performing surgery with OperationWalk. By performing some of the more difficult joint replacement surgeries in Guatemala and Cuba, I have had patients contact me from those countries to see if they could have their surgeries here.”

Newsom makes it convenient for travelers. He’ll operate on the first eye on a Monday. “We can do both, and you’ll be gone in eight days. Or, if you want can do it shorter, you could fly home on Friday.”

Newsom gets patients from word of mouth. One cataract patient came in because his son had LASIK surgery in Sebring. LASIK, laser-assisted in situ keratomileusis, corrects myopia, hyperopia and astigmatism.

“There are people all over the world who had someone at Newsom Eye taken care of them,” Newsom said. “They know someone up north, they know our practice, they know our name and our reputation.”

CDC advises medical tourists

Some Americans seek cheap treatment in foreign countries

The Centers for Disease Control defines medical tourism as traveling to another country. Up to 750,000 Americans go abroad each year because cosmetic surgery, dentistry or heart surgery is cheaper, or they’re immigrants and return to their home country for care and convalescence.

Risks depend on the country visited and the procedures performed, but international issues include communication, reusing needles between patients, an unsafe blood supply, counterfeit or lesser quality medications, antibiotic resistance, and bacteria uncommon in the U.S. Flying after surgery also increases the risk for blood clots.

The CDC recommends seeing a doctor four to six weeks before the trip to discuss medical procedures, travel specifics and risks before and after the procedure.

“The big drawback is continuity of care,” said Dr. Michael Kirsch, a Sebring periodontist. Periodontists specialize in dental implants, and the prevention, diagnosis, and treatment of gum disease and oral inflammation.

Kirsch sees a dramatic increase of snowbirds who are diagnosed, for instance, by their northern dentist, and as a matter of convenience seek treatment when they fly south in November or January.

“I have to communicate with their dentist up north,” Kirsch said.

But when medical tourists go to Costa Rica, Mexico or even India for treatment, “in my mind, there is no communication,” Kirsch said. “The local doctors here have got to then decide, ‘Do I want to take responsibility for this care that was done out of the area?’ It’s not like coming to Florida and buying a car and then going somewhere else.”

Kirsch supports the concept of medical tourism though. “It would be good for the economy, good for some of the facilities in Florida. I think hospitals here have a better handle on geriatrics.”

Cathy Albritton, a spokeswoman for Florida Hospital Heartland, defines it this way: “Patients chose to come to Highlands County because of our specialized care team and latest technology that is not available where they live. We are thankful to welcome patients from all over the world, and follow our mission to extend the healing ministry of Christ.”

Five CDC tips:

Determine legal actions to take if the procedure goes wrong.

Bring copies of medical records, including allergies.

Copy prescriptions and list medicines you take, including brand names, generic names, manufacturers, dosages and over-the-counter medicines that could cause a reaction to the medical procedure.

Find out if post-op vacation activities are permitted, such as sunbathing, drinking alcohol, swimming, or taking long tours after surgery.

Take post-op medical records before you return home.

– Original Story from Highland Today.