Engaging the Ethnographic Perspective:
"The Perfect Thai Vacation: Sun, Sea and Surgery"

 

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Student Response
by Jennifer Hemmingsen
Iowa City, Iowa

In a Sept. 9 New York Times article, "The Perfect Thai Vacation: Sun, Sea and Surgery" (p.A6, national edition), author Seth Mydans explores Thailand's burgeoning medical tourism industry.

Thousands of foreigners--most who live in countries where medical care is expensive or made unwieldy by national health care programs--flock to Thailand each year for dental, medical or cosmetic surgeries, Mydans writes. While they are there, visitorsare encouraged to check out other popular Thai tourist destinations.

The newspaper's account focuses on the resort-like atmosphere of Bumrungrad Hospital in Bangkok--with several restaurants, visiting chefs, and manicured assistants--and the bargain-basement treatment costs, such as the $7000 open-heart surgery or the $50 per night hospital room. It also addresses some cultural issues: American visitors say hospital staff are more courteous, lab results come in more quickly.

The author also notes since Sept. 11, 2001, the hospital has seen a dramatic increase in the number of Middle Eastern patients and has made accommodations for that clientele: ordering Muslim prayer rugs, serving religiously appropriate food, and hiring more Arabic interpreters.

There are several cultural factors a fieldworker would want to consider in this situation. The hospital administrator is a former hospital administrator from Los Angeles, Calif. What made him decide to work in Thailand? Was it his intention to work for a hospital there? Was it his idea to cater to foreign visitors? Is he Thai? What do hospital staff think of him?

Regarding the hospital itself, a fieldworker may ask how the change to medical tourism has affected hospital operations. What do long-term patients of the hospital think of the new clients? What do employees, neighbors, think? Has there been an effect on local health care because of the trend? Longer lines for treatment or refusal?
A fieldworker would want to know how this trend is affecting the overall Thai tourism industry. Has it bolstered tourism or replaced something else? Is it bringing a different kind of tourist or people from different countries? Are other tourist outlets changing their offerings to reflect that? How important is tourism to Thailand? To get a better perspective, a fieldworker could go to the hospital for treatment. She could also interview others who have been treated there, doctors who work there and those, if any, who refuse to work there, employees, and others. She could inquire with any regulatory agencies about staffing records, other documents. In preparing for her research, she should familiarize herself with Thai culture, politics, economy and language.

It would be crucial for the fieldworker to spend a significant amount of time in Thailand before beginning the research, or to have other means of effectively reading the culture.

 

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New York Times: International

"The Perfect Thai Vacation: Sun, Sea and Surgery"
by Seth Mydans
Monday, September 9, 2002

BANGKOK, Sept. 3 -- Thailand, the land of temples, floating markets and elephant rides, has begun promoting a new attraction for tourists--root canals.

Having put just about everything else it has on the market for foreign visitors, Thailand has turned to what it calls medical tourists, offering services that range from dental care to cancer treatments.

The attractions for a visitor are top-quality medical care, extremely low cost and a side trip to the beach.

"We thought, listen, we have really excellent medical facilities here and we have excellent holidays," said Teerapol Chotichanapibal, director of Royal Orchid Holidays. "If you can come and get a clean bill of health and then go and enjoy your holiday, what could be better?"

So, in Royal Orchid's glossy "Discover Thailand" brochure, a traveler can choose from options that include a performance of classical dance, a visit to the River Kwai, a Thai cooking class or a seven-hour "Comprehensive Health Examination for Women or Men."

The key to this new promotion is the high level of medical care that has emerged here in the past decade or two. The top private hospitals in Bangkok boast foreign-trained and certified doctors and modern medical equipment. They offer and inexpensive alternative to visitors who may need procedures not covered by health insurance or who live in countries with long waiting lists for national health care.

 

"They'll come for hip replacement or knee replacement or
cataracts and, yup, while they're here they'll take a vacation,"
said Ruben Toral, director of international programs at
Bumrungrad Hospital in Bangkok. "They get their cosmetic
surgery or their dental work and, boom, they're off to the beach."

 

Katty Anderson, of Carmel, Calif., opted for a physical exam while on a visit to Thailand and says, "I tell the story of my experience to everyone, which I thought was fabulous, the efficiency and the speed. What happened to me was just the absolute opposite to anything that could happen in the United States. I came out saying, you see, it can be done."

When she tells people she had medical care in Thailand, she says, "They roll their eyes up in their heads and say, 'I can imagine.' And I say, 'No, you can't.'"

Thailand made its name as a medical destination in the 1970's with one of its specialties, sex-change operations, known more formally as gender reassignment surgery, or G.R.S.
On its Web site, Bumrungrad describes the procedures it offers, then adds: "Many Bangkok G.R.S. Center patients extend their visits to include the many sites of Thailand including Bangkok, the northern hilltribe areas of Chiang Mai/Chiang Rai and the beautiful southern islands of Phuket and Koh Samui."

Or it is possible to go directly to Phuket, one of Thailand's premier beach resorts, and check in to the Phuket International Hospital, which advertises, "Bright sun, blue sea, cosmetic surgery."

Price is also an attraction. It is still possible to save money in Asia on ready-made suits or gemstones, but some of the best bargains now seem to be things like open-heart surgery, which goes for about $7,000 at Bumrungrad, rather than the tens of thousands of dollars it might cost in the United States. An outpatient consultation is generally less than $10. A complete cardiac examination, including a full range of tests, costs about $100. The average hospital bed costs $50 a night.

The hospitals' efficiency and personal attention also come as a culture shock to many Western visitors.

"Someone dressed in a beautiful Armani suit with little high-heeled shoes simply took me around from appointment to appointment and they immediately did all these tests, one after another," Mrs. Anderson said. "I went down and had lunch at the Starbucks in the lobby of the hospital, came back up and the doctor had on his desk the most beautiful file, all bound with tabs and everything, with all the results of the tests that they had done."

"Something like that, as you know, is impossible in America," she added. "I mean, it's inconceivable."

Curtis J. Schroeder, and American who is Bumrungrad's chief executive officer, said 225,000 foreigners visited the hospital last year, about half of whom live in Thailand. Americans made up 29,000 of the outpatients and more than 30,000 of the inpatients, he said.

With its 554 beds, air of luxury and aggressive marketing, Bumrungrad now dominates Thailand's medical tourism industry and has almost single-handedly shifted the regional hub for medical care from Singapore.

Though two-thirds of its patients are Thais, the hospital caters to foreigners with a concierge service and handles such things as airport transportation, bank transactions, visas and airline tickets.

Since Sept. 11, Mr. Schroeder said, there has been a flood of Middle Eastern patients who now avoid the United States for fear of discrimination. In response, the hospital has hired extra Arabic interpreters, stocked up on Muslim prayer rugs and opened a kitchen serving religiously acceptable halal food.

"It looks like Mecca downstairs," Mr. Schroeder said.

Bumrungrad has made a deliberate effort not to look or smell like a hospital, softening its décor and filtering its air. Its gigantic, carpeted lobby with deep sofas, potted trees and a blonde-wood reception desk has the look of an expensive hotel.

As much as anything, it is the Starbucks coffee shop that draws comment, along with the McDonald's, the Au Bon Pain, the Japanese restaurant and the mezzanine food court. A bed-ridden patient can order from any of these outlets through room service.

Elevators carry portraits of a guest chef each month who visits to prepare the hospital's menu.

All of this helps patients and their families to feel safe and comfortable, Mr. Schroeder said. But it is also great for the tourist brochures.

Mr. Schroeder, who was previously the administrator of USC University Hospital in Los Angeles, has been an enthusiastic booster of Thailand's medical tourism.

"We looked at finding a way to do frequent-flyer miles, but we can't figure out a way to calculate them," Mr. Schroeder said, perhaps joking. "If you have a cholecystectomy, how many miles do you get?"

 

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Student Bio
Jennifer Hemmingsen is a Master's professional student at the University of Iowa, studying narrative journalism. Before enrolling in the program, she was a newspaper reporter in Minnesota and Oregon. Jennifer can be reached at jennifer-hemmingsen@uiowa.edu

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