JEFFREY SCHULT - BEAUTY FROM AFAR 

Question: How did you develop an interest in medical tourism? What motivated you to write Beauty From Afar?
I first heard of people traveling outside the United States for medical care in early 2004, on an e-mail list about outsourcing. Someone on the list interjected that outsourcing wasn’t just about manufacturing and call centers and computer programming and financial services – that people were actually outsourcing their own medical care. I had needed some extensive dental work for several years that I could not afford in the U.S. I immediately started looking into overseas options.
I ended up choosing Costa Rica and wrote a lengthy magazine article about my positive experience. The article led directly to my finding a literary agent who believed there was a market for a book about medical tourism. The rights to Beauty from Afar were sold in early 2005 to Stewart, Tabori & Chang of New York, and I continued researching medical tourism worldwide. The book was finished in the spring of 2006 and published last summer.

Question: Did you personally visit the overseas facilities yourself to collect data that you used in Beauty From Afar?
I had originally hoped to tour the world personally as part of my research (who wouldn’t?!) but that was not in the budget. I did manage to make some trips abroad and I traveled within the United States to meet doctors and surgeons from overseas when they were visiting. But the research and interviews for the book were mostly done via telephone and e-mail with patients, doctors, surgeons and other medical professionals, along with extensive Internet research. I think, overall, I probably ended up with a better and more useful book this way. I was doing my research much the way any patient could, if they had the time (though far more in depth.) If I had traveled – well, I know I would have enjoyed the trips greatly, but the book probably would have been written more through just my own eyes rather than through the eyes of so many more people.

Question: You had extensive dental work done in Costa Rica. Did you ever have dental work done in the US? How would you compare the quality of care in the two countries?
I went to dentists in the United States, regularly, as one is supposed to, for the first 46 or so years of my life. The care was fine, as you would expect … but my upper teeth just were wearing out before they were supposed to. The restoration of my upper teeth was done superbly in Costa Rica at a cost of a half to a third of what it would have cost in the U.S. The facilities were outstanding, as were my dentists.
Comparing the two – I would say that I could not have had a better experience or result in the United States than I had in Costa Rica. And I could afford my Costa Rican experience. Without medical tourism, having a great smile in my 50s was going to be just a fantasy.

Question: Do you hear from happy or otherwise unhappy customers thanking you or complaining to you about the advice you gave in your book? What do you tell people to keep in mind when deciding upon an overseas facility for treatment?
I hear on almost a daily basis from people who have read Beauty from Afar, thanking me for giving them a way forward on their own medical, dental and cosmetic research. It’s a tremendous feeling, knowing I have helped a lot of people.
I have also heard directly from several people who have had bad experiences in seeking or obtaining medical and dental care abroad. I can recall just one who told me I had done a disservice to the public by writing the book, and he hadn’t actually read it. I also, of course, know indirectly of patients who have not gotten the results from medical tourism for which they hap hoped, and of people who died during or after surgery. Not very many, but a few. I don’t want to sound cold about such cases and I have the deepest sympathy for these people and their families. But the same thing could have happened to them in the United States.
Medical treatment and surgery does not come with guarantees. The care that one can receive in many places around the world, in the modern facilities in the major metropolitan areas, is comparable. I tell people that, and that they should look at all their medical options carefully. I think reading Beauty from Afar gives people the kind of information they need to make good decisions.

Question: How are the American healthcare providers reacting to Americans traveling overseas for care?
A Costa Rican surgeon I once interviewed kind of summed up what is going on: “Those who are not against us want to join us.” We laughed at that, but it’s true. American healthcare providers are beginning to recognize that medical tourism and out-of-country providers are viable options for many people under certain circumstances and are starting to incorporate international health care into the options available to insured Americans. This is going to evolve over the next few years, and it’s fascinating to watch.

Question: Do you foresee the American healthcare system changing owing to the rising popularity of medical tourism?
Sure, I think it will have an impact over time. But U.S. health care is a $1.5 trillion economic system and it doesn’t change rapidly. Medical tourism is a very small piece of that picture even if it continues to grow rapidly, which I think it will.
“Small” is relative, of course. In this case, “small” still means, potentially, billions or tens of billions of dollars spent annually on out-of-country health care.

Question: How about insurance companies? Do you anticipate them jumping into the medical tourism business? Do you think it will be profitable for them as well as the insured to opt for medical tourism plans?
Yes, yes, and yes.
It’s already happening. People in southern California can buy relatively inexpensive insurance that sends them to Mexico for non-emergency care, and the option is popular. Blue Cross Blue Shield of South Carolina is gearing up to offer medical tourism through a subsidiary. These are innovative, early-stage offerings and others will be along soon. It makes sense for insurers to try to cut costs. It makes sense for consumers to try to cut costs. So it’s going to be tried.

Question: To those Americans who are skeptical about going to a third world country for care, what do you have to say?
I usually say, politely, that they need to update their notion of what “third world” means, and I’ll tell them about what is available and where, and what it’s like for people who actually do this. I think awareness of medical tourism, though still low, is growing rapidly. More people are going all the time. Medical tourism has phenomenal “word of mouth” appeal. And these days, it’s getting more and more favorable treatment in the media. That has sort of evolved over time, as such things do. That people go overseas for health care no longer shocks news reporters, as it did only a few years ago. It’s no longer a “gee whiz” story. We’ve moved on to “What’s next?” and “What does it mean?”

Question: What’s coming next for you?
I’m working with a company, CPR Associates (www.cpronline.com), which has a lot of experience with the development of medical tourism, to bring out a newsletter called Medical Travel Today. I expect we’ll launch that in the next few weeks and I think we can make it a valuable resource for the international medical/business community and for patients.
I continue to promote Beauty from Afar, of course, and that’s a lot of fun. I hope I’ll eventually have the opportunity to write the next chapter of the medical tourism story but I think that may be a year or two down the road. I have a couple of other books I’m working on – I’m a journalist and writer, that’s what I do – but none of them is yet contracted for, so I’m not decided on which will get finished first!

Question: Any final words?
I’m not ready to write my epitaph quite yet. ;-)
Seriously, I appreciate the opportunity to add to the ongoing conversation in the world about medical travel and I’ll be delighted to continue the discussion if people have comments or questions.