Passage to India, for Surgery

The titanium parts that were used in Gilmore's procedure are so new, they are still awaiting U.S. Food and Drug Administration approval.

Gilmore's surgeon, Dr. S.K.S. Marya, has already performed more than 150 of these procedures using the new device. He has trained all over the West, including in the United States, England, Switzerland and Australia, and has published in academic journals and recently finished writing a book on hip resurfacings.

The group that helped organize Gilmore's trip, PlanetHospital, has relationships with hospitals in at least seven countries, and all patients have to do is show up, CEO Rudy Rupak said.

"We take care of everything, from their hospital, the airlines, their hotels," Rupak said. "When they arrive in the country of their choice, one of our team members is there to greet them. We take them to their hotel or hospital. We take them to the doctor. We act as their advocate in the country so that if they're not happy with the doctor or the surgeon or the hospital, we'll take them to another place. If there's a dispute with the bill, we stand on the patient's side to fight on behalf of the patient to get satisfaction in their ways."

Van Meter tries to run a profitable small business, but something about these wide-open spaces brings people together a bit more.

"We're kind of a family. Dodie needs this help, and we're willing to help her if this is the only way that she can get the surgery that she needs," said Van Meter, who knows that keeping a fit and productive real estate agent will pay dividends.

"Dodie and she will pay me back many times with her being able to go back into the field, you know, sell a ranch (and she) could get my money back," he said.

It is a choice so many small businesses struggle with -- how to balance the bottom line with the needs of their employees.

Overseas medical travel has been popular for a long time for those patients seeking more minor procedures, like cosmetic surgery, but now everything from hip to heart to brain surgeries are available overseas -- at a fraction of the price.

Rick Wade, spokesman for the American Hospital Association, said the hospitals in his network aren't concerned yet. But he admits that this is a sign of how broken some parts of the American medical system are. And he wonders whether people are willing to take all the risks involved in globetrotting for medical care.

"Does it make a difference to you that there has been a military coup outside the hospital where you just went for surgery?" Wade said.

For some doctors, though, the trend is cause for concern.

"I think the number of people considering going overseas for care should be an absolute red star, if you will, to health policy makers to everyone in elected office, that this system is in serious trouble," said Nancy Dickey, the president of the Health Science Center and vice chancellor for health affairs in the Texas A&M System.

Dickey points out there could be a rise in postoperative care back in the United States if there are complications, and warns that there may not be malpractice laws in place in other countries. But she acknowledges these are some of the reasons health care in the United States is so expensive.

"I may do tests, extensive imaging ... not because I want those test results but because I want those test results to protect me down the road in case you want to sue me," Dickey said.

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