The following piece was published 22 April 2013, SBS World News Australia Radio.
By Ildi Amon
A growing number of Australians are choosing to go overseas, especially to Asia, for medical procedures in a trend known as medical tourism.
The procedures include plastic surgery and complex dental work.
The motive, often, is the ability to receive treatments at a much lower cost than in Australia.
But, as Ildi Amon reports, it's a trend being lamented by the Australian Medical Association.
Australians are travelling to countries including Thailand, India, South Korea, Turkey and Malaysia, for a range of medical and dental work.
In many cases, they're going for procedures to alter their personal appearance, though some are addressing medical needs.
Sharon Wilsnatch is from Global Health Travel, an Australian company that markets what it calls health travel packages.
"The most popular procedures overseas are obviously cosmetic surgery: your breast augmentations, facelifts, tummy-tucks and more and more we're seeing an increase in enquiries for spinal surgeries, neck surgery, hip replacements, knee replacements, shoulder reconstructions, fertility treatments."
Rita Coleiro is an Australian who has undergone dental procedures twice in Thailand.
She organised her own medical holidays first in Bangkok and then in the resort town of Phuket undergoing teeth whitening, dental bridges and crowns.
"I don't think their technology is that great in Australia, because they gave me a plate that goes under the roof of my mouth and with wires. Whereas in Bangkok the temporary tooth they gave me was just a tooth that kind of just slipped in, it was just amazing. Very, very cheap it would have cost me probably 160 dollars, whereas here they charged me 700 dollars for that barbaric thing they put in my mouth."
Rita Coleiro says even with flights and accommodation, the work she had done in Thailand was cheaper than it would have been in Australia - and quicker.
"I just found them professional, clean, no waiting, no stuffing around. The work I needed done ideally should have taken about two weeks but I told them I didn't have the time and they did it in like five days. They were just brilliant, I just found them more superior and much more advanced."
Meredith Jones from Sydney's University of Technology is researching one aspect of medical tourism - cosmetic surgery - and says price is no longer the only motivator.
"Now I'm getting more people saying things to me like I'd prefer to have it overseas because I can recover away from family and friends or more interestingly they say I think I'll get better care overseas. So there is also this perception now that you do actually get better care for obviously far less money."
But Vice President of the Australian Medical Association, Geoff Dobb, says Australians should avoid undergoing medical procedures overseas.
"People need to be aware that the standards of medical facilities are often significantly less than they would be in Australia and without carefully inspecting all of the procedures they have in those hospitals they may not be aware of the risks that they are exposing themselves to."
The medical tour operator, Sharon Wilsnatch, says in part, the trend is being driven by the expertise of some foreign surgeons.
But she says all surgery carries risk and medical tourists should do their research and always have adequate medical travel insurance.
"All surgery needs to be taken seriously. This is not about having a holiday. This is not about, you know, going over, getting surgery and going partying. And patients need to be educated in the fact that they're going there to have surgery, to rest up, heal properly, recover and come home safely."
Meredith Jones from the University of Technology in Sydney estimates that cosmetic surgery tourism by Australians alone is a 300 million dollar a year industry.
She says about 15,000 Australians travel overseas each year to undergo cosmetic procedures.
And her research shows a growing number of people are going in groups.
"So they're people who might not actually have the surgeries if they didn't have the opportunity to have an overseas holiday with the surgery. Most of those people are women in their late teens or early 20s. They travel in groups and they mostly have breast augmentation surgeries. And there are also people who say my friends were doing it so I decided to do it as well."
Doctor Jones says costs vary a lot overseas but cosmetic surgery is generally half or less than in Australia.
"The holiday's generally between a week and two weeks long. They have their surgery usually on the very first day. They spend a couple of days recovering and then they spend the rest of the time in some pain doing those other activities and really bonding as a group."
And Doctor Jones says according to her research, the Australians who get plastic surgery done overseas are generally happy with the result.
"They often regret it at the point of going under anaesthetic and for a few hours after waking up - perhaps when you're most likely to think: I'm doing or I've done a really stupid thing. But after those moments the vast majority of people not only have no regrets but they also say they'd do it again and that they would recommend it to friends."
But Geoff Dobb from the Australian Medical Association, says medical tourists run the risk of a less-skilled surgeon, less sterilised conditions and a higher risk of infection from multi-resistant bugs.
"If they come back to Australia with complications, these can be extremely difficult to retrieve. And of course there can be, in many occasions, very little redress against the places where the surgery has been performed. People come back and can be seriously disfigured by the surgery that they've been subjected to elsewhere."
Glenn Cohen is a medical tourism researcher and professor at Harvard Law School in the United States.
He says there is a lack of reliable data on the worldwide travel of medical tourists.
But he believes globally only a small portion travel for cosmetic reasons.
"I like to divide the world of medical tourism into three buckets. You have people travelling abroad for services that are legal both where they're coming from and where they're going to. Then you have people who are going abroad to escape a law that prohibits service in their home country. And the third bucket is people who are travelling for things that are illegal both where they're coming from and where they're going to, but where one enforcing regime is laxer."
The Sydney researcher Meredith Jones says another aspect of medical tourism is the ethical issues it raises.
"Various countries are seeing it as a good source of revenue already or as a potentially lucrative industry that the whole country would supposedly benefit from. There is some research that shows the more international medical tourists there are the less facilities there are for locals in terms of medical care."
But Rita Coleiro has no regrets about going overseas for her dental procedures and recommends it to others.
"I went for the big hospitals, I did a bit of research...researched on their equipment and what they had there and after talking to them and emailing them several times I just went ahead and did it. So I booked the hospital, booked the flight, booked the hotel and it was easy."