Flying to India for a physical

28-step exam costs $110, including meals

Hemant Buch, founder of the California Cricket Academy, flew to India last month to recruit coaches for the upcoming youth cricket tournament in Cupertino. The healthy 42-year-old also made an appointment for an annual check-up at Sterling Hospital in Ahmedabad, a city just north of Mumbai.

The 28-step examination lasted from 8 a.m. to 3 p.m., providing the medical team with enough time to assess his health in painstaking detail.

In between the phases of the physical, a friendly staffer served him breakfast, then coffee or tea, lunch, and then more coffee or tea. The bill: about $110.

The Cupertino resident is among the world's 150,000 so-called "medical tourists" who mixed business or pleasure with health care when they traveled to India this year.

Medical tourism is a side effect of globalization, which has encouraged more international business ties and opened up more frequent flights to far-off destinations.

Buch, who grew up in Ahmedabad, immigrated to the United States to pursue a master's degree in engineering at San Jose State University in 1987. During the 1990s, he only visited his homeland once every two years. The flights were expensive and grueling, requiring an eight- to 12-hour overnight layover at the airport in Mumbai or New Dehli.

Now the engineer travels to India about three times a year, often because of cricket. The trip isn't as bad as before, in part because the more convenient flight schedules shave off seven to 13 hours of thumb-twiddling time.

Improved hygiene

For the past two years, Buch has been getting his annual check-up in India. Years ago, he wouldn't have entertained the idea, largely because of hygiene. He recalled that when he was a child, some of his doctors didn't wear gloves and those who did may not have put on new ones in between patients.

But he has no doubts about the hygiene standards now. During his last exam, he watched the medical staff dispose of the used syringes in a machine that instantly incinerated the needles, instead of tossing them in a special trash can that someone eventually has to empty.

"I've never seen this even here" in Silicon Valley, Buch said. "I wish I had taken a picture."

Confidence-boosting changes like that are part of a new government campaign to attract 1 million additional medical tourists to India by 2010, according to Indian news reports. The government and the medical industry have been working to accredit India's hospitals under international standards.

The overseas promotional campaign, detailed two weeks ago by India's Minister of State for Tourism, will cast India as a medical tourism hot spot through brochures and CD-ROMs. The government has formed several committees to deal with medical insurance issues, and the tourism department has begun creating alliances between some hospitals and European insurance companies.

India is also promoting its low-cost medical treatments to travel agencies. At the World Travel Market held in London in November, India's tourism ministry for the first time brought along hospital representatives and dedicated 32 of its 212 stalls to the health care industry.

Even though annual check-ups, hip replacements, liver transplants and other procedures in India typically cost just one-tenth to one-fifth of the price paid in Western countries, medical tourism could be lucrative for India. An additional 1 million international patients could bring the country as much as $2 billion, the government estimates.

Some experts believe medical tourism, which is already growing by 15 percent annually, will be India's second-largest economic engine, right behind information technology.

Dental work

Mahesh Nihalani, 55, visited a dentist while vacationing in India three years ago to take care of a cavity, a crown and two bridges.

"Insurance doesn't cover too much of dental here anyway," said Nihalani, of Cupertino. And he snagged an appointment within a week, rather than enduring the usual monthlong wait in Silicon Valley.

"If you buy a ticket and fly to India and get your dental care done and fly back," Nihalani said, "it's still cheaper than if you get it done here."

For some potential patients, the lure of savings is offset by fear of complications that could arise after they return home. But Buch has no such worries.

By the time he left Sterling Hospital in Ahmedabad, copies of his medical report, X-ray and ultrasounds were waiting for him. The hospital also e-mailed him the report, which he can forwarded to his primary care physician in Silicon Valley.

Buch said his wife, who flies to India much less frequently, will get her annual check-up in India when she travels there next year. And he has his sights set on getting Lasik eye surgery, which will cost less than $1,000 in India.

If he doesn't get the corrective eye surgery done in India, he isn't going to get it done at all.

"I definitely will not do it here," he said, "because of the cost."

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