«Health Tourism

Goa's most popular dental clinic, features on the FRONT PAGE of Goa's Number One Newspaper.....

THE NAVHIND TIMES 
Panaji, Thursday, June 22,2006


The dentist who attracts tourists
By Aditya Anand


Since time immemorial, the main motivation for people to travel across continents has been to explore the world. But today they also do so for several other reasons. Lately, the tourists have discovered medical tourism, better known as health tourism, in India.

Following the runway success of the booming BPO, health tourism in this county is all set to provide a cheaper option to the foreign tourists keen on ensuring their health and well-being. Figures show that around 1.5 million medical tourists visit India each year. And the arrival rate is rising.

Goa, the preferred destination for tourists from rest of the country and across the world, offers a multiple choice of attractions to the visitors. Be it beaches, temples and churches or spice gardens, Goa has them all. But health tourism is a newer addition that the State can tap. Not least of the many aspects of the health sector that have attracted the tourism market, is dental care.

Read a report on health and wellness tourism in India: "Here, we can boast of highly skilled dentists at par with the international experts in the field." In Goa, one such dentist is Dr. Hubert Gomes. A resident of Benaulim and practicing in Margao, Dr. Gomes has the distinction of placing Goa on the world health tourism map.

So how many tourists visit him? "Well a lot of them," he informs. "The available skill here attracts a lot of patients from the United Kingdom, the United States of America, the Gulf countries and Canada. They prefer to visit India for their dental treatment. They save enormously on cost, while getting the same quality of treatment and, at the same time, enjoying a holiday with their families or the accompanying person."

A popular dentist to a large number of people from Goa, Dr. Gomes right from the early 1980s has been treating a large number of tourists, both foreigners and Indians, at his clinic. "I got my degree in dentistry from the Government Dental College, Hyderabad. In the early 80’s mine was one of the six dental clinics in Margao," Dr. Gomes recalls.

He later got trained in ceramic fixed dentures in Switzerland and Germany "Catering to tourist as such had never been on my mind," he says. For Dr. Gomes, his dentistry being a tourism activity is not a priority. "I still do not give any preference to treating the tourists exclusively." For him the tourists he treats are just like any other patient, who only endorses his competence in dentistry and show their trust in him.

Initially in the early 1982s, the tourists visiting the Colva-Benaulim stretch came to him for treatment. Dr. Gomes who used to treat about 10 foreign tourists then, attends to around 2,500 to 3,000 foreigners a year now. Appointments are mostly done through e-mail or over the phone.

On his part, Dr. Gomes, through his website (www.drhubertgomes.com and www.dentistingoa.com), has made it clear that any foreign patient intending to avail of treatment should either have been recommended by a friend or a relative who has been treated at his clinic earlier.

Prospective patients are also encouraged to decide on being treated Dr. Gomes only after referring to various reliable sources and being convinced of their total confidence in his treatment.

Dr. Gomes is assisted by two full-time dentists and seven other visiting Specialists. The ceramic lab that he runs by employing 12 other staff is looked after by his wife Ms. Risoleta Gomes.

The in-house dental laboratory, the third such lab to be certified by Vita of Germany, undertakes metal-free-ceramic fixed dentures, including the latest Zirconia ceramics. "I had a foreign tourist walking into my clinic in the very second month after it opened! As I do today after 23 years of practice, then, too, I treated him just the way I treat any of my local patients," informed Dr. Gomes.

In fact, Dr. Gomes does not really consider himself as being part of the medical tourism trade as his Fees are same for all his patients. "I believe in single pricing, hence my focus is not the tourist alone. I treat all my patients in the same manner." he says.

A worry expressed by Dr. Gomes is that “70 per cent of the trade in Goa today, is run by people who have settled in Goa during he last 15 years or so. About 35 per cent of locals are badly trying to make ends meet. The cost of living is high here and the government needs to pay urgent attention to this”. He is firmly of the view that health tourism in Goa should be allowed to evolve at its own pace.

"In my case, the patients I treat work as free marketing executives! It is purely a word of mouth publicity which attracts patients to my clinic", Dr. Gomes observers.

Now aiming for an ISO 9001-2000 certification, the spade work for which is almost complete, Dr. Gomes is all for attaining a better quality of management standards. His observation of foreigners has been that they are very critical about the treatment they receive, and most of them are their very good judges.

According to Dr. Gomes, who is a vital component of dental tourism in Goa, the government of the day should chalk out a framework of various parameters of wellness tourism. "Health tourism is a very delicate module of tourism. Any carelessness can lead to the state's medical fraternity earning a bad name”.

His dental clinic has also had several visitors form the international dental fraternity. This included a delegation of leading dentists from Sweden, attending an International Dental Workshop in Goa.

"They came to visit my clinic in 2005. I felt honored and humbled when these distinguished dentists told the local press that my clinic could be compared to the best of dental clinics in Sweden", remembers a proud Dr. Gomes. He said “many would not know that Sweden gave to the world not only its first successful dental implant but also its strongest mental-free dental ceramic fixed dentures called Procera”.

PLEASE read the following ‘PRESS REPORT’…It could be an Eye opener, to know the “sad side” of dentistry in Goa.

Goan Messenger
Dated 1-15 May 2006, VOL.-VIII, issue-V

Is dental Tourism in Goa… Cutting Corners?
By Sigmund de Souza

Dental clinics in Goa are apparently flourishing, thanks to tourism, with foreigners going in for a range of dental treatments which cost them only a fraction of the cost in India, for what they would be paying way back in Europe in their home countries. Such is the lure of returns for dentists, apparently, that Goan parents are advising their children to seek admission into dental colleges instead of medical colleges. There has been a sudden spurt in the number of dental clinics coming up along the coastal belt, in particular in the Calangute-Candolim area.

There are also reports circulating within the dental fraternity of dentists, that, some of them are resorting to unethical practices and hasty treatment completion on account of the easy earning coming in from tourism. With the absence of any monitory agency to ensure that ethical standards are maintained in the profession, rules are being flaunted and caution thrown to the wind. The existing situation has raised alarm within the dental fraternity that, on account of the misdeeds of a few, the entire profession might come under a cloud. The future of the growing health tourism industry could also be severely destroyed as a result, according to many sources from the fraternity.

This writer tried to find out what the fuss is all about. Why are the tourists flocking to Goa in numbers for dental treatment? Why is there so much demand for seats in the dental college in Goa? And what precautions need to be taken for preventing the problem from getting out of hand?

A dentist life is not easy. Long hours, tremendous concentration and lots of hard work are involved in the dental profession. Hence, normally, no one would grudge a dentist's clinic getting busy. The major part of a dentist’s earnings goes back in to the up gradation of his equipment. With the rapid technological advancements in the field of medicine, dentists have to spend time and money to keep up with the latest in their field. A substantial amount of their earning also go in to infection control measures and purchase of disposable gloves, suction tips, needles, cups, etc.

There are, however, many dentists who neglect these requirements and instead continue with obsolete equipments, preferring to save for them what they earn .But these are rotten apples in the field, our sources tell us.

Cause for concern:

The cause for concern arises mainly along the coastal belt where young dentists lured by the taste of easy money are resorting to unethical treatment. European tourists visiting Goa find it very economical to undergo treatment like teeth bleaching, crown and bridge, and dental implant in Goa, because, in India, these treatments cost them only a fraction of the cost of what they would be paying back home.

Yet they are paying their hard earned money for these treatments, since most medical and health insurance plans in those countries do not cover these treatments. Those policies that do cover dental treatment mostly cover only basic dental treatment like fillings and extractions. Hence, ethical practitioners in the field of dentistry are concerned that such patients are perhaps not being treated with care and honesty.

Bleaching (teeth whitening)

Zoom and Bright Smile are highly sought after dental bleaching treatments that promise quick and amazing results. However, not every person can go in for teeth bleaching or teeth whitening, as good oral hygiene and gum health are pre-requisites to start the treatment. Before a patient undergoes the teeth whitening treatment, scaling or cleaning of the teeth has to be done. In the second step, all cavities have to be sealed with a temporary material which does not interfere with the process of bleaching.

Office bleach (like Zoom and Bright smile) is more expensive than the conventional home bleach yet complications arising out of improper home bleach are easier to rectify than those arising out of the improper use of Office Bleach. During the bleaching process the teeth get dehydrated. It takes the body about ten days to re-hydrate the teeth with the help of saliva. Only after that the final results of the treatment can be ascertain. According to sources speaking to this writer it is only after gestation period that tooth colored filling can be done on the patient's teeth.

Yet the effects of dental bleaching are not life-long and need to be done repeatedly in one's lifetime. The duration of the effects of the treatments depend on a lot of factors like food intake, consumption of tea, coffee, or smoking, Otherwise the effect of a bleach treatment last for an average of one and half to two years. This treatment is extremely risky to perform on a two week visit to Goa, and yet it is being performed in such circumstances in some clinics on the coastal belt of Goa.

Dental Implants

This is the most sought after treatment in recent years, where missing teeth or bad teeth are replaced by the use of this technically advanced method. Yet before a patient undergoes this treatment, which eventually requires dental surgery, the patient's bone level, medical status and mockup take a considerable number of days; since certain investigations like blood tests, x-rays and other related medical and dental investigations need to be completed first.

Once the patient has cleared all the summary pretests, then the all important surgery is undertaken. Hygiene or infection control measures assume high priority in case of such surgeries. After the implant is placed in the jawbone, time needs to be given for the implant to integrate with the bone. This process normally takes around 3-6 months.

If any part of the treatment is rushed and the implant area gets infected, the implant has to be immediately removed and the affected area left to heal. The above treatment must not be done on tourists unless they are here for a long holiday of say at least 4-6 months. Post treatment care is of utmost importance in such cases. Hence running through this procedure for financial incentive is highly risky.

Crown and Bridge

This treatment, our sources tell us, is being performed indiscriminately by some of the dental clinics along the coastal belt of Goa. Missing/ fractured teeth are replaced in this form of treatment. However, like in other dental treatment, indication and contraindication has to be looked into. Sometimes blood investigation and x-ray are recommended. It is a precision treatment requiring considerable time because it involves aesthetics as well functionality, and hence, cannot be completed in a hurry.

Dental filling also offer brisk business to dentists operating these coastal clinics. Whether the fees charged for the filling done are commensurate to the materials used is difficult to ascertain. Different materials significantly vary in cost.

The solution to this rising problem is to appeal to the good nature of these “erring black sheep '' from the profession our sources tell us. The other option is for the state government to commission an agency to look into such malpractices. The third is to educate the patients themselves, so that they do not become helpless victims.

Concerned members of the dental fraternity fear such malpractices will give a bad name not just to medical tourism, but to tourism in general.