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Tooth painting is a custom practiced by the Si La ethnic group. The Si La men paint their teeth red and the women paint theirs black. This practice has slowly declined with each new generation.
The practice of whitening teeth has also become popular in Western culture as a form of aesthetic enhancement.
In 17th-century Elizabethan England, women would paint their teeth colorfully, especially green or purple, in accordance with what some people of the period found beautiful.
From Wikipedia, the free encyclopedia
Jumat, 07 Maret 2008
Tooth fairy
The tooth fairy is an example of Americanfolklore mythology. The fairy gives children a gift (often money) in exchange for a baby tooth when it comes out of the child's mouth. Children typically leave the tooth under their pillow for the fairy to take while they sleep. While originating in the United States, the tooth fairy myth is actively practiced in Ireland, Italy, South Africa, Australia, Canada, New Zealand and much of the UK.
Origins
The development of the Tooth Fairy legend
At one time in Europe, there was a tradition to bury baby teeth that fell out. The most commonly accepted belief by academics is the fairy's development from the tooth mouse, depicted in an 18th century French language fairy tale. In "La Bonne Petite Souris," a mouse changes into a fairy to help a good Queen defeat an evil King by hiding under his pillow to torment him and knocking out all his teeth.
This combination of ancient international traditions has evolved into one that is distinct in the United States, Australia, United Kingdom, and other Anglophonic cultures. Folklorist Tad Tuleja suggests three factors that have turned this folk belief into a national custom: postwar affluence, a child-directed family culture, and media encouragement.
Rosemary Wells, a former professor at the Northwestern University Dental School, found archival evidence that supports the origin of different tooth fairies in the United States around 1900, but the first written reference to one specific symbol in American literature did not appear until the 1949 book, "The Tooth Fairy" by Lee Rothgow. Dr. Wells created a Tooth Fairy Museum in 1993 in her hometown of Deerfield, Illinois.
The modern image of the Tooth Fairy has been shaped by depictions in various media. The fairy's first major appearance in popular culture in the United States came in the Peanuts comic strip. In a March 1961 strip, new character Frieda asks if the prices are set by the American Dental Society. The character of the Tooth Fairy has also appeared in several children's and an adults' books and films, as well as an eponymous radio series.
Modern traditions
Tooth Fairy ritual
An eight-year-old's gift to the Tooth Fairy
In Anglophonic cultures, a child will traditionally place a lost tooth under his or her pillow before going to sleep. In the morning the child finds a coin, small banknote, or a present in the place of the tooth. The child is typically told that the tooth fairy came during the night and exchanged the tooth for the gift.
A less-common variant is for the child to place the tooth in a glass of water beside the bed. Again, in the morning, the tooth is replaced with a coin. This variant is becoming more popular, as it is far easier for parents to find a tooth in a glass of water beside the bed without waking the child than it is to search under the pillow.
The Tooth Fairy is an example of folklore mythology sometimes presented to children as fact. Other prominent examples are Santa Claus (who originates from Saint Nicholas) and the Easter Bunny linking its origins to pagan worship. The realization or discovery that others may act on behalf of the tooth fairy is considered a part of growing up. Many adults remember clearly for their whole lives when and how they discovered the truth about the tooth fairy.
Many families participate in the roles of this myth even when the children are also aware of the fictionality of the tooth fairy, as a form of play or tradition.
The primary useful purpose of the tooth-fairy myth is probably to give children a small reward and something to look forward to when they lose a tooth, a process which they might otherwise find worrisome. It also gives children a reason to give up a part of themselves that they may have grown attached to.
Some believe that other useful purposes include giving children a sense of faith in things unseen, believing in the incorporeal, and giving them a little mystery to solve, helping them understand the difference between the real and the imaginary. It is believed children gain some maturity as they solve the mystery of the source of the money or gift. According to popular folklore, teeth will be exchanged for presents on any day of the year except Christmas.
Other tooth traditions
Tooth tradition is present in several western cultures under different names. For example in Spanish-speaking countries, this character is called Ratoncito Pérez, a little mouse with a common surname, or just "ratón de los dientes" (Tooth Mouse). The "Ratoncito Pérez" character was created around 1894 by the priest Luis Coloma (1851-1915), a member of the Real Academia Española since 1908. The Crown asked Coloma to write a tale for the 8-year old Alfonso XIII, as one of his teeth had fallen out.
In Italy also the Tooth Fairy (Fatina) is often substituted by a small mouse (topino). In France, this character is called La Petite Souris (« The Little Mouse »). In Ireland the Tooth Fairy is sometimes known as annabogle, although this is a more recent tradition. From parts of Lowland Scotland, comes a tradition similar to the fairy mouse: a white fairy rat which purchases the teeth with coins.
In some Asian countries, such as Japan, Korea, and Vietnam, when a child loses a tooth the usual custom is that he or she should throw it onto the roof if it came from the lower jaw, or into the space beneath the floor if it came from the upper jaw. While doing this, the child shouts a request for the tooth to be replaced with the tooth of a mouse. This tradition is based on the fact that the teeth of mice go on growing for their whole life, a characteristic of all rodents.
In parts of India, young children offer their discarded milk tooth to the sun, sometimes wrapped in a tiny rag of cotton turf
In films
Numerous films have been made on this theme, mostly horror. One example is Darkness Falls, a film by Jonathan Liebesman, in which an evil-spirit of a woman killed long ago assumes the form of the 'Tooth Fairy', and starts haunting. Another example is The Tooth Fairy, directed by Chuck Bowman. In this film, a murderous woman kills children for their teeth.
From Wikipedia, the free encyclopedia
Origins
The development of the Tooth Fairy legend
At one time in Europe, there was a tradition to bury baby teeth that fell out. The most commonly accepted belief by academics is the fairy's development from the tooth mouse, depicted in an 18th century French language fairy tale. In "La Bonne Petite Souris," a mouse changes into a fairy to help a good Queen defeat an evil King by hiding under his pillow to torment him and knocking out all his teeth.
This combination of ancient international traditions has evolved into one that is distinct in the United States, Australia, United Kingdom, and other Anglophonic cultures. Folklorist Tad Tuleja suggests three factors that have turned this folk belief into a national custom: postwar affluence, a child-directed family culture, and media encouragement.
Rosemary Wells, a former professor at the Northwestern University Dental School, found archival evidence that supports the origin of different tooth fairies in the United States around 1900, but the first written reference to one specific symbol in American literature did not appear until the 1949 book, "The Tooth Fairy" by Lee Rothgow. Dr. Wells created a Tooth Fairy Museum in 1993 in her hometown of Deerfield, Illinois.
The modern image of the Tooth Fairy has been shaped by depictions in various media. The fairy's first major appearance in popular culture in the United States came in the Peanuts comic strip. In a March 1961 strip, new character Frieda asks if the prices are set by the American Dental Society. The character of the Tooth Fairy has also appeared in several children's and an adults' books and films, as well as an eponymous radio series.
Modern traditions
Tooth Fairy ritual
An eight-year-old's gift to the Tooth Fairy
In Anglophonic cultures, a child will traditionally place a lost tooth under his or her pillow before going to sleep. In the morning the child finds a coin, small banknote, or a present in the place of the tooth. The child is typically told that the tooth fairy came during the night and exchanged the tooth for the gift.
A less-common variant is for the child to place the tooth in a glass of water beside the bed. Again, in the morning, the tooth is replaced with a coin. This variant is becoming more popular, as it is far easier for parents to find a tooth in a glass of water beside the bed without waking the child than it is to search under the pillow.
The Tooth Fairy is an example of folklore mythology sometimes presented to children as fact. Other prominent examples are Santa Claus (who originates from Saint Nicholas) and the Easter Bunny linking its origins to pagan worship. The realization or discovery that others may act on behalf of the tooth fairy is considered a part of growing up. Many adults remember clearly for their whole lives when and how they discovered the truth about the tooth fairy.
Many families participate in the roles of this myth even when the children are also aware of the fictionality of the tooth fairy, as a form of play or tradition.
The primary useful purpose of the tooth-fairy myth is probably to give children a small reward and something to look forward to when they lose a tooth, a process which they might otherwise find worrisome. It also gives children a reason to give up a part of themselves that they may have grown attached to.
Some believe that other useful purposes include giving children a sense of faith in things unseen, believing in the incorporeal, and giving them a little mystery to solve, helping them understand the difference between the real and the imaginary. It is believed children gain some maturity as they solve the mystery of the source of the money or gift. According to popular folklore, teeth will be exchanged for presents on any day of the year except Christmas.
Other tooth traditions
Tooth tradition is present in several western cultures under different names. For example in Spanish-speaking countries, this character is called Ratoncito Pérez, a little mouse with a common surname, or just "ratón de los dientes" (Tooth Mouse). The "Ratoncito Pérez" character was created around 1894 by the priest Luis Coloma (1851-1915), a member of the Real Academia Española since 1908. The Crown asked Coloma to write a tale for the 8-year old Alfonso XIII, as one of his teeth had fallen out.
In Italy also the Tooth Fairy (Fatina) is often substituted by a small mouse (topino). In France, this character is called La Petite Souris (« The Little Mouse »). In Ireland the Tooth Fairy is sometimes known as annabogle, although this is a more recent tradition. From parts of Lowland Scotland, comes a tradition similar to the fairy mouse: a white fairy rat which purchases the teeth with coins.
In some Asian countries, such as Japan, Korea, and Vietnam, when a child loses a tooth the usual custom is that he or she should throw it onto the roof if it came from the lower jaw, or into the space beneath the floor if it came from the upper jaw. While doing this, the child shouts a request for the tooth to be replaced with the tooth of a mouse. This tradition is based on the fact that the teeth of mice go on growing for their whole life, a characteristic of all rodents.
In parts of India, young children offer their discarded milk tooth to the sun, sometimes wrapped in a tiny rag of cotton turf
In films
Numerous films have been made on this theme, mostly horror. One example is Darkness Falls, a film by Jonathan Liebesman, in which an evil-spirit of a woman killed long ago assumes the form of the 'Tooth Fairy', and starts haunting. Another example is The Tooth Fairy, directed by Chuck Bowman. In this film, a murderous woman kills children for their teeth.
From Wikipedia, the free encyclopedia
Medical tourism
Medical tourism (also called medical travel,health tourism or global healthcare) is a term initially coined by travel agencies and the mass media to describe the rapidly-growing practice of traveling to another country to obtain health care.
Such services typically include elective procedures as well as complex specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental surgery, and cosmetic surgeries. The provider and customer use informal channels of communication-connection-contract, with less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed.
Leisure aspects typically associated with travel and tourism may be included on such medical travel trips. Prospective medical tourism patients need to keep in mind the extra cost of travel and accommodations when deciding on treatment locations.
A specialized subset of medical tourism is reproductive tourism, which is the practice of traveling abroad to undergo in-vitro fertilization and other assisted reproductive technology treatments.
History
The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism.
Spa towns and sanitariums may be considered an early form of medical tourism. In eighteenth century England, for example, medtrotters visited spas because they were places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis.
Description
Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.
Medical tourists can come from anywhere in the world, including Europe, the UK, Middle East, Japan, the United States, and Canada. This is because of their large populations, comparatively high wealth, the high expense of health care or lack of health care options locally, and increasingly high expectations of their populations with respect to health care.
A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non-urgent medical care. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in Singapore, Hong Kong, Thailand, Cuba, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival. In Canada, the number of procedures in 2005 for which people were waiting was 782,936. Additionally, patients are finding that insurance either does not cover orthopedic surgery (such as knee/hip replacement) or imposes unreasonable restrictions on the choice of the facility, surgeon, or prosthetics to be used. Medical tourism for knee/hip replacements has emerged as one of the more widely accepted procedures because of the lower cost and minimal difficulties associated with the traveling to/from the surgery. Colombia provides a knee replacement for about $5,000 USD, including all associated fees, such as FDA- approved prosthetics and hospital stay-over expenses. However, many clinics quote prices that are not all inclusive and include only the surgeon fees associated with the procedure. According to an article by the University of Delaware publication, UDaily:
“
The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the U.S., for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa." ”
Popular medical travel worldwide destinations include: India, Brunei, Cuba, Colombia, Hong Kong, Hungary, Jordan, Lithuania, Malaysia, The Philippines, Singapore, South Africa, Thailand, and recently, Saudi Arabia, UAE, Tunisia and New Zealand.
Popular cosmetic surgery travel destinations include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico and Turkey. In South America, countries such as Argentina, Bolivia, Brazil and Colombia lead on plastic surgery medical skills relying on their experienced plastic surgeons. It is estimated that 1 in 30 Argentineans have had plastic surgery procedures, making this population the most operated in the world after the US and Mexico.[citation needed] In Bolivia and Colombia, plastic surgery has also become quite common. According to the "Sociedad Boliviana de Cirugia Plastica y Reconstructiva", more than 70% of middle and upper class women in the country have had some form of plastic surgery. Colombia also provides advanced care in cardiovascular and transplant surgery.
In Europe Belgium, Poland and Slovakia are also breaking into the business. South Africa is taking the term "medical tourism" very literally by promoting their "medical safaris". However, perceptions of medical tourism are not always positive. In places like the US, which has high standards of quality, medical tourism is viewed as risky. In some parts of the world, wider political issues can influence where medical tourists will choose to seek out health care.
Health tourism providers have developed as intermediaries to unite potential medical tourists with provider hospitals and other organisations. Companies are beginning to offer global health care options that will enable North American and European patients to access world health care at a fraction of the cost of domestic care. Companies that focus on medical value travel typically provide nurse case managers to assist patients with pre- and post-travel medical issues. They also help provide resources for follow-up care upon the patient's return.
International healthcare accreditation
Because standards are important when it comes to health care, there are parallel issues around medical tourism, international healthcare accreditation, evidence-based medicine and quality assurance.
In the United States, Joint Commission International (JCI) fulfills an accreditation role, while in the UK and Hong Kong, the Trent International Accreditation Scheme is a key player. The different international healthcare accreditation schemes vary in quality, size, cost, intent and the skill of their marketing. They also vary in terms of cost to hospitals and healthcare institutions using them. Increasingly, some hospitals are looking towards dual international accreditation, perhaps having both JCI to cover potential US clientele and Trent for potential British and European clientele.
Other organizations include:
The Society for International Healthcare Accreditation (SOFIHA), a free-to-join group providing a forum for discussion and for the sharing of ideas and good practice by providers of international healthcare accreditation and users of the same. The primary role of this organisation is to promote a safe hospital environment for patients.HealthCare Tourism International, the first US-based non-profit to accredit the non-clinical aspects of health tourism, such as language issues, business practices, and false or misleading advertising prevention. The group provides accreditation for all major groups involved in the health tourism industry including hotels, recovery facilities, and medical tourism booking agencies.
Risks and rewards
Medical tourism carries some risks that local medical procedures do not. Should complications arise, patients might not be covered by insurance or able to seek compensation via malpractice lawsuits. However new insurance products are available that do protect the patient should a medical malpractice occur overseas. Some countries currently sought after as medical tourism destinations provide some form of legal remedies for medical malpractice. However, this legal avenue is unappealing to the medical tourist. Advocates of medical tourism advise prospective tourists to evaluate the unlikely legal challenges against the benefits of such a trip before undergoing any surgery abroad. Patients should also be aware that the quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be different from US or Western standards.
Some countries, such as India, Malaysia, Costa Rica, or Thailand have different infectious diseases than Europe and North America, and different prevalences of the same diseases compared to nations such as the U.S., Canada, and the UK. Exposure to disease without having built up natural immunity can be a hazard for weakened individuals, specifically for gastrointestinal diseases (e.g Hepatitis A, amoebic dysentery, paratyphoid) which could weaken progress, mosquito-transmitted diseases, influenza, and tuberculosis (e.g., 75% of South Africans have latent TB). International hospital accreditation with Trent or JCI, mentioned earlier, may be of value here when people are trying to choose a destination for their procedure.
Also, travel soon after surgery can increase the risk of complications, as can vacation activities. For example, scars will be darker and more noticeable if they sunburn while healing.[7] Long flights can be bad for those with heart (thrombosis) or breathing-related problems. To avoid these problems medical tourism patients often combine their medical trips with vacation time set aside for rest and recovery in the destination country.
However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of any infectious disease, including HIV, TB, and typhoid, there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be "rare" in the West. For hospitals and doctors seeking to provide medical tourism services, there is the risk of being sued by a disgruntled patient, so medical indemnity services such as those provided by the Medical Protection Society are essential.
Destinations
North America
Canada
Canada has entered the medical tourism field. In comparison to U.S. health costs, medical tourism patients can save 30 to 60 percent on health costs in Canada. Canada's quality of healthcare is cited by the World Health Organization as equal to if not better than that of the U.S. in most categories.
Cuba
Cuba has been a popular medical tourism destination for more than 40 years. Thousands of patients travel to Cuba, particularly from Latin America and Europe, attracted by the "fine reputation of Cuban doctors, the low prices and nearby beaches on which to recuperate."[11] In 2006, Cuba attracted nearly 20,000 health tourists. Medical treatments included joint replacement, cancer treatment, eye surgery, cosmetic surgery and addictions rehabilitation. Costs are about 60 to 80 percent less than US costs. For example, Choice Medical Services, a health tourism provider, provides a hip replacement in Cuba for US$5,845/C$6120/€4227. Cuba has hospitals for Cuban residents and others that focus on serving foreigners and diplomats. In the 2007 American documentary film, "Sicko," which criticizes the US healthcare system, producer Michael Moore leads a group of uninsured American patients to Cuba to obtain more affordable medical treatment. "Sicko" has greatly increased foreigners' interest in Cuban healthcare. A recent Miami Herald story focused on the high quality of health care that Canadian and American medical tourism patients receive in Cuba. The Cuban government has developed Cuban medical tourism to generate income for the country. Residents of Canada, the UK and most other countries can travel to Cuba without any difficulty; a tourist visa is generally required. For Americans, however, because of the US trade policy towards Cuba, travelers must either obtain US government approval, or, more frequently, travel to Cuba from Canada, Mexico, the Bahamas, Jamaica or the Dominican Republic. Cuban immigration authorities do not stamp the passports of US visitors so that Americans can keep their travels a private matter.
However, few Cuban hospitals as yet have international healthcare accreditation.
Dominican Republic
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One of the medical tourism destinations nearest to the US mainland is the Dominican Republic. The country has become a popular destination for plastic surgeries, hip-replacements, knee replacements, bariatric surgeries, eye surgeries and all other types of surgeries and medical treatments. The costs are generally 50 to 75 percent less than cost of similar procedures in the US.
Mexico
Americans, particularly those living near the Mexican border, now routinely cross to Mexico for medical care. Popular specialties include dentristry and plastic surgery. Mexican dentists often charge one-fifth to one-fourth of US prices, while other procedures typically cost a third what they would in the US. This trend has alarmed American healthcare providers who, fearing a loss of business, warn patients away from Mexico. "The phenomenon has unsettled US-based dentists who tell horror stories of rampant infections, undetected cases of oral cancer and shoddy work south of the border -- claims hotly disputed by Mexican dentists." "In Texas, legislators explored the possibility of allowing health maintenance organizations to operate on both sides of the border. However, physicians in south Texas lobbied against the changes, arguing that local doctors could not compete with the lower costs in Mexico". US doctors point out that the Mexican legal system makes it almost impossible to sue Mexican doctors for malpractice. However, many who travel to Mexico for care report that they are satisfied. According to a report commissioned by Families U.S.A., a Washington advocacy group for health-care issues, "About 90 percent [feel] the care they had received in Mexico had been good or excellent. About 80 percent rated the care they had received in the United States as good or excellent". Indeed "some U.S. dentists ... have conceded to the competition and begun a 'reverse migration' opening offices in Mexico to take advantage of lower costs". American insurers are providing coverage for travelers, as the out-of-pocket costs to them are much lower. "With healthcare costs in the United States continuing to rise, many employers in Southern California are turning to insurance plans that send their workers to Mexico for routine care, plans that are growing by nearly 3,000 people a year".
In addition to dental and plastic surgery, Mexican hospitals are popular for bariatric surgery for weight loss, considered an elective procedure that is not covered by some US insurers. A popular bariatric procedure, lap band surgery, which was approved by the FDA in the US in 2001, has been performed for longer by Mexican surgeons.
Panama
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In Panama, health and medical tourism is growing rapidly. Factors drawing medical tourists include Panama's tourist appeal, position as a hub for international travel, and use of the dollar as the official currency. More important, Panama's medical professionals are trained around the world, use the latest technologies and medications, and have earned a high reputation. Many of Panama’s doctors are bilingual, board certified, and accustomed to working with the same medical equipment and technology used in the United States and Europe. On most procedures, Panama offers savings of more than 50% compared to the US and Europe. For example, Dental implants cost an average of $2,500 per implant in the US or Canada. In Panama, the same procedure with board and lodging, personal tour guide, and transportation is available at a much lower cost.
Popular procedures include dental implants, plastic surgery, assisted reproduction, cardiology, cosmetic dentistry, pulmonology and orthopedics. Panama's hospitals have affiliations to international organizations such as: Baptist Health International of Miami, Cleveland Clinic, Tulane Health Science Center, Johns Hopkins International, Miami Children's Hospital, University of Nebraska Medical Center, The Kendall Medical Center in Florida, and Harvard Medical Faculty and Physicians at Beth Israel Deaconess Medical Center in US.
South America
Colombia
Colombia has been treating foreign patients for years, especially for cosmetic and eye surgery. Colombia has also provides advanced cardiovascular and transplant surgery. What often compels persons to seek transplant surgery offshore is not only cost considerations, but waiting lists (such as in the US) or the lack of an organized organ inventory and donor system in the home country. Colombia has such an organ donor and banking system which makes organs available to foreigners with certain legal restrictions. Orthopedic surgeries, such as knee and hip replacements, are done in Colombia with US-made, (FDA-approved) prosthetics at a fraction of the cost.
Colombia has many surgeons that have either trained and/or practiced in other countries such as the US and Europe. Salaries for doctors, nurses, and supporting personnel in Colombia are about 20% of US salaries for similar occupations even though they are required to have the same level of education and job skills. Real estate costs related to medical care facilities are also a fraction of what they are in the US
One advantage of Colombia for those from the US and Canada is ease of travel and close proximity. Colombia offers cheaper airfares from the US and Canada (and some European countries) than other more-distant destinations, and does not have the visa restrictions of other countries currently in the medical tourism market.
Asia/Pacific
Hong Kong
Hong Kong has 12 private hospitals and more than 50 public hospitals. A wide range of health care services are offered. All 12 of Hong Kong's private hospitals have been surveyed and accredited by the UK's Trent Accreditation Scheme since early 2001. This has been a major factor in the ascent of standards in Hong Kong's private hospitals. The Trent scheme works closely with the hospitals it assesses to generate standards appropriate to the locality (with respect to culture, geography, public health, primary care interfaces etc.), and always uses combinations of UK-sourced and Hong Kong-sourced surveyors. Some of Hong Kong's private hospitals have now gone on to obtain dual international accreditation, with both Trent and JCI (and have therefore attained a standard surpassing some of the best hospitals in Thailand and Singapore). Others are looking towards dual international accreditation with Trent and the Australian group. Hong Kong public hospitals have yet to commit to external accreditation.
India
India is known in particular for heart surgery, hip resurfacing and other areas of advanced medicine. The government and private hospital groups are committed to the goal of making India a leader in the industry. The industry's main appeal is low-cost treatment. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain. Estimates of the value of medical tourism to India go as high as $2 billion a year by 2012. The Indian government is taking steps to address infrastructure issues that hinder the country's growth in medical tourism.
The south Indian city of Chennai has been declared India's Health Capital, as it nets in 45% of health tourists from abroad and 30-40% of domestic health tourists.Dental care has also caught on in India, with tourists coupling stays in cities like Udaipur with general check-ups and complex procedures.
Malaysia
Malaysia has ambitions to develop itself as a medical tourism hub. The country has excellent hospitals, English is widely spoken, and many staff have been trained to a high level in the UK or in the US. There is a highly active Association for Private Hospitals of Malaysia working to develop medical tourism.[27] While Malaysia has a national accreditation scheme (MSQH), few of Malaysia's hospitals currently hold international healthcare accreditation.
New Zealand
New Zealand is a relatively new player to the medical travel market, focusing on non-acute surgical procedures and fertility treatment. Like other Commonwealth countries, New Zealand's medical system is based on the British health system. Most of its specialist physicians have received training in New Zealand and the US or the UK, and all use English as their first language. The costs of private healthcare are significantly cheaper than the US or the UK, with packages (airfare, accommodation, medical service etc) for procedures like hip replacement, or coronary artery bypass costing in total approximately 40% of the procedure cost alone in the US. Many private hospitals in New Zealand are accredited by the national accreditation agency Quality Health New Zealand (QHNZ). QHNZ, like JCI, is a member of the International Society for Quality in healthcare or ISQua.
Philippines
The Philippines has been growing as a destination for medical tourism. Procedures can be performed at a fraction of the amount that a patient would spend on the same procedure in the US or Europe. Philippine medical and nursing curricula are more challenging than in many in Southeast Asia, and many Filipino doctors have acquired their postgraduate or fellowship training from well-known institutions in the US, the UK and other developed countries.
Medical centers in Metro Manila have complied to ISO standards, and are periodically and regularly undergo accreditations from Philippine's Department of Health. Others have already accredited by the American accreditation group Joint Commission International (JCI), while some are looking at UK-sourced hospital accreditation.]
Singapore
Singapore Medicine is a multi-agency government initiative that aims to develop Singapore into a leading destination for health care services. In 2005, some 374,000 visitors came to Singapore purely to seek healthcare.[29] Many patients come from neighboring countries, such as Indonesia and Malaysia. Patient numbers from Indochina, South Asia, the Middle East and Greater China to Singapore are also growing. Patients from developed countries such as the United States and the UK are beginning to choose Singapore as their medical travel destination for relatively affordable health care services in a clean cosmopolitan city.
Thailand
Medical tourism is a growing segment of Thailand's tourism and health-care sectors. In 2005, one Bangkok hospital took in 150,000 treatment seekers from abroad. In 2006, medical tourism was projected to earn the country 36.4 billion baht. Thailand offers everything from cardiac surgery to organ transplants at a price much lower than the US or Europe, in a safe, clean environment. Thai medicine also features a higher, more personalized level of nursing care than westerners are accustomed to receiving in hospitals at home. One patient who received a coronary artery bypass surgery at Bumrungrad International hospital in Bangkok said the operation cost him US$12,000 (8,200 euros), as opposed to the $100,000 (68,000 euros) he estimated the operation would have cost him at home.[31]
Hospitals in Thailand are a popular destination for other Asians. Another hospital that caters to medical tourists, Bangkok Hospital, has a Japanese wing and Phyathai Hospitals Group has interpreters for over 22 languages, besides the English-speaking medical staff. When Nepal Prime Minister Girija Prasad Koirala needed medical care in 2006, he went to Bangkok.[32]
One Thai hospital, Bumrungrad International, states that many of its doctors and staff are trained in the UK, Europe and the US. Bumrungrad International was accredited most recently in 2005 in order to ensure an international standard of medical services.[33] The modern Thai medical system shares in an Anglo-U.S. inheritance, as Prince Mahidol of Songla, the King's father, earned his MD degree from Harvard Medical School in the early 20th century. Prince Mahidol and another member of the Thai Royal Family paid for an American medical education for a group of Thai men and women.[citation needed] Prince Mahidol also convinced the Rockefeller Foundation to provide scholarships for Thai citizens to study medicine and nursing.[citation needed] Funds from the Rockefeller Foundation were also used to help build modern medical training facilities in Thailand. The men and women who studied medicine and nursing as a result of Prince Mahidol's efforts became the first educators for the modern Thai medical system.[citation needed]
Today many Thai physicians hold US or UK professional certification. Several Thai hospitals have relationships with educational facilities in the US and UK (for example, Sheffield Hallam University has links with Bangkok}. The US Consular information sheet gives the Thai health care system high marks for quality, particularly facilities in Bangkok, although the World Health Organization ranks the Thai healthcare system at number 47, which is below the USA's ranking at 37 and the United Kingdom's ranking at 18. The UK's Foreign and Commonwealth Office web site states "There are excellent international hospitals in Bangkok but they can be expensive".
While a very small percentage of Thai are internationally accredited, there are a growing number of hospitals with Joint Commission accreditation. Again, international hospital accreditation may be one way for hospitals to demonstrate their worth, and increasingly Thai hospitals competing for business in this sector may need to expand their international accreditation, including looking towards other international healthcare accreditation schemes sourced outwith of the US, to augment their appeal if they are to remain competitive.
Europ
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Germany
Germany has long been a medical tourism destination for people from the Middle East and North Africa. Now with a reduction in tension between East and West, many Russians and other Eastern Europeans are seeking treatment in Germany. British and Canadians, no longer willing to wait for treatment in their home country, are also traveling to Germany for treatment. Americans are also heading to Germany for the latest in spine surgery and novel cancer treatments and much lower prices than they would pay in the US. However, few German hospitals as yet have international healthcare accreditation.
Malta
Malta has a strong medical heritage and possesses a high-quality healthcare system modeled on the British system. The population is English-speaking. Malta is part of the European Union and has the euro as its currency. There are a number of private hospitals within Malta (see List of hospitals in Malta) which are developing medical tourism, especially for UK residents. As yet, Maltese hospitals have not engaged in international healthcare accreditation.
Portugal
Portugal's health care system was highly rated by the World Health Organization's year 2000 ranking of the world's health systems, rated 12th of 191 countries. This is a European Union country with regulatory bodies that certify doctors and health facilities, thereby protecting patients’ rights. Proximity to the US and Northern Europe reduce patients’ travel risks, while Portugal's mild climate is well-suited for convalescence. English is widely spoken by the majority of the population and Portugal is well known for its low crime rate. Dental clinics and cosmetic surgery facilities are popular. Prices are low when compared with similar procedures performed in the UK or the US. Other medical procedures include orthopedics, cardiology and eye surgery.
Spain
Spain's strong economy over recent years have provided for modern hospitals and well-trained health care professionals, making it an up-and-coming medical tourism destination.
Turkey
Turkey has attracted hundreds of thousands of tourists form Europe seeking for health care.
Ukraine
Ukraine features modern dental clinics with high-quality equipment, materials and effective anesthetics. They provide patients with dentistry services at lower cost in comparison with Western and Russian clinics. Other popular medical tourism offerings in Ukraine include spas, ophthalmology (eye surgery), plastic]] surgery, and mud baths. As yet, Ukraine medical clinics have yet to seek international healthcare accreditation.
Israel
Israel is emerging as a popular destination for medical tourists. Its modern, field-leading set of physicians and medical facilities are often used by international patients. In 2006, 15,000 foreigners travelled to the country for medical procedures, bringing in $40 million of revenue. Medical tourists choose Israel for several reasons. Some come from European nations such as Bulgaria and Cyprus where certain procedures are not available. Others come to Israel, perhaps most commonly from the US, because they can receive quality health care at a fraction of the cost it would be at home, for both surgeries and in-vitro fertilization treatments. Other medical tourists come to Israel to visit the Dead Sea, a world-famous therapeutic resort.
from,wkipedia.org
Such services typically include elective procedures as well as complex specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental surgery, and cosmetic surgeries. The provider and customer use informal channels of communication-connection-contract, with less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed.
Leisure aspects typically associated with travel and tourism may be included on such medical travel trips. Prospective medical tourism patients need to keep in mind the extra cost of travel and accommodations when deciding on treatment locations.
A specialized subset of medical tourism is reproductive tourism, which is the practice of traveling abroad to undergo in-vitro fertilization and other assisted reproductive technology treatments.
History
The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism.
Spa towns and sanitariums may be considered an early form of medical tourism. In eighteenth century England, for example, medtrotters visited spas because they were places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis.
Description
Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.
Medical tourists can come from anywhere in the world, including Europe, the UK, Middle East, Japan, the United States, and Canada. This is because of their large populations, comparatively high wealth, the high expense of health care or lack of health care options locally, and increasingly high expectations of their populations with respect to health care.
A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non-urgent medical care. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in Singapore, Hong Kong, Thailand, Cuba, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival. In Canada, the number of procedures in 2005 for which people were waiting was 782,936. Additionally, patients are finding that insurance either does not cover orthopedic surgery (such as knee/hip replacement) or imposes unreasonable restrictions on the choice of the facility, surgeon, or prosthetics to be used. Medical tourism for knee/hip replacements has emerged as one of the more widely accepted procedures because of the lower cost and minimal difficulties associated with the traveling to/from the surgery. Colombia provides a knee replacement for about $5,000 USD, including all associated fees, such as FDA- approved prosthetics and hospital stay-over expenses. However, many clinics quote prices that are not all inclusive and include only the surgeon fees associated with the procedure. According to an article by the University of Delaware publication, UDaily:
“
The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the U.S., for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa." ”
Popular medical travel worldwide destinations include: India, Brunei, Cuba, Colombia, Hong Kong, Hungary, Jordan, Lithuania, Malaysia, The Philippines, Singapore, South Africa, Thailand, and recently, Saudi Arabia, UAE, Tunisia and New Zealand.
Popular cosmetic surgery travel destinations include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico and Turkey. In South America, countries such as Argentina, Bolivia, Brazil and Colombia lead on plastic surgery medical skills relying on their experienced plastic surgeons. It is estimated that 1 in 30 Argentineans have had plastic surgery procedures, making this population the most operated in the world after the US and Mexico.[citation needed] In Bolivia and Colombia, plastic surgery has also become quite common. According to the "Sociedad Boliviana de Cirugia Plastica y Reconstructiva", more than 70% of middle and upper class women in the country have had some form of plastic surgery. Colombia also provides advanced care in cardiovascular and transplant surgery.
In Europe Belgium, Poland and Slovakia are also breaking into the business. South Africa is taking the term "medical tourism" very literally by promoting their "medical safaris". However, perceptions of medical tourism are not always positive. In places like the US, which has high standards of quality, medical tourism is viewed as risky. In some parts of the world, wider political issues can influence where medical tourists will choose to seek out health care.
Health tourism providers have developed as intermediaries to unite potential medical tourists with provider hospitals and other organisations. Companies are beginning to offer global health care options that will enable North American and European patients to access world health care at a fraction of the cost of domestic care. Companies that focus on medical value travel typically provide nurse case managers to assist patients with pre- and post-travel medical issues. They also help provide resources for follow-up care upon the patient's return.
International healthcare accreditation
Because standards are important when it comes to health care, there are parallel issues around medical tourism, international healthcare accreditation, evidence-based medicine and quality assurance.
In the United States, Joint Commission International (JCI) fulfills an accreditation role, while in the UK and Hong Kong, the Trent International Accreditation Scheme is a key player. The different international healthcare accreditation schemes vary in quality, size, cost, intent and the skill of their marketing. They also vary in terms of cost to hospitals and healthcare institutions using them. Increasingly, some hospitals are looking towards dual international accreditation, perhaps having both JCI to cover potential US clientele and Trent for potential British and European clientele.
Other organizations include:
The Society for International Healthcare Accreditation (SOFIHA), a free-to-join group providing a forum for discussion and for the sharing of ideas and good practice by providers of international healthcare accreditation and users of the same. The primary role of this organisation is to promote a safe hospital environment for patients.HealthCare Tourism International, the first US-based non-profit to accredit the non-clinical aspects of health tourism, such as language issues, business practices, and false or misleading advertising prevention. The group provides accreditation for all major groups involved in the health tourism industry including hotels, recovery facilities, and medical tourism booking agencies.
Risks and rewards
Medical tourism carries some risks that local medical procedures do not. Should complications arise, patients might not be covered by insurance or able to seek compensation via malpractice lawsuits. However new insurance products are available that do protect the patient should a medical malpractice occur overseas. Some countries currently sought after as medical tourism destinations provide some form of legal remedies for medical malpractice. However, this legal avenue is unappealing to the medical tourist. Advocates of medical tourism advise prospective tourists to evaluate the unlikely legal challenges against the benefits of such a trip before undergoing any surgery abroad. Patients should also be aware that the quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be different from US or Western standards.
Some countries, such as India, Malaysia, Costa Rica, or Thailand have different infectious diseases than Europe and North America, and different prevalences of the same diseases compared to nations such as the U.S., Canada, and the UK. Exposure to disease without having built up natural immunity can be a hazard for weakened individuals, specifically for gastrointestinal diseases (e.g Hepatitis A, amoebic dysentery, paratyphoid) which could weaken progress, mosquito-transmitted diseases, influenza, and tuberculosis (e.g., 75% of South Africans have latent TB). International hospital accreditation with Trent or JCI, mentioned earlier, may be of value here when people are trying to choose a destination for their procedure.
Also, travel soon after surgery can increase the risk of complications, as can vacation activities. For example, scars will be darker and more noticeable if they sunburn while healing.[7] Long flights can be bad for those with heart (thrombosis) or breathing-related problems. To avoid these problems medical tourism patients often combine their medical trips with vacation time set aside for rest and recovery in the destination country.
However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of any infectious disease, including HIV, TB, and typhoid, there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be "rare" in the West. For hospitals and doctors seeking to provide medical tourism services, there is the risk of being sued by a disgruntled patient, so medical indemnity services such as those provided by the Medical Protection Society are essential.
Destinations
North America
Canada
Canada has entered the medical tourism field. In comparison to U.S. health costs, medical tourism patients can save 30 to 60 percent on health costs in Canada. Canada's quality of healthcare is cited by the World Health Organization as equal to if not better than that of the U.S. in most categories.
Cuba
Cuba has been a popular medical tourism destination for more than 40 years. Thousands of patients travel to Cuba, particularly from Latin America and Europe, attracted by the "fine reputation of Cuban doctors, the low prices and nearby beaches on which to recuperate."[11] In 2006, Cuba attracted nearly 20,000 health tourists. Medical treatments included joint replacement, cancer treatment, eye surgery, cosmetic surgery and addictions rehabilitation. Costs are about 60 to 80 percent less than US costs. For example, Choice Medical Services, a health tourism provider, provides a hip replacement in Cuba for US$5,845/C$6120/€4227. Cuba has hospitals for Cuban residents and others that focus on serving foreigners and diplomats. In the 2007 American documentary film, "Sicko," which criticizes the US healthcare system, producer Michael Moore leads a group of uninsured American patients to Cuba to obtain more affordable medical treatment. "Sicko" has greatly increased foreigners' interest in Cuban healthcare. A recent Miami Herald story focused on the high quality of health care that Canadian and American medical tourism patients receive in Cuba. The Cuban government has developed Cuban medical tourism to generate income for the country. Residents of Canada, the UK and most other countries can travel to Cuba without any difficulty; a tourist visa is generally required. For Americans, however, because of the US trade policy towards Cuba, travelers must either obtain US government approval, or, more frequently, travel to Cuba from Canada, Mexico, the Bahamas, Jamaica or the Dominican Republic. Cuban immigration authorities do not stamp the passports of US visitors so that Americans can keep their travels a private matter.
However, few Cuban hospitals as yet have international healthcare accreditation.
Dominican Republic
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One of the medical tourism destinations nearest to the US mainland is the Dominican Republic. The country has become a popular destination for plastic surgeries, hip-replacements, knee replacements, bariatric surgeries, eye surgeries and all other types of surgeries and medical treatments. The costs are generally 50 to 75 percent less than cost of similar procedures in the US.
Mexico
Americans, particularly those living near the Mexican border, now routinely cross to Mexico for medical care. Popular specialties include dentristry and plastic surgery. Mexican dentists often charge one-fifth to one-fourth of US prices, while other procedures typically cost a third what they would in the US. This trend has alarmed American healthcare providers who, fearing a loss of business, warn patients away from Mexico. "The phenomenon has unsettled US-based dentists who tell horror stories of rampant infections, undetected cases of oral cancer and shoddy work south of the border -- claims hotly disputed by Mexican dentists." "In Texas, legislators explored the possibility of allowing health maintenance organizations to operate on both sides of the border. However, physicians in south Texas lobbied against the changes, arguing that local doctors could not compete with the lower costs in Mexico". US doctors point out that the Mexican legal system makes it almost impossible to sue Mexican doctors for malpractice. However, many who travel to Mexico for care report that they are satisfied. According to a report commissioned by Families U.S.A., a Washington advocacy group for health-care issues, "About 90 percent [feel] the care they had received in Mexico had been good or excellent. About 80 percent rated the care they had received in the United States as good or excellent". Indeed "some U.S. dentists ... have conceded to the competition and begun a 'reverse migration' opening offices in Mexico to take advantage of lower costs". American insurers are providing coverage for travelers, as the out-of-pocket costs to them are much lower. "With healthcare costs in the United States continuing to rise, many employers in Southern California are turning to insurance plans that send their workers to Mexico for routine care, plans that are growing by nearly 3,000 people a year".
In addition to dental and plastic surgery, Mexican hospitals are popular for bariatric surgery for weight loss, considered an elective procedure that is not covered by some US insurers. A popular bariatric procedure, lap band surgery, which was approved by the FDA in the US in 2001, has been performed for longer by Mexican surgeons.
Panama
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In Panama, health and medical tourism is growing rapidly. Factors drawing medical tourists include Panama's tourist appeal, position as a hub for international travel, and use of the dollar as the official currency. More important, Panama's medical professionals are trained around the world, use the latest technologies and medications, and have earned a high reputation. Many of Panama’s doctors are bilingual, board certified, and accustomed to working with the same medical equipment and technology used in the United States and Europe. On most procedures, Panama offers savings of more than 50% compared to the US and Europe. For example, Dental implants cost an average of $2,500 per implant in the US or Canada. In Panama, the same procedure with board and lodging, personal tour guide, and transportation is available at a much lower cost.
Popular procedures include dental implants, plastic surgery, assisted reproduction, cardiology, cosmetic dentistry, pulmonology and orthopedics. Panama's hospitals have affiliations to international organizations such as: Baptist Health International of Miami, Cleveland Clinic, Tulane Health Science Center, Johns Hopkins International, Miami Children's Hospital, University of Nebraska Medical Center, The Kendall Medical Center in Florida, and Harvard Medical Faculty and Physicians at Beth Israel Deaconess Medical Center in US.
South America
Colombia
Colombia has been treating foreign patients for years, especially for cosmetic and eye surgery. Colombia has also provides advanced cardiovascular and transplant surgery. What often compels persons to seek transplant surgery offshore is not only cost considerations, but waiting lists (such as in the US) or the lack of an organized organ inventory and donor system in the home country. Colombia has such an organ donor and banking system which makes organs available to foreigners with certain legal restrictions. Orthopedic surgeries, such as knee and hip replacements, are done in Colombia with US-made, (FDA-approved) prosthetics at a fraction of the cost.
Colombia has many surgeons that have either trained and/or practiced in other countries such as the US and Europe. Salaries for doctors, nurses, and supporting personnel in Colombia are about 20% of US salaries for similar occupations even though they are required to have the same level of education and job skills. Real estate costs related to medical care facilities are also a fraction of what they are in the US
One advantage of Colombia for those from the US and Canada is ease of travel and close proximity. Colombia offers cheaper airfares from the US and Canada (and some European countries) than other more-distant destinations, and does not have the visa restrictions of other countries currently in the medical tourism market.
Asia/Pacific
Hong Kong
Hong Kong has 12 private hospitals and more than 50 public hospitals. A wide range of health care services are offered. All 12 of Hong Kong's private hospitals have been surveyed and accredited by the UK's Trent Accreditation Scheme since early 2001. This has been a major factor in the ascent of standards in Hong Kong's private hospitals. The Trent scheme works closely with the hospitals it assesses to generate standards appropriate to the locality (with respect to culture, geography, public health, primary care interfaces etc.), and always uses combinations of UK-sourced and Hong Kong-sourced surveyors. Some of Hong Kong's private hospitals have now gone on to obtain dual international accreditation, with both Trent and JCI (and have therefore attained a standard surpassing some of the best hospitals in Thailand and Singapore). Others are looking towards dual international accreditation with Trent and the Australian group. Hong Kong public hospitals have yet to commit to external accreditation.
India
India is known in particular for heart surgery, hip resurfacing and other areas of advanced medicine. The government and private hospital groups are committed to the goal of making India a leader in the industry. The industry's main appeal is low-cost treatment. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain. Estimates of the value of medical tourism to India go as high as $2 billion a year by 2012. The Indian government is taking steps to address infrastructure issues that hinder the country's growth in medical tourism.
The south Indian city of Chennai has been declared India's Health Capital, as it nets in 45% of health tourists from abroad and 30-40% of domestic health tourists.Dental care has also caught on in India, with tourists coupling stays in cities like Udaipur with general check-ups and complex procedures.
Malaysia
Malaysia has ambitions to develop itself as a medical tourism hub. The country has excellent hospitals, English is widely spoken, and many staff have been trained to a high level in the UK or in the US. There is a highly active Association for Private Hospitals of Malaysia working to develop medical tourism.[27] While Malaysia has a national accreditation scheme (MSQH), few of Malaysia's hospitals currently hold international healthcare accreditation.
New Zealand
New Zealand is a relatively new player to the medical travel market, focusing on non-acute surgical procedures and fertility treatment. Like other Commonwealth countries, New Zealand's medical system is based on the British health system. Most of its specialist physicians have received training in New Zealand and the US or the UK, and all use English as their first language. The costs of private healthcare are significantly cheaper than the US or the UK, with packages (airfare, accommodation, medical service etc) for procedures like hip replacement, or coronary artery bypass costing in total approximately 40% of the procedure cost alone in the US. Many private hospitals in New Zealand are accredited by the national accreditation agency Quality Health New Zealand (QHNZ). QHNZ, like JCI, is a member of the International Society for Quality in healthcare or ISQua.
Philippines
The Philippines has been growing as a destination for medical tourism. Procedures can be performed at a fraction of the amount that a patient would spend on the same procedure in the US or Europe. Philippine medical and nursing curricula are more challenging than in many in Southeast Asia, and many Filipino doctors have acquired their postgraduate or fellowship training from well-known institutions in the US, the UK and other developed countries.
Medical centers in Metro Manila have complied to ISO standards, and are periodically and regularly undergo accreditations from Philippine's Department of Health. Others have already accredited by the American accreditation group Joint Commission International (JCI), while some are looking at UK-sourced hospital accreditation.]
Singapore
Singapore Medicine is a multi-agency government initiative that aims to develop Singapore into a leading destination for health care services. In 2005, some 374,000 visitors came to Singapore purely to seek healthcare.[29] Many patients come from neighboring countries, such as Indonesia and Malaysia. Patient numbers from Indochina, South Asia, the Middle East and Greater China to Singapore are also growing. Patients from developed countries such as the United States and the UK are beginning to choose Singapore as their medical travel destination for relatively affordable health care services in a clean cosmopolitan city.
Thailand
Medical tourism is a growing segment of Thailand's tourism and health-care sectors. In 2005, one Bangkok hospital took in 150,000 treatment seekers from abroad. In 2006, medical tourism was projected to earn the country 36.4 billion baht. Thailand offers everything from cardiac surgery to organ transplants at a price much lower than the US or Europe, in a safe, clean environment. Thai medicine also features a higher, more personalized level of nursing care than westerners are accustomed to receiving in hospitals at home. One patient who received a coronary artery bypass surgery at Bumrungrad International hospital in Bangkok said the operation cost him US$12,000 (8,200 euros), as opposed to the $100,000 (68,000 euros) he estimated the operation would have cost him at home.[31]
Hospitals in Thailand are a popular destination for other Asians. Another hospital that caters to medical tourists, Bangkok Hospital, has a Japanese wing and Phyathai Hospitals Group has interpreters for over 22 languages, besides the English-speaking medical staff. When Nepal Prime Minister Girija Prasad Koirala needed medical care in 2006, he went to Bangkok.[32]
One Thai hospital, Bumrungrad International, states that many of its doctors and staff are trained in the UK, Europe and the US. Bumrungrad International was accredited most recently in 2005 in order to ensure an international standard of medical services.[33] The modern Thai medical system shares in an Anglo-U.S. inheritance, as Prince Mahidol of Songla, the King's father, earned his MD degree from Harvard Medical School in the early 20th century. Prince Mahidol and another member of the Thai Royal Family paid for an American medical education for a group of Thai men and women.[citation needed] Prince Mahidol also convinced the Rockefeller Foundation to provide scholarships for Thai citizens to study medicine and nursing.[citation needed] Funds from the Rockefeller Foundation were also used to help build modern medical training facilities in Thailand. The men and women who studied medicine and nursing as a result of Prince Mahidol's efforts became the first educators for the modern Thai medical system.[citation needed]
Today many Thai physicians hold US or UK professional certification. Several Thai hospitals have relationships with educational facilities in the US and UK (for example, Sheffield Hallam University has links with Bangkok}. The US Consular information sheet gives the Thai health care system high marks for quality, particularly facilities in Bangkok, although the World Health Organization ranks the Thai healthcare system at number 47, which is below the USA's ranking at 37 and the United Kingdom's ranking at 18. The UK's Foreign and Commonwealth Office web site states "There are excellent international hospitals in Bangkok but they can be expensive".
While a very small percentage of Thai are internationally accredited, there are a growing number of hospitals with Joint Commission accreditation. Again, international hospital accreditation may be one way for hospitals to demonstrate their worth, and increasingly Thai hospitals competing for business in this sector may need to expand their international accreditation, including looking towards other international healthcare accreditation schemes sourced outwith of the US, to augment their appeal if they are to remain competitive.
Europ
This section does not cite any references or sources. (January 2008)Please improve this section by adding citations to reliable sources. Unverifiable material may be challenged and remove.
Germany
Germany has long been a medical tourism destination for people from the Middle East and North Africa. Now with a reduction in tension between East and West, many Russians and other Eastern Europeans are seeking treatment in Germany. British and Canadians, no longer willing to wait for treatment in their home country, are also traveling to Germany for treatment. Americans are also heading to Germany for the latest in spine surgery and novel cancer treatments and much lower prices than they would pay in the US. However, few German hospitals as yet have international healthcare accreditation.
Malta
Malta has a strong medical heritage and possesses a high-quality healthcare system modeled on the British system. The population is English-speaking. Malta is part of the European Union and has the euro as its currency. There are a number of private hospitals within Malta (see List of hospitals in Malta) which are developing medical tourism, especially for UK residents. As yet, Maltese hospitals have not engaged in international healthcare accreditation.
Portugal
Portugal's health care system was highly rated by the World Health Organization's year 2000 ranking of the world's health systems, rated 12th of 191 countries. This is a European Union country with regulatory bodies that certify doctors and health facilities, thereby protecting patients’ rights. Proximity to the US and Northern Europe reduce patients’ travel risks, while Portugal's mild climate is well-suited for convalescence. English is widely spoken by the majority of the population and Portugal is well known for its low crime rate. Dental clinics and cosmetic surgery facilities are popular. Prices are low when compared with similar procedures performed in the UK or the US. Other medical procedures include orthopedics, cardiology and eye surgery.
Spain
Spain's strong economy over recent years have provided for modern hospitals and well-trained health care professionals, making it an up-and-coming medical tourism destination.
Turkey
Turkey has attracted hundreds of thousands of tourists form Europe seeking for health care.
Ukraine
Ukraine features modern dental clinics with high-quality equipment, materials and effective anesthetics. They provide patients with dentistry services at lower cost in comparison with Western and Russian clinics. Other popular medical tourism offerings in Ukraine include spas, ophthalmology (eye surgery), plastic]] surgery, and mud baths. As yet, Ukraine medical clinics have yet to seek international healthcare accreditation.
Israel
Israel is emerging as a popular destination for medical tourists. Its modern, field-leading set of physicians and medical facilities are often used by international patients. In 2006, 15,000 foreigners travelled to the country for medical procedures, bringing in $40 million of revenue. Medical tourists choose Israel for several reasons. Some come from European nations such as Bulgaria and Cyprus where certain procedures are not available. Others come to Israel, perhaps most commonly from the US, because they can receive quality health care at a fraction of the cost it would be at home, for both surgeries and in-vitro fertilization treatments. Other medical tourists come to Israel to visit the Dead Sea, a world-famous therapeutic resort.
from,wkipedia.org
Dental tourism
Dental Tourism is a subset of the sector known as medical tourism. It involves individuals seeking dental care outside of their local healthcare systems.
Reasons for travel
While dental tourists may travel for a variety of reasons, their choices are usually driven by price considerations. Wide variations in the economics of countries with shared borders have been the historical mainstay of the sector. Examples include travel from Austria to Slovakia and Slovenia, the U.S.A to Mexico, and the Republic of Ireland to Northern Ireland. While medical tourism is often generalized to travel from high income countries to low cost developing economies, other factors can influence a decision to travel, including differences between the funding of public healthcare or general access to healthcare.
Mobility of Labour
For countries within the European Union, dental qualifications are required to reach a minimum approved by each country’s government. Thus a dentist qualified in one country can apply to any other EU country to practice in that country as a dentist allowing for greater mobility of labour for dentists (Directives typically apply not only to the EU but to the wider designation of the European Economic Area - EEA)]. The Association for Dental Education in Europe (ADEE) has standardization efforts to harmonize European Standards. Proposals from the ADEE's Quality Assurance and Benchmarking taskforce cover the introduction of accreditation procedures for EU dentistry universities as well as programmes to facilitate dental students completing part of their education in foreign dentistry schools. Standardization of qualification in a region reciprocally removes one of the perceptual barriers for the development of patient mobility within that region.
Pricing and quality
The UK and The Republic of Ireland are two of the largest sources of Dental Tourists. Both have had their dental professions examined by competition authorities to determine whether consumers were receiving value for money from their dentists. Both countries’ professions were criticised for a lack of pricing transparency. A response to this is that dentistry is unsuitable for transparent pricing: each treatment will vary, an accurate quote is impossible until an examination has occurred. Thus price lists are no guarantee of final costs. Though they may encourage a level of competition between dentists, this will only happen in a competitive environment where supply and demand are closely matched. The 2007 Competition Authority report in the Irish Republic criticised the profession on its approach to increasing numbers of dentists and the training of dental specialties – orthodontics was a particular area for concern with training being irregular and limited in number of places. Supply is further limited as new dental specialties develop and dentists react to consumer demand for new dental products, further diluting the pool of dentists available for any given procedure.
Media Coverage
The sector has received media coverage in the U.S.A, the UK and Ireland. The majority of articles originate in money or finance sections of press publications highlighting the savings available from travel. Articles often carry warnings from the local dental professional body advising against travel or recommending that patients should be aware that redress may be different or unavailable in foreign countries and that the constraints placed upon procedures if they are to be carried out during a short stay may lead to poorer quality work than if the same procedure was carried out over a longer period at home[7].Though informative of the potential for difficulties and the personal experience of individual patients there tends to be little comparative data to draw conclusions from.
Retrieved from "http://en.wikipedia.org/wiki/Dental_tourism"
Reasons for travel
While dental tourists may travel for a variety of reasons, their choices are usually driven by price considerations. Wide variations in the economics of countries with shared borders have been the historical mainstay of the sector. Examples include travel from Austria to Slovakia and Slovenia, the U.S.A to Mexico, and the Republic of Ireland to Northern Ireland. While medical tourism is often generalized to travel from high income countries to low cost developing economies, other factors can influence a decision to travel, including differences between the funding of public healthcare or general access to healthcare.
Mobility of Labour
For countries within the European Union, dental qualifications are required to reach a minimum approved by each country’s government. Thus a dentist qualified in one country can apply to any other EU country to practice in that country as a dentist allowing for greater mobility of labour for dentists (Directives typically apply not only to the EU but to the wider designation of the European Economic Area - EEA)]. The Association for Dental Education in Europe (ADEE) has standardization efforts to harmonize European Standards. Proposals from the ADEE's Quality Assurance and Benchmarking taskforce cover the introduction of accreditation procedures for EU dentistry universities as well as programmes to facilitate dental students completing part of their education in foreign dentistry schools. Standardization of qualification in a region reciprocally removes one of the perceptual barriers for the development of patient mobility within that region.
Pricing and quality
The UK and The Republic of Ireland are two of the largest sources of Dental Tourists. Both have had their dental professions examined by competition authorities to determine whether consumers were receiving value for money from their dentists. Both countries’ professions were criticised for a lack of pricing transparency. A response to this is that dentistry is unsuitable for transparent pricing: each treatment will vary, an accurate quote is impossible until an examination has occurred. Thus price lists are no guarantee of final costs. Though they may encourage a level of competition between dentists, this will only happen in a competitive environment where supply and demand are closely matched. The 2007 Competition Authority report in the Irish Republic criticised the profession on its approach to increasing numbers of dentists and the training of dental specialties – orthodontics was a particular area for concern with training being irregular and limited in number of places. Supply is further limited as new dental specialties develop and dentists react to consumer demand for new dental products, further diluting the pool of dentists available for any given procedure.
Media Coverage
The sector has received media coverage in the U.S.A, the UK and Ireland. The majority of articles originate in money or finance sections of press publications highlighting the savings available from travel. Articles often carry warnings from the local dental professional body advising against travel or recommending that patients should be aware that redress may be different or unavailable in foreign countries and that the constraints placed upon procedures if they are to be carried out during a short stay may lead to poorer quality work than if the same procedure was carried out over a longer period at home[7].Though informative of the potential for difficulties and the personal experience of individual patients there tends to be little comparative data to draw conclusions from.
Retrieved from "http://en.wikipedia.org/wiki/Dental_tourism"
Dentistry throughout the world
Dentistry throughout the world is practiced differently, and training in dentistry varies as well.
Dentistry in Australia
Australian dentistry is overseen by the Australian Dental Association, while specialization is overseen by the Royal Australasian College of Dental Surgeons. Dentists trained in Australia must meet the entry requirements of one of the Australian institutions offering dental courses, and then complete the required full-time academic training leading to a dental degree. If dentists wish to specialize, they must complete extra study after having had clinical experience.
In order to practice dentistry in Australia, you must be registered in the particular State in which you intend to practice. Registration requirements vary from State to State. Generally, the only persons immediately entitled to apply to be registered as dentists are persons holding the qualifications of BDS, BDSc, BDent from the Australian, New Zealand universities. Usually registration will not be granted to a foreign graduate until he or she is a resident in the State, holds a visa approved for employment, and has passed the ADC examinations and/or completed a 2-year advance standing program in order to obtain a locally accredited dental qualification.The Universities of Adelaide, Melbourne, Queensland, Western Australia, LaTrobe, and Griffith University all offer undergraduate dental degree courses of 5 years in length. Sydney University offers a graduate entry program which is 4-years duration and requires a previous bachelors degree for admission (Melbourne University also will be transitioning to a 4-year graduate entry dental program by 2010). Charles Sturt University dental school will commence in 2009. The qualifications awarded by these schools satisfy the formal academic requirements for registration of all Australian Dental Boards.
Australian dental schools
University of Adelaide
Griffith University
University of Melbourne
University of Sydney
University of Queensland
University of Western Australia
Latrobe University
Charles Sturt University
Dentistry in New Zealand
New Zealand dentistry is overseen by the New Zealand Dental Association, while specialization is also overseen by the Royal Australasian College of Dental Surgeons.
University of Otago is New Zealand's only dental school that offers the required academic training. Entry into New Zealand's only dental school requires the student to compete into the second year dentistry course via the Health Sciences First Year course. Once in the course, students will start their dental education in their second year of University study. The total time to complete the course, including the first year competitive course, is 5 years of full-time academic study.
Dentistry in Canada
Canadian dentistry is overseen by the Canadian Dental Association, while specialization is overseen by the Royal College of Dentists. Today, Canada has about 16,000 dentists. Canadian dentistry is not publicly run (see Medicare (Canada)); however, some provinces provide for free dental care for children and the elderly. Other Canadians are mostly covered by workplace dental plans, but many have to pay out-of-pocket.
For most of the early colonial period dentistry was a rare and unusual practice in Canada. In severe situations, barbers or blacksmiths would pull a tooth, but for many years Canada lagged behind European advances. The first dentists in Canada were United Empire Loyalists who fled the American Revolution. The first recorded dentist in Canada was a Mr. Hume who advertised in a Halifax newspaper in 1814.
During the first half of the 19th century, dentistry expanded rapidly. In 1867 the Ontario Dental Association was formed and in 1868 they founded Canada's first dental school in Toronto, the Royal College of Dental Surgeons of Ontario. The University of Toronto agreed to be affiliated with the dental school. As time passed, other Canadian universities also created dentistry programmes. However, the University of Toronto still has the largest dental school in Canada that features the most postgraduate research opportunities as well as certifications for all the dental specialties.
Dental care is not covered by the Canadian health care system, as it is in many other countries with public health care.
Canadian dental schools
University of Toronto (1868)
McGill University (1905)
Université de Montréal (1905)
Dalhousie University (1908)
University of Alberta (1923)
University of Manitoba (1958)
University of British Columbia (1964)
University of Western Ontario (1966)
University of Saskatchewan (1968)
Université Laval (1971)
Dentistry in Chile
The first dental school was established at the Universidad de Concepción in the year 1919. Other institutions providing professional dental education in Chile are Universidad de Chile, Universidad de Valparaíso, Universidad de Talca, and Universidad de Antofagasta.
Dentistry in Costa Rica
Dentistry is overseen by the Colegio de Cirujanos Dentistas de Costa Rica. Dentists complete 6 year courses from the University of Costa Rica in D.D.S. (Doctor of Dental Surgery), or similar courses from various private universities. Costa Rica is often cited as being one of the top ten countries in the world for medical tourism, including dentistry.
Dentistry in Hong Kong
To become a dentist in Hong Kong, one must complete the 5-year B.D.S. course in The University of Hong Kong. Students learn basic health sciences, dental sciences under the Problem Based Learning policy. Besides, formal training and supervised practice are prescribed. It is accepted that only after 5 years of such training would the trainees achieve a superior level of professional competence.
Graduates can enter general practice or pursue a specialist M.D.S. degree after gaining one to two years of working experience.
Before the dental school was established in the University of Hong Kong(in 1980), most of the practicing dentists
obtained their dental degree from the Philippines.
Dentistry in India
Modern Indian dentists must earn the Bachelor of Dental Surgery degree (B.D.S.), which requires four years of study and one year of internship. This degree is overseen by the Dental Council of India In most states, one has to appear for an entrance test conducted by the Directorate of Medical Education, whereas some autonomous universities conduct their own entrance tests. Post graduate courses (Master of Dental Surgery. MDS) are also available in different specialities. It requires 3 years of study after BDS.
The Master of Dental Surgery is available in the following specialities - Orthodontics, Oral and Maxillofacial Surgery, Conservative and endodontics, Periodontics, Prosthodontics, Pediatric Dentistry, Oral Pathology, Oral medicine and Radiology, Community Dentistry. Although many institutions are offering other short or long courses in Dental Implantology and Esthetic Dentistry, These are yet to be regularised by the Council.
Besides Certificate courses are also offered in Dental Mechanics and Dental Hygiene. These are two year certificate courses. Dental Mechanics offers knowledge about Prosthodontic appliances to be fabricated in a dental laboratory while a Dental Hygienist deals with clinical part, viz scaling, polishing, et.al.
The First Dental College of India was established in Calcutta presently Kolkata in the year 1924. It was then called Calcutta Dental College and Hospital and was constructed single handedly by Dr.Rafiuddin Ahmed without any government aid. Incidentally it was the first Dental College to be established in Asia.
After his death on 9 February 1965 the college was renamed after him. After that many Other Dental Colleges have come up in India.
Dentistry in Iran
In Iran dentists require six years of post secondary education. The whole program is one single degree of D.D.S. (Doctor of dental surgery). After this, those wishing to specialize in a particular field may pursue higher education. Upon graduation, a dentist may need to fulfill a two year military requirement (as a dentist in uniform) in order to start in private practice. There are many dental schools but two of the most notable are:
University of Tehran (School of Dentistry .1939) Dental School of Shahid Beheshti University
Dentistry in Italy
In Italy dentists complete 5 years of undergraduate study to earn a degree. Nevertheless it is possible to agree on certain basic clinical competences common to all member states of the European Union.
The following is an example of one such clinical competency (excision of a buried tooth root): If a clinician is deemed to be clinically competent in the surgical removal of a buried root, this implies much more than the technical and surgical ability required to excise a buried piece of root from alveolus. It embraces a broad range of pre-clinical and clinical knowledge and understanding on which surgical treatment is based.
Dentistry in Malta
The first course leading to a degree in Dental Surgery, at the University of Malta, commenced in 1933. The qualification was recognized by the Medical Council of the United Kingdom in 1936.
Dental Surgery was established as a separate Faculty in 1954, previous to which the course was under the direction of a Board of Studies within the Faculty of Medicine and Surgery. The Faculty caters for an undergraduate intake of 8 students annually. A B.Ch.D Degree is awarded at the completion of the 5 year course.
Dentistry in Mexico
Dental care in Mexico is considerably less expensive. Many travel yearly to Tijuana for quality care but one must research and exercise care. See Dentists in Tijuana.
Dentistry in Norway
The 5-year dental education is offered at three universities:
University of Oslo
University of Bergen
University of Tromsø
All dentists in Norway are organized through "Tannlegeforeningen". Dental services are free for children.
Dentistry in Pakistan
History of dentistry in Pakistan starts even before its birth. Pakistan's premier and oldest dental institution 'de'Montmorency college of Dentistry' was established in 1934 at Lahore by then Governor of Punjab Sir Jeff Fitz Harway de' Montmorency. It was the only dental college at the time of partition of subcontinent that existed in this part of the world,today which we know as Pakistan. de'Montmorency College of Dentistry as a very rich heritage of academic and clinical excellence both before and after independence. History of dentistry in Pakistan is in fact story of progress of de'Montmorency College of Dentistry. At present there are upwards of 20 dental schools (public & private) throughout Pakistan, according to the Pakistan Medical & Dental Council the state regulatory body has upwards of 6200 registered dentists. The four year training culminates in achieving a Bachelor of Dental Surgery (BDS) degree, which also requires a one year compulsory internship to be a registered dentist in Pakistan.
Dental schools in Pakistan
de'Montmorency College of Dentistry, Lahore
Dental Section Nishter Medical College, Multan
Dental Section Jamshoro Medical College, Hyderabad
Dental Section Khyber Medical College, Peshawer
Dental Section Ayub Medical College, Abbotabad
Dental Section Bolan Medical College, Quetta
Hamdard University
Baqai University
Fatima Jinnah Dental College
Altamash Institute of Dental Medicine
Lahore Medical and Dental College
International Islamic University Islamabad
Dentistry in the Philippines
Most Filipino Dentists must earn a total of 6 years of dental school (2 years preparatory; 4 years proper) to obtain the degree Doctor of Dental Medicine (D.M.D.). Presently, the country has a total of 17 dental schools, in which the board licensing is administered and regulated by the Board of Dentistry of the Professional Regulation Commission. Centro Escolar University is noted to have the largest enrollment of Dentistry students every year in the country.
Ago Medical and Educational Center
Cebu Doctors University
Centro Escolar University
Davao, Medical School Foundation
De Ocampo Memorial College
Emilio Aguinaldo Colleges
Our Lady of Fatima University
Iloilo Doctors College
Lyceum of Batangas
Lyceum Northwestern
Manila Central University
Medina College
Mindanao Medical Foundation
Misamis University
National University
Pines City Educational Center
Southwestern University
Unciano Paramedical Colleges
University of Baguio
University of the East
University of Perpetual Help
University of the Philippines
University of the Visayas
Virgen Milagrosa University Foundation
Dentistry in Slovakia
In Slovakia, dentists complete 6 years of undergraduate study to earn a MUDr (lat. Medicinae Universae Doctor) degree. Dental education is offered at two universities: Comenius University in Bratislava and University of Pavol Jozef Safarik in Košice. Junior graduates work under a skilled doctor for at least 3 years to receive their license from The Slovak Chamber of Dentists. Part of dental service is paid from health insurance but mostly treatment (fillings, prosthodontics) is paid cash by patient.
Dentistry in Sweden
The 5-year dental education is offered at four universities:
University of Malmö http://www.mah.se/templates/Page____13098.aspx
University of Gothenburg http://www.odontology.gu.se/
Karolinska Institutet, at Huddinge Hospital http://ki.se/ki/jsp/polopoly.jsp?d=1524&l=en
University of Umeå http://www.odont.umu.se/index_eng.html
Most dentists in Sweden are organized through "Tandläkarförbundet" which also issues the scientific 'Swedish Dental Journal': http://www.tandlakarforbundet.se/swe/default.asp.
Dental care is provided at public and private dental offices. Dental services are free for everyone up to 20 years of age. From the age of 20 and upwards there is a fixed state refund which usually is, depending on the dentist's fee and what type of dentistry performed, around 10 % - 15 % of the total cost. For more expensive dental work above the age of 65 the patients only pay 7800 SEK (~ $1,000) plus the cost of the dental material that was used.
The English title given to dental graduates in Sweden is D.D.S (Doctor of Dental Surgery)
All dentists in the European Union/EES are elegible to work in Sweden. Dentists with an exam outside EES are required to take a one year course at Karolinska in Stockholm.
Dentistry in Taiwan
After graduating from high school, students are required to take a 6 year dental program to get their D.M.D. degree. The first dental school in Taiwan belonged to the College of Medicine at National Taiwan University. There are currently 7 dental schools in Taiwan:
China Medical University (Taiwan)
Chung Shan Medical University
Fu Jen Catholic University
Kaohsiung Medical University
National Cheng Kung University
National Defense Medical Center
National Taiwan University
National Yang Ming University
Taipei Medical University
Dentistry in the United Kingdom
An NHS dentist performing an examination
In the United Kingdom, dentists complete 5 years of undergraduate study to earn a B.D.S. or BChD degree. After graduating most dentists will enter a V.T. (vocational training) scheme, of either 1 or 2 years length, to receive their full National Health Service registration. Dentists must register with the G.D.C. (General Dental Council), and meet their requirements as the governing body of the profession, before being allowed to practice.
Dentistry in the United States
In the United States dentistry is generally practiced by dentists who have completed a post-graduate course of professional education. With exception of rural Alaska, Dental therapists, technicians without medical training, are not permitted to practice in the United States. Use of dental therapists or dental hygienists to independently perform routine fillings or cleaning is strongly opposed by the American Dental Association, (the A.D.A.), the dentists' professional association. This has resulted in excellent but high-priced treatment which, however, fails to delivers services at a reasonable price to the lower social classes. With only a few exceptions neither government sponsored health care programs such as Medicare or Medicaid nor private medical insurance cover routine dental treatment. As a result large sections of the population do without. The worst conditions are in Kentucky and West Virginia. Rates for dental services have been rising rapidly, out pacing the rate of inflation. After falling for many years, the percentage of both adults and children with unfilled cavities began to rise in 2000 as did the percentage of adults with no teeth. Increasingly, people with adequate income to pay the fees are forgoing treatment.
Dental technicians
Outside the United States, more than 50 countries allow technicians called dental therapists to drill and fill cavities, usually in children. In the U.S., state boards of dentistry have blocked dental therapists from working, arguing that only dentists should be allowed to drill teeth, because it is an “irreversible surgical procedure” and "can lead to serious complications like infections or nerve damage".
Dental education in the United States
There are limited opportunities for dental education in the United States with only 4,440 graduating in 2003, down from 5,750 in 1982. There is little or no movement on the part of the American Dental Association, the ADA, or the states to expand dental education. Due to the hands-on training required, dental education is expensive and is not subsidized by the federal government. In the United States, dentists earn either a D.D.S. (Doctor of Dental Surgery) or D.M.D.(Doctor of Dental Medicine) degree. There is no difference in the training for either degree. The degrees are equivalent, and recognized equally by all state boards of dentistry. There are 56 Accredited Dental schools in the United States requiring 4 years of post graduate study (except for one unique 3 year program at the University of the Pacific). Most applicants to dental school have attained at least a B.S. or B.A. degree, however, a small percentage are admitted after only fulfilling specific prerequisite courses. So unlike many other countries (other than US, Canada, and Australia), it usually takes more than 8 years to become a dentist. (List of dental schools in the United States) The difference relates to the history involved in the division of medicine and surgery in medical practice. There has been a recent movement to include a 5th year of education that focuses on purely practical training in the clinical setting. In at least one state, New York, a state dental license can be received without taking the licensing exam (State Board Exam) upon completing this additional year of training (usually in the form of a GPR or AEGD).
Licensure is organized on three levels in most areas. All dentists must pass National Boards, Regional Boards, and then take a jurisprudence exam accepted by their state to fulfill their requirements to get a state license. Although a state license is only valid in the issuing state, because of the regional boards a dentist may be able to apply for licensure in any other state within the jurisdiction of their regional board. There are many cooperative agreements between states that allow recognition of another state's license so as to procure a license either via "licensure by credentials" or "licensure by reciprocity." Although a national licensure exam has yet to be made, the American Dental Association (ADA) has worked with education and examining groups to form such an exam. A dentist may go on for further training in a dental specialty which require an additional 1 to 7 years of post-doctoral training. There are 9 recognized dental specialties. They are Endodontics (root canal treatment), Oral and Maxillofacial Pathology, Oral and Maxillofacial Radiology, Pediatric Dentistry, Periodontics (gums), Prosthodontics (complicated dental reconstruction), Orthodontics (moving teeth), Oral and Maxillofacial Surgery (tooth removal and surgery of the oral and facial structures), and Dental Public Health. There is no specialty in esthetic dentistry or implantology, and no additional training is required for a dentist to make the claim of being an esthetic or cosmetic dentist. Dentists are forbidden to claim that they are specialists in areas of practice in which there is no recognized specialty. They may limit their practices to a single area of dentistry, and claim that their practice is limited to that area.
Any general dentist may perform those procedures designated within the enumerated specialties if they deem themselves competent. Many general dentists train in certain aspects of the above specialties such as the placement and restoration of dental implants, advanced prosthodontics and endodontics, and have limited or heavily focused their practices to these areas. When a general dentist performs any procedure that falls within the realm of a specialty, they are expected to perform with the same level of expertise as a certified specialist and are legally held to such standards with respect to any issues of malpractice.
From Wikipedia, the free encyclopedia
Dentistry in Australia
Australian dentistry is overseen by the Australian Dental Association, while specialization is overseen by the Royal Australasian College of Dental Surgeons. Dentists trained in Australia must meet the entry requirements of one of the Australian institutions offering dental courses, and then complete the required full-time academic training leading to a dental degree. If dentists wish to specialize, they must complete extra study after having had clinical experience.
In order to practice dentistry in Australia, you must be registered in the particular State in which you intend to practice. Registration requirements vary from State to State. Generally, the only persons immediately entitled to apply to be registered as dentists are persons holding the qualifications of BDS, BDSc, BDent from the Australian, New Zealand universities. Usually registration will not be granted to a foreign graduate until he or she is a resident in the State, holds a visa approved for employment, and has passed the ADC examinations and/or completed a 2-year advance standing program in order to obtain a locally accredited dental qualification.The Universities of Adelaide, Melbourne, Queensland, Western Australia, LaTrobe, and Griffith University all offer undergraduate dental degree courses of 5 years in length. Sydney University offers a graduate entry program which is 4-years duration and requires a previous bachelors degree for admission (Melbourne University also will be transitioning to a 4-year graduate entry dental program by 2010). Charles Sturt University dental school will commence in 2009. The qualifications awarded by these schools satisfy the formal academic requirements for registration of all Australian Dental Boards.
Australian dental schools
University of Adelaide
Griffith University
University of Melbourne
University of Sydney
University of Queensland
University of Western Australia
Latrobe University
Charles Sturt University
Dentistry in New Zealand
New Zealand dentistry is overseen by the New Zealand Dental Association, while specialization is also overseen by the Royal Australasian College of Dental Surgeons.
University of Otago is New Zealand's only dental school that offers the required academic training. Entry into New Zealand's only dental school requires the student to compete into the second year dentistry course via the Health Sciences First Year course. Once in the course, students will start their dental education in their second year of University study. The total time to complete the course, including the first year competitive course, is 5 years of full-time academic study.
Dentistry in Canada
Canadian dentistry is overseen by the Canadian Dental Association, while specialization is overseen by the Royal College of Dentists. Today, Canada has about 16,000 dentists. Canadian dentistry is not publicly run (see Medicare (Canada)); however, some provinces provide for free dental care for children and the elderly. Other Canadians are mostly covered by workplace dental plans, but many have to pay out-of-pocket.
For most of the early colonial period dentistry was a rare and unusual practice in Canada. In severe situations, barbers or blacksmiths would pull a tooth, but for many years Canada lagged behind European advances. The first dentists in Canada were United Empire Loyalists who fled the American Revolution. The first recorded dentist in Canada was a Mr. Hume who advertised in a Halifax newspaper in 1814.
During the first half of the 19th century, dentistry expanded rapidly. In 1867 the Ontario Dental Association was formed and in 1868 they founded Canada's first dental school in Toronto, the Royal College of Dental Surgeons of Ontario. The University of Toronto agreed to be affiliated with the dental school. As time passed, other Canadian universities also created dentistry programmes. However, the University of Toronto still has the largest dental school in Canada that features the most postgraduate research opportunities as well as certifications for all the dental specialties.
Dental care is not covered by the Canadian health care system, as it is in many other countries with public health care.
Canadian dental schools
University of Toronto (1868)
McGill University (1905)
Université de Montréal (1905)
Dalhousie University (1908)
University of Alberta (1923)
University of Manitoba (1958)
University of British Columbia (1964)
University of Western Ontario (1966)
University of Saskatchewan (1968)
Université Laval (1971)
Dentistry in Chile
The first dental school was established at the Universidad de Concepción in the year 1919. Other institutions providing professional dental education in Chile are Universidad de Chile, Universidad de Valparaíso, Universidad de Talca, and Universidad de Antofagasta.
Dentistry in Costa Rica
Dentistry is overseen by the Colegio de Cirujanos Dentistas de Costa Rica. Dentists complete 6 year courses from the University of Costa Rica in D.D.S. (Doctor of Dental Surgery), or similar courses from various private universities. Costa Rica is often cited as being one of the top ten countries in the world for medical tourism, including dentistry.
Dentistry in Hong Kong
To become a dentist in Hong Kong, one must complete the 5-year B.D.S. course in The University of Hong Kong. Students learn basic health sciences, dental sciences under the Problem Based Learning policy. Besides, formal training and supervised practice are prescribed. It is accepted that only after 5 years of such training would the trainees achieve a superior level of professional competence.
Graduates can enter general practice or pursue a specialist M.D.S. degree after gaining one to two years of working experience.
Before the dental school was established in the University of Hong Kong(in 1980), most of the practicing dentists
obtained their dental degree from the Philippines.
Dentistry in India
Modern Indian dentists must earn the Bachelor of Dental Surgery degree (B.D.S.), which requires four years of study and one year of internship. This degree is overseen by the Dental Council of India In most states, one has to appear for an entrance test conducted by the Directorate of Medical Education, whereas some autonomous universities conduct their own entrance tests. Post graduate courses (Master of Dental Surgery. MDS) are also available in different specialities. It requires 3 years of study after BDS.
The Master of Dental Surgery is available in the following specialities - Orthodontics, Oral and Maxillofacial Surgery, Conservative and endodontics, Periodontics, Prosthodontics, Pediatric Dentistry, Oral Pathology, Oral medicine and Radiology, Community Dentistry. Although many institutions are offering other short or long courses in Dental Implantology and Esthetic Dentistry, These are yet to be regularised by the Council.
Besides Certificate courses are also offered in Dental Mechanics and Dental Hygiene. These are two year certificate courses. Dental Mechanics offers knowledge about Prosthodontic appliances to be fabricated in a dental laboratory while a Dental Hygienist deals with clinical part, viz scaling, polishing, et.al.
The First Dental College of India was established in Calcutta presently Kolkata in the year 1924. It was then called Calcutta Dental College and Hospital and was constructed single handedly by Dr.Rafiuddin Ahmed without any government aid. Incidentally it was the first Dental College to be established in Asia.
After his death on 9 February 1965 the college was renamed after him. After that many Other Dental Colleges have come up in India.
Dentistry in Iran
In Iran dentists require six years of post secondary education. The whole program is one single degree of D.D.S. (Doctor of dental surgery). After this, those wishing to specialize in a particular field may pursue higher education. Upon graduation, a dentist may need to fulfill a two year military requirement (as a dentist in uniform) in order to start in private practice. There are many dental schools but two of the most notable are:
University of Tehran (School of Dentistry .1939) Dental School of Shahid Beheshti University
Dentistry in Italy
In Italy dentists complete 5 years of undergraduate study to earn a degree. Nevertheless it is possible to agree on certain basic clinical competences common to all member states of the European Union.
The following is an example of one such clinical competency (excision of a buried tooth root): If a clinician is deemed to be clinically competent in the surgical removal of a buried root, this implies much more than the technical and surgical ability required to excise a buried piece of root from alveolus. It embraces a broad range of pre-clinical and clinical knowledge and understanding on which surgical treatment is based.
Dentistry in Malta
The first course leading to a degree in Dental Surgery, at the University of Malta, commenced in 1933. The qualification was recognized by the Medical Council of the United Kingdom in 1936.
Dental Surgery was established as a separate Faculty in 1954, previous to which the course was under the direction of a Board of Studies within the Faculty of Medicine and Surgery. The Faculty caters for an undergraduate intake of 8 students annually. A B.Ch.D Degree is awarded at the completion of the 5 year course.
Dentistry in Mexico
Dental care in Mexico is considerably less expensive. Many travel yearly to Tijuana for quality care but one must research and exercise care. See Dentists in Tijuana.
Dentistry in Norway
The 5-year dental education is offered at three universities:
University of Oslo
University of Bergen
University of Tromsø
All dentists in Norway are organized through "Tannlegeforeningen". Dental services are free for children.
Dentistry in Pakistan
History of dentistry in Pakistan starts even before its birth. Pakistan's premier and oldest dental institution 'de'Montmorency college of Dentistry' was established in 1934 at Lahore by then Governor of Punjab Sir Jeff Fitz Harway de' Montmorency. It was the only dental college at the time of partition of subcontinent that existed in this part of the world,today which we know as Pakistan. de'Montmorency College of Dentistry as a very rich heritage of academic and clinical excellence both before and after independence. History of dentistry in Pakistan is in fact story of progress of de'Montmorency College of Dentistry. At present there are upwards of 20 dental schools (public & private) throughout Pakistan, according to the Pakistan Medical & Dental Council the state regulatory body has upwards of 6200 registered dentists. The four year training culminates in achieving a Bachelor of Dental Surgery (BDS) degree, which also requires a one year compulsory internship to be a registered dentist in Pakistan.
Dental schools in Pakistan
de'Montmorency College of Dentistry, Lahore
Dental Section Nishter Medical College, Multan
Dental Section Jamshoro Medical College, Hyderabad
Dental Section Khyber Medical College, Peshawer
Dental Section Ayub Medical College, Abbotabad
Dental Section Bolan Medical College, Quetta
Hamdard University
Baqai University
Fatima Jinnah Dental College
Altamash Institute of Dental Medicine
Lahore Medical and Dental College
International Islamic University Islamabad
Dentistry in the Philippines
Most Filipino Dentists must earn a total of 6 years of dental school (2 years preparatory; 4 years proper) to obtain the degree Doctor of Dental Medicine (D.M.D.). Presently, the country has a total of 17 dental schools, in which the board licensing is administered and regulated by the Board of Dentistry of the Professional Regulation Commission. Centro Escolar University is noted to have the largest enrollment of Dentistry students every year in the country.
Ago Medical and Educational Center
Cebu Doctors University
Centro Escolar University
Davao, Medical School Foundation
De Ocampo Memorial College
Emilio Aguinaldo Colleges
Our Lady of Fatima University
Iloilo Doctors College
Lyceum of Batangas
Lyceum Northwestern
Manila Central University
Medina College
Mindanao Medical Foundation
Misamis University
National University
Pines City Educational Center
Southwestern University
Unciano Paramedical Colleges
University of Baguio
University of the East
University of Perpetual Help
University of the Philippines
University of the Visayas
Virgen Milagrosa University Foundation
Dentistry in Slovakia
In Slovakia, dentists complete 6 years of undergraduate study to earn a MUDr (lat. Medicinae Universae Doctor) degree. Dental education is offered at two universities: Comenius University in Bratislava and University of Pavol Jozef Safarik in Košice. Junior graduates work under a skilled doctor for at least 3 years to receive their license from The Slovak Chamber of Dentists. Part of dental service is paid from health insurance but mostly treatment (fillings, prosthodontics) is paid cash by patient.
Dentistry in Sweden
The 5-year dental education is offered at four universities:
University of Malmö http://www.mah.se/templates/Page____13098.aspx
University of Gothenburg http://www.odontology.gu.se/
Karolinska Institutet, at Huddinge Hospital http://ki.se/ki/jsp/polopoly.jsp?d=1524&l=en
University of Umeå http://www.odont.umu.se/index_eng.html
Most dentists in Sweden are organized through "Tandläkarförbundet" which also issues the scientific 'Swedish Dental Journal': http://www.tandlakarforbundet.se/swe/default.asp.
Dental care is provided at public and private dental offices. Dental services are free for everyone up to 20 years of age. From the age of 20 and upwards there is a fixed state refund which usually is, depending on the dentist's fee and what type of dentistry performed, around 10 % - 15 % of the total cost. For more expensive dental work above the age of 65 the patients only pay 7800 SEK (~ $1,000) plus the cost of the dental material that was used.
The English title given to dental graduates in Sweden is D.D.S (Doctor of Dental Surgery)
All dentists in the European Union/EES are elegible to work in Sweden. Dentists with an exam outside EES are required to take a one year course at Karolinska in Stockholm.
Dentistry in Taiwan
After graduating from high school, students are required to take a 6 year dental program to get their D.M.D. degree. The first dental school in Taiwan belonged to the College of Medicine at National Taiwan University. There are currently 7 dental schools in Taiwan:
China Medical University (Taiwan)
Chung Shan Medical University
Fu Jen Catholic University
Kaohsiung Medical University
National Cheng Kung University
National Defense Medical Center
National Taiwan University
National Yang Ming University
Taipei Medical University
Dentistry in the United Kingdom
An NHS dentist performing an examination
In the United Kingdom, dentists complete 5 years of undergraduate study to earn a B.D.S. or BChD degree. After graduating most dentists will enter a V.T. (vocational training) scheme, of either 1 or 2 years length, to receive their full National Health Service registration. Dentists must register with the G.D.C. (General Dental Council), and meet their requirements as the governing body of the profession, before being allowed to practice.
Dentistry in the United States
In the United States dentistry is generally practiced by dentists who have completed a post-graduate course of professional education. With exception of rural Alaska, Dental therapists, technicians without medical training, are not permitted to practice in the United States. Use of dental therapists or dental hygienists to independently perform routine fillings or cleaning is strongly opposed by the American Dental Association, (the A.D.A.), the dentists' professional association. This has resulted in excellent but high-priced treatment which, however, fails to delivers services at a reasonable price to the lower social classes. With only a few exceptions neither government sponsored health care programs such as Medicare or Medicaid nor private medical insurance cover routine dental treatment. As a result large sections of the population do without. The worst conditions are in Kentucky and West Virginia. Rates for dental services have been rising rapidly, out pacing the rate of inflation. After falling for many years, the percentage of both adults and children with unfilled cavities began to rise in 2000 as did the percentage of adults with no teeth. Increasingly, people with adequate income to pay the fees are forgoing treatment.
Dental technicians
Outside the United States, more than 50 countries allow technicians called dental therapists to drill and fill cavities, usually in children. In the U.S., state boards of dentistry have blocked dental therapists from working, arguing that only dentists should be allowed to drill teeth, because it is an “irreversible surgical procedure” and "can lead to serious complications like infections or nerve damage".
Dental education in the United States
There are limited opportunities for dental education in the United States with only 4,440 graduating in 2003, down from 5,750 in 1982. There is little or no movement on the part of the American Dental Association, the ADA, or the states to expand dental education. Due to the hands-on training required, dental education is expensive and is not subsidized by the federal government. In the United States, dentists earn either a D.D.S. (Doctor of Dental Surgery) or D.M.D.(Doctor of Dental Medicine) degree. There is no difference in the training for either degree. The degrees are equivalent, and recognized equally by all state boards of dentistry. There are 56 Accredited Dental schools in the United States requiring 4 years of post graduate study (except for one unique 3 year program at the University of the Pacific). Most applicants to dental school have attained at least a B.S. or B.A. degree, however, a small percentage are admitted after only fulfilling specific prerequisite courses. So unlike many other countries (other than US, Canada, and Australia), it usually takes more than 8 years to become a dentist. (List of dental schools in the United States) The difference relates to the history involved in the division of medicine and surgery in medical practice. There has been a recent movement to include a 5th year of education that focuses on purely practical training in the clinical setting. In at least one state, New York, a state dental license can be received without taking the licensing exam (State Board Exam) upon completing this additional year of training (usually in the form of a GPR or AEGD).
Licensure is organized on three levels in most areas. All dentists must pass National Boards, Regional Boards, and then take a jurisprudence exam accepted by their state to fulfill their requirements to get a state license. Although a state license is only valid in the issuing state, because of the regional boards a dentist may be able to apply for licensure in any other state within the jurisdiction of their regional board. There are many cooperative agreements between states that allow recognition of another state's license so as to procure a license either via "licensure by credentials" or "licensure by reciprocity." Although a national licensure exam has yet to be made, the American Dental Association (ADA) has worked with education and examining groups to form such an exam. A dentist may go on for further training in a dental specialty which require an additional 1 to 7 years of post-doctoral training. There are 9 recognized dental specialties. They are Endodontics (root canal treatment), Oral and Maxillofacial Pathology, Oral and Maxillofacial Radiology, Pediatric Dentistry, Periodontics (gums), Prosthodontics (complicated dental reconstruction), Orthodontics (moving teeth), Oral and Maxillofacial Surgery (tooth removal and surgery of the oral and facial structures), and Dental Public Health. There is no specialty in esthetic dentistry or implantology, and no additional training is required for a dentist to make the claim of being an esthetic or cosmetic dentist. Dentists are forbidden to claim that they are specialists in areas of practice in which there is no recognized specialty. They may limit their practices to a single area of dentistry, and claim that their practice is limited to that area.
Any general dentist may perform those procedures designated within the enumerated specialties if they deem themselves competent. Many general dentists train in certain aspects of the above specialties such as the placement and restoration of dental implants, advanced prosthodontics and endodontics, and have limited or heavily focused their practices to these areas. When a general dentist performs any procedure that falls within the realm of a specialty, they are expected to perform with the same level of expertise as a certified specialist and are legally held to such standards with respect to any issues of malpractice.
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