Orthopaedic medical tourism in Singapore

We have been in practice now for more than 20 years and have attended to patients literally from all over the world including Malaysia, Indonesia, Vietnam, Japan, Korea, Australia, New Zealand, The Polynesian Islands, Europe, Russia, India, China, Pakistan, Bangladesh, Canada, United Sates of America, Brazil…..just to name a few. In that time we have received essentially the same set of questions which we thought would be useful to consolidate in one document.

 

1. Cost of surgery

The biggest question usually is cost. The only fair comparisons here are to compare costs on standardized procedures like hip, knee and arthroscopic surgery and then to decide if the fee is comparable. There is no logic in making a comparison to, say, a pelvic resection and arthroplastic reconstruction with plastic surgery closure because such procedures require highly skilled multi-disciplinary teams and can only be counseled on a case-to-case basis (Figure 1). By that token a hip replacement usually costs about USD 60,000 in the US and USD 25,000 in Singapore. Much cheaper options are available in the region but do not have various medico-legal and healthcare quality assurance standards (ISO, JCI, HSA, FDA etc) built into the infrastructure of healthcare provision in the country. Ironically, because the highest end of medical care is provided in Singapore, there are significant cost savings to be made on , say, implant costs which for the same device may be half the cost of an implant elsewhere.

 


Figure 1. The standard hip replacement in a fit patient with a condition of minimal bone loss requiring a 90 minute operation and staying only three days in surgery (top panel) cannot be compared to a dislocated and infected proximal femoral hip replacement requiring cement spacers, long-term antibiotic therapy and reconstruction with highly specialized implants and bone transplants a year later. Knowing the former would allow one to extrapolate on the latter in general terms but the latter case is simply too unpredictable and requires high specialization to deliver on the results.

2. Medico-legal framework

This is a question often asked by patients from first-world countries who are concerned about their recourse to compensation in the appropriate circumstance. Every practicing doctor in Singapore is covered by medical malpractice insurance. While premiums on this service are rising and do contribute to rising healthcare costs that must ultimately borne by the patient, these premiums are some of the lowest in the developed world. This is a testament to the standard of care and accountability provided in the country. Medical malpractice insurance affords the practicing doctor legal representation in the event of alleged remiss. Regulation is exercised under 2 arms – the Singapore Medical Council and the Courts. In general proceedings are fair and in the case of true negligence the matters are settled amicably – no doctor ever intends harm. Nevertheless, certain expectations like “loss of income”, or “loss of potential gains” are not generally acquiesced.

 

3. VISA

Singapore has a bilateral arrangements with various countries on the requirements for visa. Generally, without qualification, the length of a visa is one month. If there is a requirement for healthcare this may be extended to 89 days per application and immigration authorities are generally sympathetic.


4. Accomodation

There are numerous options ranging from hotels, serviced apartments and rentals. Hospitals are easily able to provide such contacts.

 

5. Transport

There is a well-connected network of trains, buses, taxis, ambulances, etc. A taxi ride of say 10km would be about USD 8.

 

6. Food

Probably, one of the widest choices of cuisine in the (dare we say) world at all prices to suit all budgets.

 

7. Safety

Extremely safe. Firearm ownership is illegal in Singapore.


8. Religious tolerance

Singapore is amongst the most religiously tolerant countries in the world. Religious and ethnic harmony is in the cornerstone of the country's constitution.


 

Did we miss anything? Please drop us a line at info@limbsalvagesurgery.com if there are any other questions that you’d like to see answered on this list.