Tourists welcome

Dr. James Spearman works in an operating room of the Lowcountry Outpatient Surgery Center in Summerville.

When James Spearman was a teenager, years before he started practicing orthopedic surgery, he worked as a Myrtle Beach lifeguard.

He met a lot of people that summer, mainly tourists from up and down the East Coast who were spending a week on the beach with their families.

But many of them weren’t on the Grand Strand just for the sun and surf and seafood buffets, he soon found out. They were in town getting dentures made.

“There’s a place in Florence called the Sexton Dental Clinic,” said Spearman, now a surgeon at Lowcountry Orthopaedics. “They offered discount dentures, same day service. And so people would drive from New York, go by the dental clinic, get their teeth pulled, get their dentures made, go to the beach, spend a week at the beach, go back to New York and save money having their dentures made.”

It would have cost them more to have their dentures made in New York than they spent on the whole trip, he said.

Years later, that got him thinking. “I read an article about people going overseas to get stuff done and how much it saved them.” Why not offer that service in Charleston? The idea for Travel Surgery USA was born.

“You don’t have to go to India and spend $15,000 on a plane ticket to get a total knee done for $15,000. You can get it done here for $20,000 and actually save money,” he said.

The market for global medical tourism is estimated to be worth as much as $55 billion. Patients Without Borders, which aggregates information on “trustworthy medical destinations” online, acknowledges that reliable data on the industry is difficult to gauge, but the group believes 1.2 million Americans traveled outside the United States for medical treatment last year.

Information on domestic medical tourism, Americans who travel within the U.S. for a procedure, is hard to find, too, but Laura Carabello, the executive editor of U.S. Domestic Medical Travel, said it’s becoming more common. “It’s not as rare as you think it is anymore,” she said.

Large businesses, in particular, are trying to capitalize on this emerging industry as they grapple with ways to control health care costs. For example, Walmart established a travel surgery program for cardiac and spine procedures, Carabello reported. Walmart employees who are insured through the company may cross state lines for surgery. The outcomes are better and the prices are cheaper than some local hospitals can offer.

Spearman, who launched the Travel Surgery USA website three years ago, admitted that most doctors are reluctant to publish their prices online. While it’s becoming more common for primary care appointments, it can be virtually impossible for patients to find the total cost of surgery at a hospital.

“There’s a bigger taboo about people putting their prices out there,” Spearman said. “It’s not illegal, but nobody wants to do it.”

Prices on Travel Surgery USA are easy to find. For a total knee replacement, Spearman charges $17,880 for an outpatient procedure. That includes everything: the surgery, the anesthesia, the facility fee, the physician fee, the implant. And, it’s much lower than the $40,000 average market price.

He has established flat fees for more than two dozen orthopedic procedures on his website and while follow-up care, including physical therapy, is not included in these prices, Spearman negotiated a discounted cash price with a local physical therapy group that his patients can pay per visit.

“Everybody I’ve talked to says it’s a great idea,” he said.

But so far, business is slow. No one from out of town has traveled to Charleston for one of Spearman’s procedures since he started the medical tourism website and he’s only had about 10 local clients who have taken advantage of the flat fees. Most of them are accident victims who need work done pending a settlement.

The vast majority of Lowcountry Orthopaedics patients, more than 100 every month, are insured and their surgeries are billed to an insurance company.

Spearman has also had trouble encouraging other specialists to join him. Eventually, he’d like to offer flat fees for a variety of procedures, including urology, ophthalmology and gastroenterology.

Still, the flat fees for orthopedic surgeries serve a purpose, even if Travel Surgery USA never really takes off, Spearman said.

“It’s really about saving people money on health care,” he said. “If you can use my prices and negotiate a better deal in your hometown, you should be doing it.”

Reach Lauren Sausser at 937-5598.