The key to the success of a country defining itself as medical tourism destination is found not only through the expertise of its physicians, but also in the foundation and support provided by its government. In El Salvador we found a terrific combination of both.
Familiarization (FAM) Tour
The MTA recently joined forces with EXPORTSALUD, the Export Chamber of Medical Services in El Salvador to host a Familiarization (FAM) Tour in which six different U.S. based medical tourism facilitators had the unique opportunity to visit El Salvador, to personally meet with the physicians promoting themselves in Medical Tourism and to visit their clinics and hospitals.
Upon our arrival, after only a short 2 ½ hour flight from Miami we were greeted at El Salvador’s Aeropuerto Internacional Comalapa in San Salvador by bright smiles and a warm embrace from a magnificent group of members from EXPORTSALUD. They welcomed us with the excitement and affection that only family would offer.
During our visit we stayed at the Radisson Plaza Hotel, which features some of the city’s most breathtaking panoramic city and mountain views. It is connected to San Salvador’s World Trade Center as well as many international businesses. The hotel is only ten minutes away from cinemas, entertainment and three beautiful malls: La Gran Vía, Multiplaza and the Galería.
Country Focus
El Salvador is located in Central America, within the septentrional zone giving it its year round warm climate. Bordered by Guatemala, Honduras and Nicaragua, El Salvador has a population of roughly 7 million people with a size of 8,123 square miles. Since January 1, 2001 the U.S. dollar was accepted as legal tender and is now the official currency throughout the country, which makes it very accessible for stable pricing for medical tourism packages.
Its principal exports include coffee, textiles, cotton, sugar and seafood. Additionally, El Salvador is the only producer in the world of Balsam, which is used for the manufacturing of pharmaceutical and cosmetic products. Although El Salvador is the smallest country in Central America, it consists of extensive valleys, broad plains, volcanoes, the Sierra Madre mountain chain and the Pacific Coast, not to mention the third largest economy in the region.
There are over twenty-five inactive volcanoes throughout the entire country with Santa Ana as the tallest Volcano at 7,804 feet above sea level. The intricate river system of El Salvador is divided into ten different basins according to the climate, geography and vegetation.
Two hydroelectric dams are located in the Lempa River supplying the country’s electric power needs. The three main lakes in El Salvador are Ilopango, Coatepeque and Guija, which is shared with Guatemala. All of which provides a tremendous about of ecotourism possibilities.
El Salvador has 184 miles of alluring Pacific Ocean coastline made up of geological structures such as vast cliffs and large rock formations covered with rich, tropical vegetation. The Litoral Highway connects all of El Salvador’s captivating beaches from the West Coast to the East Coast.
These beautiful beaches include Los Cabonos, Metalio and Playa Dorada, which offer exciting recreational activities and private beach clubs. Among others are San Diego and Costa del Sol, where events and competitions generally take place. El Espino, El Cuco and the Gulf of Fonseca are also amid the most popular beaches in the country.
In an effort to promote tourism, El Salvador has placed 14 tourist recreational centers along the Pacific Ocean Coast, Central Mountain Range and other areas of the inviting country. Needless to say, it is a tourism dream and awaiting the arrival of patients who can combine their high quality healthcare needs with a little bit of paradise.
Clinic Tours
Throughout the four days of the FAM Tour, the group was welcomed into 14 different Clínical settings with specialties ranging from dental, plastics and ophthalmology, to bariatric & weight loss, orthopedics and cardiology. These physicians set time aside from their busy schedules to meet with each of the facilitators, give them a tour of their clinics and introduce them to their staff, providing facilitators with a first hand look at what a medical tourist would encounter when seeking treatment in El Salvador.
Lunch was graciously sponsored by the Ministry of Tourism every afternoon during the FAM Tour. MiTur did an outstanding job choosing the locations each day, exposing the group to tourism and recreational areas such as La Grand Vía (for shopping and restaurants), and Esperanto, a beautiful cliff top restaurant overlooking one of the top surfing destinations in the world. This provided the group the opportunity to come together, discuss their observations and share their thoughts.
Hospital Tours
The two hospitals included in the FAM Tour were El Hospital de Diagnóstico and El Hospital de La Mujer.
Dr. Rodrigo Brito, director of El Hospital de Diagnóstico personally greeted the group in the hospital’s conference room, gave an enlightening presentation and provided valuable information about the hospital.
“Diagnóstico” combines a modern hospital with a team of over 100 distinguished physicians and offers an outstanding Diagnostic Medical Imaging Center and a Clínical Laboratory with cutting edge technology. Currently the nurse to patient ratio is 2 to 1 and 251 foreign patients were treated at El Hospital de Diagnóstico in 2008.
Dr. Brito provided a tour which included Operating Rooms, the Intensive Care Unit, the Radiology Department and finalized with the newly renovated International Patient Suites. These beautiful suites are equipped with flat screen TVs with complementary cable, wireless Internet access and each suite has its own balcony offering patients a stunning view of San Salvador.
Additionally, there are also suites available with a connecting room for the patients’ families that provides the perfect level of privacy for both parties. The U.S. White House has chosen El Hospital de Diagnóstico as the designated hospital for the President of the United States in case of the need for medical treatment during his visits to El Salvador.
El Hospital de La Mujer was the second hospital visited. The group was given a presentation on the services offered and later taken on a tour of the facility which included Operating Rooms and the Intensive Care Unit.
El Salvador Medical ~ High Expertise
El Salvador Medical is a group of talented and very well educated physicians that have come together to offer their patients top quality healthcare in El Salvador. Having all trained in the United States for their pertinent specialties, they possess the knowledge and empathy necessary to treat international patients.
Dr. Rafael Lorenzana
Dr. Rafael Lorenzana is an American Board Certified dentist-prothodontist specializing in dental implants. Dr. Lorenzana received his Doctorate in Dental Surgery in El Salvador and then went on to the University of Texas Health Science Center where he became certified in Occlusion and Fixed Prosthodonics.
Dr. Lorenzana received a certificate in Prosthodontics from the Medical University of South Carolina followed by Baylor College of Dentistry in Dallas, Texas where he received his Doctorate in Dentistry and was later hired as a Professor for many years.
Dr. Lorenzana is certified by the American Board of Prothodontics and a Fellow of the American College of Prosthodontics. Along with being a member of El Salvador Medical, Dr. Lorenzana owns Lorenzana Dental Center, in San Salvador where he offers his patients over 30 years of teaching experience, quality dental material, advanced dental equipment and well trained staff which communicates efficiently in both Spanish and English.
Herb Stevens, CEO of Health Travel Guides was one of the facilitators that participated in the FAM Tour and became a medical tourist himself during the tour. “While in El Salvador, I had the opportunity to put my mouth where my money is. During the familiarization tour, after meeting one of the top dentists in El Salvador, Dr. Rafael Lorenzana, I actually sat in his dental chair and had a titanium dental implant procedure.
I had cracked a tooth a few weeks before the trip and had received quotes from two dentists in the U.S.,” he boasted. “I am very happy to report that my experience with Dr. Lorenzana was excellent and that I saved over 60% (from the lowest U.S. quote) on the implant. His dental clinic is world class and I would highly recommend him to everyone,” he added.
Dr. Jaime A. Flores
Dr. Jaime Flores is an Orthopedic Surgeon specializing in Arthroscopic Surgery and Total Joint Replacement Surgery. Dr. Flores received his Medical Doctorate from the Universidad Nacional de El Salvador. He then attended The State University of New York at Buffalo as well as The University of Toronto in Ontario, Canada to specialize in Orthopedic Surgery.
Dr. Jaime Flores’ memberships include The American Academy of Orthopedic Surgeons, The College of Physicians and Surgeons of Ontario, Canada as well as La Asociasión Salvadoreña de Ortopedia y Traumatologia.
Dr. Gerardo Flores-Lima
Dr. Gerardo Flores-Lima is a Plastic Surgeon with vast experience and an impressive educational background. Dr. Flores-Lima received his Medical Doctorate from the Universidad Evangélica de El Salvador. He then completed his General Surgery Residency at HMC in El Salvador and went on to complete a Plastic and Reconstructive Surgery Residency at Pontifica Universidad Católica in Argentina as well as at Clínica Raúl González in Sao Paulo, Brazil where he specialized in Gluteal Implants.
Dr. Flores is one of only four plastic surgeons in the world who has published articles regarding Intramuscular Gluteal Implants. Dr. Flores-Lima completed his Fellowship Training in Plastic Surgery at Indiana University, Purdue University of Indianapolis (IUPUI) Medical Center in Indianapolis, Indiana.
Among the services Dr. Flores-Lima offers his international patients, he has implemented a concierge service in his clinic which provides patients and their families with tourism information about El Salvador and assists them in coordinating leisure activities.
Dr. Roberto Zelaya
Dr. Roberto Zelaya specializes in Bariatric and Weight Loss Surgery as well as Gastrointestinal Surgery & Endoscopy. Dr. Zelaya received his Medical Doctorate from the Universidad Evangélica in El Salvador. His training includes the Research Institute for Cancer of the Digestive System at Louis Pasteur University in Strasbourg, France.
Dr. Zelaya then completed a fellowship at Ohio State University Medical Center, at the Center for Minimally Invasive Surgery in Columbus, Ohio. Dr. Zelaya also completed a fellowship at the Hospital Clinic of Barcelona in Barcelona, Spain. Along with being a member of El Salvador Medical, Dr. Zelaya is the owner of Gastrointestinal Surgery and Endoscopy Clinic in San Salvador.
He offers treatments for obesity including Intragastric Balloon, Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Band. Dr. Zelaya is a member of the International Federation of Surgery for Obesity.
López Beltran Ophthalmology Clinic
The family-owned López Beltran Ophthalmology Clinic offers its patients over fifty years of experience in the art of visual care. Together, Dr. JoséFrancisco López Beltran Sr., Dr. JoséFrancisco López Beltran Jr., Dr. and Dr. Lourdes Amato de López offer an impressive educational foundation and pride themselves in being the pioneers in Central America with over ten thousand refractive surgeries.
Utilizing top of the line equipment such as Alcon, the López Beltran Ophthalmology Clinic provides services such as Ocular Ultra Sounds, Angiography, Biometrics, Ocular Tomography, 3D Ocular Topography, Paquimetry, Yag Laser, Argon Laser and Digital Campimetry.
Their educational experience includes the Universidad Autónoma de Guadalajara in México, Universidad Autónoma de Centro America in Costa Rica, Moorfields Eye Hospital in London, Perth in Scotland, Hospital Roosevelt in Guatemala as well as Shands Hospital at the University of Florida in Gainesville, Florida.
Their memberships include the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Central American Society of Retina and the Salvadoran Society of Ophthalmology.
El Hospital de Diagnóstico is also part of El Salvador Medical, allowing the group to create complete package deals for international patients which were shared with the group of facilitators during their visit.
El Salvador Medical held a dinner for the FAM Tour at a beautiful country club in San Salvador called Club Campestre. Each physician gave a presentation on their specialty and expressed their enthusiasm and commitment to make El Salvador a top destination of choice for medical tourism.
What was most beneficial for the facilitators was the ability to get to know the physicians on a personal level and further discuss business opportunities. You may learn more about this medical group at www.elsalvadormedical.com.
Clínica Zaldívar ~ Raising the Bar in Cosmetic Procedures
Dr. Román Zaldívar is an American Board Certified Plastic Surgeon who completed his General Surgery Residency at Jackson Memorial Hospital in Miami, Florida and his Plastic, Reconstructive and Maxillofacial Residency at the University of Pittsburgh Medical Center in Pennsylvania. Dr. Zaldívar returned to Miami to complete a fellowship in Aesthetic Surgery and was in private practice for 5 years in Miami before returning to his native land of El Salvador to open his privately owned Outpatient Clinic, “Clínica Zaldívar.”
We had the opportunity to interview Dr. Zaldívar in San Francisco in September 2008 during our first annual World Medical Tourism & Global Health Congress. Dr. Zaldívar shared that part of the reason that he returned to El Salvador was, “the quality of life that his country offered him and his family.” Dr. Zaldívar is currently a member of The American Society of Plastic and Reconstructive Surgeons as well as The American Society for Aesthetic Plastic Surgery.
During our visit to Clínica Zaldívar, he shared the exciting new project of opening a new State of the Art Outpatient Clinic, set to be ready December 2009. The architect designing the clinic is Juan Pedro Alvarez, who has a Design Studio in Los Angeles, California. The facility offers multiple VIP entries, allowing inconspicuous arrivals, personalized attention, and retreat from the outside world to relax and recover in luxurious accommodations.
Working within the existing 600 square meter facility, are two state-of the-art operating rooms with recovery areas, 2 private recovery rooms for overnight stay, a doctor/nurse change room, 2 consultation rooms, physician’s office, a common waiting area and 2 private waiting rooms where patients are educated about their upcoming procedures through LED touch screen monitors, along with staff support areas.
Combined in the same space is a medical spa where patients can receive different types of skin and rejuvenation treatments. Backlit suspended soffits and over and under-lit white walls dematerialize boundaries.
Surgical Specialties Abroad ~ Partnerships for the Delivery of Quality
Dr. Carlos Ramos Hinds
Dr. Carlos Ramos Hinds, president of EXPORTSALUD, founded Surgical Specialties Abroad, which consists of eight excellent and passionate physicians. Dr. Ramos Hinds specializes in laparoscopic surgery. He received his Medical Doctorate from the Universidad Evangélica de El Salvador and completed his General Surgery Residency at Hospital Nacional Zacamil, Hospital Nacional Rosales and Hospital Regional San Juan de Dios San Miguel.
Dr. Ramos specialized in Video Laparoscopic Surgery at the Hospital Nacional Zacamil and the Universidad Evangélica de El Salvador. He then completed a fellowship in Video Laparoscopic Surgery at the Louis Pasteur University in Strasbourg, France. Dr. Ramos is extremely motivated and has certainly been a driving force in the growth of medical tourism in El Salvador.
Dr. Adrián Avendaño Valiente
Dr. Adrián Avendaño Valiente specializes in dental implants and periodontics. He received his Doctorate in Dentistry from the Universidad Salvadoreña Alberto Masferrer and specialized in periodontics Universidad Autónoma de Nuevo León, in Monterrey, México. Dr. Avendaño works with the latest technology and has structured his office in a way that makes his patients feel as if they were home.
Dr. Avendaño is the President of The Salvadoran Periodontal Association as well as an International Member of the American Academy of Periodontology, the Salvadoran Dental Association and the UANL Periodontal Postgraduates Association.
Dr. Julio Rodriguez
Dr. Julio Rodriguez specializes in dental implants & oral rehabilitation. Dr. Rodriguez received his Medical Doctorate from the Universidad Evangélica de El Salvador and completed his Implantology and Oral Rehabilitation Residency at UCLA School of Dentistry in Los Angeles, California.
Dr. Augusto A. Magaña
Dr. Augusto A. Magaña specializes in Orthopedics. Dr. Magaña received his Medical Doctorate from Universidad Salvadoreña Alberto Masferer and completed his General Surgery Residency in the Instituto Salvadoreño del Seguro Social.
He then continued his education at Hospital Nacional Zacamil, Hospital Ángel del Pedregal in México and Universidad del Estudio in Milan, Italy. Dr. Magaña’s memberships include the Asociación Salvadoreña de Ortopedia y Traumatología and the Asociación Mexicana de Ortopedia y Traumatología.
Dr. Mauricio Guerrero
Dr. Mauricio Guerrero a plastic surgeon who received his Medical Doctorate from the Universidad Alberto Masferrer and Autónoma de México. Dr. Guerrero completed his Plastics and Reconstructive Surgery Residency at the Hospital Nacional Rosales and the Universidad de El Salvador.
Dr. Iván Solórzano
Dr. Iván Solórzano specializes in ophthalmology and received his Medical Doctorate from Universidad de El Salvador and completed his Ophthalmology Residency at Hospital Nacional Zacamil, Dr. Juan José Fernández in San Salvador. Dr. Solórzano was awarded the Gillingham Scholarship and continued his education at Tulane Univeristy Medical Center in New Orleans.
He then completed a fellowship in the area of glaucoma at The Kentucky Lions Eye Center at the University of Louisville in Kentucky. Dr. Solórzano’s memberships include the Sociedad Salvadoreña de Oftalmología de El Salvador, Sociedad Salvadoreña de Glaucoma, Sociedad Salvadoreña de Retina y Vítreo, the International Glaucoma Society, the American Academy of Ophthalmology and the American Medical Association.
Dr. Boris Ferman Sampson
Dr. Boris Ferman Sampson specializes in anesthesiology and received his Medical Doctorate from the Universidad Evangélica de El Salvador. He completed his General Surgery Residency and Anesthesiology Residency at Hospital Medico Quirúrgico del ISSS.
Dr. Ferman’s memberships include the Asociación de Médicos Anestesiólogos de El Salvador, founder and member of the Asociación Cooperativa de Médicos Anestesiólogos, Dr. Ferman is a member and co-founder of the first Anesthesiology Radiofrequent, Oxygen and Ozonetherapy Equipment for pain management in El Salvador.
Dr. Gerardo Roberto Sosa
Dr. Gerardo Roberto Sosa specializes in Anesthesiology. Dr. Sosa received his Medical Doctorate from the Universidad Evangélica in El Salvador. He completed his General Surgery Residency and Anesthesiology Residency at Hospital Medico Quirúrgico del ISSS, where he is now the coordinator of the Emergency Department.
During the dinner Surgical Specialties Abroad hosted for the FAM Tour Surgical Specialties Abroad gave a very informative presentation and shared one of their internal quality indicator projects with the group. This project will benefit not only international patients, but local patients as well because the overall standard of care will be improved. This is truly a dynamic group of physicians that offer their services with a touch of Salvadoran hospitality.
FAM Tour Press Conference
A press conference was held at the Radisson Plaza Hotel and the four key speakers were the vice president Ana Vilma Albanez de Escobar, the minister of tourism Ruben Rochi, the president of EXPORTSALUD Carlos Ramos Hinds and Renée-Marie Stephano, COO of the Medical Tourism Association.
Ruben Rochi boasted, “The excellent infrastructure of roads and highways is just another added advantage, since patients can benefit from leisure tourism exploring El Salvador’s mountaintops, archeology sites and beaches throughout their treatments.”
Government Support ~ Medical Tourism in High Priority
Agencies such as EXPORTSALUD, EXPORTA, PROESA and MiTur have committed to aid the healthcare industry in the country through the establishment of protocols, promotion and even allocating a budget for the purpose of medical tourism growth – solidifying the government’s commitment in making El Salvador a viable medical tourism destination.
The vice president of El Salvador, Ana Vilma Albanez de Escobar welcomed the group in the Presidential House, where we also had the opportunity to meet with EXPORTA, the government program responsible for exporting El Salvador’s products and services abroad and PROESA, the country’s Investment Promotion Agency.
“This enormous niche market is precisely what El Salvador seeks to attract, taking advantage of its convenient geographic location, American currency and excellent value in its healthcare services, clinics and private hospitals,” stated Ana Vilma Albanez de Escobar.
Among the topics discussed was the issue of implementing English courses into El Salvador’s education system, as this is imperative to ensure the success in international patient treatment.
Though the physicians we encountered during our visit were bilingual and had the opportunity to study abroad, many of the nurses and the staff did not have the same exposure and being such an important part of the equation, it is vital for them to have the opportunity to receive English courses and become familiar with medical terminology in English as well. The all around patient experience depends on the interaction with not only the physician, but his or her staff as well.
Accreditation ~ In the Works
One of the most challenging aspects for El Salvador to be competitive in the global market for medical tourism is the need for international accreditation. Although the quality of the healthcare services is evidenced through the experience and the outcomes of the surgeons, patients and insurance companies are looking for international accreditation as an assurance of a certain standard for quality.
In response to this market demand, the hospitals and clinics have been assessing the best options for international accreditation using accreditation schemes such as Joint Commission International, Trent Accreditation, Accreditation Canada and Surgical Facilities Resources, a Clinical accreditation program. The decision of which accreditation systems or combinations of systems will be used ultimately will come down to affordability and return on investment.
For El Salvador, the interest in attracting American patients is of the highest importance with Canadian and European patients falling next in line in terms of market potential. It is estimated that accreditation processes will commence this year.
El Salvador is in the unique position to have the cooperation of EXPORTSALUD, USAID and BID to assist the facilities in obtaining international accreditation for a large number of their healthcare clinics making El Salvador the first country in Latin America to focus on their clinics for the exportation of healthcare services.
The FAM Tour proved to be a huge success and an incomparable networking opportunity for international healthcare providers and medical tourism facilitators.
ExportSalud, El Salvador Medical, Lorenzana Dental Center and Zaldívar Cosmetic Clinic are all members of the Medical Tourism Association.
