The concept of Medical Tourism (U.S. patients going to India or Thailand to receive ‘better, cheaper’ surgeries in ‘state of the art’ facilities) has served to undermine confidence in our healthcare system. Michael Moore’s movie, Sicko, portrays foreign doctors and medical facilities as vastly superior to those within the United States. But that’s not how I and many other practicing surgeons in South Florida see things: the idea of ‘Reverse Medical Tourism’ has become a growth industry. In 2006, Baptist Hospital of South Florida catered to 12,480 international patients mainly from Central America, South America, and the Caribbean Islands. Year-to-date in 2007, they’ve already seen over 14,000 international patients, which puts the hospital on pace to receive more than 20,000 international patients by year’s end. I am blessed to be able to travel abroad often to conduct seminars on the latest orthopedic technologies, tour facilities, and perform training sessions for local surgeons. In recent years, I’ve been seeing an ever increasing amount of foreign patients. At my personal practice in Miami, I saw nearly 600 international patients last year. These patients mainly came from Central America, the Caribbean Islands, and South America, but also from Europe, Mexico, and occasionally other regions. Patients often travel to south Florida for treatment of a wide variety of conditions. As a hand surgeon, I find that local surgeons are frequently not trained in newer advanced surgical techniques. Additionally, many surgical implants are often not even available for doctors to utilize. This leads to the use of archaic surgical procedures, which often result in longer patient recovery times and a myriad of other potential issues. Last month, Cayman Islands resident Barbara Currie Dailey flew to Miami to have surgery to treat carpal tunnel syndrome. She said that her main concern about receiving care in the Caymans was that “there’s no board of medical examiners confirming the qualifications of either private doctors or government hospital staff in Grand Cayman.” After several frightening misdiagnoses and consistently poor healthcare in the past, Mrs. Dailey decided treatment outside of the Cayman Islands was her only option. A few weeks ago, I performed surgery on a patient who flew all the way from Trinidad to be treated. He happened to play for the national soccer team and needed complex tendon transfer surgery to restore function in his hand, critical for playing his position as goaltender! After poor initial management of the injury in Trinidad, he decided that he could not trust the available surgeons, facilities or treatments there. Despite Michael Moore’s highly publicized opposing claims, it seems that, at least in South Florida, foreign patients recognize the quality of care they receive in the U.S. The U.S. community has this romantic notion that foreign medicine is at an excellent level despite some hardship, but often, nothing could be further from the truth.