Ease of travel and geographic accessibility are key factors in attracting medical tourists, and may rival choice of surgeon or medical facility in importance to consumers. While many flights to destinations in Asia or Eastern Europe require 12 to 18 hours, Cartagena is only 2.5 hours from Miami, Florida. In medical terms, travel distance is more than convenience and comfort. It is crucial for patient safety, particularly as many of these tourists have chronic illnesses and disabilities .
Cost remains a primary motivator in all aspects of medical tourism. Typically, airfare is not included in medical tourist packages, and airfare to India or Asia can run in the thousands, with the average fare exceeding a thousand dollars per person. In contrast, several carriers offer direct flights to Cartagena for around three hundred dollars. In addition, one of the popular airlines offers frequent specials to Colombia, including travel to Cartagena for less than a hundred dollars each way. While many packages do cover food, and lodging, more independent travelers find Colombia attractive due to the availability of services in a wide range of prices, fitting more modest budgets. The medical care itself is moderately and competitively priced versus other destinations.
Medical tourism is prompted by medical need rather than a desire for travel or exploration. Medical tourists are seeking comfort, and familiarity. Climate and cultural similarities are important features for medical tourists. Cartagena’s Caribbean culture and warm tropical weather is very favorable to potential tourists, and the city itself is attractive and welcoming to outsiders. The standard of living is equivalent to that of many Americans’ with outward signs of wealth such as clean, well maintained streets, and gleaming high rises. For example, when traveling from tourist quarters such as el Centro to the medical facilities in Bocagrande, visitors see little indication of wide economic disparities that exist. Notoriously, medical tourists judge the medical care by the outward appearance and cleanliness of the destinations. This is one of the problems that currently plagues India. Despite modern surgeries, and spotlessly clean hospitals with the latest technologies, the average tourist can not get past stereotype images of pestilence and overcrowding.
Colombia is not without its own detractors. A pervasive negative stereotype regarding crime, drugs and personal safety continues to plague Colombia. A long standing civil war, several political scandals, and new tensions with Venezuela add to this reputation. However much of this could be successfully countered by an aggressive publicity campaign as most North Americans are general unfamiliar with Cartagena, versus Cali or Medellin, which remain infamous in the minds of most visitors. Much of the infrastructure is already in place for this effort but needs to be utilized more fully. Colombian medical tourism companies have little presence on-line or in the global health care marketplace, which is easily changed with a few concerted efforts on the current gateways to Colombia such as Los Angeles, Miami or Dallas, Texas.
Language can be a barrier to many visitors. Unlike Mexico and other Latin American nations with a heavy influx of English speaking visitors, there are few fluent English speakers in many parts of Colombia. While many of the current medical visitors are bilingual, the lack of English amenities limits the potential growth of medical tourism by non-Spanish speakers. Some of the medical travel companies attempt to address this deficiency by providing translators, and the city of Cartagena recently provided cab drivers with English-Spanish flash cards. More widespread English language campaigns for medical tourists could publicize the availability of translators and bilingual providers.
One of the most easily addressed problem for Cartagena’s emerging medical tourism trade is the limited availability of several surgical specialties. While orthopedics, plastic surgery, bariatric surgery and dentistry are well represented, interventional cardiology, cardiothoracic and vascular surgery services are scarce in Cartagena. If medical tourism increased demand for these specialties, services would expand.
As economic conditions continue to deteriorate in the United States, and the health care system remains in crisis, more and more Americans will explore overseas options. The city of Cartagena, and the nation of Colombia, with a little effort, is well-poised to advance further into the global health care market and become a premier destination for medical tourism.
 This article primarily focuses on the United States but growing numbers of Canadians are utilizing medical tourism despite their reputation for ‘universal care.’
 The risk of thromboembolism or blood clot (i.e “Coach class syndrome” increases dramatically in post-operative patients in the first few weeks after surgery. The risk is greatest for people on lengthy flights. Many people have chronic conditions that predispose them to developing blood clots.
K. Eckland is an Acute Care Nurse Practitioner with a background in Cardiology & Cardiothoracic Surgery, and world traveler. She currently lives and practices in the US Virgin Islands. She is also the author of Hidden Gem: A Guide to Surgical Tourism in Cartagena, Colombia.