Fresno County has long been a destination for tourists who come for sporting events, to get a closer look at how food is grown or who stop here on the way to Yosemite and other nearby national parks.
But now tourists are coming here because they developed surgical complications while trying to lose weight.
Medical tourism, fueled by the work of world famous bariatric surgeon Kelvin Higa and other local doctors, is on the rise and helping to boost the economy in the Fresno/Clovis area. The trend is expected to continue as Fresno hospitals expand and market specialty programs for patients with ailments such as heart disease and cancer.
“I think Fresno and Clovis should be known for the great community and medical care we deliver, not just as the gateway to Yosemite,” said Higa of Advanced Laparoscopic Surgery Associates in Fresno, whose patients come from across the U.S., Canada and South America. He also is director of the Minimally Invasive and Bariatric Surgery program at Fresno Heart & Surgical Hospital.
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Medical tourism is a $100 billion global industry catering to people looking for expertise at internationally recognized health centers or wanting cheaper medical services.
Medical tourists spend five to 10 times more in the local economy than a typical vacationer. There are numerous reasons why: The stay is longer, the patient or family members traveling with them are eating in local restaurants and shopping locally and they are engaged in local tourist activities, said Renee-Marie Stephano, president and founder of the Medical Tourism Association and Global Healthcare Resources, a Florida-based trade organization and consulting business.
It is one of several factors fueling a recent increase in hotel construction and tourism in the region, said Layla Forstedt, president and chief executive officer of the Fresno/Clovis Convention & Visitors Bureau.
A handful of hotels, including some brands with new-to-Fresno concepts such as Hilton, Hyatt and Marriott that provide suite accommodations, are expected to open here by spring 2019. That’s more than 600 new hotel rooms and at least 600 new jobs, Forstedt said.
Community Medical Centers, which operates the heart hospital, is starting this year to research and develop a program that would take what Higa has started and market Fresno and Clovis as a medical destination.
Patients have choices for health care, so it’s important to have a program in place to help patients looking “for some place safe, some place active for tourism” and an appropriate destination for different cultures, Stephano said. That becomes part of the decision-making process and makes a difference on a patient and that family’s experience, she said.
It’s about “creating concierge medical services,” said Berj Apkarian, vice president of physicians and international health relations, who was recently appointed to spearhead the effort. It begins the moment a patient has contact with the medical system and continues through their arrival at the airport, hotel stays and restaurant recommendations, he said.
“All those experiences really have an impact on (a patient’s impression) of what they will get,” Apkarian said. “That will play a critical role in terms of the success of the program.”
Apkarian met with Stephano last month to learn how to begin creating a local medical tourism program. He has already been to the Cleveland Clinic and plans to visit the Mayo Clinic in Rochester, Minn. and Johns Hopkins Hospital in Baltimore. The three are among the nation’s top medical destination centers, attracting patients from around the globe.
“My goal is to learn from the best and develop a program that brings pride in our city and in our organization, and put Fresno on the map as a medical destination center.”
Higa, the bariatric surgeon, has been at the forefront of that. Over the past two decades, he has helped Fresno develop a reputation for weight-loss surgeries and other services, earning patient referrals from doctors at some of the nation’s top hospitals including Cedars-Sinai Medical Center in Los Angeles, the Mayo Clinic and Stanford University Medical Center in the Bay Area.
He came to Fresno to complete his general surgical training after graduating from the Biomedical Sciences Program, a collaboration between the University of California Schools in Riverside and Los Angeles. He stayed because he wanted to practice general surgery in a Fresno-sized city, where traffic is lighter and he’s more likely to bump into patients at the grocery store.
In 2000, Higa almost left Fresno for a position at the Cleveland Clinic. He was on his third interview and had already contacted a real estate agent. But he got an offer he couldn’t refuse from Tim Joslin, who was the new chief executive officer for Community Medical Centers and who told Higa “you’re going to do what’s best, and we’re going to support it.”
In 2014, the hospital completed 821 bariatric surgeries, the most in the state according to the most recent numbers from the Office of Statewide Health Planning and Development. Saint Bernardine Medical Center in San Bernardino County came close with 720 surgeries. Higa said the Fresno hospital now performs around 1,300 bariatric surgeries a year.
Patients come to Fresno and stay a few days, even a few months, depending on the severity of their problems, Higa said.
But patients aren’t the only visitors coming here for the bariatric program. Higa, a lecturer who is often asked to perform live surgeries around the world, has organized international medical conferences locally since 2000, hosting up to 35 doctors at a time. Some countries even pay for surgeons to stay in Fresno for several months of training, he said.
His primary focus is caring for residents in the Central Valley, and he encourages people to seek care where they live because bariatric surgery requires lifelong care and support. But some patients have high risk problems, can’t figure out what’s wrong with them or don’t have access to quality care. Those patients are sent his way from colleagues around the world.
“We have a no-refusal policy,” he said. “We will take any bariatric patient who has an emergent problem, no matter who did the original operation, from anywhere, period.”