Business boosters are increasingly pushing medical tourism as a remedy for Las Vegas' economic ailments, but Dr. Bernie Hanna is one of the few who has tried it.
About three months ago, Hanna bought an online listing with the Medical Tourism Association, hoping that favorable prices, the reputation of his Las Vegas Bariatrics weight-reduction surgery clinic and the city's allure would draw patients from across or even outside the country. So far, office manager Carmen Tellez said, the results have been negligible.
"It has been disappointing," she said. "We didn't get the flood of calls we thought we would, but maybe it will take time."
Medical tourism, people traveling outside their localities for health care, has existed long before it acquired that name. People have come to the United States for decades for certain specialties unavailable elsewhere or to avoid long waiting lists in countries with government-run health care. More recently, medical tourism gained prominence as Americans flew to countries from Costa Rica to India to get surgical procedures at a fraction of the domestic cost.
Medical tourism has a long history in Las Vegas. Moe Dalitz built Sunrise Hospital and Medical Center in the 1950s partly as a haven for mobsters who wanted to be treated in anonymity to reduce the chance of a coup by underlings.
But at the same time, locals who could afford it would leave town for sophisticated treatments. This gave rise to the old joke: Where do you go in Las Vegas for the best medical care? McCarran International Airport.
The updated version of local medical tourism seeks to meld improving facilities and physician capabilities with the resorts to lure out-of-towners who want adult entertainment to help the medicine go down. CT scans during the day, blackjack at night.
However, many in the health care industry are not convinced this theory will work in practice.
Some leaders of the Cleveland Clinic Lou Ruvo Center for Brain Health have pushed medical tourism, starting with Larry Ruvo, who led the drive to build the clinic. Maureen Peckman, CEO of Keep Memory Alive, the clinic's fundraising adjunct, has used her seat on the task force studying economic diversification in Nevada to push medical tourism as a top priority.
The committee will send its report to the Legislature when it convenes in February. Frank Woodbeck, director of Las Vegas operations and work-force training for the Nevada Commission on Economic Development, is steering the effort. He said the report is not far enough along to say what prominence medical tourism will receive.
Former Lt. Gov. Lorraine Hunt-Bono has rallied behind medical tourism.
"We could draw an upper-end clientele and help fill some of those new hotel rooms as well as enhance the whole image of our medical community," said Hunt-Bono, who is working with a small, informal group of locals to build medical tourism.
At least initially, she would focus on what she termed the "health and wellness" market, including executives who would come for extensive physicals and bring their families. Treating people who are seriously ill wouldn't happen soon.
"It's certainly not like we're going to be competing with Stanford and Mayo clinics," she said.
Dr. Mitchell Forman, president of the Clark County Medical Society, said specialties such as stroke care, oncology and orthopedic surgery have improved enough to attract patients.
"Clearly, we have seen the emergence of certain centers of excellence," he said.
Although the Mafia days ended long ago, Sunrise still pursues a form of medical tourism even if executives don't call it that. Patients from northwest Arizona now amount to 10 percent of the hospital's total; they come to Las Vegas for procedures or treatments beyond the capabilities of small-town facilities. Sunrise has also launched marketing aimed at Strip visitors who are injured or fall ill.
Several months ago, when Carrie Bilansky was pregnant, her physician discovered that the left side of the heart of the daughter she was carrying was not functioning. The doctor referred her to Sunrise for hypoplastic surgery, which occurred almost immediately after daughter Lilly McMillan was born Dec. 15. The expertise wasn't available in Bilansky's hometown of Boise, Idaho.
Bilansky and boyfriend Troy McMillan have shuttled between the hospital and the Ronald McDonald House, where Sunrise social workers arranged for her to stay.
"Otherwise, we would not have been able to do this," she said.
That has ruled out trying to piggyback a vacation on the treatment.
However, some industry experts doubt whether medical tourism will ever amount to much in the valley.
"It could be an engine of growth for a particular provider," said Chris Brandt, a health care-sector leader with Deloitte Consulting. "But it wouldn't make an impact on an entire city or county."
Even top institutions have only a handful of medical tourists a day, he said, not the hundreds or thousands needed to boost an entire metropolitan area, he said.
Further, he added, the party-heavy atmosphere of "What happens here, stays here" would be wrong for promoting treatment or the thorough executive examinations and wellness programs some people are pushing for the city. Blood work may require fasting or abstaining from alcohol. And jumping on a treadmill for a 7 a.m. stress test should not happen after someone goes to bed at 3 a.m.
"The things you want to do in Las Vegas would fly in the face of what you should do for medical procedures," he said.
Nevada Cancer Institute CEO Dr. John Ruckdeschel said the attractiveness of a medical center and desirability of the surroundings often move in the opposite directions. The Karmanos Cancer Institute in Detroit, where he was formerly CEO, had a "very elegant" breast cancer screening clinic in an upscale suburban mall. The clinic hoped women would want to tack an examination onto a shopping trip, but the visits were so infrequent that Karmanos closed the location.
"You don't go to Johns Hopkins because East Baltimore is a great place to visit," he said. "You go because of their medical expertise."
Experts agree that the checklist for building medical tourism must cover:
■ Cost. Prices must appeal to a patient paying part or all of the bill. If an insurance company is involved, prices must be low enough to justify sending someone out of the provider network.
■ Quality. People will travel to a particular institution only if it has developed a specialty generally regarded as superior to anything else within a radius of perhaps hundreds of miles.
■Breadth. People will travel to an institution that can tap a wide range of specialties on site and let them avoid bouncing from clinic to clinic or hospital to hospital to treat a problem. Ruckdeschel cited University of California, Los Angeles, Medical Center as one example. This does not exist in Las Vegas, he said, but could be assembled through a referral network.
■ Marketing. Las Vegas does not come to mind as a destination for the ill.
"As always, there is difficulty in spreading the word that there is more to Las Vegas besides being a center of the entertainment industry," said foreign trade consultant Victor Udin, who works extensively in Eastern Europe.
Affluent Russians like U.S.-grade medicine, he said, but generally go to Los Angeles, New York or Miami.
Even if Las Vegas could follow this recipe, it faces a lengthening line of medical tourism rivals.
"Especially with the new health care law, a lot of U.S. hospitals are looking to bring in patients who pay cash," said John McGee, president of the Fort Myers, Fla.-based booking firm Medical Retreat Abroad.
Moreover, medical tourism has proved vulnerable to recession. A Deloitte Report last year found that the number of people leaving the country for health care dropped from 750,000 in 2007 to 648,000 in 2009, as rising unemployment and loss of benefits reduced the number of people who could afford to go abroad.
Deloitte also dropped its prediction for medical tourism in 2012 to 1.6 million from 9.4 million in a 2008 report.
The earlier survey estimated that medical tourists coming to the U.S. would spend $5.3 billion this year, a number that was not updated.
A McKinsey & Co. study concluded that the outbound number of medical tourists was only about 10 percent of what Deloitte found. But McKinsey & Co. did not make estimates for domestic patients.
Contact reporter Tim O'Reiley at firstname.lastname@example.org or 702-387-5290.