Finding a suitable hospital in a foreign country is a matter of serious concern for a great many. There is no universally acceptable guide to measure the quality of hospitals like that of hotels and other services. A prospective patient should understand the technology needed for the treatment along with the highly trained doctors and specialists. They should also pay attention to the level of team work and nursing services in the hospital.

The Triad of Health Care

After careful analysis, it has been postulated that the three pillars of modern medical treatment are:

(i) modern technology

(ii) trained doctor/specialists

(iii) team work and nursing care

They are intricately related to each other and if any of these are weak then the level of care at a hospital cannot reach the highest level.

Modern Technology :

Technology is at the core of everything, ranging from laboratory tests to specific treatment methods. There are many types of HIV test, ranging from $1 - $70. All tests differ significantly in terms of sensitivity and specificity.

The same concept applies to CT scans. Old models are capable of 2-4 slice CT images, but newer machines allow up to 16 slices. While the newer models may cost more, the high resolution images allow radiologists and physicians to make a more accurate interpretation of the data. The 16-slice CT also supports 3-D imagery, which makes virtual surgery possible with the aide of computer software analysis, among other benefits. This new technology enables doctors to come up with a clearer diagnosis, something almost impossible with the older machines.

A coronary by-pass operation (CABG) that uses a conventional heart-lung machine is cheaper compared to a new off-pump or beating heart technique. The off-pump operation has lower risk of failure, less complications, less blood transfusion, and shorter duration of hospitalization. Generally, conventional CABG uses veins from the leg or arm as the by-pass graft, but may not last more than ten years.

Do all patients know or understand the significance and advantages of these new technologies? Perhaps not, Even many physicians do not know all of them. This is because of the fact that medical science is developing very fast and newer technologies are added everyday. Many doctors who do not engage in any form of continuing education, read medical journals, or attend seminars have difficulty upgrading their knowledge. Some specialist doctors who only study their own area may not know what is happening in other areas of medicine.

Trained doctors and specialists :

Doctors and specialists are essential when it comes to using modern technology. One of the main factors for a doctor to make a good decision about patient management is to have the latest knowledge of medical science which is developing at a tremendous pace. It is a tall order for a practicing doctor to study medical journals, attend seminars and conferences, and then undergo training with the new technologies.

Precisely for this very reason, many developed and newly emerging countries are placing much emphasis on Continuing Medical Education (CME). The CME is an essential ingredient to keep doctors abreast with new development. The doctors not only learn about the areas they work with, but also learn and understand other areas of medicine that they do not practice.

Specialist doctors also sub-specialize in various areas. For example, a cardiologist may subspecialize only in Interventional Cardiology i.e. Angiogram and Angioplasty. Other cardiologists may sub-specialize in Arrhythmias and their management. An orthopedic surgeon may sub-specialize in Arthoplasty and Joint surgery. Others may do only spinal surgery. So it is more useful to know the problem in detail before selecting a particular doctor for treatment.

Sometimes it is very useful to visit an Internal Medicine doctor before visiting a specialist. While specialists know the treatment for their particular field very well, they may overlook problems in other parts of the body. For example, a patient with chronic back pain may visit an orthopedic surgeon. However, it is quite possible that the cause of the problem may originate from some internal organ like the urinary system, colon, even stress or major depression.

In such cases, the Internist will review all systems at the beginning and then refer to the specialists as needed. I have seen several patients receiving treatment for an illness that they do no suffer from, because they had gone straight to a specialist before consulting an Internist.

Choosing a right doctor in a foreign hospital is a serious matter; not all of them are the same. Usually experienced doctors are very busy with many patients, mostly locals who know them well. It isn't very easy to get an appointment with them from abroad. So a walk-in patient may end up with a not-so-popular doctor.

Team work and nursing care :

This is probably the most delicate part of high quality patient care. In many instances, it is not one doctor who does everything regarding treatment. This is especially true if the patient with complicated illnesses is admitted into a hospital. A neurosurgeon may do a brain surgery and then leave it up to the ICU doctors to take care of the post-operative care.

She/he also needs good cooperation from other doctors concerning proper management of blood pressure, nutrition, electrolyte imbalance, infection control, etc. It is also necessary to have a physical therapy doctor who helps early ambulation and rehabilitation after brain surgery. Nursing care is vital throughout the hospital treatment. They provide physical and mental support to the patients' well-being.

One should keep in mind that because of the very dynamics of medical treatment, the quality of care in a hospital changes over time. So one should keep the eyes and ears open before selecting the right hospital.