7 Things I learned as a health tourist

Eva Mackevic

Having spent three days in Bulgaria, been seen by seven doctors and undergone six medical examinations, Eva Mackevic reveals what it’s really like to travel abroad for treatment

If you’ve ever encountered horror stories about infected wounds, lost dental implants or botched nose jobs on forums like mumsnet.com, medical tourism may seem like a plunge into a nightmarish Louis Theroux documentary-like scenario.

Yet with NHS waiting times verging on the brink of comical and private healthcare prices reaching astronomical heights, it’s no surprise so many of us are actually considering it. Curious to find out how it works for myself, I travelled to Bulgaria’s capital, Sofia, for an extensive health check-up. Here are the seven things I learned…

 

1. The language barrier… is probably one of the first things that’ll cross your mind when considering medical tourism—it’s sometimes hard enough to find the right words to explain something to a doctor in English, let alone a language you don’t speak a word of, in a country you’ve never been to before.

And yet, while some miscommunication is inevitable, it was never an issue during my trip. In fact, it proved to be a joyous source of unexpected comedy on numerous occasions.

"Through vibrant gesturing, we arrived at an understanding that there was something unwanted in my abdomen"

First and foremost, don’t panic. Medical travel companies such as BMT Partner appoint a person who accompanies you during each doctor’s visit and assists you with anything you might need, including translation services. In my case, that person was an eagle-eyed but pleasant Bulgarian lady named Vesselina, who speedily and expertly translated every bit of information relayed to me by the doctors (even casual chit chat between themselves, addressing everything from the weather, to the recent marriage of the nurse’s friend’s brother’s co-worker) making sure that every fragment of conversation was crystal clear to me. Similarly, any medical records and test results were translated to English within hours of the procedures and presented to me straight away.

Sofia, Bulgaria

 

2. Leave enough time. Some doctors were more confident about their English skills than others. As Vesselina and I were about to step into an internist's office, she cheekily stopped the interpreter at the door, insisting that she was perfectly capable of handling our conversation without any help. I loved this little display of bravado.

As she was examining my torso with an ultrasound, she suddenly paused over the right side of my ribs. “Breathe in again?” she asked, and I obediently followed. And then again. And again. The doctor stared into the screen with serious concentration. When she started explaining her concern, it suddenly dawned on me that her English might not be as up to scratch as she claimed in the first place.

Through vibrant gesturing and awkward attempts at charades, we finally arrived at an understanding that there was something unwanted in my abdomen. Great, I thought, the beginning of the end. But what was it exactly? We turned to technology for help, and after a few moments of heated googling, we concluded that I had gallstones. A bit surprising since I’ve never experienced any pain, and my cholesterol levels—a frequent reason for these pesky intruders—were normal, according to the blood tests done earlier. The internist seemed unphased. “When are you leaving?” she asked. “Tomorrow,” I replied, prompting her to glance at her watch and say, “We can get you on the operating table in a couple of hours,” as casually as if she was offering to give me a manicure.

After quickly weighing my options, I declined a same-day gallstones removal, opting instead to get a second opinion back home. The doctor warned me, “They will grow bigger and block the ducts—it’s very painful.” It was tempting to get it sorted there and then, but the prospect of travelling home right after surgery was overwhelming. If you find yourself going abroad for treatment, make sure you give yourself enough time to resolve any possible outcome.

If, once your tests and scans are completed, any of the results come back as abnormal, you’ll want to see a specialist who can refer you for further treatment, so it’s best to allow at least three extra days for any potential further treatment.

3. Speed and efficiency... were a constant during my trip. Bouncing back and forth between doctors and dentists, I felt like I was on a long medical conveyor belt, getting examined and patched up by specialist after specialist with clockwork proficiency. “Here in Bulgaria we have the quickest access to doctors—any kind of doctors. If you have a headache, you may see your neurologist within two or three hours. Our approach is the quickest in Europe,” I was told by Dr Dimanov, the no-nonsense but good-humoured hospital director.

Considering that the average waiting time for treatment within the NHS is up to 18 weeks,* it’s not surprising that the number of British citizens seeking treatment abroad grows higher every year.

And, as I was told with a hint of bombast (a surprisingly common quality here) by Dr Dimanov, they frequently perform surgeries that are not widely practised in the UK, such as the anterior approach hip replacement—where an incision is made on the front of the hip rather than the side or back. “The anterior approach is the most modern approach for hip replacement surgery. It’s only practised by two per cent of doctors in the UK because it’s so difficult to do. There’s a huge waiting list for it,” explained Dr Dimanov.

"If there's one thing I learned about Bulgarian doctors, it's that they don't waste time on pleasantries"

 

4. Culture clash. I asked Dr Dimanov if the way they deal with UK patients is any different from Bulgarians, citing the subtle differences in culture between the two nations, expecting him to give me a zealous, affirmative answer filled with funny anecdotes about awkward encounters. Looking somewhat baffled, as if wondering why I’d ask such an arbitrary question, he replied, “It’s no problem. Our doctors speak English, so everything’s OK.” Short and to-the-point. This humorous exchange itself was the perfect illustration of what I meant by my question.

If there’s one thing I learned about Bulgarian doctors, it’s that they don’t waste time on social pleasantries. Unlike their British counterparts—soft-spoken, easing their patients into the simplest of procedures—they’re direct and matter-of-fact, a trait which upon first encounter might even be interpreted as rudeness.

Hospital director, Dr Dimanov Hospital director, Dr Dimanov 

Later that day, it was time for my ECG scan. As I lay on the examination table, I made clumsy attempts at chummy small talk with the cardiologist, trying to distract my brain from predicting the impending results of the neglected tachycardia I was diagnosed with as a child.

Yet my charmingly gruff, stocky cardiologist with a slightly resigned expression, was having none of it. Swiftly clamping the cold metal electrodes onto my ankles and arms, he instructed me to stay still with a few wordless motions, vigorously adjusting my awkwardly flailing limbs into place. Once the reading was done, he nonchalantly threw a few paper towels on my chest to wipe off the conductive gel—and we were done. As I was leaving, however, he rewarded me with quickest flash of a friendly smile, muttering, “Sorry, my English is not very good.”

 

5. Facilities. The standards and types of clinics I visited turned out to be as varied as the people I met. While some places still bear strong evidence of Bulgaria’s communist past (I was presented with a sharpie-signed plastic water cooler cup for my urine sample at the hospital), others are uber glamorous, such as the sleek dental clinic I visited the next day. Visitors are required to don shoe covers upon entry and there’s shiny, beige marble everywhere you turn.

I found that the extreme self-confidence that defined Dr Dimanov’s attitude towards medical treatment was echoed here at the dental practice as I chatted to the oral surgeon, Dr Uzunov. “We have days when we place eight implants a day and we never have any complications,” he tells me. As we chat in more detail about some of his recent dental implant cases, he turns out to be something of a miracle worker, performing surgeries that other doctors simply refuse to do. “We had a really difficult case with a British patient who had a horizontally retained tooth in the lower jaw, which was just one millimetre above the channel so I was really afraid not to damage the nerve. But we were extremely careful and we managed to remove the tooth successfully.”

"The types of clinics I visited were as varied as the people I met" 

The before-and-after pictures of some of the case studies are almost too good to be true. Patients who come to the clinic with virtually no teeth, return home with a beautiful set of pearly whites in just ten days.

After my chat with Dr Uzunov, I had my teeth whitened, which, while not the most flattering procedure in the world (imagine having your mouth stretched by a retractor the size of a hefty grown man’s fist for two hours), was smooth and mostly painless, leaving me with a set of fresh-looking gnashers and a thorough after-care pamphlet in English (coffee from a straw and no red wine for two weeks).

 

6. Healing for the mind as well as the body. There’s a peculiar bi-product to travelling to a foreign country solo to seek medical treatment.

A strange feeling of liberation and peace set in once all my medical tests were done and all I had to do was wait for the results. I enjoyed solitary meals in great restaurants, read books I’d been putting off finishing for months, went on long walks down the sun-drenched streets of Sofia, taking respite from the heat in cool, spacious Orthodox churches. My bit was done and I naturally slipped into an oddly soothing “come what may” attitude.

Somehow, the medical aspect enhances the tourist experience—you’re suddenly more alert and in the moment, contemplating how lucky you are just to be exploring this part of the world in the first place. The uncertainty of the forthcoming test results serves as a potent reminder that you never really know what waits around the corner in life. With that notion in the back of your mind, you begin to appreciate the small things and live each moment to the fullest. Revelations like these don’t usually occur on a regular family holiday, when you’re busy rushing from place to place, looking after your kids or posting pictures on Instagram.

 

7. A friendly face. On the other hand, I was never really alone in Sofia. Vesselina, my diligent companion, was by my side whenever I needed her. From interpreting during the doctor’s visits, to showing me around the city, she was caring, kind and genuinely keen on making my stay as stress-free and enjoyable as possible.

We’re at our most vulnerable when we’re ill, so having someone to look after you throughout the trip builds an instantly sincere relationship between two strangers: something Vesselina cares about deeply. That's why she’s always there, at the ready, whether her clients need translating, a bit of reassurance or just a pair of hospital slippers.

“I’ve been a patient in a foreign country myself, so I know what people need. I know what it means to be sick, and what you need in critical moments in your life. I try to support people emotionally during the process because the psychological aspect of the process is just as important as the medical one,” she told me. It’s such a visceral reminder that we’re all just human, united by our need for understanding and someone to just lend a friendly ear.

 

Bulgaria Medical Travel Partner is a medical tourism facilitator that acts in the territory of Bulgaria and offers fixed price medical services. 

For more information on services and price list, visit bmtpartner.co.uk/services

+44 20 3778 0379

info@bmtpartner.co.uk