Medical tourism is booming in India, according to the Times of India, with surgeons in South Gujarat picking up much of the business. Harshad Joshi, M.D., a knee replacement surgeon, will be performing nearly 200 surgeries during November and December. About 70% of the patients he will operate on during this period will be non-resident Gujaratis (NRGs) from the United States, the United Kingdom, South Africa, Australia and New Zealand.
Medical Tourism Grows in India

Specialized and planned surgeries have become a lucrative business for the Surat city doctors. Five years ago just 10% of NRGs from south Gujarat planned medical treatment to coincide with return visits to their homes. Now, this percentage has gone up to 60%, according to the Times.
In South Gujarat, the peak months for the NRG visits are November, December, January and February. During this period doctors work overtime to attend to the huge number of patients coming for knee and joint replacements and spine surgeries.
A simple knee-joint implant is available for Rs 90, 000 in India which, depending on the exchange rate, is $14, 000 to $15, 750 U.S. dollars. As a result, many NRG patients, who are without insurance in the USA and the UK, pre-plan their treatment during the visit to their home towns in India.
“The treatment here is affordable. It is a huge saving for the NRGs. We have started receiving bookings from NRGs in South Africa and the UK, ” said Joshi. K.C. Jain, a neurosurgeon, added, “The cases of NRGs coming to India for spinal surgeries have gone up. It is not as big compared to knee-replacement, but there has been a steady 10 per cent increase on a year-on-year basis.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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