Touristic Medicine in Puerto Vallarta –
Interview with Dr. Essaú Gutiérrez
By Jesús de Avila • Translation by Eduardo Rincón-Gallardo • October 2009
Requests on information for future travels, as well as destinations to be visited by healthy people or those who suffer from some ailment limiting them or their families from traveling, are becoming more numerous and demanding every day. Travelers nowadays are not only tourism oriented but they leave their country for business reasons, to search for a place for retirement, for religious purposes, for health matters, for education, to get married, also seeking adventure and much more. People like never before, want to be informed and feel safe visiting places around the world, mainly when medical attention becomes necessary.
Touristic medicine is medicine geared at caring for illnesses or accidents among tourists and foreign residents ―mainly senior citizens― in a given country besides what is currently being offered by the so called: Health Tourism.
Dr. Juan Bosco Rodríguez, medical-director manager of the Hospital Internacional Xanit, in Benalmádena (Málaga), mentioned the following during a conference in Madrid, in June 2006: “Touristic Medicine is a complex business from which all parts involved (patient, tour operator, hoteliers, health and insurance company) want to benefit. Although the practicing criteria put forth by Touristic Medicine is not widespread knowledge, work is presently underway creating a quality medicine within this field which has evolved towards higher professionalism and better attention to patients and their families. Moreover, in the past years this type of medicine has extended into middle to long term residential tourism, offering high-level residences, as well as medical check-up programs, alternative treatments, and also those treatments with long wait-lists in their countries of origin”
Basing ourselves in this context and being Puerto Vallarta & Riviera Nayarit destinations receiving international tourism; wanting to know more about the subject, we focused on interviewing Doctor Essaú Gutiérrez, a Touristic Medicine specialist in the region:
Q: Doctor Gutiérrez, what is touristic medicine?
A:The organism of a traveling person is exposed to very diverse conditions, as well as bacteria, chemical and organic substances different to those of his/her home environment. His/her body responds to those conditions in a different manner than what he/she is used to. The mere act of traveling produces an alteration of the stress level and that has an effect on the organism. When a person travels and gets sick – even if it is just a sore throat – the organism’s reaction is different than when at home.
There is a medical specialty known as emporiatrics for the specific treatment of people who get sick outside of their daily environment. Those of us who practice it are traveler’s doctors or Travel Medicine doctors.
Emporiatrics encompasses the following basic areas: First is the preventive part, when the person contacts his/her doctor before the trip to get the necessary medical recommendations to take into consideration in accordance to the destination to be visited. In this part of the process the traveler receives information mainly about vaccines and/or medications to take along. The second area is when the traveler actually needs medical attention. That is when we, the travel medicine specialists come into action. The third area of emporiatrics is when the traveler has returned to his/her place of origin, here mainly epidemiologists and infectologists participate; they deal with studying all things that could have made the traveler ill during a trip, as well as the mid and long term consequences the traveler will suffer.
Q: As a specialist then, are you prepared or capable to take the call of any traveler with health problems?
A:Since I am located in the touristic destinations of Puerto Vallarta & Riviera Nayarit, it is definitely my duty to care for the health of people in the second area or emporiatrics, that is, during their traveling period, I am of course accurately prepared to deal with any ailment or problem related to their physical, mental and emotional health.
Q: What is the difference between a general practitioner and one specialized in touristic or travel medicine?
A:First thing is, those dedicated to touristic medicine are familiar with the types of treatments travelers receive in their countries of origin; how to deal with their health insurance companies; what treatments are presently being researched, as well as perfectly speaking and understanding their language. To mention one example, I can share with you that in the case of a diabetes problem, if a person tells me he/she is taking a medication known as Actos, practicing emporiatria I am aware of the medication’s formula, its indications and counter-indications as well as its secondary effects. This medication was used the United States five years before it was available in Mexico, a vital aspect while treating a patient that a general practitioner most likely does not know.
Due to our experience with foreign patients and our constant updating on novelties and medical breakthroughs on a global level through specific, specialized publications; as touristic doctors we are always ahead in transcendental aspects when dealing with patients of other countries. This kind of information as well as the fast research resources available to those who practice emporiatrics, allows us to know – among other things – if certain treatment should or not be modified; whether certain treatment or medication is compatible with another, etc. This is something the majority of local medical practitioners are not familiar with. The health of a traveler is something that definitely requires specialization.
Q: Considering the size of our destination and the number of annual tourists, are Puerto Vallarta & Riviera Nayarit prepared to cover the demand of this type of medical services?
A:Yes of course, just me, I am the director of a group of seven doctors, besides fifteen others who are in the same business. I believe the demand for touristic medicine doctors is almost totally covered. Although it is important to know that not all doctors are equally qualified or specialized in the various areas of this practice, therefore channeling travelers to the most appropriate doctor, according to the case to be treated, is of utmost importance.
Q: Being a foreign visitor, how can I evaluate and determine that?
A:To that effect nothing is better than references; first the insurance companies, they provide their clients with a list of doctors they consider qualified in each tourist destination. If found in the area, that means the doctor has passed their scrutiny and their approval certifies that he is capable. Another formula is asking consular agencies, they can also provide references on doctors they know are capable of resolving any problem regarding a traveler’s health. Another resource could be specialized agencies or local hospitals. On the other hand, if the traveler is staying at a hotel, the best indicated person to ask is the concierge, who generally knows or has the contact information of the most recommended doctor.
We for instance, provide our services to hotels and condominiums through City Médica; besides having worked for several years with larger developments such as Grand Velas, Villa del Palmar Flamingos and La Estancia, Dreams Villa Magna, Meliá, Marina Residences and Ocean Vista, among others.
An important fact is that cautious travelers already have information about one or various doctors who they can call if need be. A guest has the right to be cared for by whoever he prefers and it is the duty of the hotel to contact that doctor and/or allow the doctor to care for his patient in their very hotel room.
Q: As a specialized doctor, what message would you like to convey to the foreign traveler?
A: To always rest assured that Puerto Vallarta & Riviera Nayarit have all the resources to care for any health problem that may affect them. We have qualified doctors, people familiar with the complications that usually arise. Here we are going to help you with anything having to do with your health, we will even help you obtain hard to get medications and in case it does not exist, we will find the appropriate substitute.
To those who decide to stay longer periods of time in Puerto Vallarta or the Riviera Nayarit, besides welcoming you, it is important for you to know that it is highly recommended to have a family doctor to care for you always. When a patient is registered in a local doctor’s office, in case he/she requires advanced treatment of a different kind, as a cardiologist, endocrinologist, or any other specialist, through their family doctor they will always have the exact reference to the best doctor available, as well as the best hospital that adjusts to their records, present medical needs and budget. In fact, we as family doctors will intervene to make sure the fees are correct, among other things all this is part of the duties of a family doctor.
Stretching what I just said, I can also comment that in certain cases when the patient should need to contact a specialist directly, say a nose specialist, this is a surgeon generally dedicated to operate in accordance to the patient’s request, maybe without going into detail or very intimate aspects in the patient’s records, like allergies to certain substances in the environment. We as family doctors, are familiar with this kind of information that is vital when deciding whether surgery should or should not be performed at the time and place suggested by the surgeon. As family doctor I should recommend a specialist who will treat the referred patient as my patient, not his, which obligates him to notify me on anything at all that happens during consultation and check-up.
Another question many times unknown to the patients is that we as family doctors must inform them that not all specialists have the same qualifications. There may be some magnificent knee surgeons; others are excellent dealing with foot problems and someone else is an expert on hip questions. Being familiarized with everyone of these specialists in the destination places me in the best position to determine whom to channel my patients to when required.
As a family doctor, my relationship with my patients goes well beyond that of doctor-patient. I check on my patient four to five times a year, I visit them personally, I know their line of work or activity as well as their lifestyle. We practically become friends and as such, I am familiar to a degree that in case of need, I will always make sure he/she receives the best possible attention during their residence in our country.
Q: I can see that as a family doctor, when needed, you become a link between your patient and the specialist, what happens when your patient requires hospitalization?
A: As happens with specialists; although all hospitals are quite competent, all have their differences. There are very well structured hospitals to take care of certain cases, while others are not. Based on our knowledge of these differences I always make a recommendation to the benefit of my patient and his budget.
Q: What about the cost of your services?
A:In City Médica we have a tariff at our clinics, while at hotels the fees vary depending on various factors, for instance: according to the frequency of cases that occur in a hotel per month. The rate goes from 60 to 100US per consultation. It is important to clarify that the price of consultation does not include stitches, curing processes, ear rinse or other treatments that are paid separately.
A:City Medica is a primary medical center we identify as first contact medicine. Although we have been operating as a group for eight years, City Medica was born a year ago. In this type of clinics we strive to provide the first contact medicalservices, which is all a person may need in the medical area such as: vaccines, consultation andemergencies at a reduced cost.
When someone asks us: What specialties do you have? Well the concept here is we do not have specialties! We perform first contact medicine, all a person may need at first instance gets fixed here. An important fact is that according to statistics 95% of medical problems are solved in this type of clinics, while only 5% require specialization, that is why we try to provide our services at an affordable cost.
City Médica’s Project contemplates having 10 more medical units like this one in Nuevo Vallarta in the bay area within the next 5 years, so that at each community as: Bucerias, San Vicente, La Cruz de Huanacaxtle or Punta de Mita, among others, patients will have access to a medical unit like ours no farther than 5 minutes away.
The doctors serving here are bilingual and we continue to serve the hotels and to deal with local patients. We do not service only tourism, in fact our average rate is $400.00 pesos, quite convenient to the foreign visitor and the local resident.
We have a 24-hour service since, besides the doctor on duty, at night time we have peripheral doctors serving the hotels. Our range of operation goes from the north hotel zone of Puerto Vallarta all the way to Sayulita in the Riviera Nayarit. We have a doctor on duty for all zones and another base like this one in Sayulita. We function like a “Walk-in Clinic”, to our visitors this means that they do not need to be our registered patient to receive treatment.
Per our standards a patient should not wait more than 15 minutes to be cared for, we have all the necessary resources to treat the simplest of cases to life-threatening complications.
Doctor Essaú Gutiérrez, thank you very much for granting us the space for this interview and most specially for briefing us on the meaning of Touristic Medicine and its great benefits to our international visitors with doctors like you practicing it in our destination. Email to a friend
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A: The organism of a traveling person is exposed to very diverse conditions, as well as bacteria, chemical and organic substances different to those of his/her home environment. His/her body responds to those conditions in a different manner than what he/she is used to. The mere act of traveling produces an alteration of the stress level and that has an effect on the organism. When a person travels and gets sick – even if it is just a sore throat – the organism’s reaction is different than when at home.
A: First thing is, those dedicated to touristic medicine are familiar with the types of treatments travelers receive in their countries of origin; how to deal with their health insurance companies; what treatments are presently being researched, as well as perfectly speaking and understanding their language. To mention one example, I can share with you that in the case of a diabetes problem, if a person tells me he/she is taking a medication known as Actos, practicing emporiatria I am aware of the medication’s formula, its indications and counter-indications as well as its secondary effects. This medication was used the United States five years before it was available in Mexico, a vital aspect while treating a patient that a general practitioner most likely does not know.
A: To always rest assured that 
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