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Dr. Barbara Davidson M.D. was a practicing family physician in Dallas, Texas before she and her husband, Blair, an entrepreneur, decided to take some time to travel in Latin America. Ultimately they decided to reside permanently in Mexico. “Once we began to experience life in Mexico, where the culture is rich and complex yet the lifestyle is simple, we were hooked,” states Barbara.
Blair and Barbara have encountered and overcome many challenges in the nearly ten years that they have traveled and lived in Mexico, but the greatest by far, and the one that ultimately changed the direction of their lives, came two years ago in August, 2010.
After spending a year in Argentina, they had returned to Mexico with plans to pursue business opportunities in the Puerto Vallarta area. “The difficulty at this time was that Blair was almost always tired; he was easily winded and generally weak. When we met almost 15 years earlier, Blair had been competing internationally in martial arts, and had always been really healthy. His weakness developed gradually, so I don’t think we really appreciated how severe it had become.”
Though they did not realize it at the time, these nonspecific symptoms were an indication of a more serious problem. “I had been urging Blair strongly for the past several years to see a cardiologist because he had a heart murmur that was getting louder and louder.”
The last Sunday in August, 2010, their family spent the afternoon at Playa de Los Muertos in Puerto Vallarta. “There is a long, high pier at this beach, where the young people like to dive off the end and swim back to shore. Our daughters wanted to dive, so Blair went with them. While he was swimming back he knew something was wrong, and when he reached the sand he concentrated only on making it to a chair by me. He collapsed in the chair, said ‘Something’s wrong,’ then lost consciousness. He seemed to be dead — our sons were shaking him and yelling ‘Daddy, Daddy!’ There were a lot of people on the beach, and after about 45 seconds two lifeguards arrived. They were starting to call an ambulance when Blair suddenly shook his head, opened his eyes, mumbled a bit and then said, ‘What happened?’ Needless to say our family was quite frightened and Blair changed his mind about delaying a visit to the cardiologist.”
Blair had experienced an episode of syncope, which is a transient loss of consciousness. The echocardiogram performed by a cardiologist in Puerto Vallarta the following day revealed that he suffered from severe aortic stenosis, which had developed due to a birth defect in his heart. During his life, the diameter of his aortic valve, which is normally 3.0 cm, had gradually become calcified and narrowed to 0.9 centimeters, which was significant enough to impede the flow of blood from his heart to his arteries.
The three classic symptoms of aortic stenosis are shortness of breath from heart failure, chest pain, and syncope. However, 4% of patients with aortic stenosis die from sudden death before experiencing any of these symptoms. Without effective treatment, the average life expectancy is less than three years after the onset of symptoms. “The cardiologist told Blair, ‘I have good news and bad news. The bad news is that you have aortic stenosis. Any time that you exert yourself, physically or emotionally, you could experience syncope again, only the next time you might be driving or swimming when it happens, or it might end in sudden death. The good news is that your heart has not sustained any permanent damage, and the stenosis can be surgically corrected with replacement of your aortic valve.'”
Blair and Barbara did not delay in seeking surgical treatment. “We were surrounded by excellent doctors who helped us to find our best options right away. Here in Mexico, there are so many choices available to patients — first among physicians, and then among facilities where those doctors can practice.
As we discussed surgeons, Dr. Octavio Victal came up again and again as being one of the best cardiovascular surgeons in Mexico, with an international reputation. We chose a relatively small hospital in Guadalajara which offered excellent economic value, and were extremely pleased with the quality of care and personal attention Blair received. The total cost for everything associated with the surgery was less than $30,000. Since we were self-insured this really mattered to us. We would have paid between $150,000 and $200,000 in the U.S. for the same surgery.”
On Thursday, four days after Blair experienced syncope at Playa de Los Muertos, Dr. Victal replaced his aortic valve. By Saturday, he was recovering in his room, and he and Barbara had begun discussions with Dr. Victal which would ultimately culminate in a joint venture to offer to other Americans and Canadians what they had just experienced — timely, high-quality, affordable surgical care in Mexico. “Dr. Victal knew that I was a physician and that we had significant business experience in the U.S. He was already doing hundreds of cases per year, but like most surgeons he is always interested in helping more people.”
Blair and Barbara returned to Puerto Vallarta with Dr. Victal’s request on their minds and, over the next six months, Barbara began to research medical tourism and to talk extensively with Blair and Dr. Victal.
“All of our initial discussions centered around the theme of what we would do differently. Medical tourism as an industry falls short in many ways of the very best that the private healthcare sector in Mexico has to offer — what really makes it special. We desired to focus on ways that we could help patients maximize quality and choice as they contemplate options for their surgical care.
“In Mexico there are wonderful, fully accredited hospitals in every city. Patients really can focus on choosing the surgeon who is best for them, and then choose a hospital from there.
Most patients in the U.S. and Canada have limited choice with respect to their surgeon or hospital, due to various provider requirements, so when they consider care in Mexico, they are often happy just to get to choose a hospital, not realizing that they can take it a step further and choose the surgeon who operates on them. In Mexico, the best surgeons can operate in any of the top hospitals in the country, so that decision can come at the end, and can be made based on preferences, be it economic, choices of amenities, city, etc.”
Drs. Davidson and Victal incorporated International Surgeons of the Americas (ISA Surgical) at the beginning of 2012, with Canadian partners.
“We are only about surgeons and patients, who of course will both be supported by the patient’s primary care physician. We have surgeons in our network in nineteen areas of surgical practice, all of the professional caliber of Dr. Victal, all who can operate at a variety of hospitals, and all of whom really care that patients not only receive the best quality of care available in the world, but also that they receive good economic value.”
Blair is now two years past his surgery, has a perfectly functioning heart, and is once again jogging three miles per day and teaching martial arts to his children. “Two and a half years ago we never could have imagined that we would go through something so difficult, and we especially could not have imagined all that would develop as a result.”
The philosophy of ISA Surgical has emerged from Blair and Barbara’s experience and that of Dr. Victal, as patient, spouse, primary care physician and surgeon. “Not only do I have firm ideas about the way that medicine is best practiced, but I’ve also lived it with my family, in Mexico. Our goal is to help patients navigate around all that is out there to the best surgeons, who are operating in a manner that provides the best value for the patient. Medicine practiced this way is very satisfying to all involved, and we want to pass that on to others.”