The Real Tijuana

No one needs a passport to be admitted into their own country. Recently, we were asked the same question by Club Medico USA, a medical tourism group working with Tijuana doctors and dentists. Their members were worried. Our blog ran an item about the passport question a few years ago and, like we told them, what we said then still holds true today. The club reported back that their members have had no problem crossing with driver's licenses and birth certificates. What the Department of Homeland Security is trying to do is have everyone who crosses the border carry identification with RFID chips because that speeds up their process a bit. Current passports have that chip. So do the "enhanced" driver's licenses issued by four states. People with RFIDs can get into special "Ready Lanes" that presumably go faster than the regular lanes -- but people coming here for bariatric surgery most often return home in their own special "medical pass" lane, which is even faster.

I'm a Tijuana resident, not a bariatric patient, so I'll answer only the questions I'm suitable for. You should have received a quotation in writing. Anything beyond that specification needs your approval. If you can't come to an agreement, you should contact Cotuco, SecTurE, or the Comisión de Arbitraje Médico del Estado to intervene on your behalf. The clinic is able to contact all three agencies. Your hotel knows at least the first two. Cotuco is our local tourist commission, the first line of defense. SecTurE is the state Department of Tourism; I think they still have attorneys on staff. CAME is the state arbitrator for medical and dental problems. It's probably more common to let you settle into your hotel room first. But that's not set in stone. The clinics are full of people who speak English. On the street and in the hotels, if you look even vaguely gringo, people often introduce themselves just to practice their English on you. And the upper-class folks like to show off how much English they can speak. Mexican doctors' prescriptions are filled in Mexico, U.S. doctors' prescriptions are filled in the U.S. You can cross the border with Mexican meds as long as they're for personal use; Customs rarely even asks to see the scrips. Most clinics have arrangements with particular hotels and get those rooms at a good discount. They can credit you for whatever they would have had to pay the hotel for your stay. (Tijuana trivia: the family that owns Hospital Ángeles also owns Hotel Camino Real down the street.) That depends on how adventurous you are. But the only area nearby that you might want to avoid is the red-light district (known as "La Coahuila" or the "zona norte") northwest of Revolución and First Street downtown. Your clinic and hotel will most likely be in the Zona Río, one of the more upscale parts of town. Enjoy your stay! Try to do something cultural while you're here.

More likely you'll have the hotel room for the whole time you're here. Undoubtedly. Bring as much money as you like and don't forget to spend it. Tijuana uses both the peso and the dollar. Credit cards are widely accepted. It's hard to know what you'll need to pay for. Your clinic should have arranged for payment of their package with you already. If you have to pay extra for the hotel, they normally take credit cards. Restaurants, if you're allowed them, can run from $5 to $100 per person per meal and will be less expensive than their counterparts in the U.S. Taxis run between $5 and $15 per trip. There's a nice museum close by, the Centro Cultural or CECUT, that charges about $5 for admission and another $5 for Cinerama movies. You can find more information on our blog, http://realtijuana.blogspot.com/

I apologize for straying so far from the subject of bariatric surgery. I do so to respond to a polite request and in the interest of fairness to an underappreciated medical-tourism destination. Ever since the Reagans declared their War on Drugs, the various cartels have been contributing a lot of soft money to Mexican presidents. Until Vicente Fox, the presidents used to divide up the territories and keep peace between the groups. With Fox, the cartels suddenly had two political parties that wanted their soft money and that allowed them to play favorites. Calderón tried to capitalize on this confusion. Calderón partnered with “El Chapo” Guzmán in an attempt to consolidate all the drug cartels. That would have given Calderón’s party, the PAN, a monopoly on all the narco soft money which in turn would have broken the PRI’s back. (Cliffs Notes: PAN = Republicans, PRI = Democrats.) The army was sent against Guzmán’s PRI-leaning competitors one after another, failing each time. Calderón first sent his army after the Arellano-Félix Cartel here in Tijuana. Our mayor at the time, the only PRI politician in the state, is a member of that cartel and Calderón was keen to make an example of him. He failed to consider that the Arellano-Félix Cartel has also contributed to our PAN politicians. For three years, our news programs seemed like Gilbert and Sullivan being staged by Tim Burton. Then Calderón threw in the towel with us and sent his army to Juárez. No luck there either, so they went on to Monterrey. And boy was that a mistake. Now, the really odd part is that, during the three years when Calderón’s army was tooling around Tijuana in their pick-up trucks, all the mayhem they were causing showed up only on television and in the newspapers. Rarely did we know people who actually witnessed any of this violence. I don’t want to sound like a Holocaust Denier or anything, it’s just that a lot of our news reports didn’t ring true. For example, one night the Sinaloa cartel was supposed to have shot up the police station two blocks from where I lived, hundreds of AK-47 rounds, and yet no one in the neighborhood heard anything and the station showed no signs of attack. Apologists for Tijuana have liked to point out that even during the height of the violence, our murder index never came close to those of Detroit or New Orleans. Which is probably true. It’s easy to think ill of Tijuana. It’s like the Hell’s Angels say, “people only remember the bad things we do.”

About a million people from the United States have gone to Mexico and never came back. They are, for the most part, alive and well. They are ex-patriots who have come to live here permanently. The HIPAA comment raised a red flag for me, too, because of its negative implications. Mexico had HIPAA before the U.S. did and we began exchanging secured electronic patient records about ten years sooner. Because Mexico is so often dismissed by the AMA and the U.S. media, we have been holding ourselves to higher standards than our counterparts north of the border do. For customer satisfaction, we conform to ISO9000 methodology. For the patient's peace of mind (third-party verification of credentials and financial indemnification against post-op complications), we are starting to be certified by IBMS. You don't see clinics in the U.S. doing this -- they just hire on more sales and marketing people instead. I hope that's enough to allay your fears. I hope I don't have to debunk the so-called drug war, too.

If it will make you feel any better about your visit, you're welcome to read our blog, http://realtijuana.blogspot.com/. We started it in 2009 specifically for people like you. There's really no reason to worry about drugs, violence, or even the unknown. Just make sure you have enough free time to do touristy things while you're here. Visit Pasaje Gómez and Pasaje Rodríguez. Go to the Mercado Hidalgo and the Centro Cultural. Those sorts of things.

(1) Some doctors might be able to convince Aetna to pay. Check with their patient liaison people. (2) The doctors who advertise on the Internet invest heavily in reassuring potential patients. Make use of their 800 numbers -- you'll be talking to intelligent, English-speaking sales agents. Also, our blog has put up several items under the "medical tourism" and "culture" tags that should help reassure you that things are on the up-and-up around here. (3) Every surgeon should answer this question for you. Some have reciprocal arrangements with doctors in the U.S. for follow-ups, others prefer being present for the recovery period. There's some nice scenery around here.

By now I hope you've been convinced that you don't need a passport to cross at San Ysidro. For complete details, you can read http://realtijuana.blogspot.com/2010/07/do-i-need-passport-to-visit-baja.html The blog also has a lot of advice on getting around without a car (since that's how most first-time visitors like to show up). Parking on the U.S. side costs $7 or more per day; a lot of people come down on the trolley. When you walk into Tijuana, the Customs official doesn't even ask to see your ID. Most plastic surgeons in Tijuana will send a driver or a taxi to pick up their patients from either side of the border, take them to the doctor's office, and make sure they're settled into their hotel. As someone mentioned already, clinics' drivers don't always speak a lot of English but that doesn't mean they're kidnappers. (Believe it or not, the crime rate here is very low.) Most taxi drivers, on the other hand, do speak a fair amount of English.

Greetings from south of the border. First of all, you do not need a passport to cross by land. An enhanced license (which contains the RFID chip that DHS loves) is more than sufficient. Find all the details at http://realtijuana.b...visit-baja.html Next, most medical procedures cost about a third of what they do in the U.S. even though the work is every bit as good or better. Sometimes your Mexican doctor can figure out how to get your U.S. insurance to cover the work. Sometimes not but it's worth asking about. Most also have access to a variety of financing programs. It's important to confirm the credentials of your doctor. (Here in Tijuana, we recently had a U.S. family doctor practicing as a plastic surgeon, for which he was arrested and charged with a felony. He told his patients he was a great plastic surgeon!) Just as in the U.S., plastic surgeons must be board-certified. We have a state agency, the Comisión de Arbitraje Médico del Estado de Baja California, that used to check certifications by e-mail ... used to ... they have a new guy at the top who doesn't answer e-mail anymore. Another option would be to see if your doctor is certified with the International Board of Medicine and Surgery , but, since that is a voluntary certification authority, not every surgeon is represented. The fact that your Dr Aceves is so well-respected here is another good indicator. Recovery services are becoming more and more popular for patients who come a long way. Both spas and regular hotels offer this now and it's a great excuse to give yourself a mini-vacation. (Of course, you'd have a better vacation here in Tijuana than you would in Mexicali. We're San Francisco and they're Sacramento.)

No, people cross here all the time without passports. It would be a violation of international human rights to require a citizen to present a passport in order to enter their own country. We'll be doing an entry on our blog soon about this question, just to set everyone's minds at ease.