He said health tourists spent an average of US$362 (Bt13,600) per day, compared with $144 for leisure travellers. However, there needs to be guidelines for advertising ethics and the use of patients' images in promoting medical travel.

"We have to be very wary of some of the claims we see on the Internet. Unnecessary surgery is being recommended," said Dr Bakar.

India is aggressively promoting medical tourism in the pursuit of foreign exchange. The India Medical Tourism Expo will take place in London in June, and the Indian government will issue a medical-tourism visa to promote the sector. In Malaysia, Dr Bakar said the Indian government first promoted medical tourism in 1998 and now estimated the sector to be worth $40 million annually.

Visitors from Europe and North America are attracted to medical facilities in Southeast Asia, due to sharp price advantages, short or no waiting lists and standards as professional as those found in Western hospitals.

Jason Yap, director of healthcare services for the Singapore Tourism Board, said sector gains must be tempered by awareness of the risks. Yap said Singapore had taken the decision to promote medical tourism to create enough work for its doctors.

Curtis Schroeder, group CEO of Bumrungrad International, said ethical hospitals in the medical-tourism sector should not have a two-tiered pricing systems for domestic and foreign visitors.

He added that word-of-mouth advertising was the most effective type.

From May 3-5, Thailand will host the International Spa and Wellness Conference and Exhibition at Bangkok's Queen Sirikit National Convention Centre.

The event will be organised by the International Spa Association (ISPA). The annual conference will bring buyers to meet sellers of new products, trends and technologies, as well as operators of spas, hotels, resorts; of fitness, beauty, health, aesthetic centres, travel companies, major retail chains and distributors and even unique Asian cuisine and health techniques.

Suchat Sritama, The Nation