It all started thousands of years ago in ancient Greece, when the sick and ailing would travel across the Mediterranean to the coastal town of Epidaurus to worship at the sanctuary of the healing god Asklepios, a journey usually undertaken only by the truly rich or desperately ill. Nowadays, medical tourism is a thriving multibillion-dollar industry that allows people to enjoy a sun-and-sand vacation along with their medical procedure, all at a fraction of the cost back home. 'The main reason [behind the popularity of medical travel] is really the cost. It's the biggest factor of all,' said one Hong Kong private doctor, who preferred not to be named. The appealing price tag was one of the primary motivators behind his decision to travel to the famous Bumrungrad International hospital in Bangkok for his personal health check-ups. Bumrungrad International offers a regular health check-up for 2,600 baht (HK$610) and prices comprehensive examinations for men and women over 40 years old at 13,000 baht and 15,300 baht respectively. Meanwhile, one local health check and medical diagnostic centre charges between HK$900 and HK$1,380 for a similar regular check-up, HK$4,100 for a comprehensive examination suited to males over the age of 40, and HK$4,700 for the female equivalent. The price difference proves particularly attractive when patients are looking into medical procedures that their insurance does not cover, such as cosmetic surgery, dental work or other elective surgeries. The aforementioned doctor also listed privacy as one of his reasons for travelling to Thailand. 'Because of my age, a colonoscopy is one of the examinations I must include in my health check-up, and I'd prefer to keep this matter private from the office,' he said, adding that another bonus that comes with medical travel is the opportunity to tack on a short holiday after completing the procedure, making for a 'win-win situation'. The popularity of certain medical tourism destinations is due in part to the availability of beaches and other entertainment opportunities on-site. Travel packages are increasingly common, and a large percentage of patients are booking in a vacation along with their procedure, so much that South Africa sought to gain a competitive edge by offering medical safaris - a wildlife-inspired twist on the surgery, sun and sand combination. The idea of mixing medical business with pleasure is not a new one, and some governments promote their countries as medical tourism destinations. Tourism Malaysia, for example, has been working with the Association of Private Hospitals of Malaysia to promote the country as a medical and wellness tourism destination to target markets. Having grown from treating more than 296,000 foreigners seeking health care in 2006 to about 341,000 foreigners last year, Malaysia has enjoyed a 15 per cent increase in revenue and has set the health sector revenue target at M$2.2billion (HK$5.37billion) by 2010. Along with Thailand and Malaysia, countries such as India, Singapore, Vietnam and even the Philippines are all fighting to get a piece of the multibillion-dollar pie. With the number of medical institutions in these countries on the rise, it is no surprise that quality control has become a growing concern, and a number of health care accreditation establishments have been set up to provide a safety and quality standard for health care organisations worldwide. Joint Commission International (JCI) is one such establishment. As the largest accreditor of health care organisations in the United States, JCI also handles international institutions and major hospitals in Asia that have received JCI accreditation include those in India's Apollo Hospitals Group, Siloam Hospital Lippo Karawaci in Indonesia, Singapore's Changi General Hospital as well as Bumrungrad International. The Trent Accreditation Scheme (TAS) is, like JCI, a non-profit health care accreditation organisation, and has started work on health care organisations in the Philippines and in Malta, although its primary focus was initially on British hospitals and a large number of local private hospitals. With the success that Thailand, India and even Singapore have been enjoying in the medical travel industry, Hong Kong is also aiming to get a piece of the action. Mence, a male beauty and body toning centre in Hong Kong, has been treating male clients from overseas locations such as Australia and the US and could put Hong Kong on the map as a medical tourism destination. The centre offers a number of programmes including slimming and firming treatments that span several months. The programmes are tailor-made for each client, and can therefore be customised to fit in with travel plans and business schedules. While the company certainly offers an ideal solution for a one-stop quick beauty fix, Hong Kong is still not high on the list for those looking for a more invasive medical procedure, and the anonymous private doctor said that this would be an uphill battle. He said that Hong Kong was trying hard, and had been attracting a lot of medical tourism from the mainland, seeing as many mainland tourists could afford the higher costs in exchange for the convenience of being treated in Hong Kong. Geographical reasons aside, he pointed out that the mainland was also relatively backward with regard to its medical institutions, with facilities and services leaving much to be desired, whereas standards in Hong Kong hospitals were very high, and local doctors were 'leapfrogging each other to keep up with the latest techniques'. Even with these high standards, 'we simply cannot compete at similar prices because of the cost', he said, pointing out that from lab materials and manpower to the rental costs for the premises, the charges added up to a lot more than what would be needed in a country with a lower cost of living. 'A medical procedure in Hong Kong would certainly be double that of a similar package in Thailand. Hong Kong still has a long way to go before it can catch up with Thailand,' the doctor said.