More wealthy Chinese are seeking medical treatment in the United States as top American hospitals expand their reach through mainland partners. "We currently have 1,000 patients from 70 countries, including China, and we will see the number of Chinese patients rise with referrals from our partner," said Spencer Koerner, medical director of the international health centre of Cedars-Sinai Medical Centre in Los Angeles. Cedars-Sinai has treated many Hollywood celebrities including Angelina Jolie, who underwent a preventative double mastectomy there. Cai Qiang, chairman of Saint Lucia Consulting, the hospital's partner in China that refers patients to the US, said a patient would typically be able to see a physician at the hospital two weeks after obtaining a visa for treatment in the US. The hospital's physicians were ready to give advanced treatment to these patients, including experimental types of procedures, Koerner said. Many Chinese patients are turning to hospitals abroad, mostly in the US, as their last resort. The number of Chinese patients using referral agencies, such as Saint Lucia, is on the rise. The agencies' medical professionals evaluate each case and charge a fee for producing a summary of the patient's medical history, translating test results, booking appointments and escorting the patient overseas. Cai said that in 2011, only 3 per cent of affluent Chinese were aware they could have offshore treatment for critical conditions, but that figure rose to 40 per cent last year. The number of Chinese patients went overseas for medical treatment had also risen from fewer than 200 in 2011 to 3,000 last year, he said. Of those who sought medical help abroad, about 70 per cent had cancer while the rest suffered from cardiovascular, cerebral, neurological or bone diseases, according to Cai. The US was their most popular destination, he said, followed by Britain, Germany, Japan and Singapore. Another top American hospital popular with Chinese patients is the Mayo Clinic, a non-profit group based in Rochester, Minnesota. The hospital can come up with a second opinion and a treatment plan for a patient newly diagnosed with cancer for around US$20,000 to US$30,000. The treatment itself, which may include operations, chemotherapy and radiotherapy, can cost US$100,000 to US$150,000. Cai said one patient referred by Saint Lucia spent nearly 5 million yuan (HK$6 million) on his treatment. He added that most of his clients came to him only after they had already visited China's top hospitals and were desperate for better treatment or higher hopes of survival. "They always say two things. First, money isn't a problem, and second, they want the best doctor," Cai said. Even so, no one can guarantee a cure. "We have patients die every month," Cai said. "At first I could barely face it. But nobody can guarantee a cure, even if it's just a cold." Koerner said the outcome for patients who sought treatment at Cedars-Sinai depended on their diseases and when they started seeking help from the hospital. "Many Chinese patients who come to the US have late-stage cancer. It is harder to manage those cases," he said. "In heart diseases, our outcome is better than the national average for any type of procedure. Patients have fewer complications and have better outcomes. We have a neurosurgery programme that increases a patient's life expectancy from 18 months up to four years." Gu Yunyi, marketing manager of Ryavo Healthcare, which offers consultation services for medical treatment overseas, said more patients were choosing to conduct video or phone consultations rather than seeking treatment abroad. But of those who did go overseas, some were after higher medical standards - especially for children - while others were after better care and services. "A client decided to treat her two-year-old son's congenital heart disease in the US because he would have to wake up alone in the intensive care unit and find himself with a scar," Gu said. "The mother was worried about the mental impact the experience would have on her child. In the US, the child would have to undergo a psychological evaluation before the operation, and she really cared about that." The husband of a terminal lung cancer patient sought treatment in the US after a doctor in China simply glanced at his wife's scan and told him there was no point in having surgery as his wife would die anyway, Gu said. But Gu also said that Chinese doctors had only a few minutes to talk to each patient as there were simply too many of them. It was not uncommon for a doctor to see 100 patients a day, he said. "It is not fair to blame the doctors when it is really the system that is at fault," he said.