Some weeks ago, an unemployed construction worker from Oregon and his wife stopped briefly in Miami on their way to Trinidad for a prostate operation.

By itself, the saga of Wayne and Suzanne Vautier was just another in the many desperate attempts by people around the world to find quality healthcare at a price they can afford. What made their story unusual was that their surgeon made the trip with them.

Arnon Krongrad, a well known urologist in Aventura, had listened to the Vautiers' pleas to get affordable treatment, and he agreed to do the operation. Total cost: About $25,000, half of what it would have been in the United States.

''This may be an unusual case, but I think it's a growing trend,'' says Renée-Marie Stephano of the Medical Tourism Association. ``It's cost prohibitive for many people to have treatment in the United States, so I think this kind of thing is going to happen more and more.''

How many Americans go abroad for care is still hotly debated. A Deloitte study estimates that it's 750,000 a year. McKinsey & Co. estimates it's no more than 85,000, but says the potential is huge. A Gallup Poll says 29 percent of Americans say they would consider traveling abroad for care.

For many patients, a major concern is quality. Joint Commission International, a wing of the body that accredits hospitals in the United States, has been working on that issue. It now has given its seal of approval to almost 250 facilities around the world.

Paul R. vanOstenberg, a JCI executive, says the standards are slightly different from those used in the United States, because they must take into account local rules and regulations. However issues of patient safety, credentials of the medical staff and a clean, safe environment remain the same.

Stephano says the Medical Tourism Association, a nonprofit based in West Palm Beach, has started a process to accredit medical tourism facilitators, who are frequently used to find facilities and negotiate prices for patients seeking cheap, quality care.

SOUND RATIONALE

In the case of the Oregon construction worker, Krongrad decided to do it for several reasons. ''He made a cogent case,'' he said of the Vautier's pleas. The Oregon man had done research on the Internet and with local doctors. Because prostate problems were hereditary in his family and because the tumor was aggressive, he wanted a radical prostatectomy, in which the gland is removed completely. He also wanted a laparoscopic procedure, in which the gland is removed through a small incision, which speeds recovery. This is the type of surgery Krongrad has specialized in for the past decade.

But Krongrad was also interested in exploring some other issues about healthcare travel at a time when reform permeates American politics.

''I'm at the grass roots,'' the surgeon says. ``How do we preserve the quality . . . while preserving costs. . . . If we're going to have a healthcare debate, surgeons need to be at the table.''

He finds it odd that travel for healthcare is generally called ''medical tourism.'' Brochures of coronary bypass-surgery in India, for example, often come with photos of the Taj Mahal and information on side trips. ``Is tourism what this is all about?''

Of course it isn't, he concluded. In fact, travel in search of healthcare is nothing new. Patients have long traveled to the Mayo Clinic in Rochester, Minn., or the MD Anderson Cancer Center in Houston for treatment.

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