Florida's medical facilities are cultivating a thriving business among foreigners seeking healthcare. About 400,000 patients visited the U.S. in 2008.

Alex Barnes, a 5-year-old English boy from the country's Midlands region, has battled a brain tumor for more than 14 months. When the tumor returned last year, his doctors in England said he had few options other than traditional radiation therapy — treatment that could have left him deaf, partially blind and unable to walk. Appalled by the potential side effects, Alex's mother, Rosalie Barnes, surfed the internet looking for alternatives.

Barnes' research introduced her to proton beam therapy, a form of radiation that can be precisely targeted to spare the healthy tissue around a tumor. There are 26 proton beam machines in the world — five are in the U.S., but none in England. In September, Alex and his mother packed their bags and flew 4,200 miles from their Leicester home to Jacksonville, where Alex was treated at the University of Florida Proton Therapy Institute at Shands.

"I was hoping for great things when I got there," says Barnes.

Alex was just one of an estimated 400,000 foreign residents who sought medical care in the U.S. last year, according to a 2008 study by the Deloitte Center for Health Solutions. Collectively, those patients spent almost $5 billion here to get treatment that was either unavailable or required too long a wait at home.

Florida medical facilities actively, if quietly, market to attract that overseas business. Many offer special services geared toward foreign customers: Staffs at most major Florida hospitals now include international services divisions that help patients with everything from applying for tourist visas to scheduling airline reservations and hotel stays. Miami Children’s Hospital, for example, has negotiated special hotel rates for its international patients and their families; upon request, it will arrange for limousines, baby-sitting, special meals and tours.

Some facilities are able to capitalize on brands and reputations that are already recognized internationally. In Jacksonville, Mayo Clinic Florida draws between 1,400 to 1,500 international patients each year with very little marketing.

"In other countries, particularly in Latin America, La Clinica Mayo is very well known," says Nancy Skaran, who leads the clinic's international services group. Much of the international patient traffic, she explains, results from relationships that Mayo cultivates with physicians around the globe. Once a month, Mayo's Spanish-speaking physicians conduct "grand rounds" in Spanish and broadcast them to five or six hospitals and universities in Latin America.