Nip/tuck in Budapest

Randy Simor connects U.S. patients with Hungarian care.

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LONDON (FORTUNE Small Business) -- Randy Simor's entrepreneurial savvy was severely tested when police and anti-government protesters in Budapest skirmished during celebrations commemorating the 50th anniversary of the 1956 Hungarian uprising against the Soviet Union. As the CEO of Meditours Hungary, a Budapest-based business offering Americans and Europeans access to Hungarian medical care, he had five clients in the city that day.

"I kept hearing the sound of rubber bullets," recalls Simor, 40. "Our eyes were stinging from tear and pepper gas."

Even so, his clients made their appointments and got their surgeries. Says Simor: "It was my proudest moment."

Simor, raised in New York as the son of Hungarian immigrants, moved to Budapest to attend medical school 15 years ago. After working as a consultant and hospital administrator, he launched Meditours in 2005; it currently boasts annual revenues of around $150,000.

Meditours is one of several U.S. firms that facilitate low-cost Eastern European medical care for Western clients, including many American small businesses. And medical tourism is just one example that illustrates the recent emergence of Eastern Europe as a low-cost outsourcing destination for everything from liposuction to software engineering.

For multinational behemoths such as IBM (IBM, Fortune 500) and Siemens (SI), outsourcing to Eastern Europe began in earnest in the early years of the millennium. What's new now is the range and sophistication of such opportunities, and the fact that smaller companies are able to take advantage of Eastern Europe's low wages, language skills, and educated, tech-savvy workers. And all this in a region that is cheaper to fly to than Bangalore or Beijing.

IT Six Global, a subsidiary of KVG Consultants, based in Arizona, is a 100-person software solutions company in southwestern Romania. IT Six Global has honed a niche building software for small U.S. tech companies. Clients range from an L.A. fire-wall developer to a Dallas company that sells mobile platforms aimed at the Latino market.

India may have more software developers, concedes Serdan Ioneseu, the company's chief technical officer. But he argues that Romanian engineers are more creative.

"We're not just following the instructions of project managers in the U.S.," he says. "Our guys give solutions, and we're very flexible. When it comes to quality, innovation, and creativity, Romania is much better [than India]."

For Ioneseu, who hires only employees who can speak English well, a shared Western culture makes for easy communication: "We're all watching MTV and CNN, right?"