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Medical Tourism

In recent years, individuals are crossing borders for more than vacations and business trips. Skyrocketing surgical costs have sent hard-pressed Americans to Asia, the Pacific Rim and South America for elective surgery and other medical procedures (most often cosmetic surgery) that can be scheduled in advance. In the UK and Canada where Socialized Medicine determines cost of treatment, people are packing their bags and taking holidays in places where the cost of care is dramatically less.

Risk factors when traveling for surgeries:
In the United States, there is a level of safety people feel and expect because of stringent regulations. This is not the case abroad, and an individual may encounter:

  • Quality of care concerns – there is no international regulatory group to inspect and certify facilities around the world
  • Inconsistency in training of medical staff – physicians and nurses can have varied levels of education and experience
  • Lack of post-op care – many overseas facilities do not have 24-hour monitoring
  • Lack of dialog between the doctor and patient – often, discussions and consent forms dealing with procedures and potential complications are not common or elaborate
  • Language barriers – not all staff may speak English, and medical forms may not be in English either
  • Cultural differences – patient rooms may not have telephones, comfort and cleanliness standards are different from country to country
  • No malpractice insurance – individuals generally don’t have an opportunity to sue for malpractice because many foreign providers do not have malpractice insurance

“The problem is, in this ‘you get what you pay for’ world, the level of care is often dramatically less…sometimes fatally so,” says FrontierMEDEX Corporation’s Chief of Operations Rob Currie. “Once having made their plans and traveled to their exotic locale, patients frequently find the facility they booked to be ill-equipped and under-staffed, with ill-trained employees, and bearing little or no resemblance to the description in a brochure or on a website.”

Additional concerns and considerations:
Medical systems abroad can be very different from country to country. Many provider networks are more focused on financial discounts than medical capabilities and quality of care. Individuals seeking medical care abroad should consider:

  • Insurance exclusions – even if you have international medical insurance, most policies include an exclusion about “traveling for the purpose of obtaining medical care”
  • Paying cash for services – many foreign providers require travelers to pay upfront for services
  • Legal matters that can affect your care – in some countries, a woman’s treatment can be contingent upon the approval of her husband
  • Finding good providers & facilities – websites and brochures can be misleading and are sometimes designed to attract travelers searching for surgical bargains

Currie emphasizes that those relying on misleading websites and brochures for international surgical decisions are more often than not bargaining for trouble.“Recently we inspected a facility in Tibet that was promoted on the web as a 240-bed trauma center. On our credentialing visit we discovered that the staff re-used needles, they had such limited diagnostic equipment that we couldn’t even get a clear chest x-ray, and a nursing staff that was not on duty 24/7 for critical care. That facility clearly earned its ‘DO NOT USE’ rating in the FrontierMEDEX database.”

MEDEX does not condone medical tourism and cautions that travelers are taking a very high risk when traveling abroad for surgeries. However, for those travelers who recognize these risks and are still determined to seek elective medical treatment abroad, the following tips can help, at minimum, to be better prepared:

  1. Be skeptical of claims made on websites and in brochures. Seek independent verification from other sources; perform several Internet searches for the facility and see if there are postings made by former patients.
  2. Ask about credentials and consult the Joint Commission International (JCI), which is affiliated with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
  3. Wherever possible, seek advice from the American or Western expatriate community living in the country to which you are going. They often share positive and negative experiences with each other.
  4. Remember to be prepared financially. You may not be covered by insurance and may have to pay out-of-pocket. Unexpected expenses can find your procedure delayed, or your post-op recuperative time spent drawing cash from an ATM.
  5. Don’t travel alone to seek treatment. Ask if the hospital has double rooms for family to stay with you. This is especially important to ensure responsive post-op monitoring and timely care.
  6. Ask questions before leaving. If the answers are unacceptably vague or unresponsive, move on to another facility. Relevant requests for information include statistics on minimally invasive surgeries at their facility and their compliance with International Red Cross standards for blood transfusions. NOTE: FrontierMEDEX typically advises against any blood transfusions outside of the US.
  7. Be prepared to turn around and come back if something doesn’t seem right about the facility or your treatment.
  8. If possible, schedule your own credentialing visit to check out the facility first-hand before you decide to have treatment abroad. Be sure to observe such telltale conditions as:

    a. Overall cleanliness of the facility including hallways and waiting rooms;
    b. Whether the staff is properly attired in uniforms with nametags;
    c. Whether they use disposable equipment and dispose of it after use.
    d. The number of English speaking staff members
    e. The schedule of the nursing staff – is it 24/7?
    f. The ratio of nurses to patients
    g. The accessibility you have to your treating physician/surgeon?
  9. Know where to turn for help. FrontierMEDEX members can call toll-free or collect for 24-hour professional assistance in emergency situations. Click here to learn more about programs available to individuals through MEDEX Insurance Services, Inc.  
    MEDEX’s international medical insurance programs do not pay for elective surgeries. Member benefits when “traveling for the purpose of obtaining medical care” (program exclusion) will be limited to the 24-hour assistance services provided through FrontierMEDEX Corporation’s Emergency Response Center.