Medical tourism refers to people leaving their own country to seek medical treatment abroad. They are typically treated as private patients and the costs are fully paid by the patient. Many treatments and cosmetic procedures are available at a much lower cost than in the USA.
In fact, because cosmetic plastic surgery procedures aren’t covered by insurance, they make up a major part of the burgeoning medical tourism market. For example, a breast augmentation procedure that would cost $6,000 in the U.S. can be done for $2,200 in India. Even after the costs of airfare are factored in, having an operation overseas can be much less expensive.
However, this is a risky choice that can potentially come with heavy consequences, including death.
Be safe. If you’re considering medical tourism, be fully aware of these dangers and take action to do what you can to minimize them:
Dangers of Medical Tourism
One of the biggest risks of medical tourism is infections. Other parts of the world have different standards for sanitation, and medical facilities can be unsanitary.
This is not just a personal health issue, either, nut affects public health. For example in 2011, an enzyme associated with extensive antibiotic resistance called New Delhi metallo-ß-lactamase-1 (NDM-1), endemic in India and Pakistan and spreading worldwide, was found in two people in the Toronto area, one of whom acquired it in Canada.
NDM-1 has spread because of worldwide travel, medical tourism and its ability to transfer between bacteria.
Infections can occur for a range of reasons, including unsanitary practices and facilities. The equipment used during surgery may not be sterile.
Bacterial and viral infections are a major risk. In addition, you may end up with a serious disease such as HIV or hepatitis from dirty needles and surgical equipment. These infections can be permanent issues and may cost you your life.
Inspect the facilities ahead of time.
2. Medication Dangers
You may require medications before, during, or after your treatment in another country. In mainland Southeast Asia, for instance, there is an epidemic of counterfeit Artesunate, used for treating malaria. Multiple studies conducted between 2000-2005 sampled blister packs of “artesunate” and found between 38% and 52% contained no active ingredient.
There is evidence suggesting production is being done on an industrial scale and from multiple sources; 100,000 counterfeit artesunate tablets were purchased from one large pharmacy.
The medications you receive may be low quality or have incorrect ingredients.
It’s common to find counterfeit medications during medical tourism journeys. These medications can hurt you.
Research your doctor and the pharmacy that will be providing your medications.
3. Communication Issues
If you don’t know the language of the other country, the risks are higher. You may not be able to communicate your health issues or ask for help if something goes wrong, even with the help of an interpreter.
Communication can be a serious issue in a foreign land. How will you be able to tell others about your needs and get the care you require?
Misunderstandings can lead to serious complications after treatments.
4. Blood Supply Issues
You may require a blood transfusion during or after your treatment, so it’s crucial that it’s safe. Does the foreign medical facility have high screening standards for blood donations?
- Standards for donations can vary greatly and put you at risk of getting a serious infection (hepatitis, HIV). You won’t be able to see the issue until it’s too late.
5. Travel Concerns
Taking air travel flights may increase your risk of blood clots. Plus, the combination of surgery and being stressed or fatigued following long multi-time zone airplane flights can make the risk even higher.
- Traveling can increase your risk of infection and complications after surgery.
6. Follow-up Care
Foreign medical facilities have different rules for follow-up care. Post-op recovery can often be crucial the success of a procedure. You should make contingency plans for emergency follow-up if needed upon your return home.
Patients who travel abroad for medical treatment risk returning with complications or infections that require costly treatment, costly both on a personal and societal level.
Will you receive adequate follow-up care in the foreign facility? It’s important to understand that your hospital or clinic stay may be cut short, and you might not get the follow-up care you need.
What will you do if you have a serious infection or complication and can’t get the medical facility to treat you?
7. Legal Issues
If there are issues with your surgery or treatment, what are your legal recourses?
- Foreign medical facilities may make it difficult for you to pursue a case. You may not have legal rights and may not be able to receive compensation for a mishandled surgery.
8. Credential Issues
Foreign medical facilities may have different credential standards. Check for the qualifications of the health care providers who will be doing the procedure and the credentials of the facility where the procedure will be done. The Joint Commission International (US-based) certifies health care facilities according to specific standards.
- Will you receive treatment from a licensed professional, or a person who isn’t capable of handling a procedure or surgery? How will you check the credentials and licenses in a foreign land with possible language barriers?
9. Hidden Costs
Medical tourism may seem like a less expensive alternative, but it has hidden costs. Make sure that you have a written agreement with the health care facility or the group arranging the trip, defining what treatments, supplies, and care are covered by the costs of the trip.
- Will you be able to afford all of the treatments and medications in a foreign medical facility? What if you require an extra-long hospital stay or extra care? It’s important to consider these additional costs.
10. Ethical Concerns
Transplant tourism is an offshoot of medical tourism focusing solely on transplantation surgery. Given the critical shortage of available organs in the U.S., transplant tourism has grown in popularity among patients awaiting transplantation.
Currently, the United Network of Organ Sharing (UNOS) reports there are more than 105,000 Americans on the transplant candidate waiting list with more than 15,000 patients awaiting a liver transplant. Furthermore, UNOS data shows a decline in donorship with living donor numbers decreasing by 1.7% and deceased donors down by 1.2% in 2008.
Over the last few years, professional associations have established transplant tourism policies to provide guidance to clinicians and uphold the principles of medical ethics. The AASLD and International Liver Transplant Society (ILTS) have positions against the exploitation of donors, the recovery of organs from executed prisoners, and condemned the use of paid living donors.
- Can you verify that the organ you receive has been obtained in an ethical manner? You could potentially be contributing to the exploitation of lower income populations, teenagers, children or prisoners.
Tips For Medical Tourism
If you are planning to travel to another country for medical care, see a local travel medicine practitioner at least 4–6 weeks before the trip to discuss general information for healthy travel and specific risks related to the procedure and travel before and after the procedure.
Obtain copies of your medical records that includes the lab and other studies done related to the condition for which you are obtaining the care and any allergies you may have.
Prepare copies of all your prescriptions and a list of all the medicines you take, including their brand names, their generic names, manufacturers, and dosages.
Get copies of all your medical records related to the procedure before you return home.
Medical tourism can be a dangerous way to seek surgeries and other treatments. Understand the risks before you travel to get medical care.
For more information:
* [American Medical Association Guidelines on Medical Tourism [PDF - 20KB]](http://www.ama-assn.org/ama1/pub/upload/mm/31/medicaltourism.pdf) * [Organization for Safety, Asepsis, & Prevention's Travelers Guide to Safe Dental Care](http://www.osap.org/?page=travelersguide&terms=dental+and+tourism) * [The International Society of Aesthetic Plastic Surgery Guidelines for Travelers](http://www.isaps.org/medical-procedures-abroad-the-key-guidelines-for-plastic-surgery-travelers.html) * [Cosmetic Surgery Tourism Briefing Paper](http://www.plasticsurgery.org/Media/Briefing_Papers/Cosmetic_Surgery_Tourism.html) * [CDC Yellow Book 2014 information on Medical Tourism](http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-2-the-pre-travel-consultation/medical-tourism) * [Outpatients: The Astonishing New World of Medical Tourism](http://amzn.to/1ShRfft), Sasha Issenberg, Columbia Global Reports * [Patients with Passports: Medical Tourism, Law, and Ethics](http://amzn.to/1W6M9oS); I. Glenn Cohen, Oxford University Press
Julianne V. Kus, et al. New Delhi metallo-ß-lactamase-1: local acquisition in Ontario, Canada, and challenges in detection. Canadian Medical Association Journal, May 30, 2011 DOI: 10.1503/cmaj.11047
Newton PN, McGready R, Fernandez F, Green MD, Sunjio M, Bruneton C, et al. (2006) Manslaughter by Fake Artesunate in Asia—Will Africa Be Next? PLoS Med 3(6): e197. doi:10.1371/journal.pmed.0030197
Wright, I. G., I. A. Walker, and M. H. Yacoub Specialist surgery in the developing world: luxury or necessity? Anaesthesia 62.s1 (2007): 84-89.
Burkett, Levi. Medical tourism: concerns, benefits, and the American legal perspective. The Journal of legal medicine 28.2 (2007): 223-245.
Schiano et al. The dilemma and reality of transplant tourism: An ethical perspective for liver transplant programs Liver Transplantation, 2010; 16 (2): 113 DOI: 10.1002/lt.21967