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Hundreds of thousands of Americans travel abroad for surgical procedures each year. As the guardian of patients’ vital health, the American Society of Anesthesiologists (ASA) is urging those considering traveling internationally for medical care to educate themselves, and take the necessary precautions to avoid unexpected complications.
According to the Deloitte Center for Health Solutions, approximately 540,000 Americans traveled abroad for medical care in 2008. This number could potentially reach upward of 1.6 million in 2012, with sustainable annual growth of 35 percent.
“Patients who have decided to go abroad must be vigilant in considering all the variables of their medical care abroad,” said Amrik Singh, M.D., associate clinical professor at the University of California Davis Health System. “They must carefully consider their preoperative and postoperative treatment. They must be comfortable with the physicians and facility administering the procedure, as well as feel secure in the urgent hospital care available if complications occur. Patients must ask tough questions, check accreditations and success rates and work closely with their health care provider at home.”
Patients report seeking medical treatment abroad for a number of reasons including: costs, access and timing. The top non-cosmetic procedures sought by medical tourists include heart bypass, heart valve replacement, hip replacement, knee replacement, hysterectomy and other gynecological procedures. Common cosmetic and plastic surgery procedures include abdominoplasty, eyelid surgery, breast augmentation/reduction, cosmetic skin refinishing and body contouring, face lifts and implant surgery, liposuction and rhinoplasty.
“Patients should know and research the potential risks of traveling abroad for medical treatment,” Joseph Antognini, M.D., professor at the University of California Davis Health System said. “These risks include exposure to infectious diseases prevalent in the host country, possible substandard quality of care at certain facilities and travel-related health complications.”
The ASA offers the following checklist of questions patients should ask when deciding whether or not to seek medical care abroad.
Have I involved my local doctor in my decision-making?
You should work with your local medical provider when preparing for the procedure, as he/she will likely play an important role in both your preoperative and postoperative care. Ideally, patients should get preoperative exams done locally, and because some patients develop postoperative complications, it’s important to maintain regular contact with your local doctor.
Are the physicians who will be performing the procedure licensed specifically for the procedure, and is the facility accredited by a reputable organization such as the Joint Commission International (JCI)?
Find out what professional memberships, training and qualifications the physicians hold (e.g., surgeon, anesthesiologist, etc.). Choosing an accredited facility ensures the hospital proved it met certain standards of care intended to keep patients safe. While most hospitals feature this information on their Web sites, you can find those accredited by JCI at www.jointcommissioninternational.org. You should also make sure to research mortality rates, infection rates and other performance measurements.
What is the “pain culture” of the host country?
Different cultures have different views on what are acceptable vs. unacceptable levels of pain. Find out specifically whether the anesthesiologists will take into account your wishes, providing it’s safe to do so. Make sure the anesthesiologist will provide pain evaluations before and after surgery.
Is the facility performing my procedure at the same facility that would care for me if I needed extended care as a result of complications? If not, where would I stay, and what is my comfort level with that facility?
Understand the potential complications associated with the procedure, and be prepared for an unexpected hospital stay. Many facilities offer onsite hospitality following the procedure, but it’s best to check with the facility you are working with to discuss these details. You need to be confident that your procedure will be performed appropriately, and also comfortable with the care you will receive following the procedure (particularly if complications occur).
What access will I have to preoperative and postoperative medications with the physician performing the procedure? Are the medications safe?
Have a list of existing medications you are taking and find out which ones you will be given before, during and after the procedure. It is also important to find out what the procedures are in order to gain access to those medications you will need before and after the procedure, as well as where they are made.
Have I made contact with my insurance provider to determine the coverage and reimbursement policies for my procedure?
Depending on your health insurance provider, some procedures may or may not be covered. Never assume any procedure – or medications or other aspects associated with that procedure – is covered. Also, for those patients without insurance, it is possible that travel and related expenses negate any savings from having the procedure conducted abroad.
Have I considered working with a medical tourism company?
Medical tourism service providers can guide you through the process by doing everything from transferring your medical records to coordinating your travel logistics. It is critical that you research them carefully because, as is the case with hospitals, they can vary in quality of service. As a first step, you should check with the hospital where you are having the procedure, as it likely has a dedicated medical tourism group.
Have I spoken with patients who have had similar surgeries conducted at the hospital chosen for my procedure?
Potential patients should ask to talk to other patients who have had similar surgeries conducted at that hospital. In addition to asking if the surgery was a success, patients should ask about the care received before and after surgery, and what experiences they had accessing medications.
Who will be traveling with me for this procedure?
A support group can play a significant role in the overall outcome and experience associated with having a medical procedure abroad. If possible, patients should identify a family member or friend who can accompany them. In addition to ensuring that patients are receiving the best care possible, they can also play a motivational role, which can make the experience more comfortable and decrease recovery times.
Please visit www.LifelinetoModernMedicine.com for more information about traveling internationally for medical treatment.
