Medical Tourism: 4 Things To Consider

Medical tourism or health tourism is the modern practice of traveling to another country to obtain medical treatment, ostensibly at a lower cost. Dental procedures, fertility treatments and weight loss surgeries are among the most popular reasons people engage in this endeavor. While the savings can sometimes be substantial, the risks often outweigh the rewards.

Thomas Borland, M.D., FACS is a New Iberia, LA based bariatric surgeon who, with his wife, formulated a way to keep gastric sleeve weight loss surgeries under $10,000, mostly in an attempt to give people in the U.S. a safe alternative to crossing the border. “There are hidden risks that you don’t always uncover with an internet search,” says Borland. Here are 4 things to consider before traveling abroad to obtain medical care.

1) Health Risks

Trying to improve your health for a lower cost while simultaneously exposing yourself to potentially life threatening conditions is the equivalent of taking one step forward and two steps back. Deep Vein Thrombosis, which is the formation of a blood clot, usually in the legs, can have life-threatening complications such as pulmonary embolisms. According to the Center for Disease Control (CDC), says the following:

Virchow’s classic triad for thrombus formation is venous stasis, vessel wall damage, and the hypercoagulable state. Prolonged cramped sitting during long-distance travel interferes with venous flow in the legs and causes venous stasis. Seat-edge pressure on the popliteal area may contribute to vessel wall damage as well as venous stasis. Coagulation activation may result from an interaction between cabin conditions (such as hypobaric hypoxia) and individual risk factors for VTE. Studies of the pathophysiologic mechanisms for the increased risk of VTE after long-distance travel have not produced consistent results, but venous stasis appears to play a major role; other factors specific to air travel may increase coagulation activation, particularly in passengers with individual risk factors for VTE.

Coupled with the risk of substandard hygiene and looser restrictions on infection control, the risks associated with flying shortly after a surgery do not merit saving a few bucks.

2) Differing Epidemiology

In addition to general concerns about varying hygiene practices and post-operative air travel, an important thing to consider is whether or not you want to travel to places that have diseases that have been eradicated in the United States through the use of vaccinations. As a rule, you should definitely be up to date on all of your vaccinations before traveling abroad to perform any procedure. This, from Wikipedia:

Some countries, such as India, South Africa, or Thailand have very different infectious disease-related epidemiology to Europe and North America. Exposure to diseases without having built up natural immunity can be a hazard for weakened individuals, specifically with respect to gastrointestinal diseases (e.g. Hepatitis A, amoebic dysentery, paratyphoid) which could weaken (post-operative) progress and expose the patient to mosquito-transmitted diseases.

3) Their country, their rules

Science and medicine can, quite frankly, only have so many variables. The law, however, is much more nuanced. It can be an immense burden to fully and exhaustively review your legal boundaries, especially on families who need medical care sooner than later to treat a condition.

From the American Association of Orthopedic Surgeons’ website:

A patient who is injured through negligent care has very limited options in obtaining justice and compensation. With different laws in other nations, the legal alternatives for patients are few. In his book on medical tourism, Beauty From Afar: A Medical Tourist’s Guide to Affordable and Quality Cosmetic Care Outside the U.S., Jeff Schult states “My sort of blunt advice is that if your primary concern in going to a doctor, surgeon or dentist is whether or not you’re going to have legal recourse if you don’t like the work you get, you shouldn’t go overseas.”

Simply put, there is no medical malpractice in Mexico. Unlike the United States, the extent of damages you can receive from tort (personal injury) law are extremely limited, if not nonexistent.

4) Language Barriers and Ethical Ambiguity

If you or a loved one has ever had a surgery here in the U.S., you can agree that the time you spend with your physician is fleeting and above all, it is important. The precious few moments you have with your doctor while he is making rounds can sometimes answer questions that would keep you up all night worrying otherwise. The rapid fire of information, medical advice and nuanced discussions about pain management make many people feel as though they should pull out a pen and a paper when the doctor walks in, not wanting to miss a thing.

Now imagine, if you will being in a foreign country to receive medical care. Assume that in most cases, the doctor will not speak english as a first language. Though many physicians abroad speak better english than most American doctors speak another language, this does not fully account for the small, finely nuanced messages that can result in serious mix ups. Mixing unfamiliar medical terms with unfamiliar languages is an almost sure fire disaster.

Additionally, latitudes affect attitudes toward ethical standards. What is commonplace here in the U.S. is, well, foreign overseas.

From News Medical Net:

“Patient autonomy and informed consent both represent a cornerstone of bioethics, which can sometimes mean a concerning issue for medical tourists. In the context of medical tourism, informed consent can be influenced by ambiguous or incomplete information on websites, problems in obtaining veracious information about success rates and the quality of care in destination facilities.

Even under optimal circumstances it is often difficult to obtain informed consent for medical procedures; the international dimension raises those concerns even more. Limited health literacy (coupled with aforementioned inadequate access to accurate information) can result in patients’ inability to make a thoroughly informed decision about medical tourism and to eventually accept the risks of seeking healthcare in another country.”