Misgivings about medical tourism

Medical tourism makes me queasy. While a growing trend, I have put off writing about it. However, on January 28, CBC Radio Noon hosted a call-in program about it.

When it comes to medical travel/medical tourism the advice is do your research. Great. But as a lay person who do you research and vet foreign hospitals, professionals, procedures?

At home we rely on the advice of our doctors – if you have one – or a specialist they have recommended or someone at the local clinic or hospital. If someone feels foreign treatment is preferable, then shouldn’t the research start with your local medical professional? If she/he doesn’t have someone to recommend, they might at least know of places to avoid.

I understand the frustration of being on a waiting list, but I continue to question why Nova Scotia’s medical system can’t improve wait lists to meet national standards? Patients have paid for and continue to pay for the system, so why should they have to pay again for foreign treatment?

Two years ago a U.S. colleague told me his mother suffered a stroke. Her hospitalization, therapy and long-term care cost $2.5 million! This explains why three in 10 Americans are prepared to travel for treatment. Because of the extraordinary costs associated with American care there is a Medical Tourism Association for this multi-trillion-dollar industry. “Industry” is their description for medical tourism. Their magazine is here: http://www.MedicalTourismAssociation.com.

For Canadians considering the foreign option think about this:

  1. beyond checking the medical qualifications of the doctor and team (and how do you really judge those?), are the physical conditions of the facility in which they work. You can look on-line, but what’s to say the site is truthful, fully informed, up-to-date, or hasn’t been fed misinformation? Just as there are less-than-honest hotel reviews, so can there be similar reviews for facilities.
  2. Are you prepared to and can you afford to pay for treatment? A January 2014 CBC article priced knee replacement surgery in the Turks and Caicos at $40,000.
  3. In addition to the actual treatment and care costs are the travel costs: airfare, ground transportation, accommodations, meals.
  4. Are you going to do this on your own or will someone accompany you for support? That carries additional dollar and emotional costs. Maybe even physical costs.
  5. What happens if there are complications? How adapt are you or the person with you at dealing with issues in foreign countries, cultures and languages?
  6. Have you considered the travel implications on your recovery? Travel can be tiring. If you are recovering from treatment, that can put additional stress on your body. The medical team may want you to wait for an extended period before travelling. And given the potential for delays and flight cancellations – as I write this, 11,100 flights in North America have been cancelled or delayed due to storms – you could be stuck in transit longer than is healthy for you. Additionally, have you checked airlines to see if they have prohibitions on transporting people in recovery? Some airlines don’t allow women who are eight months pregnant to fly for fear of early delivery, so are there other regulations?
  7. Does your doctor approve?
  8. Will you be able to receive follow-up treatment when you return home? There have been incidents of doctors in other parts of Canada refusing to treat patients who went out of country for surgery. The doctors didn’t want to become responsible for someone else’s mistakes or dropped the patient for going against medical advice. Some treatments, like a knee replacement, are clear cut, while other treatments may be something the patient wants but be of no actual medical advantage.
  9. If you go out of country, do you have all the pertinent medical records with you or forwarded to the foreign treatment team? And will they provide you with all the correct records for your return home? What if something is overlooked or their procedures are so different that there is a gap in the information available to your domestic medical professional?
  10. Finally, does your foreign medical care negatively impact the care available to citizens of that country? Are medical professionals diverting their skills from local need in favour of foreigners prepared to pay, thereby contributing to their wait times?

Going abroad for care isn’t a simple matter of jumping a queue at home.

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4 Responses to Misgivings about medical tourism

  1. Bruce Bishop says:

    Your advisory warnings are well taken from one who has researched hospitals & specialists in Bangkok in 2013. I did indeed go, met the doctors, saw the luxurious hospital and decided against treatment since it was elective and non-crucial at that time. I wrote about the experience for two Canadian magazines (one online and one print), so the curiosity in going abroad for an operation is truly a national interest.

    The more research I did before leaving for Thailand, the better I felt upon arriving. Online, there are discussion groups re: operations in Bangkok, for example; evaluations of doctors (think “TripAdvisor”-style reviews); videos on the hospitals; testimonials from patients — you name it and it’s there. You really can’t do enough research before you leave and undergoing the treatment.

    Perhaps you will write a piece someday about medical tourism facilities in Nova Scotia? They may be virtually non-existent now, but I know of at least one foreign doctor with a dream of setting up a clinic — for *international patients* coming here.

    • Thanks Bruce for sharing your real experience with us.

      My attitude is that before we bring international patients here we should clear up our backlogs. Last week a doctor told me his wife has been told it will be two years before she has knee surgery! It’s ridiculous that we have let orthopaedic surgeons, who wanted to practice here, go. One because there was no money to pay her (Annapolis Valley Health), one because his health authority (Pictou) kept the OR dark as a budget-stretching manoeuvre.

  2. ghjkl says:

    Good day,

    My comment is on the statement “Some treatments, like a knee replacement, are clear cut”.

    I remember 8 or 9 years ago a lady who was told by the surgeon that her knees will be replaced once she lost such and such amount of weight. The lady was on the news and commented on how judgemental was the surgeon regarding her weight. So she went to Cuba, got her knees replaced. I don’t know if she found a physician to care for her when she got back to NS, but I would totally understand that “the healthcare system” in Nova Scotia refuse to pay for the complications of a procedure done against medical advice and very likely to fail because of the huge BMI the lady was carrying. For this lady losing weight before surgery would have a been almost a garantee that her prostheses would not wear out too rapidly…

    On another note, physicians in Canada who are doing elective (non-urgent) procedures on US patients may end up in US court and be sued, without their knowledge. Their usual professional insurance would not take care neither of their defence nor, if found responsible, the payment of the damages to the patient.

    Thanks

    • That’s an interesting twist on foreign patients suing Canadian practitioners in their home countries. No doubt there would be a jurisdictional challenge, but it’s all still a cost and complication and diverts time from delivering care. Thanks.

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