Second Opinion: Medical Tourism

—Medical Tourism

Traveling abroad for medical care is nothing new. In ancient times, people traveled to Greek and Roman centers for expert care — what we now call medical tourism. Today, those seeking healthcare abroad are not just Americans but include those from Europe and the Middle East where medical costs are high and there are long waiting lists for elective procedures such as dental, cosmetic, heart, or cancer treatments, gender care, and in vitro fertilization.

The number of Americans going abroad is increasing as healthcare costs rise. One of my patients, Helena is overweight and has been wanting bariatric surgery for years — for both health and aesthetic reasons. Her bare-bones insurance will not cover the procedure.

Helena (not her real name) asked me if she should go abroad for her surgery. I knew this was not a fleeting desire — she had wanted the surgery for the five years I had known her. I reminded her the decision was completely hers, but she should carefully weigh the risks and benefits and do background checks.

Helena was willing to travel anywhere for care. She considered Thailand, Costa Rica, India, and Turkey. Eventually, she decided to go to Mexico for the procedure, which she reported would cost her 25% of US prices and included a package deal with a hotel and follow-up care.

Helena is one of around 20 million people who travel outside their country for medical care, and that number is increasing.

Helena arranged a date for the surgery and her daughter took time off from work to travel with her. Within a few days of surgery, she developed a fever because of an infection. She reported that the doctors were concerned but couldn’t seem to treat the drug-resistant infection as it spread. Her daughter arranged for her quick return to California, where she was aggressively treated for nearly three months — much of that time in a hospital away from her work and family.

This is not uncommon. In one research study, infection was the most common complication of medical tourism. In part, this results from less strict healthcare standards, less aggressive certification of surgeons, and poor access to people’s prior medical records. About a year ago, several people died, and others became seriously ill from fungal infections following routine cosmetic surgery performed in Mexico.

As a result of Helena’s complications, her deductibles, co-pays, and incidentals ended up leaving her in debt. One study suggests that treatment for complications following cosmetic surgery abroad exceeded eight weeks, often involved surgery and hospitalization, and cost up to $155,000 per case.

Helena reports she would never again opt for elective surgery abroad. However, many others have had good experiences and received care they could not afford here in the US. Certainly, a lot depends on the surgery, the surgeon, and the facility, all of which deserve careful scrutiny before scheduling any procedure. As a nation, we need a national database whereby people can report complications and see if a clinic they’re considering has had any red flag warnings.

– Dr. Michael Wilkes with a Second Opinion

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