Continuity of care traditionally means a physician follows a patient throughout the course of their epidode of illness. For example, when someone presents to a surgeon for a possible operation, the surgeon does a preoperative evaluation, performs the procedure if necessary, and the sees the patient in follow up to be sure there are no complications or requirements for further care. Medical tourism is forcing a change in the paradigm.
First, patients no longer expect their doctors to do the surgery when they are looking for another treatment option away from home. The new model proposes that the home doctor assist the patient with finding the best place for care at the most reasonable cost and assist with preoperative assessment, records transfer or communcation with the operating surgeon. Likewise, after surgery, the patient will expect their doctor to help with any postoperative complications or needs for further treatment.
Second, continuity of care may be an obsolete model that needs to be replaced with connectedness of care. The one-on-one face-to-face doctor appointment is an unsustainable business model given the changes in healthcare financing and systems. Medical tourism events will be just one of many possible points of care that need to be integrated into a patient health record or healthcare information exchange. The impact will be a need to reassess how we train doctors, how we define the doctor-patient relationship and its responsibilities, and how we reimburse providers for patient encounters using other than face-to-face appointments and visits.
Medical tourism will continue to challenge our traditional notion of how we deliver and pay for care. Some will ignore the changes and fade away, others will adapt and thrive.
