Category Archives: Medical Tourism

MedVoy’s Blog related to medical tourism industry and its offerings towards medical travel

Medical Tourism | Follow up care

One of the questions that frequently comes up when considering getting care outside of your home country is “how do I get follow up care and who pays for it”?
Here are some tips:
1. Whenever possible, be sure to establish a relationship with a care provider in your home country BEFORE you leave and discuss your plan to get care.
2. Introduce your primary provider at home to your provider overseas
3. Be sure you have adequate information to give your primary provider so he or she knows what kind of procedure you had done.
4. Check with your insurance company and your overseas provider to determine the limits of postoperative care
5. Consider buying a postoperative care/complications insurance policy
6. Discuss with a local surgeon whether and under what conditions they will see you if you have a complication from surgery done outside your home country.

As with most procedures, there are risks. Fortunately, most procedures go smoothly without complications. Should they occur, however, it’s best to have a plan in place before you have a procedure.

Arlen Meyers, MD, MBA

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Is it safe?

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In the 1976 thriller, “Marathon Man”, a sadistic ex-Nazi dentist(Laurence Olivier) tortures an unknowing grad student ( Dustin Hoffman) to determine the whereabouts of stolen jewels, constanting asking “Is it safe?”. The line was etched into the annals of celluloid history. It is now reappearing as more and more potential patients are asking whether it is safe to get care away from home. A few things to remember:

1. Healthcare, whether delivered in the US or somewhere else, is never completely safe. The operating room, a hospital bed or even an outpatient clinic is potentially dangerous under the best of circumstances.

2. In general, the more times a surgeon and the facility where he or she works does a procedure, the better the outcome.

3. While education, credentials, experience and certification are important quality benchmarks, they sometimes do not tell the whole story.

4. Whether in the US or around the world, quality outcomes data are often incomplete or non-existent.

Patients choose doctors for many reasons. A rational decision based on quality data is rarely one of them.

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Healthcare reform and medical tourism

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Will reforms to the US healthcare “system” impact medical tourism? Of course, no one can predict the future. Potential patients choose medical tourism for 5 reasons (http://www.imtjonline.com/articles/2008/medical-tourism-vs-traditional-international-medical-travel-a-tale-of-two-models/): cost, accessablity, availability, travel and confidentiality.

Perhaps the most likely thing to change as a result of reform efforts would be cost, although that is uncertain. Even if reform bends the curve, however, certain procedures will not be covered, like cosmetic surgery, and copays and deductables are likely to increase. The increase in patients seeking care for obesity , for example, drives patients to look for cheaper alternatives for care as well as other elective procedures. A sudden influx of over 30 million people into the system will tax the supply side of the equation and will take almost a generation to correct. Technologies, like stem cell treatments, are subject to political forces and regulatory pressure unlikely to change in the near future. Medical tourists, by definition, are not adverse to travel for care, sometimes combining it with a vacation or recuperation. Finally, there are people who just don’t want others at home to know they had “something done”.

Bottom line: As Niels Bohr noted, prediction is very difficult, especially about the future. The terms in this equation, however, reform outcomes seem to favor the growth of medical tourism.

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Medical tourism redefines continuity of care

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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.

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Will medical tourism improve surgical safety?

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Will the growth of medical tourism improve surgical safety throughout the world or will economic factors create separate systems: one for the domestic population and one for inbound medical tourists willing to pay for a higher class of care? While some would argue that a two class system presently exists in several industrialized countries, including the United States, a favorable outcome realized from the growth of medical tourism would be improved surgical quality standards and outcomes for all patients.

The answer to the question is important for several reasons. First, there is an unserved burden of global surgical care. Improved standards, outcomes, manpower and per patient expeditures in developing countries would help meet the needs of underserved domestic populations.

Second, important ethical, political and socioeconomic problems arise when there are different healthcare standards for different people in a given country. We should strive for the highest accreditation standards for everyone.

Third, a potential backlash to medical tourism might occur if citizens feel they are getting second class care at the expense of medical tourists. For example, how would Americans feel if the Center for Medicare and Medicaid Services reimbursed for care outside of the United States?

Politicians like to say that all boats benefit from a rising tide. Let’s hope some don’t sink.

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Medical Tourism – Medical Continuity

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As this medical tourism space grows, one thing which most of them forget is the importance of medical continuity. You simply cannot take a patient from U.S healthcare or any country’s healthcare and put the patient in a different country and expect everything to be normal upon the patient’s return.

Some things that needs to be watched out before travelling abroad for medical treatment are

•Is your prescribed drugs available at your local pharmacist?
•Any post-complication protection?
•Any group of physcians who can provide followup visits locally?
•How about post-vital sign measurement services and reporting back to the hospital abroad?
•Do I have the data in a secure fashion so I can plug in to my physicians’ EMR system or hospital system?
The list is not limited to this but you get the point, good planning always helps

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A view of the future of cross border healthcare

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If you are interested in how cross-border (read cross state) healthcare in the US is likely to look, pay attention to what’s going on in Europe. The EU charter guarantees care for any EU citizen in any EU country. The European Directive on cross border healthcare is being debated and Spain joined several other countries in defeating the most recent attempt to ratify the arrangement. Experts note that there are several key issues that need to be resolved. These include health information exchange, quality assurance, interchangeable business processes, insurance and e-billing, and logistical issues concerning shifts of patients around the continent.

As the US migrates to a cross state sytem, the issues will be same. We should learn on Europe’s nickel so we don’t make the same mistakes.

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Center for Disease Control’s 2010 travel health guide includes medical tourism

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The Center for Disease Control’s (CDC) 2010 travel health guide has a much-expanded section on medical tourism — the practice of going abroad for your medical care. U.S. citizens going overseas for medical or dental procedures often cite lower costs as their primary motivator.

The CDC updates its Health Information for International Travel (also called the “Yellow Book”) every two years. The latest edition discusses the pros and cons of medical tourism, and explains why the practice is on the rise.

“In recent years, standards have been rising in other parts of the world even faster than prices have surged in the U.S. Many physicians abroad trained in the U.S. and the Joint Commission International (JCI) applies strict standards to accreditation of offshore facilities. Those facilities use the same implants, supplies, and drugs as their U.S. counterparts. However, a heart bypass in Thailand costs $11,000 compared to as much as $130,000 in the U.S. Spinal fusion surgery in India at $5,500 compares to over $60,000 in the U.S.”

The CDC guide quotes the American Medical Associations tip for planning a surgery abroad:

–Patients should check to see if the medical facilities abroad have been accredited by recognized international accrediting bodies such as the Joint Commission International or the International Society for Quality in Health Care.

– Prior to travel, arrange local follow-up care to ensure continuity of care when you return from medical care outside the US

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Cost vs. Quality in Medical Tourism

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We encounter on a daily basis patients who heavily price shop when it comes to getting medical treatments abroad. Price shopping is good however there needs to be a balance maintained . Some questions which you have to ask yourself or your facilitator before travelling abroad are as follows

1. Is the hospital abroad accredited?

2. Is the surgeon abroad doing the procedure American Board certified?

3. What kinda protections your facilitator or the hospital guarantee in terms of post complication surgery?

4. Has the facilitator visited those countries, hospitals before? Or are they blindly sending you to a place where they have never been?

5. Ask for the resume of the physician/surgeon

6. Share as much as medical history possible to the surgeon /hospital abroad in a more private, secure compliant manner so as to make sure that the price quoted are realistic. You dont want to end up paying more at the hospital than what was quoted.

Good upfront planning and by working with the right facilitator who has good experience will definitely play a tremendous factor in ensuring your safety, cost savings and more important getting the surgery done in a high quality setting with superior care of service.

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MedVoy visits JCI accredited hospitals in Jordan for its medical tourism offering

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Recently MedVoy had the opportunity to visit 4 JCI accredited hospitals in Jordan. Jordan has not only been one of the popular tourist destinations with its modern seven wonder Petra, Dead Sea and its religious ties to ancient history but also has offered treatments to almost 210,110 patients from 48 countries treatment in 2008. Jordan is the only country in the Middle East that generates more income than what it spends on health and has been witnessing a yearly steady increase of around 10 percent of foreign patients. This beautiful country with its very ancient history has a lot to offer when it comes to medical tourism and offers a comprehensive solution with the high quality and competitive cost healthcare.

All major JCI accredited hospitals namely Jordan Hospital, King Hussein Cancer Center, Al-Essra Hospital, and Specialty Hospital have the high quality standards with excellent western atmosphere luxury patient rooms. They have not only the latest technologies and medical devices but also have well trained, qualified English speaking staffs giving the best care of service. All the doctors involved in providing international patient care have reputed credentials with wide international medical experiences and some of them include American/UK Board certified surgeons who have returned back home. One factor that differentiates and puts Jordan as a leading destination in medical tourism industry is the experience they have already gained by dealing with international medical tourist patient. 30-40% of their inpatients in year 2008 are from countries outside Jordan. This international exposure combined with their high quality treatments, low cost (almost as low as 25 percent of the value the same medical procedures in U.S.) puts Jordan one of the top most medical tourist destinations in the world. I was impressed on all levels and the quality of care provided truly exceeds the expectation of any accreditation standards and it’s far better than majority of the U.S. based hospitals.

I have no doubt that Jordan is going to be the top most medical tourist destination in the years coming. MedVoy is currently working on adding more medical tourism offerings in the country of Jordan for its North American patients.

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