First, experts are predicting severe otolaryngology manpower shortages in the US. If these predictions are true, availability for services will shrink and patients will seek care outside the US.

Second, given that 49% of the membership of the AAO-HNS now practices outside of the US, intercontinental referrals will accelerate with the consequent need for information transfer and continuity of care arrangements.

Finally, geopolitical risk (drug wars and violent regime changes
, currency fluctuations and global epidemics (swine flu) are impossible to predict and will impact global tourism numbers.

Doctors have a lot of things to think about these days. The impact of medical tourism on the practice of surgical specialists, like ear, nose and throat surgeons, is one more.