People are now calling referring patients to someone in the same country domestic medical tourism. Doctors call it an out-of-area referral. Whether the consulting physician is located in a place recognized for excellence in diagnosing or treating a particular illness, like National Jewish Hospital (Denver) for pulmonary care or MD Anderson Hospital (Houston) for cancer care, the usual model involves one provider referrring the patient to another provider. The referring provider takes responsiblity for sending the appropriate records and reassuming care for post treatment issues when the patient returns home.

Domestic medical tourism implies something different. First, patients armed with information provided by the Internet or medical tourism facilitators, are requesting care without necessarily seeking the referral or “permission” of their provider at home. Second, given improving price transparency, in part a response to the transparency of foreign providers, patients can shop for value, something their insurance providers are encouraging by covering some or all of the out of network charges. Finally, when patients return home, they may have trouble finding someone to care for them is they have had treatment, particularly sugery, somewhere else.

Domestic medical tourism will evolve as quality and outcomes data and prices become less opaque and as interstate insurance cooperatives or other insurance models make it easier for patients to go to the best place for care regardless of location.