Medical Tourism: Getting Medical Care or Medical Procedures done overseas
‘Medical tourism’ (otherwise known as healthcare tourism or medical travel) is defined as travelling to another country for medical care and is undertaken for many reasons: some people will head overseas for care because treatment is cheaper in another country, others may visit abroad to receive a procedure, surgery, or therapy not available in Australia or to avoid a long waitlist. Each year, over 15,000 Australians travel for overseas medical tourism and among the most common procedures they undergo are cosmetic and dental surgeries, and more recently, heart surgery, joint replacements and even fertility treatments which are performed in hospitals and private clinics.
Risks of Medical Tourism
Quality of care and health standards
One of the main concerns of Australian medical and surgical bodies relating to medical tourism (or tourists travelling for medical care) is that the burden of liability is often carried by the patient and not, as we have here, by the health practitioner performing the procedure. With this in mind, the advice rendered includes ensuring all phases of the pre- and post-procedure are discussed in detail, as well as all risks relating to the intervention itself.
The first step should be in ensuring there is a written agreement with the trip organiser, hospital or healthcare facility outlining the costs of treatment, care, accommodation and any necessary supplies (medications, dressings, implants).
It is beholden on the patient to study and research all relevant details of the surgeon (or practitioner) including their qualifications and experience – ideally speak to patients who have already been treated by him or her. Can you communicate effectively with the doctors and carers in case of language barriers?
What is the procedure to be performed and where? What are the credentials of the hospital or facility and is it internationally recognised? Seek more information from agencies such as Joint Commission International, DNV International Accreditation for Hospitals and the International Society for Quality in Healthcare.
Risk of exposure to blood-borne diseases such as hepatitis B and HIV may be increased due to potential re-use of medical equipment or sub-standard blood collection techniques, screening and storage in destination countries. The emergence of antibiotic-resistant pathogens in some countries or regions may also pose a risk to those undergoing medical procedures.
Post-operative care
How is surgery post-op care and rehabilitation to be managed and where?
If an implant or prosthesis is to be inserted, is it genuine and reliable? Also consider that medications may be counterfeit or of poor quality in some countries.
Bear in mind that antibiotic-resistant bacteria are more prevalent in some regions, so if an infection occurs, treatment could be problematic.
When can you leave the country and head home, knowing the increased risks of flying too soon after an operation or surgery?
And on return to Australia, all documentation relating to the procedure should be available in the event of any follow-up care (which may not be covered by Medicare).
The American Medical Association has developed some guiding principles (see Box 9-03) which medical tourists should be aware of when travelling overseas.
Travel insurance
Anyone thinking of travelling overseas for medical services as a tourist will need to carefully consider their travel health insurance and should obtain a specialised policy that covers complications or costs associated with their surgery or procedure.
The reciprocal healthcare agreements currently in place with 11 countries are only for emergency treatment and essential medical care while travelling in those countries. They do not replace private health insurance for overseas travel. Tourists considering having a medical procedure performed overseas are advised to study and research their options carefully, as well as check their travel insurance to see whether it provides for:
- medical care - including hospital fees and costs
- emergency assistance
- emergency medical transfer back to Australia, by air, in the event of a major complication
- repatriation of remains in the event of death
Consular services and medical tourism
Consular services are limited in when and how they can support Australians overseas.
Ethical considerations
There are also ethical concerns around the medical tourism industry which travellers and tourists need to be aware of. The provision and access of medical services for foreign nationals may divert resources, including funding, from the public to the private health sector in destination countries. It may also prioritise the needs of international patients over domestic health needs, changing the emphasis of providing, growing, and ensuring proper access to health care for the local population.
Still intent on proceeding?
Discuss the proposed trip and procedure with your doctor, making sure you are in good health, have any existing medical conditions under control and have all your records (history, x-rays, pathology reports).
Visit a travel health provider 6-8 weeks before you leave to ascertain any local conditions and disease risks at your destination that may pose a concern during your stay.
References:
- Department of Health, Australia: https://www.betterhealth.vic.gov.au/health/HealthyLiving/medical-tourism
- US Centers for Disease Control & Prevention: https://wwwnc.cdc.gov/travel/page/medical-tourism
- Smartraveller: Going overseas for a medical procedure (medical tourism) https://www.smartraveller.gov.au/before-you-go/health/medical-tourism
- Medical Tourism (2015) https://www.racgp.org.au/afp/2015/januaryfebruary/medical-tourism/
- Royal Australasian College of Surgeons: Medical Tourism Position Paper (2017) https://www.surgeons.org/about-racs/position-papers/medical_tourism_2017
- National Travel Health Network and Centre (NATHNAC): Medical Tourism (Travelling for treatment) https://travelhealthpro.org.uk/factsheet/59/medical-tourism-travelling-for-treatment
- Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018–2019 https://wwwnc.cdc.gov/eid/article/28/1/21-1880_article